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Sample records for serous retinal detachment

  1. Bilateral Serous Retinal Detachments Associated with Accelerated Hypertensive Choroidopathy

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    Yoshio Hirano

    2010-01-01

    Results and discussion. One month after antihypertensive treatment, the serous retinal detachments resolved and the visual acuity improved. A patient with those findings should be considered as having hypertensive choroidopathy and treated as soon as possible.

  2. Serous retinal detachment after trabeculectomy in angle recession glaucoma

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    Roy, Avik Kumar

    2015-12-01

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

  3. Bilateral serous retinal detachments associated with IgA nephropathy.

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    Andión-Fernández, M; Dorado-Fernández, T; Juárez-Casado, M A; Santamarina-Pernas, R

    2015-11-01

    A 41-year-old woman with a bilateral loss of visual acuity and a history of IgA nephropathy. The ophthalmic examination revealed bilateral neurosensory detachments that resolved completely after four months of peritoneal dialysis. Bilateral serous retinal detachments are a rare manifestation of IgA nephropathy, in which the etiology is probably multifactorial and their resolution depends on the underlying disease. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

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

    DEFF Research Database (Denmark)

    Pryds, Anders; Hamann, Steffen; Larsen, Michael

    2012-01-01

    PURPOSE: To describe a presumed precursor stage of central serous chorioretinopathy (CSC). METHODS: Two patients were identified during follow-up study of patients with CSC or CSC-related conditions. Two patients first seen with retinal pigment epithelial detachment subsequently developed findings...... compatible with CSC. RESULTS: A juxtafoveal retinal pigment epithelial detachment with apical atrophy of the retinal pigment epithelium with corresponding severe attenuation of the pigmentation of the retinal pigment epithelium was observed in both patients. One of the patients presented with a serous...... neurosensory retinal detachment with smokestack leakage 7 years after first being seen. The other patient was never seen with a neurosensory detachment. CONCLUSION: Isolated pigment epithelial detachment with apical retinal pigment epithelial atrophy may represent a precursor stage of CSC....

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

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    Chang, Yuh-Shin; Weng, Shih-Feng; Chang, Chun; Wang, Jhi-Joung; Chen, Hong-I; Ko, Shun-Yao; Tu, I-Te; Chien, Chih-Chiang; Wang, Jian-Jhong; Wang, Ching-Min; Jan, Ren-Long

    2017-01-01

    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 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.

  6. Shallow Anterior Chamber in a Severe Case of Unilateral Acute Central Serous Retinal Detachment

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    Ahmet Colakoglu

    2017-05-01

    Full Text Available Background: Atypical serous chorioretinopathy can present with symptoms similar to those of other pachychoroid diseases; however, a proper differential diagnosis will prevent unnecessary intensive treatments. To this end, we report on the shallowness of anterior chamber and transitory anterior vitreous cells in a patient with atypical severe serous retinal detachment. Case Presentation: A 42-year-old woman presented with unilateral visual loss accompanied by mild, vague eye pain for 4 days. Spectral-domain OCT scans of the left eye showed macular and peripapillary serous detachment. Optical biometry showed the clinically significant shallow anterior chamber. Conclusions: Severe central serous chorioretinopathy can show up in an atypical fashion with macular, extramacular, juxtapapillary serous detachments, temporary existence of anterior vitreous cells, clinically detectable decreased anterior chamber depth, and mild eye pain of short duration.

  7. Recurrence of acute lymphoblastic leukemia manifesting as serous retinal detachments and optic disc swelling.

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    Yabas Kiziloglu, Ozge; Mestanoglu, Mert; Totuk Gedar, Ozgun Melike; Adiguzel, Cafer; Toygar, Okan

    2017-07-15

    The aim of this case report is to describe a patient with acute lymphoblastic leukemia (ALL) who developed bilateral serous retinal detachments and unilateral optic disc swelling. A 23-year-old woman with ALL presented to the ophthalmology clinic with bilateral subacute visual loss. Ophthalmologic examination revealed bilateral serous retinal detachments and unilateral optic disc swelling. Magnetic resonance imaging for differential diagnosis was inconclusive; however, cerebrospinal fluid sampling demonstrated leukemic involvement of the central nervous system. The patient's vision improved and fundus findings resolved with the institution of systemic and intrathecal chemotherapy. Serous retinal detachment and optic disc swelling are unusual ocular manifestations of ALL. They may occur due to leukemic infiltration of ocular structures and may indicate extramedullary recurrence of the disease. Early recognition and treatment is crucial to improve prognosis.

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

    African Journals Online (AJOL)

    by thrombocytopenia, hemolysis and elevated liver enzymes.[1]. The development of seizures in a pregnant woman with preeclampsia makes the diagnosis of eclampsia and usually leads the patient to coma. Retinal detachment is a rare complication of preeclampsia, affecting 1–2% of patients with its severe form and 10% ...

  9. Severe HLA B27-associated uveitis complicated by hypotony, serous retinal detachment, and ciliochoroidal effusion

    NARCIS (Netherlands)

    Veer, E.G. van der; Keunen, J.E.E.; Rothova, A.

    2014-01-01

    PURPOSE: To report on severe HLA B27-associated anterior uveitis complicated by vitritis, hypotony, and serous retinal detachment. METHODS: Retrospective case series. RESULTS: Five patients with HLA B27-associated uveitis presented with an acute anterior uveitis complicated by vitritis, hypotony,

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

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    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.

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

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

    2017-10-01

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

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

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    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.

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

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

    2016-03-01

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

  14. Headache in a 27-year-old man: Bilateral serous retinal detachment

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    Gholamhossein Yaghoubi

    2011-01-01

    Full Text Available A 27-year-old man with a complaint of headache, tinnitus, and visual obscuration presented to a neurologist. Neurologic evaluations, including MRI and CT scan, were within normal limit. The prescribed medicines were propranolol, sumatriptin, valproate sodium, and dexamethasone. Ophthalmic examination was associated with reduction of visual acuity of eyes, bilateral uveitis, and serous retinal detachment. The most probable diagnosis was Vogt-Koyanagi-Harada (VKH disease. Prescribing high-dose oral steroid and acetazolamide-improved systemic and ocular symptoms. Although HLAB5 is positive in Behηet disease, it also may be seen in VKH.

  15. Bilateral Serous Retinal Detachment Associated with Inferior Posterior Staphyloma Treated with Scleral Shortening and Vitrectomy

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    Akihito Kasai

    2016-05-01

    Full Text Available Purpose: We report a case of bilateral serous retinal detachment (SRD associated with inferior posterior staphyloma (IPS treated successfully with scleral shortening. Patient and Methods: A 63-year-old woman presented with bilateral visual loss due to an SRD with IPS. The best-corrected visual acuity levels were 0.6 (20/30 and 0.5 (20/40 in the right and left eye, respectively. The patient underwent vitrectomy and scleral shortening in the right eye. The lamellar scleral crescent was resected 4 mm in width from the 5- to 8-o'clock positions. Seven interrupted 5-0 polyester sutures were placed at the edge of the lamellar scleral crescent. After 25-gauge three-port vitrectomy, the sutures were tightened. Optical coherence tomography showed decreased curvature at the staphyloma border. The choroidal thickness decreased in the superior flat portion of the fundus and increased slightly in the staphyloma. The SRD resolved 3 months postoperatively. The best-corrected visual acuity in the right eye improved to 0.8 (20/25 6 months postoperatively. Angiography 6 months postoperatively showed decreased diffuse dye leakage at the fovea in the right eye; indocyanine green angiography did not show marked changes. Discussion: Scleral shortening with vitrectomy changes the eye wall shape, may improve the retinal pigment epithelial integrity, and may be a treatment option for SRD with IPS.

  16. Serous Retinal Detachment in Dome-shaped Macula with 7 Years Follow-up.

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    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.

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

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    Paulo Escarião

    2014-01-01

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

  18. Retinal Detachment in Preeclampsia

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    Prado Renata Silva do

    2002-01-01

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

  19. Retinal Detachment: Torn or Detached Retina Symptoms

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

  20. Retinal Detachment: Torn or Detached Retina Treatment

    Science.gov (United States)

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

  1. Retinal Detachment: Torn or Detached Retina Diagnosis

    Science.gov (United States)

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

  2. Considering photodynamic therapy as a therapeutic modality in selected cases of dome-shaped macula complicated by foveal serous retinal detachment.

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    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.

  3. A case of bilateral posterior scleritis with serous detachment

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    Murat Aslankurt, , ,,

    2012-12-01

    Full Text Available Seventeen years old male patient was admitted to theclinic with complaints of pain in the right eye, reductionof vision, painful eye movements and headache for 10days. Visual acuity was found Snellen 0.2 on the right eyeand 1.0 on the left eye. Anterior segment examinationwas normal. Fundus examination revealed bilateral chorioretinalfold on the papillo-macular bundle and serousmacular detachment on the right eye. Fundus angiography(FA revealed late macular hyperfluorescence due toleakage. Exudative retinal detachment on the right maculawas observed in optical coherence tomography (OCT.Orbital ultrasonography and computed tomography wererevealed thickening of the right posterior scleral wall. Investigationsdid not reveal any other cause of headacheor systemic associated autoimmune disease. Oral steroidtreatment (metil prednisolon 64 mg/day was started. Itwas seen that the left eye also affected at the secondweek of treatment. OCT revealed bilateral exudative retinaldetachment. Treatment was going on. Complaint ofdecreased visual acuity was recovered one month later,and bilateral exudative retinal detachment resolved. Inthis article, we aimed to present a case of bilateral idiopathicposterior scleritis and associated exudative retinaldetachment and with good response to therapy.Key words: Posterior scleritis, serous retinal detachment,steroid therapy

  4. Multifocal central serous chorioretinopathy with photoreceptor-retinal pigment epithelium diastasis in heritable pulmonary arterial hypertension

    DEFF Research Database (Denmark)

    Li, Xiao Qiang; Pryds, Anders; Carlsen, Jørn

    2015-01-01

    with clinical examination, enhanced depth optical coherence tomography, fluorescein and indocyanine green angiography, and fundus photography. RESULTS: At presentation, atypical central serous chorioretinopathy with multiple retinal pigment epithelial detachments, a thick subfoveal choroid, and dilated...

  5. Resolution of bilateral cystoid macular edema and subfoveal serous retinal detachments after treatment with bortezomib in a patient with "smoldering" multiple myeloma.

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    Grannis, Charity H; Dewan, Vinay N; Wang, Robert C

    2014-01-01

    To describe a case of a patient with multiple myeloma without extraocular end-organ damage but with cystoid macular edema and macular detachments who was treated with bortezomib and dexamethasone. There was a complete resolution of retinal and subretinal fluid and significant improvement of vision. The patient's ocular disease was monitored with visual acuity, dilated fundus examinations, and optical coherence tomography before, during, and after treatment. The patient in this case report was a 43-year-old African American man with a medical history of untreated, "smoldering" multiple myeloma, hypertension, hyperlipidemia who presented to our clinic with progressive painless loss of vision in both eyes over 6 weeks. Before treatment with bortezomib and dexamethasone, the patient had complaints of confusion, muscle stiffness, joint pain, and 20-lb unintentional weight loss; however, he did not have hypercalcemia, renal insufficiency, anemia, or bone lesions typical of active multiple myeloma. The bilateral cystoid macular edema and subfoveal neurosensory retinal detachments, noted on presentation and confirmed by optical coherence tomography, completely resolved over the course of treatment with bortezomib and dexamethasone. This case of bilateral cystoid macular edema and subfoveal neurosensory retinal detachments is remarkable for both its presentation and response to therapy. The macular edema and macular detachments along with nonspecific complaints of confusion, muscle stiffness, joint pain, and weight loss were the presenting signs and symptoms; signs typically used as guides to initiate treatment for multiple myeloma were not present. Macular edema in the context of paraproteinemia is usually associated with Waldenstrom's macroglobulinemia and has classically been reported as "silent" with respect to fluorescein angiography. Our patient has multiple myeloma and demonstrated leakage on fluorescein angiography. The case is also notable in that there was

  6. Missed retinal breaks in rhegmatogenous retinal detachment

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    Brijesh Takkar

    2016-12-01

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

  7. Outcomes in bullous retinal detachment

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    Sarah P. Read

    2017-06-01

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

  8. GRAFT-VERSUS-HOST DISEASE PANUVEITIS AND BILATERAL SEROUS DETACHMENTS: MULTIMODAL IMAGING ANALYSIS.

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    Jung, Jesse J; Chen, Michael H; Rofagha, Soraya; Lee, Scott S

    2017-01-01

    To report the multimodal imaging findings and follow-up of a case of graft-versus-host disease-induced bilateral panuveitis and serous retinal detachments after allogenic bone marrow transplant for acute myeloid leukemia. A 75-year-old black man presented with acute decreased vision in both eyes for 1 week. Clinical examination and multimodal imaging, including spectral domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and swept-source optical coherence tomography angiography (Investigational Device; Carl Zeiss Meditec Inc) were performed. Clinical examination of the patient revealed anterior and posterior inflammation and bilateral serous retinal detachments. Ultra-widefield fundus autofluorescence demonstrated hyperautofluorescence secondary to subretinal fluid; and fluorescein angiography revealed multiple areas of punctate hyperfluorescence, leakage, and staining of the optic discs. Spectral domain and enhanced depth imaging optical coherence tomography demonstrated subretinal fluid, a thickened, undulating retinal pigment epithelium layer, and a thickened choroid in both eyes. En-face swept-source optical coherence tomography angiography did not show any retinal vascular abnormalities but did demonstrate patchy areas of decreased choriocapillaris flow. An extensive systemic infectious and malignancy workup was negative and the patient was treated with high-dose oral prednisone immunosuppression. Subsequent 6-month follow-up demonstrated complete resolution of the inflammation and bilateral serous detachments after completion of the prednisone taper over a 3-month period. Graft-versus-host disease panuveitis and bilateral serous retinal detachments are rare complications of allogenic bone marrow transplant for acute myeloid leukemia and can be diagnosed with clinical and multimodal imaging analysis. This form of autoimmune inflammation may occur after the recovery of T-cell activity within the donor graft targeting the host

  9. Bilateral Serous Macular Detachment in Acute Myelogenous Leukemia

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    Müge Karataş

    2014-03-01

    Full Text Available A 31-year-old woman, diagnosed and treated for acute myelogenous leukemia (AML type M2, complained of blurred vision and general deterioration in vital signs in her fourth week of hospitalization for induction chemotherapy. Her ophthalmologic examination revealed bilateral serous macular detachment. Despite immediate institution of salvage therapy for refractory disease, extensive intraretinal and preretinal hemorrhages developed in both eyes. Three weeks after reinstitution of chemotherapy, the patient deceased. Bilateral serous macular detachment is rarely an ocular manifestation of AML. This may be a sign of leukemic infiltration of the choroid and worsening of the clinical symptoms. (Turk J Ophthalmol 2014; 44: 151-3

  10. Ceramide production associated with retinal apoptosis after retinal detachment.

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    Ranty, Marie-Laure; Carpentier, Stéphane; Cournot, Maxime; Rico-Lattes, Isabelle; Malecaze, François; Levade, Thierry; Delisle, Marie-Bernadette; Quintyn, Jean-Claude

    2009-02-01

    During retinal detachment, premature apoptosis of photoreceptors and a loss of optimally corrected visual acuity occur. We hypothesized that retinal cell death and generation of ceramide, a pro-apoptotic lipid, would progress as a function of time following experimental retinal detachment, and undertook to define the appropriate temporal window. Unilateral retinal detachment was induced in white New Zealand rabbits by subretinal injection of sodium hyaluronate. In experimental animals, we injected sphingosine-1-P into the vitreous 2 hours before retinal detachment. Both eyes were removed on days 1, 3 and 6 for histological and biochemical examination. The number of photoreceptors was counted in section, the level of apoptosis was assessed using the TUNEL assay, and the production of ceramide was analyzed in situ with immunohistochemistry. The concentration of ceramide was also determined on retinal homogenates using a diacylglycerol kinase assay. We confirmed that the average number of live photoreceptors decreased gradually after retinal detachment. In eyes pre-treated with sphingosine-1-P the number of apoptotic photoreceptors was significantly lower. The proportion of apoptotic photoreceptors (14%) remained constant as a function of time in the window studied. As compared to controls, the detached retina showed intense ceramide immunostaining that was prominent in the photoreceptors, but also present to a lesser extent in other retinal layers. The total concentration of intra-retinal ceramide increased by 40% on the first day and continued augmenting through the sixth day after retinal detachment. Retinal apoptosis during experimental retinal detachment is associated with in vivo production of ceramide.

  11. Serous detachment of the macula associated with advanced glaucomatous cupping.

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    Spaide, Richard F

    2014-01-01

    Enhanced depth imaging of the optic nerve of a patient with a serous detachment and profound cupping of the optic nerve secondary to angle-closure glaucoma revealed a large dehiscence of the lamina cribrosa. Adjacent to the defect in the lamina were cystoid spaces within the nerve appearing to contain fluid. The most temporal of these could be seen to extend through the optic nerve and up into the macula. This visualized pathway suggests that mechanical dehiscence of the lamina may allow fluid, possibly derived from cerebrospinal fluid, to track up into the macula. Copyright 2014, SLACK Incorporated.

  12. Retinal detachment in black South Africans

    African Journals Online (AJOL)

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

  13. MAINTENANCE OF GOOD VISUAL ACUITY IN BEST DISEASE ASSOCIATED WITH CHRONIC BILATERAL SEROUS MACULAR DETACHMENT.

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    Gattoussi, Sarra; Boon, Camiel J F; Freund, K Bailey

    2017-08-10

    We describe the long-term follow-up of a patient with multifocal Best disease with chronic bilateral serous macular detachment and unusual peripheral findings associated with a novel mutation in the BEST1 gene. Case report. A 59-year-old white woman was referred for an evaluation of her macular findings in 1992. There was a family history of Best disease in the patient's mother and a male sibling. Her medical history was unremarkable. Best-corrected visual acuity was 20/20 in her right eye and 20/25 in her left eye. The anterior segment examination was normal in both eyes. Funduscopic examination showed multifocal hyperautofluorescent vitelliform deposits with areas of subretinal fibrosis in both eyes. An electrooculogram showed Arden ratios of 1.32 in the right eye and 1.97 in the left eye. Ultra-widefield color and fundus autofluorescence imaging showed degenerative retinal changes in areas throughout the entire fundus in both eyes. Optical coherence tomography, including annual eye-tracked scans from 2005 to 2016, showed persistent bilateral serous macular detachments. Despite chronic foveal detachment, visual acuity was 20/25 in her right eye and 20/40 in her left eye, 24 years after initial presentation. Genetic testing showed a novel c.238T>A (p.Phe80Ile) missense mutation in the BEST1 gene. Some patients with Best disease associated with chronic serous macular detachment can maintain good visual acuity over an extended follow-up. To our knowledge, this is the first report of Best disease associated with this mutation in the BEST1 gene.

  14. Bevacizumab in macular serous detachments associated with Waldenstrom's macroglobulinemia.

    Science.gov (United States)

    Kapoor, Kapil G; Wagner, Maxwell S

    2015-01-01

    Waldenström's macroglobulinemia (WM) is a lymphoproliferative B-cell disorder characterized by monoclonal proliferation of immunoglobulin M. WM can be associated with impressive hyperviscosity retinopathy and a unique tendency to develop serous macular detachments. These have been described as immunogammopathy maculopathy and portend a poor visual prognosis, often persisting despite multiple plasmapheresis treatments. In this case report, the authors demonstrate the accelerated resolution of hyperviscosity retinopathy and associated macular detachments in a patient with WM with marked visual improvement. This case report serves to raise awareness of the potential role of anti-vascular endothelial growth factor modulation in the treatment of patients with hyperviscosity retinopathy associated with WM. Copyright 2015, SLACK Incorporated.

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

    Directory of Open Access Journals (Sweden)

    Shukla Dhananjay

    2007-01-01

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

  16. 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.

  17. Quantification of fluid resorption from diabetic macular oedema with foveal serous detachment after dexamethasone intravitreal implant (Ozurdex(®) ) in a pregnant diabetic

    DEFF Research Database (Denmark)

    Hodzic-Hadzibegovic, Delila; Ba-Ali, Shakoor; Valerius, Marianne

    2017-01-01

    with type 1 diabetes for 33 years presented with diabetic macular oedema with foveal serous detachment and symptomatic vision loss at 16 gestational weeks. Best-corrected visual acuity (BCVA) in Snellen notation and central retinal volume assessed by optical coherence tomography (OCT, Topcon Corporation...

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

    African Journals Online (AJOL)

    Bernt Lindtjørn

    Abstract. Aim: To determine and describe the causes and risk factors predisposing Ethiopian patients to rhegmatogenous retinal detachment (RRD). Methods: A retrospective study of all patients with RRD seen at the retina clinic of Menilik II Hospital, Addis Ababa, from April 1999 to October 2003 was done. Charts of ...

  19. [Retinal detachment in various myopic refractions].

    Science.gov (United States)

    Alimanović-Halilović, Emina

    2009-01-01

    The basic aim of this study was to find the group of "critical" myopic refraction with the highest occurrence of retinal detachment. In the study, 180 myopic eyes were analyzed. Upon the targeted ophthalmological anamnesis, definition of the objective refraction, and indirect binocular ophthalmoscopy, we analyzed the distribution of retinal detachment and the area affected in relation to refraction. All the eyes were divided into groups according to the refraction height. Average age of our patients ranged from 48.43 to 51.60 years with SD from 13.88 to 18.45. We did not find a statistically significant difference for a certain age. The study covered 102 (56.6%) male and 78 (43.3%) female patients. The highest occurrence of retinal detachment was found in Refraction Group from 3.5 to 7.49 dsph, total 21 (11.6%). The retinal detachments usually affected 2/4 or 3/4 of the eye fundus surface respectively.

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

    Directory of Open Access Journals (Sweden)

    Fukutaro Mano

    2018-01-01

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

  1. Risk of Retinal Detachment After Pediatric Cataract Surgery

    DEFF Research Database (Denmark)

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

    2014-01-01

    PURPOSE: To determine the long-term risk of retinal detachment following pediatric cataract surgery and to identify risk factors for retinal detachment. METHODS: We included all children (aged 0 to 17 years) who during the time period of 1977 to 2005 underwent pediatric cataract surgery in Denmark......, excluding cataract cases caused by trauma, or acquired systemic or acquired ocular pathology, and cases with ocular anomalies associated with the development of retinal detachment. Cases of cataract were ascertained from the mandatory Danish National Patient Register, and information on retinal detachment...... was based on medical chart review. RESULTS: Among 1043 eyes of 656 children undergoing surgery for pediatric cataract, 25 eyes (23 children) developed retinal detachment at a median time of 9.1 years after surgery. The overall 20-year risk of retinal detachment was 7% (95% confidence interval [CI]: 3...

  2. Pediatric retinal detachment in cutis aplasia and cutis marmorata telangiectasia.

    Science.gov (United States)

    Lagan, Maeve; Brennan, Rosie; McLoone, Eibhlin

    2012-01-01

    This is a report of 2 cases of cutis aplasia and cutis marmorata telangiectasia with associated retinal detachment. Retrospective case report. Illustration of ophthalmic associations of the rare congenital dermatologic presentations and description of successful treatment with laser photocoagulation. Awareness of the association between retinal detachment and cutis aplasia and cutis marmorata should be acted upon as laser photocoagulation has been shown in this case report to successfully treat the associated retinal detachment.

  3. The Frequency of Serous Macular Detachment in Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Onur Yaya

    2015-05-01

    Full Text Available Objectives: To investigate the epidemiology and frequency of serous macular detachment (SMD in patients diagnosed with diabetic macular edema (DME. Materials and Methods: Hundred and forty-three eyes of 104 patients with DME were examined retrospectively. According to the results of OCT, the patients were separated into two groups; patients diagnosed with SMD and DME (group 1 and patients diagnosed with DME (group 2. They were assessed based on demographic characteristics, average age, duration of diabetes mellitus (DM, hypertension (HT history, best-corrected visual acuity, and diabetic retinopathy stages. Results: The average age of the patients was 61±8.7 years. Forty-three patients (41.3% were female and 61 patients (58.7% were male. Fifty-four of 104 patients (51.9% had DME with SMD. 21 (38.8% patients had bilateral SMD. In group 1, 31 patients were male (57.4% and 23 patients were female (42.6%. In group 2, 30 (60% patients were male and 20 (40% patients were female. In group 1, average age was 60.2±9.6 and the average duration of DM was 12.2±7.0 years, whereas the average age was 61.9±7.6 and the average duration of DM was 14.06±6.8 years in group 2. Forty-two patients in group 1 (77.8% and 30 patients (60% in group 2 had history of HT. Before the treatment, the average best-corrected visual acuity was found to be 0.30±0.24 in group 1 and 0.32±0.25 in group 2. Conclusion: Today, it is thought that diabetic maculopathy is the leading cause of SMD and it is a determining factor of treatment applications. In our study, we aimed at investigating the frequency of SMD in DME and the risk factors for the development of SMD. Although there were some differences between the factors, only the history of HT was found statistically higher in patients with SMD (p=0.04. (Turk J Ophthalmol 2015; 45: 92-96

  4. 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.

  5. Intravitreal Injection of Dexamethasone Implant in Serous Macular Detachment Associated with Waldenström's Disease.

    Science.gov (United States)

    Fenicia, Vito; Balestrieri, Marco; Perdicchi, Andrea; Maraone, Giorgia; Recupero, Santi Maria

    2013-01-01

    To evaluate the efficacy of one intravitreal injection of dexamethasone (Ozurdex(®); Allergan, Inc., Irvine, Calif., USA) in serous macular detachment (SMD) of one eye, associated with bilateral central retinal vein occlusion (CRVO) in a patient affected by Waldenström's macroglobulinemia (WM). A female patient, affected by WM, complained of a progressive decrease in visual acuity, mainly in the left eye (LE). SMD in the LE associated with bilateral CRVO was diagnosed. One intravitreal injection of dexamethasone was administered in the LE and the patient was tested 1, 2, and 6 months after the injection. 1, 2, and 6 months after the injection, the spectral domain optical coherence tomography (SD-OCT) showed a progressive slight reduction of foveal thickness that was not related to any improvement of visual function. Treatment with dexamethasone (Ozurdex) induced a progressive slight reduction of SMD but no improvement of visual acuity, and it is possible that this is related to the condition of hematic hyperviscosity that is present in WM.

  6. Intravitreal Injection of Dexamethasone Implant in Serous Macular Detachment Associated with Waldenström's Disease

    Directory of Open Access Journals (Sweden)

    Vito Fenicia

    2013-07-01

    Full Text Available Purpose: To evaluate the efficacy of one intravitreal injection of dexamethasone (Ozurdex®; Allergan, Inc., Irvine, Calif., USA in serous macular detachment (SMD of one eye, associated with bilateral central retinal vein occlusion (CRVO in a patient affected by Waldenström's macroglobulinemia (WM. Patients and Methods: A female patient, affected by WM, complained of a progressive decrease in visual acuity, mainly in the left eye (LE. SMD in the LE associated with bilateral CRVO was diagnosed. One intravitreal injection of dexamethasone was administered in the LE and the patient was tested 1, 2, and 6 months after the injection. Results: 1, 2, and 6 months after the injection, the spectral domain optical coherence tomography (SD-OCT showed a progressive slight reduction of foveal thickness that was not related to any improvement of visual function. Conclusions: Treatment with dexamethasone (Ozurdex induced a progressive slight reduction of SMD but no improvement of visual acuity, and it is possible that this is related to the condition of hematic hyperviscosity that is present in WM.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Retinal Detachment due to CrossFit Training Injury

    OpenAIRE

    Joondeph, Stephanie A.; Brian C. Joondeph

    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.

  12. Stickler syndrome. Epidemiology of retinal detachment.

    Science.gov (United States)

    Vilaplana, F; Muiños, S J; Nadal, J; Elizalde, J; Mojal, S

    2015-06-01

    A review was performed on all patients with Stickler syndrome that had been treated in our Centre since it was diagnosed, in order to evaluate the risk of suffering a retinal detachment (RD). A total of 14 patients, diagnosed by clinical criteria, were included. The following variables were evaluated: age, gender, ocular background, follow-up, initial and final visual acuity (VA), optical prescription, prophylactic treatment, surgery and techniques performed. The risk age to suffer a RD, as well as cataracts, was determined by using the Kaplan-Meier survival curve analysis. From a total of 5 men and 9 women, the median initial VA was 0.35, which was the same as the final VA. The median optical prescription was -9.5 D myopia. The median of follow-up was 7 years. Ocular background was 4 RD cases and 2 Lasik surgeries. The operations performed were 8 RD, 12 cataract, 2 glaucoma, 2 macular hole, and one endotropia. The median age of RD was 20 years and cataract 34 years. As regards surgical tecnique, 4 scleral buckle cases, and 4 scleral buckle+pars plana vitrectomy cases were formed. The prophylactic treatments performed were: one scleral buckle case, 4 endolaser photocoagulation, and one cryotherapy. Two of which presented with RD. In the series presented, retinal detachment in Stickler syndrome mainly occurs in the second decade of life, with cataracts mainly developing in the fourth decade. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Retinal detachment caused by Arruga suture scleral intrusion. Treatment.

    Science.gov (United States)

    Sánchez-Vicente, J L; Rueda-Rueda, T; González-García, M L; López-Herrero, F; Sánchez-Vicente, P; Castilla-Lázpita, A

    2015-10-01

    We present the case of an 81-year-old man with retinal detachment caused by intrusion of an Arruga suture. The encircling buckle was located in the sub-retinal space and caused retinal breaks with retinal detachment A pars plana vitrectomy was performed along with intraocular cutting of the Arruga suture with retinal re-attachment. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  14. Large-spot subthreshold transpupillary thermotherapy for chronic serous macular detachment

    Directory of Open Access Journals (Sweden)

    Giuseppe Lo Giudice

    2011-03-01

    Full Text Available Giuseppe Lo Giudice1, Valentina de Belvis2, Marco Tavolato1, Alessandro Galan11San Paolo Ophthalmic Center, San Antonio Hospital, Padova, Italy; 2Paediatric Low Vision Center, Paediatric Rare Eye Disease Center, Department of Paediatrics, University of Padova, ItalyPurpose: To report the effect of subthreshold transpupillary thermotherapy (TTT in treating serous detachment of the neurosensory retina secondary to chronic central serous chorioretinopathy (CCSC.Methods: Seven eyes from five patients with CCSC, persistent serous detachment of the neurosensory retina and a clinical course of between 12 and 60 months were treated. All eyes received large-spot TTT guided by indocyanine green angiography (ICGA. Subthreshold TTT was performed using an 810 nm diode laser with a spot size of 3.0 mm (power was set at 350 mW. Treatment was applied for 60 seconds to the areas of choroidal hyperfluorescence on ICGA.Results: The mean number of TTT sessions was 1.4 ± 0.5. All eyes were followed up for at least 6 months (mean 9.6 ± 3.2 standard deviation; range 6–12 months. The mean logarithm of the minimum angle of resolution best-corrected visual acuity was significantly better compared with baseline. All TTT-treated eyes had stable or improved vision (P < 0.001. Mean optical coherence tomography (OCT central foveal thickness was significantly lower in all patients (P < 0.001 compared with pretreatment OCT, with a reduction in subretinal fluid and resolution of serous detachment associated with anatomical fovea restoration. No patient had any treatment-related side effects.Conclusion: Modified subthreshold TTT appears to have a beneficial effect in treating patients with CCSC and persistent neurosensory detachment. The encouraging results and lack of visually significant complications suggest that further investigation is warranted.Keywords: central serous chorioretinopathy, indocyanine green angiography, neurosensory detachment, transpupillary

  15. Basic aspects and practical considerations in retinal detachment surgery.

    Science.gov (United States)

    Foulds, W S

    1986-05-01

    Factors responsible for retinal attachment include structural factors such as the integrity of the retina and the interdigitation of receptor cells with the retinal pigment epithelium combined with dynamic factors which include the movement of water from the vitreous to the choroid under the influence of colloid osmotic pressure in the presence of an intact posterior blood-ocular barrier. In successful retinal detachment surgery an intact cortical vitreous is important. Retinal detachments can be subdivided into simple or complex according to the degree of vitreous abnormality present. Complex detachments demand vitreous surgery and the use of vitreous substitutes. Silicone oil may have a dual role in the eye, tamponade of retinal breaks and waterproofing of the retina with which it is in contact, so reducing transretinal water movement and lightening the load on the mechanisms responsible for retinal reattachment.

  16. 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.

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

    Science.gov (United States)

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

    2017-08-01

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

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

    African Journals Online (AJOL)

    [11] Nonetheless, there were very few trauma‑related tractional detachment in spite of a long delay in presentation. This may be due to the fact that most of these patients sustained blunt trauma. Tractional detachment is associated less with blunt than by penetrating eye injury. Table 1: Anatomical location of the retinal tears.

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

    African Journals Online (AJOL)

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

  20. Bilateral 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.

  1. RECURRENT CENTRAL SEROUS CHORIORETINOPATHY ASSOCIATED WITH RETINITIS PIGMENTOSA TREATED WITH CARBONIC ANHYDRASE INHIBITORS.

    Science.gov (United States)

    Pomykala, Matthew; Rubin, Phillip; Rubin, Jeffrey S

    2016-01-01

    To describe a rare case of recurring central serous chorioretinopathy associated with retinitis pigmentosa successfully treated with oral acetazolamide. A 17-year-old male with retinitis pigmentosa who developed four separate episodes of central serous chorioretinopathy over a 12-month period. After the patient's fourth recurrence, he was treated with daily oral acetazolamide, which resulted in resolution of submacular fluid. He has had no subsequent recurrences while being maintained on alternating and then biweekly doses of oral acetazolamide. Recurrent central serous chorioretinopathy associated with retinitis pigmentosa is a rare occurrence. The presented case demonstrates that oral acetazolamide successfully treated and may have delayed recurrent episodes of central serous chorioretinopathy in the patient with retinitis pigmentosa.

  2. Characteristics and vitreoretinal management of retinal detachment in eyes with Boston keratoprosthesis.

    Science.gov (United States)

    Petrou, Petros; Banerjee, Philip J; Wilkins, Mark R; Singh, Mandeep; Eastlake, Karen; Limb, G Astrid; Charteris, David G

    2017-05-01

    To review the incidence and features of vitreoretinal complications of a permanent Boston keratoprosthesis and to report the use and outcomes of 23-gauge vitrectomy to manage vitreoretinal pathology. Retrospective non-comparative, interventional case series. 27 eyes of 27 patients managed with a Boston keratoprosthesis at Moorfields Eye Hospital over a 3-year period. All eyes that underwent pars plana vitrectomy (PPV) and had at least 6 months follow-up were analysed with a specific focus on the anatomical and histological characteristics of retinal detachment and outcomes of surgery. Anatomical success and characteristics of retinal detachment over the follow-up period. 27 patients underwent Boston keratoprosthesis implantation over the study period. Of these, six (22%) required PPV for retinal detachment which demonstrated a specific pattern of serous elevation with subsequent severe anterior proliferative vitreoretinopathy (PVR). The mean follow-up period was 9 months (range 6-14 months). At final follow-up, visual acuity ranged from perception of light to 6/18, and five of six cases had attached retinae under the silicone oil. Histological analysis of a subretinal membrane demonstrated a predominantly glial/retinal pigment epithelium fibrocellular tissue, consistent with PVR. The study showed that retinal detachment complicated by PVR, as demonstrated by the clinical and histological characteristics of this condition, is common in patients undergoing Boston keratoprosthesis. We also showed that 23-gauge vitrectomy can be effectively performed in patients with a permanent prosthesis. Visual acuity often remains poor, despite successful anatomical results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Effect of ranibizumab on serous and vascular pigment epithelial detachments associated with exudative age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Panos GD

    2013-07-01

    Full Text Available Georgios D Panos,1 Zisis Gatzioufas,1 Ioannis K Petropoulos,1 Doukas Dardabounis,2 Gabriele Thumann,1 Farhad Hafezi11Department of Ophthalmology, Geneva University Hospitals and Faculty of Medicine of the University of Geneva, Switzerland; 2Department of Ophthalmology, University Hospital of Alexandroupolis, GreecePurpose: To report the effect of intravitreal ranibizumab therapy for serous and vascular pigment epithelial detachments (PED associated with choroidal neovascularisation (CNV secondary to age-related macular degeneration (AMD.Methods: In a prospective study, best-corrected visual acuity (BCVA and optical coherence tomography (OCT data were collected for 62 eyes of 62 patients, with serous or vascular PED associated with CNV secondary to AMD. Intravitreal ranibizumab 0.5 mg was administered with a loading phase of three consecutive monthly injections, followed by monthly review with further treatment, as indicated according to the retreatment criteria of the PrONTO study. The change in visual acuity and PED height from baseline to month 12 after the first injection was determined.Results: Sixty-one eyes of 61 patients (one of the patients developed retinal pigment epithelial tear and was excluded from the study were assessed at the 12-month follow-up examination. There were two types of PED, including vascular PED in 32 patients (Group A and serous PED (Group B in 29 patients. The mean improvement of mean BCVA from baseline to 12 months was 0.09 logMAR (Logarithm of the Minimum Angle of Resolution in Group A and 0.13 logMAR in Group B. Both groups showed significant improvement of the mean BCVA 12 months after the first injection compared with the baseline value (P < 0.05. In relation to the PED height, the mean decrease of mean PED height from baseline to 12 months was 135 µm in Group A and 180 µm in Group B. Both groups showed significant reduction of the PED height during the follow-up period (P < 0.01. The PED anatomical response

  4. Retinal Detachment Associated With Basketball-Related Eye Trauma.

    Science.gov (United States)

    Lee, Tsung-Han; Chen, Yi-Hao; Kuo, Hsi-Kung; Chen, Yung-Jen; Chen, Chih-Hsin; Lee, Jong-Jer; Wu, Pei-Chang

    2017-08-01

    Basketball is a popular sport involving significant body contact, which may frequently result in ocular trauma. The aim of this study was to evaluate the characteristics and visual outcomes of retinal detachment associated with basketball-related injury. Retrospective, interventional case series. We reviewed the course of patients who sustained traumatic retinal detachment from basketball-related ocular trauma between 2003 and 2015. Thirteen patients were evaluated for basketball-related traumatic retinal detachment. Twelve (92%) were male and 1 (8%) female, with an average age of 18.2 years. The majority (9 of 13, 70%) of patients had moderate-to-high myopia, and none were using protective eyewear when they sustained the eye trauma. Rhegmatogenous retinal detachment was observed in all eyes. The preoperative mean visual acuity was 20/625 (range, hand motions to 20/20). Initial surgery using scleral buckling alone was performed in most (8 of 13, 62%) of the patients. Retinal reattachment was achieved in 10 (76%) eyes after the first operation and in 12 (92%) at the end of the intervention. The mean follow-up was 3.9 years (range, 4 months to 12 years). The visual acuity during last follow-up was 20/231 (range, light perception to 20/20). In the multivariable analysis, initial visual acuity was an independent factor affecting the final visual outcome (P = .006). Retinal detachment associated with basketball-related injury may cause severe visual loss. In the current study, all retinal detachments were of rhegmatogenous type and commonly occurred in young individuals with myopia. Initial visual acuity was associated with the prognosis. Risk awareness for early detection and intervention are important in these traumas. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. 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.

  6. 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 al4 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.

  7. Unilateral, recurrent exudative retinal detachment in association with pansinusitis [

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    Osman Saatci, Ali

    2012-11-01

    Full Text Available [english] Aim: To report a patient with unilateral exudative retinal detachment due to pansinusitis.Methods: Case report.Results: A 65-year-old woman with a two-month history of blurred vision, red eye and lid swelling in her left eye was referred to us. Her best-corrected visual acuity was 20/20 in the right eye and 20/200 in the left. Conjunctival vessels were engorged in the OS. Funduscopy revealed a 360° exudative detachment in OS and computerized tomography (CT imaging revealed pansinusitis. Systemic antibiotic treatment was employed and exudative detachment regressed. However, exudative detachment remitted as soon as antibiotic treatment ceased. Finally she underwent sinus surgery and decompression of the orbita. Her visual acuity improved to 20/100 just two days after the surgery, stabilized at 20/30 and no further recurrences occured during the follow-up of 10 months.Conclusion: Since exudative retinal detachment usually accompanies systemic inflammatory or neoplastic diseases, systemic screening and collaboration with other disciplines are mandatory. To the best of our knowledge, this is the first report of a case that developed exudative retinal detachment due to pansinusitis and only recovered after decompression surgery.

  8. Risk factors for multiple retinal tears in patients with acute posterior vitreous detachment.

    Science.gov (United States)

    Karahan, Eyyup; Karti, Omer; Er, Duygu; Cam, Duygu; Aydın, Rukiye; Zengin, Mehmet Ozgur; Kaynak, Suleyman

    2017-02-03

    To evaluate possible risk factors for multiple retinal tears in patients with acute posterior vitreous detachment. Three hundred and seventy-six consecutive patients presenting with symptoms of floaters and/or flashes were examined. The associations of retinal tears with the duration of symptoms, multiple floaters, flashing, a family history of retinal detachment, peripheral retinal degeneration, lens status, myopia, tobacco dust, and retinal or vitreous hemorrhage were analyzed. Fifty-four (14.4%) of the 376 patients had 71 initial retinal tears. Forty of the 54 eyes had one retinal tear, and 14 eyes had multiple retinal tears. The presence of retinal or vitreous hemorrhage increased the risk of multiple retinal tears 6.1 times using univariate analysis and 7.0 times using multivariate analysis. Unrecognized retinal tears in patients with acute posterior vitreous detachment can cause subsequent retinal detachment. It is therefore important to consider multiple retinal tears, especially in patients with retinal or vitreous hemorrhage.

  9. A Review of Innovations in Rhegmatogenous Retinal Detachment Surgical Techniques

    Directory of Open Access Journals (Sweden)

    Achia Nemet

    2017-01-01

    Full Text Available Rhegmatogenous retinal detachment (RRD requires surgical intervention for its repair. There are variable techniques used for this purpose, and they are all being continuously refined. In this review, we detail the recent innovations in surgical management of RRD and proliferative vitreoretinopathy (PVR.

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

    High myopia was the third commonest ocular risk factor in our patients. High myopia constituted 10% of cases in Ibechukwu's series.[6] Ashaye[11] had also noted that myopia was an important risk factor for rhegmatogenous retinal detachment in Lagos,. Nigeria. However, high myopia is not common in Nigerians.[14‑16].

  13. Protective effects of resveratrol in experimental retinal detachment.

    Directory of Open Access Journals (Sweden)

    Wei Huang

    Full Text Available BACKGROUND: Oxidative stress is one of the major factors that trigger photoreceptor apoptosis. To investigate whether resveratrol, a potent antioxidant and small molecule activator of the FoxO pathway, would be neuroprotective against photoreceptor cell death in a rodent model of retinal detachment. METHODS: Retinal detachment was created in adult Brown Norway rats by subretinal injection of sodium hyaluronate. The animals were treated daily with vehicle or resveratrol (20 mg/kg intraperitoneal injection. Photoreceptor death was assessed by counting the number of apoptotic cells with TdT-dUTP terminal nick-end labeling (TUNEL and measurement of the outer nuclear layer (ONL thickness 3 days after RD. Changes in expression of FoxO1a, FoxO3a, and FoxO4 were analyzed by western blot. The activity of caspase 3, caspase 8, caspase 9, spectrin and their cleavage forms were studied. RESULTS: Three days after retinal detachment, caspase 3, caspase 8 and caspase 9 were significantly activated in the detached retina. Spectrin cleavage products at 120 and 145 kDa were also detected. Both caspase and calpain activation are involved in apoptotic photoreceptor cell death in detached retinas. Treatment with resveratrol increases FoxO1a, FoxO3a, and FoxO4 protein expression in detached retinas only. Resveratrol treatment decreases activation of intrinsic and extrinsic caspase apoptotic pathways triggered by RD. The number of TUNEL-positive cells decreases from 1301±51 cells/mm(2 in control groups to 430±35 cells/mm(2 in treatment groups (p<0.05. Resveratrol treatment also demonstrates 59% less ONL thickness loss compared to controls. CONCLUSIONS: Resveratrol treatment up-regulates the FoxO family and blocks Caspase3, 8, and 9 activation. Resveratrol has the potential to be used as a novel therapeutic agent for preventing vision loss in diseases characterized by photoreceptor detachment.

  14. CLINICAL PRESENTATIONS AND OUTCOMES OF RHEGMATOGENOUS RETINAL DETACHMENT IN RETINITIS PIGMENTOSA.

    Science.gov (United States)

    Dave, Vivek P; Jalali, Subhadra; Nayaka, Ashraya; Pappuru, Rajeev R; Pathengay, Avinash; Das, Taraprasad

    2016-07-01

    To describe the clinical presentations and outcomes of rhegmatogenous retinal detachments (RRD) in eyes with retinitis pigmentosa. A retrospective review of all patients of retinitis pigmentosa with RRD from January 1990 to December 2013 at a tertiary eye care institute. Of total 28,622 patients of retinitis pigmentosa over a 23-year period, 17 eyes of 17 patients had RRD. Mean age at presentation was 34.53 ± 16.42 years (median 32 years). Median duration of decreased vision attributed to RRD was 6 months. Ten eyes (59%) had cataract and 3 eyes (18%) had history of cataract surgery. Thirteen eyes (76%) had inferior retinal detachment; 9 eyes (53%) had lattice with retinal holes; and 8 eyes (47%) had atrophic retinal holes. There were no horse-shoe tears, giant retinal tears, dialysis, and macular holes related RRD. Majority (82%) of retinal breaks were in the inferotemporal quadrant. Only 3 eyes (18%) had proliferative vitreoretinopathy at presentation. Twelve eyes at presentation had best-corrected visual acuity retinitis pigmentosa is very low. Presentation, although delayed, is at a younger age. Horse-shoe tears and proliferative vitreoretinopathy are uncommon; cataract is a common coexisting pathology. Surgical reattachment rates appear high and recurrent RRD is uncommon. However, visual gain is limited by the underlying retinal degenerative condition.

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

    Science.gov (United States)

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

    2016-02-01

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

  16. Retinal detachment with severe proliferative vitreoretinopathy in Terson syndrome.

    Science.gov (United States)

    Velikay, M; Datlinger, P; Stolba, U; Wedrich, A; Binder, S; Hausmann, N

    1994-01-01

    In several reports, early vitrectomy has been proposed for eyes with vitreous hemorrhage due to Terson syndrome as a means to hasten visual recovery. But the development of nuclear sclerosis and the neurologic problems arising from this disease encourage surgeons to wait for spontaneous resorption, especially with young patients. Although the formation of epiretinal membranes has been described, to the authors' knowledge retinal detachment with proliferative vitreoretinopathy in Terson syndrome never has been observed. The authors report five eyes from four patients with Terson syndrome due to spontaneous aneurysm rupture, in whom retinal detachment with proliferative vitreoretinopathy developed. The early onset and the severe clinical course of proliferative vitreoretinopathy in these eyes showed parallels to traumatic proliferative vitreoretinopathy. The retina in all eyes could be reattached. The authors point out the necessity for accurate and close follow-up and early, extensive surgical treatment in Terson syndrome, especially in patients with a reduced general state of health.

  17. Activation of autophagy in photoreceptor necroptosis after experimental retinal detachment

    Directory of Open Access Journals (Sweden)

    Kai Dong

    2014-10-01

    Full Text Available AIM:To investigate whether photoreceptor necroptosis induced by z-VAD-FMK (pan caspase inhibitor was involved the activation of autophagy and whether Necrostatin-1, a specific necroptosis inhibitor, could inhibit this induction of autophagy after experimental retinal detachment.METHODS:Experimental retinal detachment models were created in Sprague-Dawley rats by subretinal injection of sodium hyaluronate and subretinal injections of z-VAD-FMK, vehicle or z-VAD-FMK plus Necrostatin-1. Three days after retinal detachment, morphologic changes were observed by transmission electron microscopy. In other animals, retinas were subjected to immunoprecipitation and Western Blotting, then probed with anti-RIP1, phosphoserine, LC-3II or caspase 8 antibody.RESULTS:It was proved by immunoprecipitation and western blotting, that photoreceptor necroptosis was mediated by caspase-8 inhibition and receptor interacting protein kinase (RIP1 phosphorylation activation. Transmission electron microscope and western blotting results indicated that photoreceptor necroptosis was involved the LC-3II and autophagosomes induction. We also discovered Necrostatin-1 could inhibit RIP1 phosphorylation and LC-3II induction.CONCLUSION:These data firstly indicate photoreceptor necroptosis is associated with the activation of autophagy. Necrostatin-1 protects photoreceptors from necroptosis and autophagy by down-regulation of RIP1 phosphorylation and LC-3II.

  18. Posterior Pole Retinal Detachment Due to a Macular Hole in a Patient with a Boston Keratoprosthesis.

    Science.gov (United States)

    Gologorsky, Daniel; Williams, Basil K; Flynn, Harry W

    2017-04-01

    To describe the clinical course of a patient with a Boston Keratoprosthesis type I who developed a localized posterior pole retinal detachment secondary to a macular hole. A 73-year-old patient with a Boston Keratoprosthesis developed a localized posterior pole retinal detachment secondary to a macular hole. The retinal detachment was repaired with a 23-gauge pars plana vitrectomy, membrane peel, fluid-air exchange and 18% C3F8. Retinal reattachment was achieved but the macular hole remained open. A posterior pole retinal detachment secondary to a macular hole can be repaired using standard techniques despite the limited view through a Boston Keratoprosthesis.

  19. 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

  20. 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.

  1. [Multiple retinal pigment epithelial detachments: a case report].

    Science.gov (United States)

    González-Escobar, A B; González de Gor-Crooke, J L; López-Egea-Bueno, M A; García-Campos, J M

    2014-05-01

    A 47 year-old female who presented with a bilateral idiopathic multiple pigment epithelial detachment (PED) in a routine visit. This pathology is shown as a rare clinical manifestation, where the outcome is resolution of localized atrophy of the pigment epithelium, with a good functional prognosis. PED is a common clinical manifestation in several chorioretinal diseases, particularly in macular degeneration associated with age. Idiopathic PED can be considered as a kind of central type II serous chorioretinopathy. Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) are complementary tests to study the number, extension, and nature of these PED. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  2. Characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Oono Y

    2012-06-01

    Full Text Available Yoshihiko Oono, Koji Uehara, Masatoshi Haruta, Ryoji YamakawaDepartment of Ophthalmology, Kurume University School of Medicine, Kurume, JapanPurpose: To describe the characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment.Methods: A retrospective study of pediatric patients (15 years old or younger who had undergone primary surgery for rhegmatogenous retinal detachment was conducted. Patients were divided into five groups according to the predisposing factors: trauma (group 1, myopia (group 2, atopic dermatitis (group 3, congenital or developmental anomalies (group 4, and others (group 5.Results: A total of 48 eyes of 44 patients were included in this study. There were 18 eyes (37.5% in group 1, twelve eyes (25.0% in group 2, six eyes (12.5% in group 3, five eyes (10.4% in group 4, and seven eyes (14.6% in group 5. The initial retinal reattachment rate was 89% in group 1, 100% in group 2, 83% in group 3, 20% in group 4, and 86% in group 5 (P = 0.002. The final retinal reattachment rate was 100% in group 1, 100% in group 2, 100% in group 3, 80% in group 4, and 86% in group 5 (P = 0.16. The frequency of visual acuity of 0.1 or better after surgery was 100% in group 1, 92% in group 2, 83% in group 3, 40% in group 4, and 71% in group 5 (P = 0.01.Conclusion: The overall surgical outcome was successful, but the patients in group 4 had the lowest initial reattachment rate and the worst visual prognosis.Keywords: children, detached retina, surgical outcome, predisposing factor

  3. Retinal Detachment Associated with AIDS-Related Cytomegalovirus Retinitis: Risk Factors in a Resource-Limited Setting

    Science.gov (United States)

    Yen, Michael; Chen, Jenny; Ausayakhun, Somsanguan; Kunavisarut, Paradee; Vichitvejpaisal, Pornpattana; Ausayakhun, Sakarin; Jirawison, Choeng; Shantha, Jessica; Holland, Gary N; Heiden, David; Margolis, Todd P; Keenan, Jeremy D

    2014-01-01

    Purpose To determine risk factors predictive of retinal detachment in patients with cytomegalovirus (CMV) retinitis in a setting with limited access to ophthalmic care. Design Case-control study. Methods Sixty-four patients with CMV retinitis and retinal detachment were identified from the Ocular Infectious Diseases and Retina Clinics at Chiang Mai University. Three control patients with CMV retinitis but no retinal detachment were selected for each case, matched by calendar date. The medical records of each patient were reviewed, with patient-level and eye-level features recorded for the clinic visit used to match cases and controls, and also for the initial clinic visit at which CMV retinitis was diagnosed. Risk factors for retinal detachment were assessed separately for each of these time points using multivariate conditional logistic regression models that included 1 eye from each patient. Results Patients with a retinal detachment were more likely than controls to have low visual acuity (OR, 1.24 per line of worse vision on the logMAR scale; 95%CI, 1.16-1.33) and bilateral disease (OR, 2.12; 95%CI, 0.92-4.90). Features present at the time of the initial diagnosis of CMV retinitis that predicted subsequent retinal detachment included bilateral disease (OR, 2.68; 95%CI, 1.18-6.08) and lesion size (OR, 2.64 per 10% increase in lesion size; 95%CI, 1.41-4.94). Conclusion Bilateral CMV retinitis and larger lesion sizes, each of which is a marker of advanced disease, were associated with subsequent retinal detachment. Earlier detection and treatment may reduce the likelihood that patients with CMV retinitis develop a retinal detachment. PMID:25448999

  4. Bilateral Rhegmatogenous Retinal Detachment during External Beam Radiotherapy

    OpenAIRE

    Takako Hidaka; Hideki Chuman; Nobuhisa Nao-i

    2016-01-01

    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 re...

  5. Retinal dialysis and detachment in a child after airbag deployment.

    Science.gov (United States)

    Eliott, Dean; Hauch, Adam; Kim, Rubin W; Fawzi, Amani

    2011-04-01

    A variety of airbag-associated ocular injuries have been reported in children sitting in the front passenger seat during automobile collisions. These injuries range from corneal abrasions to traumatic hyphema with secondary glaucoma and cataract. We report the case of a 5-year-old boy who experienced retinal dialysis and detachment associated with airbag deployment. The patient recovered 20/20 visual acuity after cryopexy and placement of a radial sponge. Copyright © 2011 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-03-22

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

  7. 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

  8. "VACUOLE" SIGN ADJACENT TO RETINAL PIGMENT EPITHELIAL DEFECTS ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN CENTRAL SEROUS CHORIORETINOPATHY ASSOCIATED WITH SUBRETINAL FIBRIN.

    Science.gov (United States)

    Rajesh, Bindu; Kaur, Amardeep; Giridhar, Anantharaman; Gopalakrishnan, Mahesh

    2017-02-01

    To report spectral domain optical coherence tomography features in central serous chorioretinopathy associated with subretinal fibrin. Retrospective observational case series of patients with central serous chorioretinopathy with subretinal fibrin imaged with spectral domain optical coherence tomography. Twenty-three eyes of 23 patients (19 males and 4 females), with mean age of 39.09 ± 5.8 years were included in the study. Subretinal fibrin clinically ranged from localized well-defined areas to extensive ill-defined areas. Along with the presence of subretinal hyperreflectivity (n = 23, 100%), corresponding to fibrin, spectral domain optical coherence tomography also revealed the presence of the retinal pigment epithelial (RPE) defects (n = 23, 100%) in all eyes with an adjacent well-defined hyporeflective vacuole. In 19 eyes wherein fundus fluorescein was performed, the RPE defects and vacuoles corresponded to the site of RPE leak. Serous pigment epithelial detachments (n = 18, 78.2%), multiple RPE defects in the same eye (n = 5), and multiple RPE defects in same pigment epithelial detachment (n = 1) were few other interesting features observed. The presence of a hyporeflective vacuole amid the hyperreflective fibrin adjacent to RPE defects probably indicates the site of constant fluid egress and is an important sign of disease activity especially in cases where fundus fluorescein angiography is not possible.

  9. 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.

  10. Central serous chorioretinopathy

    DEFF Research Database (Denmark)

    Wang, M.; Munch, I.C.; Hasler, P.W.

    2008-01-01

    Central serous chorioretinopathy (CSC) is a disease of the retina characterize by serous detachment of the neurosensory retina secondary to one or more focal lesions of the retinal pigment epithelium (RPE). CSC occurs most frequently in mid-life and more often in men than in women. Major symptoms...... and hypercortisolism. Ophthalmoscopic signs of CSC range from mono- or paucifocal RPE lesions with prominent elevation of the neurosensory retina by clear fluid - typical of cases of recent onset - to shallow detachments overlying large patches of irregularly depigmented RPE. The spectrum of lesions includes RPE...... CSC, treatment should be considered. Resolution of detachment can usually be achieved in acute CSC by focal photocoagulation of leaking RPE lesions or, in chronic CSC, by photodynamic therapy. The effect of therapy on long-term visual outcome is insufficiently documented. Reattachment within 4 months...

  11. Bullous Exudative Retinal Detachment after Retinal Pattern Scan Laser Photocoagulation in Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Shohei Nishikawa

    2017-10-01

    Full Text Available Laser retinal photocoagulation is the gold standard treatment for diabetic retinopathy. We describe 3 cases in which bullous exudative retinal detachment (ERD developed after pattern scan laser photocoagulation (PASCAL in diabetic retinopathy. ERD spontaneously resolved in all 3 cases with various visual courses. This case series highlights 2 key points: first, ERD can occur regardless of gender, age, glycemic control, or vitreous status and despite a moderate number of laser shots, even with PASCAL; second, ERD in nonvitrectomized eyes may cause irreversible visual loss, even if the ERD resolves within 1 month.

  12. Minimally invasive surgery - endoscopic retinal detachment repair in patients with media opacities

    NARCIS (Netherlands)

    de Smet, M. D.; Mura, M.

    2008-01-01

    Purpose Evaluate the use of an ophthalmic endoscope in patients with a retinal detachment and anterior media opacity. Materials and methods A retrospective interventional case series. Search of a comprehensive database of retinal detachment patients with pre-operatively impaired anterior segments

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    PURPOSE: To examine the incidence of retinal detachments and to evaluate patient profiles and surgical characteristics. METHODS: Retrospective review of patients operated for primary retinal detachment (RD) and redetachment between 2010 and 2012 at the Department of Ophthalmology, Odense University...... Hospital, Denmark. We included all RD such as rhegmatogenous retinal detachment (RRD), tractional retinal detachment (TRD) and exudative retinal detachment (ERD). RESULTS: In total, 779 RD surgeries were performed: 83.7% (n = 652) primary operations and 16.3% (n = 127) reoperation. For primary operation......, pars plana vitrectomy (PPV), scleral buckling and combined operations were performed in 95.1% (n = 620), 4.6% (n = 30) and 0.3% (n = 2) respectively. Over time there was less use of silicone oil and greater use of gas tamponade (p = operations (p =

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-08-01

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

  15. Use of an Ophthalmic Viscosurgical Device for Experimental Retinal Detachment in Rabbit Eyes

    Directory of Open Access Journals (Sweden)

    Satoshi Okinami

    2013-01-01

    Full Text Available To investigate the temporary tamponade effects of an ophthalmic viscosurgical device (OVD for experimental retinal tears, we performed vitrectomy in four rabbit eyes and created a posterior vitreous detachment and artificial retinal tear to produce retinal detachment. The retina was flattened with liquid perfluorocarbon (PFC, the area peripheral to the tear was photocoagulated, an OVD was applied to the retinal tear surface below the PFC and the PFC was removed by aspiration. In the control group, PFC was removed without application of OVD. At one, three and seven days postoperatively, funduscopy and optical coherence tomography (OCT were performed to examine the sealing process of the retinal tear. In OVD-treated eyes, the OVD remained on the retinal surface, and the retinal tear was patched for ≥ 3 days postoperatively. By seven days postoperatively, the OVD on the retinal surface had disappeared, and the retina was reattached. In control eyes, the edge of the retinal tear was rolled, and retinal detachment persisted. In OVD-treated eyes, the border of the retinal tear was indistinct, and the defect area was significantly decreased. These results show that application of an OVD effectively seals retinal tears and eliminates retinal detachments.

  16. Risk of pseudophakic retinal detachment in 202 226 patients using the fellow nonoperated eye as reference

    DEFF Research Database (Denmark)

    Bjerrum, Søren S; Mikkelsen, Kim Lyngby; La Cour, Morten

    2013-01-01

    To study the risk of pseudophakic retinal detachment (PRD) after first-eye phacoemulsification cataract surgery in Denmark relative to the risk of retinal detachment (RD) in the patients' fellow nonoperated eyes.......To study the risk of pseudophakic retinal detachment (PRD) after first-eye phacoemulsification cataract surgery in Denmark relative to the risk of retinal detachment (RD) in the patients' fellow nonoperated eyes....

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

    Science.gov (United States)

    Thomas, Nicey Roy; Das, Debmalya; Saurabh, Kumar; Roy, Rupak

    2017-01-01

    A 13-year-old female presented with diminution of vision in both eyes for 3 months following snakebite. Best-corrected visual acuities were hand movement in both eyes. Fundoscopy showed vitreous hemorrhage, and B-scan ultrasonography revealed an underlying tractional retinal detachment (TRD) involving the macula in both eyes. Patient underwent 25-gauge pars plana vitrectomy in conjunction with belt buckling, endolaser, and silicone oil tamponade in the left eye. At 6 weeks postoperatively, best-corrected visual acuity of the left eye was noted to be 20/200 with settled TRD and attached retina. Bilateral proliferative retinopathy with TRD is a hitherto unreported complication of snake bite. PMID:29133665

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

    Directory of Open Access Journals (Sweden)

    Nicey Roy Thomas

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sasan Mahmoudi

    2016-01-01

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

  20. A review of acute central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Mirnaghi Moosavi

    2014-09-01

    Full Text Available Central serous chorioretinopathy is a common cause of visual morbidity. It is characterized by idiopathic serous retinal detachment in macular or paramacular regions. The symptoms of the CSC include decreased vision, micropsia and metamorphopsia. The prognosis of the disease is good and almost 90% of patients obtain visual recovery in a few months. However, in less than 5% of patients the chronic disease with poor prognosis is developed. The acceptable approach is to observe patients with acute central serous chorioretinopathy, because central serous chorioretinopathy  is self-limited. The pathophysiology of central serous chorioretinopathy  is not clear and not well understood. Therefore, various medical treatments have been suggested such as propranolol, indomethacin, bevacizumab, acetazolamide, mifepristone, labetalol, etc. However, wait and watch would be the most recommended management of the central serous chorioretinopathy.

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

    Science.gov (United States)

    Bond-Taylor, Martin; Jakobsson, Gunnar; Zetterberg, Madeleine

    2017-01-01

    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. 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. 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 (Pvitreous 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). Patients seeking care on the first day have a higher risk of retinal tears. Also, symptoms of visual loss or a history of previous PVD-related pathology and vitreous/retinal hemorrhage at examination indicate a substantially higher risk of retinal complications. These findings may lead to better management and order of priority among these patients.

  2. Tauroursodeoxycholic acid (TUDCA protects photoreceptors from cell death after experimental retinal detachment.

    Directory of Open Access Journals (Sweden)

    Dimosthenis Mantopoulos

    Full Text Available BACKGROUND: Detachment of photoreceptors from the underlying retinal pigment epithelium is seen in various retinal disorders such as retinal detachment and age-related macular degeneration and leads to loss of photoreceptors and vision. Pharmacologic inhibition of photoreceptor cell death may prevent this outcome. This study tests whether systemic administration of tauroursodeoxycholic acid (TUDCA can protect photoreceptors from cell death after experimental retinal detachment in rodents. METHODOLOGY/PRINCIPAL FINDINGS: Retinal detachment was created in rats by subretinal injection of hyaluronic acid. The animals were treated daily with vehicle or TUDCA (500 mg/kg. TUNEL staining was used to evaluate cell death. Photoreceptor loss was evaluated by measuring the relative thickness of the outer nuclear layer (ONL. Macrophage recruitment, oxidative stress, cytokine levels, and caspase levels were also quantified. Three days after detachment, TUDCA decreased the number of TUNEL-positive cells compared to vehicle (651±68/mm(2 vs. 1314±68/mm(2, P = 0.001 and prevented the reduction of ONL thickness ratio (0.84±0.03 vs. 0.65±0.03, P = 0.002. Similar results were obtained after 5 days of retinal detachment. Macrophage recruitment and expression levels of TNF-a and MCP-1 after retinal detachment were not affected by TUDCA treatment, whereas increases in activity of caspases 3 and 9 as well as carbonyl-protein adducts were almost completely inhibited by TUDCA treatment. CONCLUSIONS/SIGNIFICANCE: Systemic administration of TUDCA preserved photoreceptors after retinal detachment, and was associated with decreased oxidative stress and caspase activity. TUDCA may be used as a novel therapeutic agent for preventing vision loss in diseases that are characterized by photoreceptor detachment.

  3. 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

    and 2 months follow-up and 59 had gradable images with characteristics studied in this part of the study. Exclusions were: poor images (n=8), major surgery or changes on fellow-eye (n=11), no baseline or 2-month image (n=7), re-detachment at 2-month follow-up (n=1) and eyes traumas (n=2). Retinal.......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...... eye history (including cataract surgery), present symptoms, IOP, time from RRD to surgery, preoperative proliferative vitreoretinopathy (PVR) graded according to standardized protocol as follows: A (vitreous haze, pigment, vitreous cells and clumps) , B (wrinkling of inner retinal suface, vessel...

  4. 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.

  5. 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

    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 of the vi...

  6. Scleral Buckling for Rhegmatogenous Retinal Detachment Associated with Pars Planitis.

    Science.gov (United States)

    Kim, Yong-Kyu; Yoon, Wontae; Ahn, Jae Kyoun; Park, Sung Pyo

    2016-01-01

    Purpose. To evaluate the surgical outcome of scleral buckling (SB) in rhegmatogenous retinal detachment (RRD) patients associated with pars planitis. Methods. Retrospective review of RRD patients (32 eyes of pars planitis RRD and 180 eyes of primary RRD) who underwent SB. We compared primary and final anatomical success rates and visual outcomes between two groups. Results. Primary and final anatomical success were achieved in 25 (78.1%) and 31 (96.8%) eyes in the pars planitis RRD group and in 167 eyes (92.7%) and 176 eyes (97.7%) in primary RRD group, respectively. Both groups showed significant visual improvement (p Pars planitis RRD group was associated with higher rate of postoperative proliferative vitreoretinopathy (PVR) development (12.5% versus 2.8%, p = 0.031). Pars planitis and high myopia were significant preoperative risk factors and pseudophakia was borderline risk for primary anatomical failure after adjusting for various clinical factors. Conclusions. Pars planitis associated RRD showed inferior primary anatomical outcome after SB due to postoperative PVR development. However, final anatomical and visual outcomes were favorable. RRD cases associated with pars planitis, high myopia, and pseudophakia might benefit from different surgical approaches, such as combined vitrectomy and SB.

  7. Scleral buckling biomaterials and implants for retinal detachment surgery.

    Science.gov (United States)

    Baino, Francesco

    2010-11-01

    Scleral buckling is a widely used surgical procedure that aims at repairing retinal detachments. Many materials and procedural techniques have been variously proposed and tested in an attempt to find the best combination for providing optimal results to the patient. This review highlights the evolution of scleral buckling implants and chronicles the main advances that have been made in such a context. Specifically, the limitations of the materials and implants fallen in disuse, as well as the advantages of currently adopted devices are critically examined and discussed. Future directions for the research are considered, underlining in particular the great potential carried by the development of accurate mathematical models for describing the postoperative evolution of buckled eye. These analytical models, supported by a comprehensive data set provided by advanced techniques of medical investigations, may become useful tools for helping surgeons to choose, and to design if necessary, the best buckling material and configuration to be used in each specific clinical case. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

  8. Scleral Buckling for Rhegmatogenous Retinal Detachment Associated with Pars Planitis

    Directory of Open Access Journals (Sweden)

    Yong-Kyu Kim

    2016-01-01

    Full Text Available Purpose. To evaluate the surgical outcome of scleral buckling (SB in rhegmatogenous retinal detachment (RRD patients associated with pars planitis. Methods. Retrospective review of RRD patients (32 eyes of pars planitis RRD and 180 eyes of primary RRD who underwent SB. We compared primary and final anatomical success rates and visual outcomes between two groups. Results. Primary and final anatomical success were achieved in 25 (78.1% and 31 (96.8% eyes in the pars planitis RRD group and in 167 eyes (92.7% and 176 eyes (97.7% in primary RRD group, respectively. Both groups showed significant visual improvement (p<0.001 and there were no significant differences in final visual acuity. Pars planitis RRD group was associated with higher rate of postoperative proliferative vitreoretinopathy (PVR development (12.5% versus 2.8%, p=0.031. Pars planitis and high myopia were significant preoperative risk factors and pseudophakia was borderline risk for primary anatomical failure after adjusting for various clinical factors. Conclusions. Pars planitis associated RRD showed inferior primary anatomical outcome after SB due to postoperative PVR development. However, final anatomical and visual outcomes were favorable. RRD cases associated with pars planitis, high myopia, and pseudophakia might benefit from different surgical approaches, such as combined vitrectomy and SB.

  9. Vitrectomy in eyes with peripheral retinal angioma associated with traction macular detachment.

    Science.gov (United States)

    McDonald, H R; Schatz, H; Johnson, R N; Abrams, G W; Brown, G C; Brucker, A J; Han, D P; Lewis, H; Mieler, W F; Meyers, S

    1996-02-01

    Peripheral angiomas have been associated with epiretinal membranes and traction retinal detachment. The authors investigated the timing, results, and complications of vitreous surgery to remove the retinal traction and treat the peripheral vascular tumor. The authors reviewed the results of ten eyes that had undergone vitrectomy for macular pucker and/or traction retinal detachment. These eyes had either preoperative or intraoperative treatment of the peripheral tumor. Patients were followed 4 to 95 months. Six eyes had nonfamilial peripheral acquired retinal hemangioma, three had von Hippel angiomas, and one had multiple large peripheral retinal angiomas associated with extensive retinal telangiectasis. Four eyes received cryotherapy and/or laser photocoagulation 2 to 3 months before surgery. In the remaining six eyes, initial treatment to the peripheral angioma was performed at the time of vitreous surgery. At final follow-up, all eyes were attached without retinal traction. Vision improved in all eyes; six (60%) achieved 20/50 or better visual acuity. Complications included recurrent epiretinal membrane (n=3); nonregressed angiomas (n=3); increased nuclear sclerosis (n=2); and retinal detachment (n=1). Vitreous surgery, when applied to epiretinal membranes or traction retinal detachments associated with peripheral vascular tumors, has a good chance of improving vision. Treatment of the hemangioma, before or during vitrectomy, usually results in tumor regression.

  10. 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...

  11. 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.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-10-01

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

  14. Contemporary Management of Rhegmatogenous Retinal Detachment Due to Giant Retinal Tears: A Consecutive Case Series.

    Science.gov (United States)

    Pitcher, John D; Khan, Mohammed Ali; Storey, Philip P; Hsiao-Fang-Yen, Natalie; Dollin, Michael L; Hsu, Jason; Ho, Allen C; Regillo, Carl D; Garg, Sunir J

    2015-05-01

    To investigate outcomes of contemporary surgical techniques for repair of rhegmatogenous retinal detachments (RRD) associated with giant retinal tears (GRT). Retrospective, consecutive case series including 58 eyes of 58 patients. Mean age was 52 years (range: 16 to 83 years). All patients underwent 23-gauge pars plana vitrectomy with use of perfluorocarbon liquid and intravitreal tamponade (28 with silicone oil, 25 with octafluoropropane gas, and five with sulfur hexafluoride gas). Scleral buckle (SB) was placed in 30 eyes (52%). At a mean follow-up of 17 months, mean visual acuity improved from 20/500 preoperatively to 20/88 at final follow-up. Fifty-one patients (88%) had single-surgery anatomic success, and all patients achieved final retinal reattachment. Use of SB (P = 1.0), silicone oil (P = .1), or 360° endophotocoagulation (P = .7) did not correlate with higher rates of successful repair. Contemporary vitreoretinal surgery techniques achieve high rates of primary anatomic success in GRT-related RRDs. Copyright 2015, SLACK Incorporated.

  15. 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.

  16. NONDAMAGING RETINAL LASER THERAPY FOR TREATMENT OF CENTRAL SEROUS CHORIORETINOPATHY: What is the Evidence?

    Science.gov (United States)

    Wood, Edward H; Karth, Peter A; Sanislo, Steven R; Moshfeghi, Darius M; Palanker, Daniel V

    2017-06-01

    To summarize the literature addressing subthreshold or nondamaging retinal laser therapy (NRT) for central serous chorioretinopathy (CSCR) and to discuss results and trends that provoke further investigation. Analysis of current literature evaluating NRT with micropulse or continuous wave lasers for CSCR. Sixteen studies including 398 patients consisted of retrospective case series, prospective nonrandomized interventional case series, and prospective randomized clinical trials. All studies but one evaluated chronic CSCR, and laser parameters varied greatly between studies. Mean central macular thickness decreased, on average, by ∼80 μm by 3 months. Mean best-corrected visual acuity increased, on average, by about 9 letters by 3 months, and no study reported a decrease in acuity below presentation. No retinal complications were observed with the various forms of NRT used, but six patients in two studies with micropulse laser experienced pigmentary changes in the retinal pigment epithelium attributed to excessive laser settings. Based on the current evidence, NRT demonstrates efficacy and safety in 12-month follow-up in patients with chronic and possibly acute CSCR. The NRT would benefit from better standardization of the laser settings and understanding of mechanisms of action, as well as further prospective randomized clinical trials.

  17. Retinal break and rhegmatogenous retinal detachment after transpupillary thermotherapy as primary or adjunct treatment of choroidal melanoma.

    Science.gov (United States)

    Mashayekhi, Arman; Shields, Carol L; Lee, Sung Chul; Marr, Brian P; Shields, Jerry A

    2008-02-01

    To report the development of retinal break or rhegmatogenous retinal detachment (RRD) after transpupillary thermotherapy (TTT) as primary or adjunct treatment of choroidal melanoma. In this noncomparative, interventional case series, the authors reviewed medical records of 13 patients who developed retinal break or RRD following TTT. The main outcome measures were clinical features and outcome of treatment of retinal break or RRD following TTT. Of 1574 patients managed on the Oncology Service at Wills Eye Institute with TTT as primary or adjunct treatment of choroidal melanoma, 13 (1%) developed retinal break with or without RRD. The mean patient age at diagnosis of choroidal melanoma was 56 years. Treatment for choroidal melanoma included combined plaque radiotherapy and TTT in 10 patients and TTT alone in 3 patients. The median number of TTT sessions before development of retinal break or RRD was 2. Retinal break or RRD developed at a median of 3 months following the last TTT. All the retinal breaks were located in the TTT-treated area. Retinal breaks were atrophic in 11 eyes and horseshoe shaped in 2 cases. The extent of retinal detachment was none in 1 eye, 1 quadrant or less in 5 eyes, 2 or 3 quadrants in 4 eyes, and 4 quadrants in 3 eyes. Seven patients underwent vitrectomy, one received cryotherapy and laser photocoagulation, and five were observed without treatment. In all eight patients who received treatment for RRD, the retina was attached after a mean follow-up period of 54 months with no intraocular or local extraocular tumor dissemination. Development of retinal break or RRD is a rare complication of TTT for treatment of choroidal melanoma. The majority of these cases develop within 6 months of TTT and most are caused by atrophic retinal holes in the TTT-treated area.

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

    Science.gov (United States)

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

    2010-01-01

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

  19. 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.

  20. Animal models of retinal detachment and reattachment: identifying cellular events that may affect visual recovery.

    Science.gov (United States)

    Lewis, G P; Charteris, D G; Sethi, C S; Fisher, S K

    2002-07-01

    Retinal detachment continues to be a significant cause of visual impairment, either through the direct effects of macular detachment or through secondary complications such as subretinal fibrosis or proliferative vitreoretinopathy. Animal models can provide us with an understanding of the cellular mechanisms at work that account for the retinopathy induced by detachment and for the generation of secondary effects. As we understand the mechanisms involved, animal models can also provide us with opportunities to test therapeutic agents that may reduce the damaging effects of detachment or improve the outcome of reattachment surgery. They may also reveal information of use to understanding other causes of blindness rooted in retinal defects or injuries. Understanding the effects of detachment (and reattachment) are likely to become even more important as surgeons gain skills in subretinal surgical techniques and macular translocation, both of which will generate short-lived detachments. Here we discuss the fundamental events that occur after detachment, present changes associated with reattachment, and discuss retinal changes that may affect the return of vision.

  1. 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.

  2. 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.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  4. 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

  5. Scleral buckle is good option for treatment of uncomplicated retinal detachment

    Directory of Open Access Journals (Sweden)

    Iuuki Takasaka

    2012-12-01

    Full Text Available OBJETIVE: To describe the reattachment rate and visual acuity results of patients with uncomplicated rhegmatogenous retinal detachment who underwent segmental scleral buckle surgery. METHODS: Prospective case series of 100 patients with visual loss or symptoms (floaters and photopsia of less than 30 days' duration scheduled for surgery. No patient had a retinal break greater than 30°, a retinal detachment larger than 2 quadrants or proliferative vitreoretinopathy. RESULTS: The 1-week, 1-month, and 6-month anatomical success rates were 93%, 100%, and 100%, respectively. Seven patients underwent one additional retinal detachment surgery (pars plan vitrectomy after primary failure at 1-week follow-up. The preoperative, 1-month, and 6-month best correct visual acuity were 20/100, 20/80, and 20/50, respectively. The postoperative complications were: eyelid edema in 10% of the patients, transient ocular hypertension in 5%, macular pucker in 3%, transient diplopia in 3%, and hyphema (<0.5mm in 1%. CONCLUSION: In patients with uncomplicated retinal detachment, segmental scleral buckle showed a very good anatomical and functional success, with a few number of major complications.

  6. [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.

  7. Association of systemic comorbidity in diabetic serous macular detachment and comparison of various combination therapies in its management

    Directory of Open Access Journals (Sweden)

    Soman M

    2013-01-01

    Full Text Available Manoj Soman,1 Sunil Ganekal,2 Unnikrishnan Nair,1 KGR Nair11Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, 2Nayana Superspecialty Eye Hospital and Research Center, Davangere, Karnataka, IndiaBackground: The purpose of this research was to study the association between systemic comorbidity in diabetic serous macular detachment (DSMD and the effect of different forms of combination therapies in its management.Methods: In this prospective analysis, 34 eyes from 34 patients with DSMD were investigated for the presence of systemic comorbidity including anemia, dyslipidemia, nephropathy, and cardiac disease, and treated with combination therapy of either intravitreal bevacizumab + laser (group 1, n = 14 or intravitreal triamcinolone + laser (group 2, n = 20. Sequential macular laser was done 2 weeks after intravitreal pharmacotherapy in both groups. Outcome measures included visual acuity and central foveal thickness at 1 and 3 months.Results: The mean age of the patients was 55.6 ± 7.6 years. The commonest systemic association was nephropathy (82.3%. In group 1, mean visual acuity improved marginally from 6/17 at baseline to 6/16 at 1 month (P = 0.0001 and was maintained at 3 months (P = 0.008; and mean central foveal thickness decreased from 488.7 µm to 318.7 µm at 1 month (P = 0.0001 but increased to 414.4 µm at 3 months (P = 0.049. In group 2, mean visual acuity improved from 6/22 at baseline to 6/19 at 1 month (P = 0.0001 and 6/12 at 3 months (P = 0.0001; and mean central foveal thickness decreased from 428.8 µm to 323.8 µm at 1 month (P = 0.0001 to 269.2 µm at 3 months (P = 0.0001.Conclusion: Nephropathy should be ruled out in patients with DSMD. Although at 1 month both intravitreal triamcinolone and bevacizumab improved vision and decreased central foveal thickness in eyes with DSMD when administered along with focal laser treatment, the former had a more long-lasting effect in maintaining this gain at 3 months

  8. Two-step surgery for retinal detachment caused by myopic macular hole

    Directory of Open Access Journals (Sweden)

    Lee JE

    2012-10-01

    Full Text Available Joo Eun LeeDepartment of Ophthalmology, Inje University College of Medicine, Busan, South KoreaPurpose: To report the results of a two-step operation for treating retinal detachments caused by macular holes in high-myopic patients.Methods: In the first part of the operation, pars plana vitrectomy, air–fluid exchange, and silicone oil injection were performed. At 4–6 months after the first operation, the second part of the operation was performed. This involved silicone oil removal and internal limiting membrane peeling under the aid of triamcinolone acetonide with or without gas tamponade.Results: Four eyes (four patients underwent surgery with this technique. All retinas were attached at the time of the second operation, when internal limiting membrane peeling could be performed easily and safely. The retina remained attached in all four eyes (100% during 24–32 months of follow-up after the second operation.Conclusion: Favorable surgical results were obtained with the two-step operation in the treatment of retinal detachments resulting from myopic macular holes.Keywords: internal limiting membrane peeling, macular hole, macular hole retinal detachment, retinal detachment, silicone oil, two-step

  9. Association between clomiphene citrate and central retinal vein ...

    African Journals Online (AJOL)

    2010-02-25

    Feb 25, 2010 ... a few cotton wool spots. A large central serous elevation of the macula and a swollen disc were present. Ocular motility was normal. Optical coherence tomography of the right fundus confirmed a large serous detachment/ elevation of the neurosensory retina and possibly also the retinal pigment epithelium.

  10. Postoperative perfluoro-N-octane tamponade for primary retinal detachment repair.

    Science.gov (United States)

    Rush, Ryan; Sheth, Saumil; Surka, Sam; Ho, Ivan; Gregory-Roberts, John

    2012-06-01

    To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without scleral buckling for rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs). Charts of 39 eyes at 3-24 months after primary PFO retention and secondary replacement were retrospectively analyzed for anatomical attachment rates, visual acuity gain, and postoperative complications. Intraoperatively, 33 of 39 eyes showed ≥ 4 retinal breaks, with 31 of 39 eyes having at least 1 inferior break, 10 of 39 eyes having GRT, and 12 of 39 eyes showing preoperative proliferative vitreoretinopathy. All eyes showed complete anatomical retinal attachment after primary vitrectomy for at least 7-17 days when PFO was retained without any specific posturing. With sulfur hexafluoride (SF6) gas PFO exchange, 3 cases redetached. With perfluoropropane (C3F8) gas or silicone oil PFO exchange, no cases redetached, resulting in a final anatomical success rate of 92.4%. Visual acuity improved from 2.07 ± 0.86 to 0.76 ± 0.79 logarithm of the minimum angle of resolution (P 0.05) among macula-on rhegmatogenous retinal detachment eyes. Perfluoro-n-octane retention ≥ 10 days significantly increased posterior capsular opacification (28 of 39 eyes) and cataract extraction rates (21 of 25 eyes) without affecting the final retinal attachment success rate. Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs. Perfluoro-n-octane removal within 10 days reduces its side effect profile considerably. The highest anatomical retinal reattachment rates were observed when C3F8 or silicone oil was exchanged for PFO.

  11. Signs of hydroxychloroquine toxicity in a patient with rhegmatogenous retinal detachment.

    Science.gov (United States)

    Campos-Pavón, J; Sambricio, J; Redondo-García, I

    2016-09-01

    The case is presented of a 56 year-old patient diagnosed with rhegmatogenous retinal detachment and on treatment with hydroxychloroquine (HCQ). A Spectral Domain-Optical Coherence Tomography (SD-OCT) was performed that showed changes in the outer retina in the eye with macular detachment, as well as the «flying saucer» sign in the other eye. After a complete retinopexy the «flying saucer» sign was still present. SD-OCT could be used as a test in order to reveal HCQ toxicity in the event of retinal detachment. In this case, this technique shows abnormalities such as a hyper-reflective line in the outer retina layers. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Validation of the Retinal Detachment after Open Globe Injury (RD-OGI) Score as an Effective Tool for Predicting Retinal Detachment.

    Science.gov (United States)

    Brodowska, Katarzyna; Stryjewski, Tomasz P; Papavasileiou, Evangelia; Chee, Yewlin E; Eliott, Dean

    2017-05-01

    The Retinal Detachment after Open Globe Injury (RD-OGI) Score is a clinical prediction model that was developed at the Massachusetts Eye and Ear Infirmary to predict the risk of retinal detachment (RD) after open globe injury (OGI). This study sought to validate the RD-OGI Score in an independent cohort of patients. Retrospective cohort study. The predictive value of the RD-OGI Score was evaluated by comparing the original RD-OGI Scores of 893 eyes with OGI that presented between 1999 and 2011 (the derivation cohort) with 184 eyes with OGI that presented from January 1, 2012, to January 31, 2014 (the validation cohort). Three risk classes (low, moderate, and high) were created and logistic regression was undertaken to evaluate the optimal predictive value of the RD-OGI Score. A Kaplan-Meier survival analysis evaluated survival experience between the risk classes. Time to RD. At 1 year after OGI, 255 eyes (29%) in the derivation cohort and 66 eyes (36%) in the validation cohort were diagnosed with an RD. At 1 year, the low risk class (RD-OGI Scores 0-2) had a 3% detachment rate in the derivation cohort and a 0% detachment rate in the validation cohort, the moderate risk class (RD-OGI Scores 2.5-4.5) had a 29% detachment rate in the derivation cohort and a 35% detachment rate in the validation cohort, and the high risk class (RD-OGI scores 5-7.5) had a 73% detachment rate in the derivation cohort and an 86% detachment rate in the validation cohort. Regression modeling revealed the RD-OGI to be highly discriminative, especially 30 days after injury, with an area under the receiver operating characteristic curve of 0.939 in the validation cohort. Survival experience was significantly different depending upon the risk class (P RD-OGI Score can reliably predict the future risk of developing an RD based on clinical variables that are present at the time of the initial evaluation after OGI. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc

  13. Aflibercept in Serous Foveal Detachment in Dome-Shaped Macula: Short-Term Results in a Retrospective Study.

    Science.gov (United States)

    Giacomelli, Giovanni; Mencucci, Rita; Sodi, Andrea; Biagini, Ilaria; Abbruzzese, Giacomo; Giuntoli, Matteo; Rizzo, Stanislao; Virgili, Gianni

    2017-10-01

    To evaluate short-term efficacy of intravitreal aflibercept (Eylea; Regeneron, Tarrytown, NY) in serous foveal detachment (SFD) in dome-shaped macula (DSM). A retrospective, noncomparative case series. Three monthly aflibercept injections were administered. Early Treatment Diabetic Retinopathy Study best-corrected visual acuity (BCVA), optical coherence tomography central subfield thickness (CST), and subretinal fluid (SRF) at baseline and at 2 months and 4 months after the last injection were considered for statistical analysis. The authors reviewed nine eyes affected by SFD in DSM. Mean BCVA improved from 0.42 LogMAR at baseline to 0.33 LogMAR at final follow-up (P = .06), and mean CST and SRF reduced from 347 μm to 295 μm (P = .09) and from 146 μm to 99 μm (P < .01), respectively. None of the considered eyes had resolution of the SRF. Three monthly aflibercept injections may improve BCVA and reduce CST and SRF in SFD of DSM. Further prospective studies are necessary to state the real efficacy of this approach. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:822-828.]. Copyright 2017, SLACK Incorporated.

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

    African Journals Online (AJOL)

    Rabah M. Shawky

    2013-12-05

    Dec 5, 2013 ... tural changes can cause mild to severe intellectual disability, developmental delay, and convulsions [2]. ... high-arched eyebrows, mental retardation, and multiple malfor- mations also involving the brain. .... disabilities in 100%, hearing loss in 83.3%, iris or retinal coloboma in 71.4%, and seizers in 87.5% of ...

  15. Primary vitrectomy with perfluoro-n-octane use in the treatment of pseudophakic retinal detachment with undetected retinal breaks.

    Science.gov (United States)

    Brazitikos, P D; D'Amico, D J; Tsinopoulos, I T; Stangos, N T

    1999-01-01

    This report describes the results of a prospective trial to evaluate the efficacy of pars plana vitrectomy (PPV) in conjunction with perfluoro-n-octane (PFO) as initial treatment of pseudophakic retinal detachment (RD) with no breaks diagnosed preoperatively. Fourteen consecutive eyes presenting with pseudophakic RD in which retinal breaks could not be identified preoperatively underwent primary PPV, internal microsurgical identification of the retinal breaks with endoillumination and noncontact wide angle viewing system, PFO retinal reattachment, transscleral cryopexy or endolaser treatment of breaks, PFO-air exchange, and final injection of 20% sulfur hexafluoride. In five eyes, a scleral buckle was also used. Mean follow-up period was 18 months. In 13 of the 14 eyes in which no breaks had been identified preoperatively, breaks were diagnosed during surgery. Perfluoro-n-octane retinal attachment facilitated accurate microscopic treatment of retinal breaks. The retina was reattached with a single operation in all eyes. Eleven eyes had final visual acuity of 20/60 or better. Complications were minimal. Pars plana vitrectomy in conjunction with PFO expression of subretinal fluid is effective in the initial treatment of pseudophakic RD with no preoperative diagnosis of retinal breaks.

  16. 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.

  17. 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

  18. [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.

  19. RETINAL LAYER SEGMENTATION AFTER SILICONE OIL OR GAS TAMPONADE FOR MACULA-ON RETINAL DETACHMENT USING OPTICAL COHERENCE TOMOGRAPHY.

    Science.gov (United States)

    Lee, Sung Hoon; Han, Jong Wook; Byeon, Suk Ho; Kim, Sung Soo; Koh, Hyoung Jun; Lee, Sung Chul; Kim, Min

    2018-02-01

    To evaluate and compare the effect of silicone oil and gas on the thickness of all retinal layers in eyes with macula-on retinal detachment (RD). Three hundred and sixty-seven eyes of 367 patients who received silicone oil tamponade and 310 eyes of 310 patients who received gas tamponade for the treatment of rhegmatogenous RD were initially reviewed. Automated retinal segmentation method using Spectralis optical coherence tomography was used for analysis. The primary outcome measure was the change in thickness of each retinal layer in the central 1 mm zone (silicone oil vs. gas tamponade). The secondary outcome measure was best-corrected visual acuity at postoperative 6 months and 9 months after primary RD surgery. Eyes in the silicone oil group (n = 33) had a statistically significant decrease in total retinal thickness of 23.61 + 17.01 μm and in the thickness of all retinal layers, except for photoreceptor layer at 6 months after primary RD surgery (P change in total retinal thickness was only 0.14 ± 7.26 μm (P = 0.93), with no significant decrease in any of the individual retinal layers. Postoperatively, the best-corrected visual acuity in the silicone oil groups was significantly worse than that in the gas group at 6 months and 9 months after RD surgery (P = 0.003 and P = 0.004, respectively). The postoperative decrease of the ganglion cell layer, outer plexiform layer, and outer nuclear layer thicknesses showed significant correlation with best-corrected visual acuity in the silicone oil group (all P oil tamponade had a significant impact on the reduction of retinal thickness and that the reduction of ganglion cell layer, outer plexiform layer, and outer nuclear layer thicknesses showed the strongest correlation with worse visual acuity outcome.

  20. RESULTS OF RETINAL DETACHMENT SURGERY IN EYES WITH OSTEO-KERATOPROSTHESIS.

    Science.gov (United States)

    Vilaplana, Ferran; Nadal, Jeroni; Temprano, José; Julio, Gemma; Barraquer, Rafael I

    2017-09-27

    To evaluate the anatomical and functional results of pars plana vitrectomy in eyes with osteo-keratoprosthesis, who have suffered retinal detachment. An observational, retrospective study of 18 eyes which underwent pars plana vitrectomy for retinal detachment after an implantation of an osteo-keratoprosthesis, with a minimum of 1-year follow-up. A descriptive study and a Kaplan-Meier survival analysis for anatomical and functional success were performed. Anatomical success was defined as an attached retina at the end of vitreoretinal surgery with no redetachment during the follow-up. Functional success was defined as a postoperative visual acuity of more than or equal to 20/400. The overall rate of anatomical success was 56%, and the anatomical survival rates were 67% and 53% at 6 months and 12 months, respectively, maintaining this last value at 24 months after pars plana vitrectomy. The overall rate of functional success was 17%, and the functional survival rates were 83%, 39%, and 14% at 6 months, 12 months, and 24 months after pars plana vitrectomy, respectively. The most frequent complication after retinal surgery was retroprosthetic membrane (33%). Despite the reserved prognosis and the severe complications, vitrectomy represents a valid method for treating retinal detachment in patients with osteo-keratoprosthesis, with good anatomical results but poor visual acuity.

  1. Comparison of scleral bulkling surgery for retinal detachment under microscope and under indirect ophthalmoscope

    Directory of Open Access Journals (Sweden)

    Min Kong

    2015-02-01

    Full Text Available AIM:To compare the effects of external approach microsurgery and conventional external approach surgery for retinal detachment(RD.METHODS: From January 2010 to January 2013, 60 patients(60 eyesin our hospital were randomly divided into experimental group(29 cases, 29 eyesand control group(31 cases, 31 eyes, the external approach microsurgery and conventional external approach surgery were performed respectively(by the same skilled doctor. Retinal reattachment rate, visual acuity improvement rate and operative time were compared between two groups. RESULTS: It cost shorter time for the external approach microsurgery than that of conventional external approach surgery(P=0.0087. The once successful retinal reattachment rate in experimental group was 93%(27 cases, which was higher than that in control group(90%, 28 cases, there was no statistical difference. The vision improvement rate in control group was 86%(25 cases, compare to 90%(28 casesin experimental group, there was no statistical differences. CONCLUSION: No statistical differences showed in visual acuity improvement and the once retinal reattachment rate between the two groups for rhegmatogenous retinal detachment. However, it is believed that external approach microsurgery could be faster, easier to learn with satisfactory effect.

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Ageing of the vitreous: From acute onset floaters and flashes to retinal detachment.

    Science.gov (United States)

    Lumi, Xhevat; Hawlina, Marko; Glavač, Damjan; Facskó, Andrea; Moe, Morten C; Kaarniranta, Kai; Petrovski, Goran

    2015-05-01

    Floaters and flashes are most commonly symptoms of age-related degenerative changes in the vitreous body and posterior vitreous detachment. The etiology and pathogenesis of floaters' formation is still not well understood. Patients with acute-onset floaters, flashes and defects in their visual field, represent a medical emergency with the need for same day referral to an ophthalmologist. Indirect ophthalmoscopy with scleral indentation is needed in order to find possible retinal break(s), on-time treatment and prevention of retinal detachment. The molecular and genetic pathogenesis, as well as the epidemiology of the ageing changes of the vitreous is summarized here, with view on the several treatment modalities in relation to their success rate and side-effects. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Combined orbital proptosis and exudative retinal detachment as initial manifestations of acute myeloid leukemia.

    Science.gov (United States)

    Khaja, Wassia A; Pogrebniak, Alexander E; Bolling, James P

    2015-10-01

    We report bilateral orbital and choroidal involvement as the presenting sign of acute myeloid leukemia in a 2-year-old white girl. The patient presented with painless proptosis and subconjunctival hemorrhage. Ophthalmic examination and magnetic resonance imaging revealed bilateral leukemic infiltrates of the orbits and choroid, with an exudative retinal detachment in the right eye. Bone marrow biopsy confirmed acute myeloid leukemia. Following radiation treatment, chemotherapy, and hematopoietic stem cell transplantation, the patient was doing well 12 months after presentation. Outcomes can be poor, even with treatment; prompt recognition of ophthalmic manifestations of leukemia, including proptosis, choroidal infiltration, and retinal detachment, is necessary. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Heriot, Wilson J

    2016-04-01

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

  6. 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

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Mathijs A J van de Put

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

  9. Transpupillary thermotherapy for atypical central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Kawamura R

    2012-01-01

    Full Text Available Ryosuke Kawamura1,2, Hidenao Ideta1, Hideyuki Hori1, Kenya Yuki2, Tsuyoshi Uno1, Tatsurou Tanabe1, Kazuo Tsubota2, Tsutomu Kawasaki11Ideta Eye Hospital, Kumamoto, Japan; 2Keio University, School of Medicine, Department of Ophthalmology, Tokyo, JapanBackground: Central serous chorioretinopathy (CSC has been traditionally treated with laser photocoagulation. We thought that transpupillary thermotherapy (TTT utilizing a lower temperature than that of conventional laser photocoagulation might minimize permanent retinal and choroidal damage. Studies suggest that undesirable effects on vision due to TTT are minimal even if it is applied to foveal and/or parafoveal lesions when TTT requires a larger irradiation spot. The aim of this study was to evaluate the efficacy of TTT in the management of atypical CSC.Methods: We defined atypical CSC as bullous retinal detachment with diffuse or several leakages, severe leakage with fibrin formation under serous retinal detachment, or leakage within a pigment epithelium detachment. Eight consecutive patients with atypical CSC underwent visual acuity testing, ophthalmic examination, color photography, fluorescein angiography, and optical coherence tomography to evaluate the results of transpupillary thermotherapy. Retreatment of atypical CSC was based on ophthalmic examination, optical coherence tomography, and fluorescein angiography. TTT was performed on the leaking spots shown in fluorescein angiography, with a power of 50–250 mW, spot size of 500–1200 µm, and exposure time of 13–60 seconds to minimize retinal damage.Results: In five of eight affected eyes, serous detachments completely resolved within 1 month after the initial TTT. One eye had persistent subretinal fluid and required a second TTT treatment. Two eyes showed no resolution of CSC and were treated by conventional photocoagulation. Initial best-corrected visual acuity (BCVA ranged from 20/600 to 20/20 (mean, 20/40; median, 20/30. Final BCVA

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

    Directory of Open Access Journals (Sweden)

    Fukumoto M

    2013-07-01

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

  11. 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.

  12. Outcomes and complications associated with perfluoro-n-octane and perfluoroperhydrophenanthrene in complex retinal detachment repair.

    Science.gov (United States)

    Scott, I U; Murray, T G; Flynn, H W; Smiddy, W E; Feuer, W J; Schiffman, J C

    2000-05-01

    To compare rates of perfluorocarbon liquid (PFCL) intraocular retention, anatomic and visual acuity outcomes, and complications associated with intraoperative perfluoro-n-octane (Perfluoron) versus perfluoroperhydrophenanthrene (Vitreon) in retinal detachment repair. Retrospective noncomparative consecutive case series. Records of consecutive patients who underwent retinal detachment repair with intraoperative Perfluoron (n = 78) or Vitreon (n = 84) at the Bascom Palmer Eye Institute between November 1, 1991, and October 31, 1994, were retrospectively reviewed. Comparison of PFCL intraocular retention rates, retinal reattachment rates, visual acuity outcomes, and postoperative complication rates between the Perfluoron and Vitreon groups at postoperative day 1, week 1, month 1, month 3, and month 6. To assess the study's generalizability, the Perfluoron data obtained in the current study were compared with results of the Perfluoron Multicenter Clinical Study. Retained Perfluoron was noted less frequently (P 25 mmHg) was 13 +/- 4% and 37 +/- 5%, respectively (P = 0.004). No significant difference was found between the groups in rates of postoperative hypotony. Results of this study are comparable with those observed in the Perfluoron Multicenter Clinical Study. In this study, Perfluoron was retained intraocularly less frequently than Vitreon. Although no significant difference was found between groups in retinal reattachment rates, Perfluoron is associated with slightly better 6-month visual acuity and lower rates of corneal abnormality and elevated intraocular pressure compared with Vitreon.

  13. Aniridia, aphakia accompanied by retinal detachment: problem and its ways of solution

    Directory of Open Access Journals (Sweden)

    V. N. Kanyukov

    2014-10-01

    Full Text Available Purpose: Evaluation of the results of various treatment tactics of patients with post-traumatic retinal detachment pathology combined with aniridia and aphakia.Patients and methods.The analysis of four clinical cases of surgical treatment of post-traumatic retinal detachment in conjunction with aniridia and aphakia was carried out. There was used a gradual approach of optic-reconstructive surgery: vitreoretinal stage by the standard method 23‑25 Ga with tamponade of vitreous cavity with silicone oil in two different ways. In one case, full eyeball tamponade was made, and in the other one it was made up to the diaphragm formed of polypropylene sutures. At the final stage — iridolenticular diaphragm was implanted (Reper-NN, Russia.Results. In all cases, early postoperative reaction proceeded with the phenomena of fibrino-plastic iridocyclitis, which corresponded to the severity of the initial state and the volume of surgical intervention. Periods of observation of patients in the postoperative period ranged from 3 to 12 months. In three cases where the diaphragm was formed from polypropylene sutures there was noticed full retina adaptation, wherein silicone oil, introduced in the vitreous cavity, did not penetrate into the anterior chamber during the entire period of observation. In one case, where there was a complete eyeball tamponade with silicone oil epithelial and endothelial corneal dystrophy developed. Such an outcome of a clinical case, despite high functional results, is apparently related to the severity of the initial state, the need to re-intervention for recurrent retinal detachment and relatively early stages of iridolenticular diaphragm implantation.Conclusion. Reconstructive surgery of posttraumatic aniridia and aphakia combined with retinal detachment requires a multistage approach. Reconstruction of anterior segment of the eye is preferably to carry out in long-term periods as after the trauma so after surgical treatment

  14. Aniridia, aphakia accompanied by retinal detachment: problem and its ways of solution

    Directory of Open Access Journals (Sweden)

    V. N. Kanyukov

    2014-01-01

    Full Text Available Purpose: Evaluation of the results of various treatment tactics of patients with post-traumatic retinal detachment pathology combined with aniridia and aphakia.Patients and methods.The analysis of four clinical cases of surgical treatment of post-traumatic retinal detachment in conjunction with aniridia and aphakia was carried out. There was used a gradual approach of optic-reconstructive surgery: vitreoretinal stage by the standard method 23‑25 Ga with tamponade of vitreous cavity with silicone oil in two different ways. In one case, full eyeball tamponade was made, and in the other one it was made up to the diaphragm formed of polypropylene sutures. At the final stage — iridolenticular diaphragm was implanted (Reper-NN, Russia.Results. In all cases, early postoperative reaction proceeded with the phenomena of fibrino-plastic iridocyclitis, which corresponded to the severity of the initial state and the volume of surgical intervention. Periods of observation of patients in the postoperative period ranged from 3 to 12 months. In three cases where the diaphragm was formed from polypropylene sutures there was noticed full retina adaptation, wherein silicone oil, introduced in the vitreous cavity, did not penetrate into the anterior chamber during the entire period of observation. In one case, where there was a complete eyeball tamponade with silicone oil epithelial and endothelial corneal dystrophy developed. Such an outcome of a clinical case, despite high functional results, is apparently related to the severity of the initial state, the need to re-intervention for recurrent retinal detachment and relatively early stages of iridolenticular diaphragm implantation.Conclusion. Reconstructive surgery of posttraumatic aniridia and aphakia combined with retinal detachment requires a multistage approach. Reconstruction of anterior segment of the eye is preferably to carry out in long-term periods as after the trauma so after surgical treatment

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

    Science.gov (United States)

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

    2013-10-01

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

  16. 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.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  18. 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.

  19. Extended Endotamponade with Perfluoro-n-Octane in Pediatric Retinal Detachment.

    Science.gov (United States)

    Sisk, Robert A; Berrocal, Audina M; Murray, Timothy G; Mavrofrides, Elias C

    2010-03-09

    The use of perfluoro-n-octane (PFnO) for extended endotamponade in an infant with X-linked retinoschisis and complex tractional retinal detachments associated with proliferative vitreoretinopathy (PVR) was reported. The patient had undergone multiple vitrectomy surgeries with silicone oil tamponade. After extensive retinectomy, slippage of the retina produced folds that were flattened under extended PFnO tamponade. The retinas of both eyes remained anatomically reattached 11 months after exchange of PFnO for silicone oil. Copyright 2010, SLACK Incorporated.

  20. Interleukin-6 concentrations in the vitreous body of patients with retinal detachment.

    Science.gov (United States)

    Asensio-Sánchez, V M; Collazos, J M; Cantón, M

    2015-11-01

    To measure interleuquin-6 (IL-6) levels in the vitreous body of patients with retinal detachment (RD). Undiluted vitreous samples were obtained from 40 patients with no history of prior vitreous or intraocular surgery. Patients were divided into two groups: A (n=20) patients with RD and B (n=20) patients with pre-retinal macular membranes and macular holes. IL-6 was determined using radioimmunoassay. IL-6 vitreous concentration in group A was 122.4+-16pg/mL (range 91.5-620) and in group B was 46+/-23pg/mL (range 3-150) (p <.001). These results show that the concentration of IL-6 in the vitreous body was significantly higher in patients with RD than in the control group. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Rhegmatogenous retinal detachment due to a macular hole in a patient with pars planitis: a case report.

    Science.gov (United States)

    Stavrakas, Panagiotis; Androu, Angeliki A; Tranos, Paris; Kontou, Evgenia; Milia, Maria; Georgalas, Ilias

    2015-01-01

    We report a rare case of rhegmatogenous retinal detachment due to a full-thickness macular hole in a young patient with pars planitis. This study was an interventional case report. A 38-year-old Asian man presented with acute reduction of vision in his left eye. His past ocular history revealed a precedent of two intravitreal steroid injections in his left eye, and fundoscopy revealed a total bullous retinal detachment along with 360° snowbanking at the pars plana. Precise preoperative visualization of the posterior pole was impossible due to a dense nuclear cataract. During surgery, an unexpected full-thickness macular hole with no associated epiretinal membrane was observed, which resulted in the retinal detachment. This case of chronic pars planitis complicated with a full-thickness macular hole resulting in retinal detachment was successfully treated with vitrectomy, internal limiting membrane peeling, and perfluoropropane tamponade. Visual acuity improved from hand movements to 6/36 Snellen at 12 months postsurgery. This case report illustrates the rare but possible association between pars planitis with macular hole formation and subsequent retinal detachment, underlying the beneficiary outcome of vitrectomy surgery both diagnostically and therapeutically.

  2. Retinal Detachment

    Science.gov (United States)

    ... Clinical Director Laboratories, Sections and Units Division of Epidemiology and Clinical Applications eyeGENE Research Directors Office Office ... in the doctor’s office. During laser surgery tiny burns are made around the hole to “weld” the ...

  3. Retinal detachment

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    ... retina ( ophthalmoscopy ) Checking eyeglass prescription ( refraction test ) Checking color vision Checking the smallest letters that can be read ( visual acuity ) Checking structures at the front of the eye ( ...

  4. Effect of Serial Intrasilicone Oil Bevacizumab Injections in Eyes With Recurrent Proliferative Vitreoretinopathy Retinal Detachment.

    Science.gov (United States)

    Hsu, Jason; Khan, M Ali; Shieh, Wen-Shi; Chiang, Allen; Maguire, Joseph I; Park, Carl H; Garg, Sunir J; Ho, Allen C; Kaiser, Richard S

    2016-01-01

    To investigate the effect of serial intrasilicone oil bevacizumab injections (1.25 mg/0.05 mL) on visual acuity (VA) and anatomic outcomes in eyes undergoing proliferative vitreoretinopathy (PVR)-related retinal detachment (RD) repair. Prospective, nonrandomized, historical-control pilot study. setting: Tertiary care center. Nondiabetic eyes undergoing pars plana vitrectomy (PPV) and silicone oil tamponade with or without scleral buckling procedure (SBP) for recurrent RD due to PVR. Intrasilicone oil injection of 1.25 mg bevacizumab was performed intraoperatively and at postoperative months 1, 2, and 3. Retinal reattachment rate, final VA, and rate of epiretinal membrane (ERM) formation at month 6. Twenty eyes of 20 patients were enrolled and compared to a historical control group composed of 35 age- and sex-matched controls. In the study group, logMAR VA improved from mean 1.78 ± 0.43 (Snellen 20/1205) to 1.43 ± 0.70 (Snellen 20/538, P = .04), retinal reattachment was achieved in 14 of 20 eyes (70%), and ERM formation was observed in 7 of 20 eyes (35%) at 6 months. In the control group, logMAR VA improved from mean 1.50 ± 0.74 (Snellen 20/632) to 1.43 ± 0.58 (Snellen 20/538, P = .64), retinal reattachment was achieved in 25 of 35 eyes (71%), and ERM formation was observed in 7 of 35 eyes (20%) at 6 months. No significant difference in final VA (P = .96), retinal reattachment rate (P = .75), or ERM formation (P = .33) was observed between groups. No intrasilicone oil injection-related adverse events occurred. Serial intrasilicone oil injections of bevacizumab did not improve retinal reattachment rate, improve final VA, or reduce ERM formation in patients undergoing PVR-related RD surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Anatomic and functional outcomes of retinectomy for the management of complicated retinal detachment with proliferative vitreoretinopathy

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    Tranos P

    2015-10-01

    Full Text Available Paraschos Tranos,1 Athanasios Vakalis,1 Solon Asteriadis,1 Evaggelos Lokovitis,1 Ilias Georgalas,2 Panagiotis Stavrakas3 1Ophthalmica Eye Institute, Thessaloniki, Greece; 2First Department of Ophthalmology, 3Second Department of Ophthalmology, University of Athens Medical School, Athens, Greece Abstract: The aim of this study is to report the anatomic and functional outcomes of retinectomy for the management of rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy (PVR, comparing them with previously reported data and determining prognostic factors. Fifty-one eyes of 51 patients with established PVR grade C in which retinectomy was performed were retrospectively enrolled in the study. Primary outcome measures were anatomic success rate and final visual acuity. Secondary outcome measures were intraoperative complications, number of re-operations, and postoperative hypotony. Prognostic factors in relation to retinal re-attachment and final visual acuity were retrospectively analyzed. The rate of complete retinal re-attachment after one operation was 80% and after two operations it was 84%. At the end of the follow-up, the macula was attached in 96% of the cases. Mean LogMAR best-corrected visual acuity (BCVA improved significantly from 2.45±0.66 preoperatively to 1.37±0.75 at the end of the follow-up (P<0.001. BCVA improved in 37 eyes (72%, remained the same in eleven eyes (22% and worsened in three eyes (6%. Postoperative hypotony was observed in 2% of cases. Postoperative BCVA was significantly correlated with preoperative BCVA (P<0.001, extension of PVR (P=0.013, preoperative use of gas instead of silicone oil (SO (P=0.01, and removal of SO (P=0.05. SO was left in situ in 35% of eyes. In conclusion, retinectomy is a surgical option providing good anatomical and reasonable visual outcomes in complicated retinal detachment with PVR. Better preoperative visual acuity, lesser extension of PVR, and the use of gas

  6. Postoperative Perfluro-N-Octane tamponade for complex retinal detachment surgery.

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    Reza, Ali T

    2014-08-01

    To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without sclera buckling for complex rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs) or retinal detachment with extensive proliferative vitreoretinopathy (PVR). A prospective study was carried out where in 43 patients (Group 1) PFO was exchanged with silicon oil in the same surgical procedure and in 22 patients (Group 2) PFO was kept for 3 days and then exchanged with silicon oil by a separate surgical procedure. The respective surgeon took the decision whether to exchange PFO on the same day or after 3 days. The patients were followed up for 6 months to analyze the anatomical attachment rates, visual acuity gain, and postoperative complications in both the groups. There were 33 male and 10 female patients in group 1 and 18 male and 4 female patients in group 2. Mean age distribution in group 1 was 38.88 years (SD ± 21.45) and in group 2 was 38.09 years (SD ± 16.36). Mean preoperative best corrected visual acuity in group 1 was 2.02 ± 0.58 and in group 2 was 2.01 ± 0.53 logarithm of the minimum angle of resolution (LogMAR). The LogMAR Visual acuity in group 1 improved to 1.76 ± 0.43 after 1 month (P = 0.01, paired t test) and to 1.62 ± 0.62 after 6 months (P = 0.01, paired T test). This visual acuity in group 2 improved to 1.85 ± 0.42 after 1 month (P = 0.24, paired T test) and 1.90 ± 0.72 after 6 months (P = 0.49, paired T test). There was no difference regarding visual improvement in between two groups after 1 month and 6 months of follow-up (P = 0.125, independent sample T test). The retina was detached in 6 patients (14%) in group 1 and in 7 patients (31%) in group 2 after 6 months of follow-up. There was no statistically significant difference in between two groups regarding final attachment of retina (P = 0.109, Fisher exact test). There was also no

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

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    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 

  8. Incidence of rhegmatogenous retinal detachment after bag-in-the-lens intraocular lens implantation.

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    Tassignon, Marie-José; Van den Heurck, Jonas J I; Boven, Kim B M; Van Looveren, Jan; Wouters, Kristien; Bali, Ernesto; Ní Dhubhghaill, Sorcha; Mathysen, Danny G P

    2015-11-01

    To determine the incidence of rhegmatogenous retinal detachment (RRD) and associated risk factors after phacoemulsification and bag-in-the-lens intraocular lens (IOL) implantation. Antwerp University Hospital, Department of Ophthalmology, Antwerp, Belgium. Prospective cohort study. All consecutive bag-in-the-lens IOL implantations performed between January 2001 and December 2007 were included, with the exception of combined procedures and IOL exchanges. The retinal detachment (RD) incidence was studied in the total cohort, in a subgroup of patients with 1 to 5 years of follow-up, and finally in the group remaining after exclusion of all risk factors except gender. RD after bag-in-the-lens IOL implantation in 1323 eyes with an average follow-up of 44.75 months (range 0 to 152 months) was found in 19 eyes (1.44%). The 1-year RD incidence was 0.49% (5 RD cases in 1024 eyes) (0.00% in patients without risk factors). The 2-year cumulative RD incidence was 0.84% (9 RD cases in 931 eyes; 0.15% without risk factors). Four clinically significant risk factors were confirmed: male gender, young age at time of surgery (intellectual property rights to the bag-in-the-lens intraocular lens (U.S. patent 6 027 531; EU patent 009406794; PCT/120268), which is licensed to Morcher GmbH, Stuttgart, Germany. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

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    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.

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

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    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.

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

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    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.

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

    Science.gov (United States)

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

    2016-04-01

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

  13. Choroidal Vasculopathy and Retinal Detachment in a Bald Eagle ( Haliaeetus leucocephalus ) With Lead Toxicosis.

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    Eid, Ramzi; Guzman, David Sanchez-Migallon; Keller, Krista A; Wiggans, K Tomo; Murphy, Christopher J; LaDouceur, Elise E B; Keel, M Kevin; Reilly, Christopher M

    2016-12-01

    A subadult male bald eagle ( Haliaeetus leucocephalus ) was presented for severe depression and weakness. Physical examination findings included depressed mentation, dehydration, sternal recumbency, poor body condition, and bilateral, whole-head, horizontal nystagmus. A heavy-metal panel was performed, and blood lead levels were 6.1 ppm. Treatment for lead poisoning was initiated, including subcutaneous fluids and parenteral calcium-disodium ethylenediaminetetraacetic acid, ceftiofur, and meloxicam. Ophthalmic examination findings included absent menace response, absent dazzle reflex, slow and incomplete direct pupillary light reflex, mild anterior uveitis, incipient cataracts, multifocal retinal tears, and retinal separation in both eyes. Because of poor prognosis for vision and release to the wild, the eagle was euthanatized. No lesions were observed on gross postmortem examination. Histologically, extensive myocardial necrosis and multisystemic arteriolar vasculopathy were identified. The eyes were examined after tissue processing, and the vasculopathy extended into the choriocapillaris and was associated with a secondary, bilateral, exudative, retinal detachment. This is the first report in avian species characterizing the histopathologic ocular lesions of lead poisoning.

  14. Efficacy of short-term postoperative perfluoro-n-octane tamponade for pediatric complex retinal detachment.

    Science.gov (United States)

    Imaizumi, Ayako; Kusaka, Shunji; Noguchi, Hiroe; Shimomura, Yoshikazu; Sawaguchi, Shoichi

    2014-02-01

    To evaluate the efficacy of perfluoro-n-octane as a postoperative short-term tamponade after vitrectomy in pediatric cases with complex retinal detachment (RD) and proliferative vitreoretinopathy (PVR). Prospective, noncomparative, interventional case series. The medical records of 10 eyes of 9 children (6 boys and 3 girls), whose age ranged from 3 months to 11 years, with a median of 7.5 months, were reviewed. The cause of the PVR was retinopathy of prematurity (7 eyes of 6 patients); familial exudative vitreoretinopathy; or tractional RD associated with congenital optic nerve anomalies,(1) and persistent fetal vasculature. Perfluoro-n-octane was injected into the eyes at the primary surgery in 2 eyes and at the repeat surgeries in 8 eyes. The perfluoro-n-octane was removed after 1 to 4 postoperative weeks. The patients were followed for 5 to 43 months. At the last examination, the retinas were reattached in 8 eyes (80%). In the other two eyes, a retinal attachment was not obtained. Postoperatively, the best-corrected visual acuity improved from hand motion to 0.1 in 1 eye and could not be measured in the other 9 patients because of their ages. No apparent adverse events related to the use of perfluoro-n-octane were noted. Although cautions should be exercised regarding potential mechanical retinal injuries by heavy liquids in the eye, short-term perfluoro-n-octane tamponade was effective in pediatric cases with severe PVR in which retinal reattachment is considered to be difficult with conventional gas or silicone oil tamponade. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2012-01-01

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

  16. Near-infrared and short-wavelength autofluorescence in resolved central serous chorioretinopathy: association with outer retinal layer abnormalities.

    Science.gov (United States)

    Kim, Sang-Kyoon; Kim, Seong-Woo; Oh, Jaeryung; Huh, Kuhl

    2013-07-01

    To evaluate the correlation between changes in fundus autofluorescence (AF) measured using 2 different sources (near-infrared fundus autofluorescence from melanin and short-wavelength fundus autofluorescence from lipofuscin) with changes in spectral-domain optical coherence tomography (SD OCT) and fluorescein angiography in resolved central serous chorioretinopathy (CSC). Retrospective, observational case study. A total of 91 eyes from 86 patients with a history of resolved CSC and abnormal AF imaging findings were included. In addition to AF, patients were assessed by means of SD OCT and fluorescein angiography. Outer retinal layer alterations in OCT images and abnormalities in fluorescein angiography were analyzed and correlated with the corresponding AF data. All eyes with abnormal near-infrared AF showed a hyperfluorescent angiography window defect in the corresponding area. There was a significant association between the OCT and short-wavelength AF findings. An abnormal short-wavelength AF signal was significantly associated with loss of the ellipsoid portion of the inner segments (EPIS, previously known as the junction between the inner and outer segments of the photoreceptors) on SD OCT (χ(2) test; P Near-infrared AF could not predict the status of EPIS without the short-wavelength AF image. Outer retinal layer changes in OCT images can be predicted by analyzing both short-wavelength AF and near-infrared AF images. Abnormal changes in the short-wavelength AF image were predictive of EPIS damage. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Outcomes of surgery for retinal detachment associated with proliferative vitreoretinopathy using perfluoro-n-octane: a multicenter study.

    Science.gov (United States)

    Scott, Ingrid U; Flynn, Harry W; Murray, Timothy G; Feuer, William J

    2003-09-01

    To report visual acuity and anatomical outcomes, as well as complications, of management of complex retinal detachment with proliferative vitreoretinopathy using pars plana vitrectomy and intraoperative perfluoro-n-octane (PFO), and to investigate clinical features associated with anatomical and visual acuity outcomes. Prospective, noncomparative, interventional multicenter study. The study included 555 patients (555 eyes) 15 months of age or older who underwent pars plana vitrectomy for complex retinal detachment associated with proliferative vitreoretinopathy with intraoperative PFO at 24 study sites between April 1994 and February 1996. Main outcome measures included visual acuity and rates of retinal reattachment, reoperation, retained PFO, corneal edema, elevated intraocular pressure ([IOP] > 25 mm Hg), hypotony (IOP < 5 mm Hg), and cataract. All outcome measures were assessed at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively and at the last examination. The study included 555 eyes of 555 patients followed up at a median of 5.6 months. Visual acuity of 20/200 or better was recorded in 51 (10%) patients preoperatively and 85 (24%) at 6 months postoperatively. Among the 465 eyes with both preoperative and final visual acuities available, postoperative visual acuity improved in 274 (60%) eyes, remained stable in 106 (23%), and worsened in 85 (18%) eyes. Six-month follow-up data were obtained for 356 (65%) eyes; the retina was attached in 279 (78%) eyes and retained PFO was noted in 20 (6%). Throughout follow-up, 238 of 555 (43%) eyes underwent reoperation for recurrent retinal detachment. At 6 months, corneal edema, elevated IOP, and hypotony were noted in 26 of 356 (7%), 6 of 356 (2%), and 48 of 356 (15%) eyes, respectively. Of the 114 phakic eyes without significant cataract preoperatively, 105 (92%) developed a significant cataract or underwent cataract surgery during study follow-up. Operative factors significantly (P <.05) associated with

  18. Autosomal dominant rhegmatogenous retinal detachment associated with an Arg453Ter mutation in the COL2A1 gene.

    NARCIS (Netherlands)

    Go, S.L.; Maugeri, A.; Mulder, J.J.S.; Driel, M.A. van; Cremers, F.P.M.; Hoyng, C.B.

    2003-01-01

    PURPOSE: To investigate the clinical features and molecular causes of autosomal dominant rhegmatogenous retinal detachment (RRD) in two large families. METHODS: Clinical examination and linkage analysis of both families using markers flanking the COL2A1 gene associated with Stickler syndrome type 1,

  19. 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.

  20. Improving the Outcome of Rhegmatogenous Retinal Detachment Repair by Adding Pieces to the Puzzle : Historical review and recent contributions

    NARCIS (Netherlands)

    M.A.H. Veckeneer (Marc)

    2015-01-01

    markdownabstractAbstract Thanks to the consecutive introduction of penetrating thermocautery, buckling surgery and pars plana vitrectomy, the anatomical success rate of rhegmatogenous retinal detachment (RRD) repair improved dramatically, from 1/1000 about a hundred years ago, to about 90% by

  1. Fundus Autofluorescence Patterns of Submacular Fluid Resolution Following Repair of Macula-Involving Rhegmatogenous Retinal Detachments.

    Science.gov (United States)

    Simonett, Joseph M; Grewal, Dilraj S; Fawzi, Amani A; Lyon, Alice T; Gill, Manjot K

    2016-11-01

    Submacular fluid (SMF) can persist for months to years following rhegmatogenous retinal detachment (RD) repair. The authors' objective was to describe fundus autofluorescence (FAF) and optical coherence tomography (OCT) findings associated with the absorption of persistent submacular fluid (SMF) following RD repair. Retrospective review of clinical data and FAF and OCT imaging from sequential postoperative visits in a cohort of patients with persistent SMF following RD repair. In 11 of 13 eyes with persistent SMF, patches of decreased FAF signal corresponded to SMF on OCT. In eight eyes, there was a hypo- to hyperautofluorescence transition at the time of SMF resolution. These areas of increased FAF signal correlated with inner segment/outer segment (IS/OS) junction loss on OCT. FAF imaging can be informative when following SMF after RD repair; a hypo- to hyper-FAF signal transition correlates with SMF resolution and photoreceptor loss. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1020-1029.]. Copyright 2016, SLACK Incorporated.

  2. Retained Intraocular Perfluoro-n-octane After Valved Cannula Pars Plana Vitrectomy for Retinal Detachment.

    Science.gov (United States)

    Oellers, Patrick; Schneider, Eric W; Fekrat, Sharon; Mahmoud, Tamer H; Mruthyunjaya, Prithvi; Hahn, Paul

    2015-04-01

    To investigate cases of retained intraocular perfluoro-n-octane (PFO) after pars plana vitrectomy (PPV) for retinal detachment (RD). Retrospective, noncomparative case series of six eyes with retained intraocular PFO after RD repair. Clinical data were supplemented with an experimental silicone eye model. A cluster of six cases of retained intraocular PFO after PPV for RD repair were noted shortly after transitioning to valved cannulas. PFO was noted in the anterior chamber (AC) and/or vitreous and removed with AC paracentesis, AC wash-out, and/or PPV. A silicone eye model demonstrated that PFO levels are maintained anterior to cannula insertion with valved cannulas only. The authors hypothesize that anterior PFO fill using valved cannulas can lead to sequestration within the AC, zonules, ciliary sulcus, ciliary teeth, and/or capsular bag. They suggest vigilance in not overfilling PFO, particularly when transitioning to use of valved cannulas, to minimize the risk of intraocular retention. Copyright 2015, SLACK Incorporated.

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

    Science.gov (United States)

    Borowicz, Dorota; Brzozowska, Agnieszka; Moneta-Wielgos, Joanna; Maciejewski, Ryszard; Jünemann, Anselm G.

    2017-01-01

    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. PMID:28163930

  4. 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.

  5. [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

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

    Science.gov (United States)

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

    2012-08-01

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

  7. Spectral domain optical coherence tomography and B-scan ultrasonography in the evaluation of retinal tears in acute, incomplete posterior vitreous detachment.

    Science.gov (United States)

    Abdolrahimzadeh, Solmaz; Piraino, Domenica Carmen; Scavella, Vittorio; Abdolrahimzadeh, Barmak; Cruciani, Filippo; Gharbiya, Magda; Recupero, Santi Maria

    2016-05-23

    The purpose of this study was to evaluate the extension and traction effects of posterior vitreous detachment (PVD) complicated with retinal tears using spectral domain optical coherence tomography (OCT) and B-scan ultrasonography. Complete ophthalmological examination, B-scan ultrasonography and spectral domain OCT were performed in patients with acute PVD and retinal tears. Vitreous detachment was classified as complete or incomplete, based on extent of posterior pole or peripheral vitreous detachment. Retinal tear location and persistent traction on the retinal flap was evaluated with B-scan ultrasonography and OCT. Categorical data were evaluated with Fisher's exact test. Statistical significance was considered as P vitreous detachment. The impact of complete or incomplete PVD can be of clinical value when evaluating patients with retinal tears.

  8. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  10. Silicone oil versus gas tamponade for giant retinal tear-associated fovea-sparing retinal detachment: a comparison of outcome.

    Science.gov (United States)

    Banerjee, P J; Chandra, A; Petrou, P; Charteris, D G

    2017-09-01

    PurposeSilicone oil is the most common choice of tamponade agent used when managing a giant retinal tear (GRT). Concern exists regarding its potential detrimental effect on vision. We herein report on visual and surgical outcomes of all patients treated at Moorfields Eye Hospital for a GRT over a five year period. We further analysed a subgroup of fovea-sparing retinal detachments (RD) treated by pars plana vitrectomy (PPV) with either silicone oil or gas tamponade.MethodsRetrospective comparative, non-randomised, cross-sectional review of patients with a new diagnosis of GRT from 1 September 2005 to 31 August 2010ResultsOne hundred twenty four eyes of 118 patients were identified with mean age of 45.5 years and median follow-up of 24 months. Subgroup analysis of fovea-sparing RDs (Silicone Oil n=49, Gas n=15) revealed visual loss (≥2 Snellen Lines of vision) in 49.0% (n=24) of patients managed with oil compared to 13.3% (n=2) of gas patients (P=0.019). In all, 73.3% (n=11) in the gas group achieved a final vision of 6/12 or better, compared to 36.7% (n=18) in the oil group (P=0.031). No difference was observed in eventual or primary anatomical success rate (100 vs 93.9%, and 66.7 vs 79.6%, gas vs oil, respectively, (P>0.1)). Postoperative complications were absent in 66.7% (n=10) of gas patients compared with 14.3% (n=7) of oil patients (P=0.002). Multiple variable linear regression determined tamponade choice as the only variable predictive of final visual acuity (P=0.046).ConclusionEyes with fovea-sparing GRT-related RDs managed with gas achieved a better visual outcome with fewer postoperative complications and no significant difference in anatomical success. A multicentre approach to investigate this further is advised.

  11. 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.

  12. Retinal detachment with a break at pars plicata associated with congenital malformation of the lens-zonule-ciliary body complex.

    Science.gov (United States)

    Tsai, Fang-Yi; Lau, Ling-Ing; Chen, Shih-Jen; Lee, Fenq-Lih

    2015-01-01

    Retinal detachment with a break at the pars plicata associated with congenital malformation of lens-zonule-ciliary body complex is rare; most reports are of young Japanese male patients with atopic dermatitis. The present case report is the first to describe the condition in a Chinese patient with no atopic dermatitis or trauma history. A 22-year-old male presented with blurred vision in the left eye for 4 months. Fundus examination revealed shallow lower temporal retinal detachment. Further examination with scleral indentation under maximal pupil dilatation identified a break at the far periphery beyond the ora serrata and pars plana. Gonioscopy revealed a pars plicata break at the nonpigmented ciliary epithelium associated with congenital ciliary process hypoplasia and subtle lens defect at the same meridian. The retina was successfully reattached after segmental scleral buckling, cryopexy, and laser photocoagulation.

  13. 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.

  14. [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.

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

    Science.gov (United States)

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

    2018-01-01

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

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

    DEFF Research Database (Denmark)

    Bjerrum, Søren Solborg

    2015-01-01

    ) 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......-operated fellow eyes up to 10 years after cataract surgery. The epidemiology of RD in the non-operated fellow eyes was different from the epidemiology of RD in the background population as young men had the highest risk of RD in the non-operated fellow eyes. This means that the absolute risk of PRD was highest...

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

    Science.gov (United States)

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

    2017-09-01

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

  18. 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.

  19. Perfluoro-N-octane (PFO) in the repair of complicated retinal detachments due to severe proliferative diabetic retinopathy.

    Science.gov (United States)

    Maturi, R K; Merrill, P T; Lomeo, M D; Diaz-Rohena, R; Khan, M; Lambert, H M

    1999-01-01

    To report our experience with perfluoro-N-octane (PFO) in the surgical management of complicated retinal detachments due to proliferative diabetic retinopathy. Retrospective review of 18 consecutive eyes of 18 patients with tractional or combined tractional and rhegmatogenous retinal detachments due to severe proliferative diabetic retinopathy managed by pars plana vitrectomy and the intraoperative use of PFO. Preoperative characteristics, intraoperative findings and procedures and postoperative results were recorded. The mean preoperative acuity was 2/200 (range, 20/25 to light perception). The mean final visual acuity was 4/200 (range, 20/20 to no light perception). With a mean follow-up of 6 months, there was an 89% anatomic reattachment rate at the last visit and visual acuity was stable or improved in 72% of eyes. In our experience, PFO is a helpful surgical adjunct in the anatomic reattachment of tractional or combined tractional and rhegmatogenous diabetic retinal detachments. Visual acuity was stabilized or improved in the majority of eyes.

  20. Near-infrared and short-wavelength autofluorescence imaging in central serous chorioretinopathy.

    Science.gov (United States)

    Ayata, A; Tatlipinar, S; Kar, T; Unal, M; Ersanli, D; Bilge, A H

    2009-01-01

    The aim of the study was to compare the results of short-wavelength (SW) and near-infrared (NIR) autofluorescence (AF) in acute central serous chorioretinopathy (CSC). Twenty-six eyes of the 26 patients diagnosed with CSC (mean age 37.4 years) were included in this retrospective study. AF images were evaluated and compared with angiographic and ophthalmoscopic findings. Fluorescein angiography and AF imaging were performed using a confocal scanning laser ophthalmoscope. Focally decreased AF at the leakage site was seen in most of the cases with acute CSC (20 of 26 eyes in SW-AF; 20 of 20 eyes in NIR-AF). Twenty-four of the 26 cases had decreased SW-AF corresponding to the area of the serous retinal detachment, while 19 of the available 20 cases had decreased NIR-AF corresponding to the area of the serous retinal detachment. Increased granular AF corresponding to the extent of the former retinal detachment was seen earlier with SW-AF imaging, but disappeared later in the course of disease with NIR-AF imaging. AF imaging in CSC demonstrates different patterns according to the course of the disease, reflecting RPE and outer retinal changes. Combining two different methods of AF imaging could predict recent or former CSC episodes and may be a non-invasive technique for monitoring CSC and performing differential diagnosis.

  1. Vitreous Hyper-Reflective Dots in Optical Coherence Tomography and Retinal Tear in Patients with Acute Posterior Vitreous Detachment.

    Science.gov (United States)

    Oh, Jong-Hyun; Oh, Jaeryung; Roh, Hyun Cheol

    2017-08-01

    To report the presence of hyper-reflective dots in the vitreous cavity using spectral-domain optical coherence tomography (SD-OCT) in patients with acute symptomatic posterior vitreous detachment (PVD) and investigate their association with the presence of retinal tear. The medical records of 77 patients with acute symptomatic PVD, who were examined between March 2013 and February 2015, were reviewed. The severity of vitreous hyper-reflective dots (VHDs) was graded using SD-OCT images, and the presence of retinal tear was assessed. Forty-one (53.2%) eyes had mild VHDs, 13 (16.9%) eyes had moderate VHDs, and 14 (18.2%) eyes had severe VHDs. Retinal tear was found in 21 (27.3%) eyes. The presence of severe VHDs was associated with an increased likelihood of retinal tear (positive likelihood ratio, 9.78; 95% confidence interval, 3.02-31.63). In 14 (66.7%) eyes with retinal tear, the mean number of VHDs significantly decreased from 23.2 ± 20.27 to 2.3 ± 2.66 at a mean follow-up interval of 2.8 ± 1.48 weeks (P = 0.002). The presence of severe VHDs is suggestive of retinal tear in patients with acute symptomatic PVD. However, this SD-OCT finding should be limited to the acute phase of PVD.

  2. Morphologic changes of the fovea and visual acuity associated with retinal detachment secondary to circumscribed choroidal hemangioma.

    Science.gov (United States)

    Furuta, Minoru; Sekiryu, Tetsuju; Kasai, Akihito; Oguchi, Yasuharu

    2013-07-01

    To clarify and review the early and late morphologic changes of the macula associating with visual loss in patients with subfoveal fluid secondary to extrafoveal circumscribed choroidal hemangiomas. Previously six non-treated eyes of six patients with subfoveal retinal detachment secondary to extrafoveal circumscribed choroidal hemangioma were included. Visual acuity (VA), duration of visual symptoms, color fundus photography, optical coherence tomography (OCT), fundus autofluorescence, and fluorescein angiography (FA) were evaluated. The mean patient age was 58 years (range, 25-78). The VA and duration of symptoms in each patient was 1.2 (3 days), 0.6 (1 week), 0.4 (3 months), 0.5 (6 months), 0.02 (12 months), and 0.01 (8 years), respectively. Three patients with symptoms for less than 3 months did not have retinal pigment epithelial (RPE) alterations, retinal edema, or thinning of the retinal structure in the fovea. A patient with symptoms for 3 months had subfoveal deposits underneath the detached neurosensory retina with foveal hyperautofluorescence. Two patients with symptoms exceeding 12 months had highly affected RPE and cystoid macular degeneration. The VA was affected in patients with longer visual symptoms, and there are some changes in the retina and RPE in the fovea by FA and OCT. Persistent subretinal fluid secondary to choroidal hemangiomas may result in pathologic changes in the neurosensory retina.

  3. Intraoperative B-scan ultrasonography and pars plana vitrectomy for severe open globe injury with hemorrhagic retinal and choroidal detachment.

    Science.gov (United States)

    Shiraki, Nobuhiko; Wakabayashi, Taku; Sato, Tatsuhiko; Sakaguchi, Hirokazu; Nishida, Kohji

    2017-11-01

    Our purpose was to report the initial clinical experience of intraoperative B-scan ultrasonography in combination with 25-gauge pars plana vitrectomy for severe open globe injury with hemorrhagic retinal and choroidal detachment. Six eyes of six consecutive patients with severe open globe injury underwent intraoperative B-scan ultrasonography and 25-gauge pars plana vitrectomy at Osaka University Hospital in Japan. The feasibility of intraoperative B-scan ultrasonography, best-corrected visual acuity (BCVA), retinal reattachment, and intraoperative and postoperative complications were evaluated. Five patients presented with a ruptured globe and one patient with double penetration. Preoperative best-corrected visual acuity was no light perception in four eyes and light perception in two eyes. All patients underwent intraoperative B-scan ultrasonography and 25-gauge pars plana vitrectomy within 12 h after open globe injury. Intraoperative B-scan ultrasonography was feasible in all cases and was useful for diagnosing choroidal hemorrhage (four eyes), massive subretinal hemorrhage (two eyes), and retinal detachment (five eyes). In addition, serial real-time B-scan imaging facilitated successful evacuation of the choroidal hemorrhage and massive subretinal hemorrhage by external drainage, resulting in opening of the vitreous space to allow subsequent pars plana vitrectomy without entry site-related complications. After surgery, all patients had successful retinal attachment, and there was no loss of light perception. Intraoperative B-scan ultrasonography is technically feasible and may potentially improve the safety and efficacy of severe open globe injury repair.

  4. [Retinal detachment after Excimer laser (myopic LASIK or PRK). A retrospective multicentric study: 15 cases].

    Science.gov (United States)

    Feki, J; Trigui, A; Chaabouni, M; Ben Salah, S; Bouacida, B; Chechia, N; Zayani, A; Nouira, F; Daghfous, F; Ayed, S; Kamoun, M

    2005-05-01

    Refractive surgery by LASIK or photorefractive keratectomy (PRK) generaly aims at a myopic population that has a high probability of developing rhegmatogenous retinal detachment (RD). The authors report a multicenter study with 15 cases of RD appearing after refractive surgery by Excimer laser and discuss the role played by the techniques used. Five centers fitted with nine Excimer laser devices took part in this study. Of 22,700 eyes undergoing refractive myopic surgery during the period 1994-2002, 15 eyes developed rhegmatogenous RD. The average age of the patients with RD was 37 years. The average myopia was 13.5 D. RD occurred a mean of 20 months after refractive laser. Fifteen eyes of 13 patients developed a rhegmatogenous RD, two of which were bilateral. Eight of these cases had LASIK surgery and six had photorefractive keratectomy; one of the latter patients was retreated with LASIK because of substantial regression after PRK. RD was total or subtotal in five eyes, partial superior with a temporal tear in six eyes, and nasal in three eyes. One case with inferior RD, two cases with giant retinal tear and one case with posterior tear were also repaired. Fourteen eyes were suitable for operation. The retina was reattached in 12 cases. Mean postoperative visual acuity was 7/10. The occurrence of rhegmatogenous RD in the myopic population is estimated at 2.2%. It is estimated at 0.1% in the emmetropic population. The Excimer laser, through its thermic effects, shock wave, traumatism undergone by the suction ring at the time of LASIK surgery, could increase this risk in myopic patients. A review of the literature cast doubt on the cause and effect hypothesis. Personal and multicenter studies (including ours) show that the frequency rate of rhegmatogenous RD after Excimer laser is equivalent and even lower than that estimated with an emmetropic population. The low percentage of RD after Excimer surgery found in the literature as well as in our study (surgery, the

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

    Directory of Open Access Journals (Sweden)

    Kai-Chun Cheng

    2016-05-01

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

  6. Vitreous and subretinal fluid concentrations of orally administered dabigatran in patients with rhegmatogenous retinal detachment.

    Science.gov (United States)

    Mulder, Verena C; Kluft, Cornelis; van Meurs, Jan C

    2016-11-01

    One of the factors that was shown to contribute to the development of proliferative vitreoretinopathy (PVR) is the coagulation factor thrombin. Therefore, a specific oral thrombin inhibitor such as dabigatran might be a possible therapeutic option. An oral drug has the advantage of patient-friendly prolonged administration in contrast to drugs that can only be applied during vitrectomy, on condition that the drug reaches the target site. We tested whether dabigatran reaches the vitreous and subretinal fluid (SRF) after a single oral dose of dabigatran. Twenty-eight patients with a retinal detachment received a single dose of 220 mg dabigatran etexilate 2-8 hr prior to surgery. During surgery, we took a blood sample and a vitreous or subretinal fluid sample. The concentration of dabigatran was measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The dabigatran concentration between 2 and 9 hr after administration was higher in SRF than in vitreous (max 8.5 and 3.8 ng/ml). Corresponding plasma concentrations ranged from 15 to 225 ng/ml. There was a significant relationship between SRF levels and plasma levels (rs  = 0.68, p = 0.014); the levels in vitreous fluid showed no such relationship (rs  = 0.20, p = 0.48). In addition, we measured the vitreous concentration of a non-study patient using 150 mg dabigatran twice daily. The concentration was approximately 10 times higher than after a single dosage (25.8 ng/ml). We demonstrate that oral intake of dabigatran, a candidate drug to modulate PVR, results in potentially relevant intraocular concentrations. We suggest that repeated dosing may lead to higher concentrations, but this should be further explored. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Cost-utility analysis of rhegmatogenous retinal detachment surgery in Shanghai, China.

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    Ma, Yingyan; Ying, Xiaohua; Zou, Haidong; Xu, Xiaocheng; Liu, Haiyun; Bai, Lin; Xu, Xun; Zhang, Xi

    2015-02-01

    To perform a short-term and a long-term cost-utility analysis of rhegmatogenous retinal detachment (RRD) surgery in Shanghai, China. A total of 117 patients who underwent RRD surgery at Shanghai First People's Hospital, Affiliated Shanghai Jiaotong University, and then underwent follow-up for at least 1 year, were included in the study. Costs associated with RRD surgery and time trade-off utility values before and after surgery were recorded. Short-term analysis was made for 1 year. Quality-adjusted life years (QALYs) gained by RRD surgery over the lifetime were calculated at a 3% discount rate in the long-term analysis. This study used the bootstrap method in statistical analysis and one-way sensitivity analyses to test robustness of the results. Compared with no treatment, the mean incremental costs of RRD surgery was 11,384 Chinese yuan (CN¥) (US$1751); the mean additional QALYs gained was 0.05 (95% confidence interval [CI] 0.04-0.06) for 1 year and 0.88 (95% CI 0.64-1.13) for life expectancy; the incremental cost effectiveness ratio (ICER) was CN¥224,921 (US$34,603)/QALY for the short-term, and CN¥13,794 (US$2122)/QALY for the long-term. In short-term analysis, the ICER was CN¥150,087 (US$23,090)/QALY for scleral buckling surgery, and CN¥507,727 (US$78,112)/QALY for vitreous surgery. In the long-term analysis, the ICER was CN¥6280 (US$966)/QALY for scleral buckling, and CN¥30,756 (US$4732)/QALY for vitreous surgery. For RRD patients, surgery increases QALYs. In a 1-year analysis, surgery is not a cost-effective treatment, however it is cost-effective over the lifetime.

  8. Change in refraction after lens-sparing vitrectomy for rhegmatogenous retinal detachment and epiretinal membrane.

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    Iwase, Takeshi; Yamamoto, Kentaro; Yanagida, Kosei; Kobayashi, Misato; Ra, Eimei; Murotani, Kenta; Terasaki, Hiroko

    2016-08-01

    The aim of this study was to compare changes in refraction following lens-sparing vitrectomy between patients with rhegmatogenous retinal detachment (RRD) and epiretinal membrane (ERM) and to investigate factors associated with the change in refraction.We reviewed medical records of 49 eyes of 49 patients with RRD (53.6 ± 7.8 years, mean ± standard deviation) and 24 eyes of 24 patients with ERM (50.9 ± 15.7 years) who underwent lens-sparing vitrectomy. Spherical equivalent refractive power was evaluated before and up to 18 months after surgery. The relationship between the change in refraction and several parameters was evaluated.A significant progressive myopic shift in refractive power was observed after vitrectomy in operated RRD and ERM eyes (P refraction values observed at ≥3 and ≥12 months following vitrectomy were significantly different as compared with those observed at baseline in the RRD group (P refraction between the RRD and ERM groups was significant (P = 0.030). The multiple linear regression analysis showed that only age was significantly correlated with the change in refraction in RRD (P = 0.018) and ERM (P refraction was significantly and positively correlated with age in RRD (r = -0.461, P = 0.001) and ERM (r = -0.687, P refraction owing to nuclear sclerosis was observed. Core vitrectomy itself would cause a myopic shift of refraction. The only risk factor associated with cataract progression following lens-sparing vitrectomy is age for both types of patients.

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

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    Ingrid Kreissig

    2008-12-01

    Full Text Available

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

  1. Senile macular degeneration and geographic atrophy of the retinal pigment epithelium.

    Science.gov (United States)

    Willerson, D.; Aaberg, T. M.

    1978-01-01

    The case is reported of a man who had oval areas of atrophy of the retinal pigment epithelium in paracentral areas which previously had heavy concentrations of drusen OU. This supports the suggestion by others that atrophy of the RPE in senile macular disease may in some cases occur in the absence of previous serous detachment of the RPE. Images PMID:687554

  2. Postoperative Vision-Related Quality of Life in Macula-Off Rhegmatogenous Retinal Detachment Patients and Its Relation to Visual Function

    NARCIS (Netherlands)

    van de Put, Mathijs A. J.; Hoeksema, Lisette; Wanders, Wouter; Nolte, Ilja M.; Hooymans, Johanna M. M.; Los, Leonoor I.

    2014-01-01

    Objective: To determine the vision-related quality of life (VR-QOL) after surgery for macula-off rhegmatogenous retinal detachment (RRD) in relation to visual acuity, contrast acuity, and color vision. Methods: In a prospective observational study, we included 55 patients with a macula-off RRD. Best

  3. Postoperative Metamorphopsia in Macula-Off Rhegmatogenous Retinal Detachment : Associations with Visual Function, Vision Related Quality of Life, and Optical Coherence Tomography Findings

    NARCIS (Netherlands)

    van de Put, Mathijs A. J.; Vehof, Jelle; Hooymans, Johanna. M. M.; Los, Leonoor I.

    2015-01-01

    Purpose To evaluate postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment (RRD) and its association with visual function, vision related quality of life, and optical coherence tomography (OCT) findings. Methods 45 patients with primary macula-off RRD were included. At 12

  4. RAPID MACULAR HOLE FORMATION, SPONTANEOUS CLOSURE, AND REOPENING AFTER PARS PLANA VITRECTOMY FOR MACULA-SPARING RETINAL DETACHMENT.

    Science.gov (United States)

    Sridhar, Jayanth; Townsend, Justin H; Rachitskaya, Aleksandra V

    2017-01-01

    To report a single case of macular hole (MH) opening, spontaneous closure, and reopening in the 3-month period after pars plana vitrectomy for rhegmatogenous retinal detachment (RRD). Case report. A 59-year-old man with a macula-sparing RRD underwent uncomplicated pars plana vitrectomy with gas tamponade. The patient developed a FTMH 2 months postoperatively. The hole was noted to spontaneously close 3 months postoperatively, but then reopened 4 months postoperatively and required repeat pars plana vitrectomy and inner limiting membrane peel for definitive closure. The rapidity with which the MH developed after pars plana vitrectomy for macula-sparing RRD and its dynamic behavior have not been previously reported. Full-thickness macular holes may rarely develop rapidly, spontaneous close, and reopen after pars plana vitrectomy for RRD, even in macula-sparing cases.

  5. A novel case of bilateral high myopia, cataract, and total retinal detachment associated with interstitial 11q deletion.

    Science.gov (United States)

    Sachdeva, Reecha; Sears, Jonathan E; Rychwalski, Paul J

    2010-06-01

    Jacobsen syndrome, also known as 11q deletion syndrome, is a rare condition characterized by multiple anomalies, including developmental delay, cardiac abnormalities, blood dyscrasias, distal limb abnormalities, craniofacial anomalies, and variable ophthalmic manifestations. The syndrome's phenotype is due to a terminal deletion and is usually severely debilitating, frequently associated with fatality. Interstitial deletions, not involving the terminal end, have been associated with a more variable and less severe phenotype. Herein, we describe a case of interstitial 11q deletion in a 16 year-old female with associated systemic and craniofacial abnormalities as well as a novel combination of ocular findings, specifically strabismus, high myopia, bilateral cataracts, and bilateral total retinal detachments. This case report highlights the necessity for a detailed ophthalmic examination of patients with both interstitial and terminal deletions of the long arm of chromosome 11.

  6. Perfluoro-n-octane as a temporary intraocular tamponade in a staged approach to manage complex retinal detachments.

    Science.gov (United States)

    Barthelmes, Daniel; Chandra, Jay

    2015-01-01

    To evaluate outcomes in patients with complex retinal detachments (RD) with proliferative vitreoretinopathy (PVR) requiring retinectomy using a staged approach utilizing perfluoro-n-octane (PFO) as a short-term postoperative intraocular tamponade. Retrospective analysis. Patients who underwent 23G pars plana vitrectomy for the management of complicated RD where PFO was used as a primary temporary intraocular tamponade. Only eyes with PVR in rhegmatogenous RD or eyes with penetrating injuries or globe ruptures (ocular trauma) and subsequent RD with PVR were included. Analysis of 17 eyes of 17 consecutive patients with a minimum follow-up of 12 months during a period of 5 years. The primary outcome measure was the reattachment rate after at least 12 months of follow-up after the PFO removal. Secondary outcome measures were changes in visual acuity, complications due to PFO use, and necessity for further surgeries. Eight eyes with prior penetrating injuries or globe rupture and nine eyes with rhegmatogenous pathology were included. All eyes had PFO as temporary tamponade for 14 days (median), which was replaced by silicon oil. Sixteen eyes (94%) had complete and one eye partial reattachment. No redetachments occurred. All eyes retained or improved visual acuity. On average, only 2.5 procedures, including silicon oil removal, were performed. Two eyes had long-term intraocular pressure of 5 mmHg and no eye had intraocular pressure of ≥21 mmHg. No long-term inflammation was observed. PFO seems to be beneficial in a staged approach to repair complex detachments when used as short-term tamponade. A median period of 14 days allowed for both sufficient retinal support plus a reduction in side effects seen in long-term endotamponades.

  7. Silicone Oil Reinjection without Macular Buckling for Treatment of Recurrent Myopic Macular Hole Retinal Detachment after Silicone Oil Removal

    Directory of Open Access Journals (Sweden)

    Hammouda Hamdy Ghoraba

    2014-01-01

    Full Text Available Purpose. To evaluate the efficacy of silicone oil (S.O reinjection without macular buckling for treatment of recurrent myopic macular hole retinal detachment (MHRD after silicone oil removal. Methods. A retrospective consecutive interventional study from medical reports on cases of myopic MHRD. Fifty-three eyes of 51 patients underwent silicone oil removal after successful repair of MHRD were reviewed. The main outcomes were the retinal status after silicone oil removal and management of recurrent cases. Results. The rate of recurrent RD (Re RD after silicone oil removal was 11.3% (6 out of 53 eyes. One case refused any other interference. In the remaining 5 eyes, 4 eyes (80% could be reattached by S.O re-injection and one eye (20% developed Re RD after S.O re-injection. Range of followup after management of recurrence was 5–53 months (mean 18.7 months. Conclusions. This case series concluded that the risk factors for recurrent RD after silicone oil removal from cases of myopic MHRD were high myopia, open flat MH, and large posterior staphyloma. Revision of vitrectomy and S.O re-injection can reattach most of recurrent cases.

  8. Efficacy of two different thiol-modified crosslinked hyaluronate formulations as vitreous replacement compared to silicone oil in a model of retinal detachment.

    Directory of Open Access Journals (Sweden)

    Sven Schnichels

    Full Text Available The efficacy of two novel artificial vitreous body substitutes (VBS consisting of highly biocompatible thiolated cross-linked hyaluronic acid (HA-based hydrogels in comparison to silicone oil in a model of retinal detachment was investigated. Pars plana vitrectomy (23G was performed in the right eye of 24 pigmented rabbits. Retinal detachment of two quadrants was induced by creating a small retinotomy near the vascular arcade and injecting balanced salt solution (BSS subretinally. The retina was reattached by injecting air, which was followed by increasing the infusion pressure, and the retinal tear was treated by endolaser photocoagulation. At the end of the procedure, the eye was filled either with 5000-cs silicone oil (after fluid air exchange or the respective hydrogel (with two different viscosities. Follow-up examination included slit lamp examination, funduscopy, intraocular pressure measurements (IOP, optical coherence tomography (OCT and electroretinogram (ERG measurements. After a maximum follow-up of four weeks both eyes were removed, examined macroscopically, photographed, and prepared for histology. Of the eight rabbits that received silicone oil, seven (87.5% developed a recurrent retinal detachment with pronounced proliferative vitreoretinopathy within the first two weeks after surgery. In contrast, in the hydrogel treated eyes, the retina stayed attached in the majority of the cases (73.3%. IOP and retinal morphology were normal as long as the retina remained re-attached. In conclusions, this model of retinal detachment, both thiolated crosslinked hyaluronate hydrogels showed superior efficacy when compared to silicone oil. These hydrogels have a promising potential as novel vitreous body substitutes.

  9. Efficacy of two different thiol-modified crosslinked hyaluronate formulations as vitreous replacement compared to silicone oil in a model of retinal detachment.

    Science.gov (United States)

    Schnichels, Sven; Schneider, Nele; Hohenadl, Christine; Hurst, José; Schatz, Andreas; Januschowski, Kai; Spitzer, Martin S

    2017-01-01

    The efficacy of two novel artificial vitreous body substitutes (VBS) consisting of highly biocompatible thiolated cross-linked hyaluronic acid (HA)-based hydrogels in comparison to silicone oil in a model of retinal detachment was investigated. Pars plana vitrectomy (23G) was performed in the right eye of 24 pigmented rabbits. Retinal detachment of two quadrants was induced by creating a small retinotomy near the vascular arcade and injecting balanced salt solution (BSS) subretinally. The retina was reattached by injecting air, which was followed by increasing the infusion pressure, and the retinal tear was treated by endolaser photocoagulation. At the end of the procedure, the eye was filled either with 5000-cs silicone oil (after fluid air exchange) or the respective hydrogel (with two different viscosities). Follow-up examination included slit lamp examination, funduscopy, intraocular pressure measurements (IOP), optical coherence tomography (OCT) and electroretinogram (ERG) measurements. After a maximum follow-up of four weeks both eyes were removed, examined macroscopically, photographed, and prepared for histology. Of the eight rabbits that received silicone oil, seven (87.5%) developed a recurrent retinal detachment with pronounced proliferative vitreoretinopathy within the first two weeks after surgery. In contrast, in the hydrogel treated eyes, the retina stayed attached in the majority of the cases (73.3%). IOP and retinal morphology were normal as long as the retina remained re-attached. In conclusions, this model of retinal detachment, both thiolated crosslinked hyaluronate hydrogels showed superior efficacy when compared to silicone oil. These hydrogels have a promising potential as novel vitreous body substitutes.

  10. 23-gauge vitrectomy assisted by combined endoscopy and a wide-angle viewing system for retinal detachment with severe penetrating corneal injury: a case report

    Directory of Open Access Journals (Sweden)

    Morishita S

    2011-12-01

    Full Text Available Seita Morishita, Mihori Kita, Shin Yoshitake, Miou Hirose, Hideyasu OhDepartment of Ophthalmology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, JapanBackground: We report a case of traumatic retinal detachment in an eye with severe corneal opacity that was successfully treated using 23 gauge (G transconjunctival vitrectomy assisted by endoscope and a wide-angle viewing system.Case presentation: A 22-year-old Japanese man was referred to our hospital with the suspicion of traumatic retinal detachment of the right eye, 1 month after an open globe eye injury due to fireworks. At the time of his first visit, his best-corrected visual acuity was hand motion in the right eye. A 23 G three port pars plana vitrectomy was conducted in combination with ophthalmic endoscope and a wide-angle viewing system. Endoscopy revealed a retinal detachment in the inferior quadrant with tiny retinal breaks. Primary reattachment of the retina was achieved by tamponade of SF6 gas. Five months after the vitrectomy, penetrating keratoplasty was performed and visual acuity recovered to 0.02. Optical coherent tomography revealed thinning of the retina, which might be the cause of the remaining poor vision.Conclusion: 23 G vitrectomy assisted by combined endoscopy and a wide-angle viewing system could be advantageous in managing visualization constraints due to penetrating trauma.Keywords: penetrating injury, vitrectomy, endoscope, wide angle viewing system, 23 gauge vitrectomy

  11. 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.

  12. 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.

  13. Abnormal regional spontaneous neural activity in visual pathway in retinal detachment patients: a resting-state functional MRI study

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    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

  14. 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.

  15. Treatment and Monitoring of Central Serous Chorioretinopathy in Pilots.

    Science.gov (United States)

    Shinojima, Ari; Mori, Ryusaburo; Fujita, Kyoko; Yuzawa, Mitsuko

    2016-12-01

    Central serous chorioretinopathy (CSC), which has the characteristics of a serous retinal detachment (SRD) in the macular area, affects mostly men in the 30- to 50-yr age range. Some patients have persistent SRD, which may cause retinal thinning and photoreceptor impairment. CSC symptoms are gradual vision loss and/or metamorphopsia. Some commercial airline pilots are concerned about CSC symptoms, which can disqualify them from flying for months and can also reoccur. Thus, careful monitoring and treatment of CSC are critical for pilots, especially those with chronic or recurrent CSC. The Federal Aviation Administration requires uncorrected distant visual acuity in the better eye to be 20/200 or better, with correction to 20/20 or better employing lenses of no greater power than ± 3.5 diopters spherical equivalent. Multimodal imaging modalities such as spectral domain optical coherence tomography (SD-OCT) allow early detection of CSC noninvasively. Moreover, half-dose verteporfin photodynamic therapy (PDT) can cure CSC in the early stage. Five male Japanese commercial airline pilots with CSC are presented. Four of these five pilots had been disqualified from flying for several months, but after receiving half-dose PDT, they were ultimately able to resume flying commercial aircraft. Half-dose PDT can rapidly reduce serous subretinal fluid in CSC eyes. Recurrent and/or chronic CSC is seen in clinical cases. Therefore, continuous observation by SD-OCT after half-dose PDT is essential, even if the patient's vision recovers. Early, i.e., before visual acuity decreases, treatment is highly recommended.Shinojima A, Mori R, Fujita K, Yuzawa M. Treatment and monitoring of central serous chorioretinopathy in pilots. Aerosp Med Hum Perform. 2016; 87(12):1041-1044.

  16. 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.

  17. Pars plana vitrectomy with medium-term postoperative perfluoro-N-octane for recurrent inferior retinal detachment complicated by advanced proliferative vitreoretinopathy.

    Science.gov (United States)

    Sigler, Eric J; Randolph, John C; Calzada, Jorge I; Charles, Steve

    2013-04-01

    To describe a series of patients with recurrent inferior retinal detachment complicated by proliferative vitreoretinopathy (PVR) treated with pars plana vitrectomy and postoperative perfluoro-n-octane (PFO). Consecutive patients with recurrent inferior retinal detachment and Grade C PVR were prospectively treated with 25-gauge pars plana vitrectomy and postoperative "medium-term" PFO for 2- to 3-week duration. All patients had subsequent PFO removal in a planned staged procedure. Forty-four eyes of 44 patients were included. Mean follow-up time was 30.71 ± 12.92 months. Successful reattachment was achieved in 86% of eyes (38/44). Reattachment rates were statistically equivalent between eyes with and without previous scleral buckle. Reasons for redetachment were recurrent inferior PVR (four of six) and new superior break without PVR (two of six). Additional complications observed were cataract progression requiring surgery (42%), persistent intraocular pressure elevation (36%), and transient inflammation (32%). Macula-off status (P = 0.02) and persistent intraocular pressure elevation (P = 0.02) were factors associated with worse visual outcome. Medium-term PFO was found to be an efficacious technique for operative management of recurrent inferior retinal detachments complicated by Grade C PVR. The method of primary repair (scleral buckle vs. pars plana vitrectomy) did not affect reattachment rates. Transient inflammation and intraocular pressure elevation are potential complications associated with this technique. Persistent intraocular pressure elevation was associated with worse visual outcome.

  18. Optimizing visualization in enhanced depth imaging OCT in healthy subjects and patients with retinal pigment epithelial detachment

    Directory of Open Access Journals (Sweden)

    Kampik A

    2012-11-01

    Full Text Available Lukas Reznicek, Efstathios Vounotrypidis, Florian Seidensticker, Karsten Kortuem, Anselm Kampik, Aljoscha S Neubauer, Armin WolfDepartment of Ophthalmology, Ludwig Maximilians University Muenchen, Munich, GermanyBackground: This study’s objective was to optimize the visualization of three different spectral-domain optical coherence tomography (SD-OCT display modalities and evaluate enhanced depth imaging (EDI by comparing the maximum depth of assessment in conventional versus inverted cross-sectional OCT images in healthy subjects and in patients with retinal pigment epithelial detachment (PED.Methods: Cross-sectional SD-OCT conventional and inverted images were obtained with the HRA2 (Heidelberg Retina Angiograph II, Heidelberg Engineering, Heidelberg, Germany. Horizontal as well as vertical sections in three different display modes were blinded for evaluation by three independent, experienced graders for maximal imaging depth of the deep ocular fundus layers.Results: The mean imaging depth as measured from the inner segment/outer segment (IS/OS to the outer choroid of all 14 healthy subjects was 197 ± 44 µm vs 263 ± 56 µm for conventional vs EDI scans: in black/white mode, it was significantly lower (P < 0.001 than in white/black mode (249 ± 42 µm vs 337 ± 71 µm and color/heat mode (254 ± 48 µm vs 354 ± 73 µm. The mean imaging depth of all 14 study eyes with PED was 240 ± 78 µm vs 345 ± 100 µm for conventional vs EDI scans in black/white mode, and was significantly lower (P < 0.001 than in white/black mode (393 ± 104 µm vs 464 ± 126 µm and in color/heat mode (373 ± 106 µm vs 453 ± 114 µm. In each display modality of healthy subjects and of patients with PED, EDI scans showed a significantly higher imaging depth than the corresponding conventional scans.Conclusion: White/black and color/heat modes allow increased imaging depth, compared to black/white mode using both conventional or EDI OCT scans in healthy subjects or

  19. 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

  20. Homocysteine levels in the vitreous of proliferative diabetic retinopathy and rhegmatogenous retinal detachment: its modulating role on lysyl oxidase.

    Science.gov (United States)

    Coral, Karunakaran; Angayarkanni, Narayanasamy; Gomathy, Narayanan; Bharathselvi, Muthuvel; Pukhraj, Rishi; Rupak, Roy

    2009-08-01

    Homocysteine (Hcys), a well-known inducer of vascular endothelial cell damage has been associated with extracellular matrix changes. Lysyl oxidase (LOX) is a copper-dependent amine oxidase that initiates the covalent cross-linking of collagen and elastin in the extracellular matrix (ECM). LOX contributes to the structural integrity of the ECM, and low LOX activity could promote ECM disorganization. Hydroxyproline levels are used to predict collagen turnover status, and most of the endogenous hydroxyproline present in biological fluids is derived from the degradation of various forms of collagen. As Hcys is known to regulate ECM turnover and also inhibit LOX activity, the purpose of this study was to estimate the vitreous levels of Hcys in eyes with proliferative diabetic retinopathy (PDR) and rhegmatogenous retinal detachment (RRD) and to correlate the effect of Hcys, if any on LOX activity. Undiluted human vitreous specimens obtained during vitreoretinal surgeries for PDR (n = 18) and RRD (n = 17) were used. Vitreous specimens from donor eyeballs were used as control (n = 19). Hcys was estimated by HPLC using a fluorescent detector. Hydroxyproline was estimated spectrophotometrically. The total vitreous Hcys level was found to be increased significantly in PDR (P = 0.011) and in RRD (P = 0.001) compared with that in control samples. Hydroxyproline was significantly increased in PDR (P = 0.049) and RRD (P = 0.007) compared with the level in control samples. There was a significant negative correlation between the Hcys level and the specific activity of LOX in PDR (P = 0.040) and in RRD (P = 0.029) This report shows that increased vitreous Hcys in PDR and RRD is associated with a significant decrease in LOX-specific activity along with an increase in collagen turnover.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. Recurrent Central Serous Chorioretinopathy with Dexamethasone Eye Drop used Nasally for Rhinitis.

    Science.gov (United States)

    Prakash, Gunjan; Shephali, Jain; Tirupati, Nath; Ji, Pandey D

    2013-01-01

    Central serous chorioretinopathy (CSC) is characterized by serous retinal detachment at the posterior pole. Several factors have been implicated in the pathogenesis, and endogenous or exogenous corticosteroids are thought to play a major role. Here we present a case of a 35-year-old male with complaints of a dark circle in front of his right eye. Fundus examination, optical coherence tomography and fundus fluorescein angiography were performed. The patient was diagnosed with CSC. CSC resolved completely within seven weeks. Four weeks later the CSC recurred and spontaneously resolved over eight weeks. Overall, the patient had three additional recurrences of CSC in the same eye over the next year. A detailed history taking revealed the patient was using 0.1% dexamethasone eye drops nasally for recurrent rhinitis for few days prior to each episode of CSC. This indicates the strong correlation between steroids given by any route and the pathogenesis of CSC.

  6. Spironolactone, a therapeutic alternative in the treatment of diffuse retinal pigment epitheliopathy.

    Science.gov (United States)

    Ángel-Pereira, D; Rocha-Cabrera, P; Cordovés-Dorta, L; Losada Castillo, M J; Blasco Alberto, A; Abreu Reyes, J A

    2016-12-01

    Two cases are presented of patients with chronic diffuse epitheliopathy (CDE) that showed a favourable response when treated with spironolactone. The first patient had regions of neurosensory detachment (DNS) and the second, multiple DNS, secondary intra-retinal cysts and retinal pigment epithelium detachment. After treatment with spironolactone, both patients showed a visual acuity improvement and structural changes (reduced neurosensory retinal detachment and cystoid degeneration). Aldosterone receptor agonists (ARA) used for persistent forms of chronic central serous chorioretinopathy show encouraging results and could represent a therapeutic alternative for CDE. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. A Novel Episcleral Macular Buckling: Wire-Strengthened Sponge Exoplant for Recurrent Macular Hole and Retinal Detachment in High Myopic Eyes

    OpenAIRE

    Mortada, Hassan A.

    2013-01-01

    The purpose would be to describe and evaluate a novel technique of episcleral macular buckling in postvitrectomy recurrent macular hole retinal detachment in highly myopic eyes. A 7mm silicone sponge strengthened with a U-shaped 0.5mm orthodontics stainless steel wire fed along its length and hand-bent to produce L-shaped buckle of appropriate shape and length, is used. The episcleral macular buckling has performed on 15 highly myopic eyes (axial length > 30mm) with recurrent macular hole ret...

  8. Retinal Detachment Vision Simulator

    Science.gov (United States)

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  9. Retinal detachment repair

    Science.gov (United States)

    ... EA, eds. Duane's Ophthalmology . 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3, chap 27. Wolfe ... EA, eds. Duane's Ophthalmology . 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 6, chap 59. Yanoff ...

  10. Clinical study of retinal changes in pregnancy induced hypertension

    Directory of Open Access Journals (Sweden)

    Sahana Raviraj Manipur

    2017-06-01

    Full Text Available AIM: To determine the prevalence of retinal changes in pregnancy induced hypertension(PIHpatients and to correlate between retinal changes and the severity of disease.METHODS: A cross-sectional observation study was conducted in 100 PIH patients over a period of 6mo(Dec 2014-May 2015. Fundus examination was done in all patients. Fundus changes in right or left or both eyes, was taken as positive. The PIH graded as mild pre-eclampsia(BP >140/90 to 160/90 mmHg, severe pre-eclampsia(BP>160/90 mmHgand eclampsia(severe pre-eclampsia and convulsions.RESULTS:Mean age was 23.05y(19-34y. Gestation period ranged from 28 to 41wk. Sixty-two were primi gravida and 38 were multigravida. 62%, 26%, 12% of patients had mild, severe pre-eclampsia, eclampsia respectively. Retinal changes were identified in 8 patients. Grade Ⅰ, Grade Ⅱ, Grade Ⅲ, Grade Ⅳ hypertensive retinopathy(HTR, serous retinal detachment(SRDand central serous chorioretinopathy(CSCRobserved in 1%, 0%, 2%, 2%, 1% and 2% of patients respectively. There was a statistically significant positive association of retinal changes and severity of the PIH(P=0.0001. CONCLUSION:Retinal changes were seen in 8% of patients with PIH and there is a positive correlation between retinal changes and severity of PIH.

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

    Science.gov (United States)

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

    2016-03-01

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

  12. Presumed Idiopathic Central Serous Chorioretinopathy in a 12-Year-Old Girl

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    Juan P. Velazquez-Martin

    2012-01-01

    Full Text Available Idiopathic central serous chorioretinopathy (CSC typically affects middle-aged males. To date, only one case of idiopathic CSC in a prepubertal subject has been reported. Atypical idiopathic CSC presentation may be challenging to diagnose. Exclusion of secondary causes of serous retinal detachment (SRD is warranted. We describe the atypical case of a 12-year-old female with a circumscribed SRD that resolved spontaneously and with fluorescein angiography (FA findings that were compatible with idiopathic CSC. Optical coherence tomography (OCT and systemic assessment were performed to exclude other etiologies. FA demonstrated multiple focal leaks in early phases, with subretinal leakage and pooling in late phases. OCT showed a localized circumscribed retinal detachment. Complete blood count was within normal limits. Serum cortisol was normal (22.1 µg/dl and mean arterial blood pressure was 100/60 mm Hg, thereby excluding secondary causes of CSC. This is the second reported case of idiopathic CSC in a prepubertal female and the first one documented by FA and OCT, as well as other studies to exclude secondary causes. Albeit rare, idiopathic CSC should be considered in the differential diagnosis of SRD in this (prepubertal age group, after excluding secondary ocular or systemic etiologies.

  13. Fundus Autofluorescence and Spectral Domain OCT in Central Serous Chorioretinopathy

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    Luiz Roisman

    2011-01-01

    Full Text Available Background. To describe the standard autofluorescence (FAF, the near infrared autofluorescence (NIA and optical coherence tomography (OCT patterns in central serous chorioretinopathy, correlating them with fluorescein angiography. Methods. Cross-sectional observational study, in which patients with at least seven months of CSC underwent ophthalmologic examination, fundus photography, FAF, NIA, fluorescein angiography (FA, and spectral-domain OCT. Results. Seventeen eyes of thirteen patients were included. The presentation features were a mottled hyperFAF in the detached area and areas with pigment mottling. NIA images showed areas of hyperNIA similar to FAF and localized areas of hypoNIA, which correlated with the points of leakage in the FA. OCT showed pigment epithelium detachment at the location of these hypoNIA spots. Discussion. FAF showed increased presence of fluorophores in the area of retinal detachment, which is believed to appear secondary to lipofuscin accumulation in the RPE or the presence of debris in the subretinal fluid. NIA has been related to the choroidal melanin content and there were areas of both increased and decreased NIA, which could be explained by damage ahead the retina, basically RPE and choroid. These findings, along with the PEDs found in the areas of hypoNIA, support the notion of a primary choroidal disease in CSC.

  14. Focal choroidal excavation in patients with central serous chorioretinopathy

    Science.gov (United States)

    Luk, F O J; Fok, A C T; Lee, A; Liu, A T W; Lai, T Y Y

    2015-01-01

    Purpose To evaluate the prevalence and clinical features of focal choroidal excavation (FCE) in patients presenting with central serous chorioretinopathy (CSC). Methods This is a retrospective consecutive case series of consecutive patients with CSC who were referred for spectral domain optical coherence tomography (SD-OCT) between January 2010 and December 2011. Medical records were reviewed and clinical features including presence of FCE in SD-OCT, fluorescence angiography (FA), and indocyanine green angiography (ICGA) were studied. Results Among the 116 CSC patients assessed, FCE was found in 11 eyes of 7 (6.0%) patients. FCE was associated with subretinal fluid in six eyes of six patients and serous pigment epithelial detachment in three eyes of two patients. The mean central subfield retinal thickness of CSC eyes with FCE was 283.7 μm, compared with 377.5 μm for CSC eyes without FCE (Mann–Whitney U-test, P=0.020). Five FCE eyes of five patients had focal leakage on FA. Choroidal hyperpermeability on ICGA was found in seven CSC eyes with FCE, with four eyes showing hypofluorescent spot corresponding to the FCE. After a mean follow-up of 16 months, visual acuity of all 11 eyes with FCE remained stable or improved at the last follow-up. Conclusion FCE is not an uncommon feature in patients with CSC and might be associated with choroidal hemodynamic disturbances. PMID:25853402

  15. Postoperative vision-related quality of life in macula-off rhegmatogenous retinal detachment patients and its relation to visual function.

    Science.gov (United States)

    van de Put, Mathijs A J; Hoeksema, Lisette; Wanders, Wouter; Nolte, Ilja M; Hooymans, Johanna M M; Los, Leonoor I

    2014-01-01

    To determine the vision-related quality of life (VR-QOL) after surgery for macula-off rhegmatogenous retinal detachment (RRD) in relation to visual acuity, contrast acuity, and color vision. In a prospective observational study, we included 55 patients with a macula-off RRD. Best corrected visual acuity (BCVA), color vision (saturated and desaturated color confusion indices (CCI)) and contrast acuity were measured at 12 months postoperatively in both the RRD eye and the fellow control eye, and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was filled out. Operated and fellow control eyes differed significantly in mean LogMAR BCVA (Pacuity (Pacuity (R = 0.472, Pacuity and to a lesser extent to color vision disturbances.

  16. 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...... that was mainly explained by an increase of cataract surgeries. Four hundred and seventy-one of 7,941 patients with primary RRD on one eye and no other previous eye disease developed an additional RRD in the fellow eye with an overall incidence of 1% per year. Cox analysis revealed male gender, surgery...... on the lens, and young age as significant risk factors (P eye have a 100 times greater risk of developing RRD on the second eye, and the risk increases with male gender and surgery on the lens but decreases with age....

  17. Retinoschisis and neurosensory detachment in advanced focal glaucoma.

    Science.gov (United States)

    Arranz-Márquez, E; Jarrín Hernández, E; Pastor, A; García Gil de Bernabé, J

    2017-10-01

    A 71-year-old woman with normotensive primary open-angle glaucoma presented with an asymptomatic temporal peripapillary retinoschisis, associated with serous retinal detachment in the eye with the more advanced glaucoma. It was located at the inferior pole of the optic disc, in the proximity of a glaucomatous focal disc defect. Although congenital optic pits are strongly related with juxta-papillary retinoschisis, retinoschisis can also arise from acquired defects in the proximity of glaucomatous optic discs. As symptoms depend on the extent of the retinoschisis, the prevalence of this complication could be greater than that reported in glaucomatous eyes. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Reactivation of the PI3K/Akt Signaling Pathway by the Bisperoxovanadium Compound bpV(pic) Attenuates Photoreceptor Apoptosis in Experimental Retinal Detachment.

    Science.gov (United States)

    Mao, Dan; Sun, Xiaodong

    2015-08-01

    Phosphatase and tensin homology deleted on chromosome 10 (PTEN) is crucial in neuronal apoptosis. This study evaluated the role of PTEN in photoreceptor cell apoptosis caused by retinal detachment (RD). A rat model of RD was established, and PTEN expression changes were detected at different time points by Western blotting and immunofluorescence. Some of the rats were given subretinal injections of bisperoxovanadium compound (bpV[pic]) after RD. We documented the expression and distribution of phospho-Akt (p-Akt) and B-cell lymphoma 2 (Bcl-2) in the retina by Western blot analysis and immunofluorescence. Levels of phosph-phosphoinositide-dependent kinase 1 (p-PDK1), phospho-Bcl-2 death promotor (p-BAD), cytosolic cytochrome c (Cyt c), and cleaved Caspase-3 were detected by Western blotting. We measured phosphatidylinositol 3,4,5-triphosphate (PIP3) by ELISA. Apoptosis of photoreceptors was detected using the TUNEL assay. The thickness of the outer nuclear layer (ONL) also was recorded. The expression of PTEN gradually increased after RD, peaking at 3 days and then decreasing to normal by 7 days after RD. Subretinal injection of bpV(pic) effectively reduced the apoptosis of photoreceptors and preserved the retinal thickness of the ONL after RD. Compared to vehicle-treated RD groups, levels of p-Akt and p-PDK1 were significantly upregulated in bpV-treated RD groups. In addition, bpV treatment increased the levels of p-BAD and Bcl-2, and decreased the expression levels of cytosolic Cyt c and cleaved caspase-3 after RD. Phosphatase and tensin homology deleted on chromosome 10 (PTEN) participates in the apoptosis of photoreceptors after RD. Blocking PTEN may reactivate the PI3K/Akt pathway and attenuate photoreceptor apoptosis by suppressing the mitochondrial pathway.

  19. Case report: Aqueous and Vitreous amino-acid concentrations in a patient with maple syrup urine disease operated on rhegmatogenous retinal detachment.

    Science.gov (United States)

    Kanakis, Menelaos G; Michelakakis, Helen; Petrou, Petros; Koutsandrea, Chrysanthi; Georgalas, Ilias

    2016-10-03

    Maple syrup urine disease (MSUD) is a rare metabolic disorder, affecting the metabolism of branched chain amino-acids (Valine, Leukine, Isoleukine). We present a rare case of rhegmatogenous retinal detachment (RRD) in a MSUD patient. We performed amino acid analysis of aqueous humour, vitreous and serum samples obtained during surgery from a 24 year old female MSUD patient successfully operated on RRD. Serum values for a-amino-butyric acid, valine, isoleucine, leucine, tyrosine, phenylalanine, ornithine and histidine were low, while values for citrulline, methionine and lysine were borderline low, all attributed to the patient's special diet. Serum glutamate was above normal, probably due to the breakdown of glutamine to glutamate. In the aqueous and vitreous the amino acids implicated in MSUD (Valine, Leukine Isoleukine), were within normal range. Glutamate was absent in the vitreous and presented low levels in the aqueous. Glutamate has been reported to play an important role in retinal damage. Elevated glutamate levels have been reported in vitreous specimens from patients subjected to vitrectomy or buckling surgery for RRD. In MSUD, glutamate has been implicated in the pathogenesis of brain damage. Low levels of glutamate have been observed in the cerebellum of experimental MSUD animals, as well as postmortem brain tissue from a child that died of leucine intoxication. The reduction was attributed to the elevation of a-ketoisocaproic which reverses the net direction of nitrogen flow. It could be argued that this could impact on amino acid concentration in aqueous and vitreous fluids. Although no definite conclusions can be drawn by this extremely rare case, the low vitreous and aqueous levels of Glutamate is an interesting finding. Further studies are needed to provide a better insight in the role of amino acids as neurotransmitters in the human eye in health and disease.

  20. F6H8 as an Intraoperative Tool and F6H8/Silicone Oil as a Postoperative Tamponade in Inferior Retinal Detachment with Inferior PVR

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    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.

  1. Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis

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    Shi H

    2015-03-01

    Full Text Available Hui Shi,1,2* Tao Guo,3* Peng-Cheng Liu,1 Qian-Yi Wang,1 Ya-Ru Du,1,2 Qing-Yu Liu,1 Meng-Mei He,1 Jun-Ling Liu,1 Jing Yu1 1Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 2Department of First Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, 3Department of Ophthalmology, Shanghai Third People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: This meta-analysis was performed to determine the effectiveness of steroids as an adjunct following rhegmatogenous retinal detachment (RRD surgery. Methods: RRD patients with or without proliferative vitreoretinopathy (PVR were included. The treatment group included patients in whom steroids were used as an adjunct and a control group in which placebo was used. Only randomized controlled trials were included. We searched the main electronic databases and included studies published until July 2014. PVR odds ratio, visual acuity, retinal reattachment rate, and complications were evaluated in three trials. Results: Three randomized controlled trials were included in the meta-analysis. There was no significant difference in the incidence of postoperative PVR between groups (heterogeneity I2=48%, P=0.14. However, the incidence of postoperative PVR was lower in the treatment group (I2=0%, P<0.0001 than in the control group when a PVR grade C study was excluded. There was no statistically significant difference in postoperative visual acuity between the treatment and control groups (odds ratio -0.18; 95% confidence interval -0.38, 0.02; P=0.08. The two groups had similar results for primary/final retinal reattachment and reoperation rate. There was no significant difference in postoperative intraocular pressure. Conclusion: This systematic review demonstrates that steroids may significantly reduce the incidence of

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

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    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.

  3. 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

  4. Postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment: associations with visual function, vision related quality of life, and optical coherence tomography findings.

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    Mathijs A J van de Put

    Full Text Available To evaluate postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment (RRD and its association with visual function, vision related quality of life, and optical coherence tomography (OCT findings.45 patients with primary macula-off RRD were included. At 12 months postoperatively, data on metamorphopsia using sine amsler charts (SAC, best corrected visual acuity (BCVA, letter contrast sensitivity, color vision (saturated and desaturated color confusion indexes, critical print size, reading acuity, the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25, and OCT, were obtained.Metamorphopsia was present in 39 patients (88.6%, with most of them (n = 35, 77.8% showing only mild metamorphopsia (SAC score = 1. Patients with metamorphopsia had significantly worse postoperative BCVA (p = 0.02, critical print size (p<0.0005, and reading acuity (p = 0.001 compared to patients without metamorphopsia. Other visual function outcomes and NEI-VFQ-25 overall composite score were all also somewhat lower in patients with metamorphopsia, but this did not reach statistical significance. No association with OCT findings was present.The prevalence of postoperative metamorphopsia in macula-off RRD patients is high, however, the degree of metamorphopsia is relatively low. When metamorphopsia is present, visual functions seem to be compromised, while vision related quality of life is only mildly affected.

  5. ASSOCIATION STUDY BETWEEN POLYMORPHISMS OF THE p53 AND LYMPHOTOXIN ALPHA (LTA) GENES AND THE RISK OF PROLIFERATIVE VITREORETINOPATHY/RETINAL DETACHMENT IN A MEXICAN POPULATION.

    Science.gov (United States)

    Quiroz-Casian, Natalia; Lozano-Giral, David; Miranda-Duarte, Antonio; Garcia-Montalvo, Ivan; Rodriguez-Loaiza, Jose L; Zenteno, Juan C

    2017-01-18

    To report the results of an association study between single-nucleotide polymorphisms of the p53 and LTA genes and the risk of proliferative vitreoretinopathy (PVR)/retinal detachment (RD) in a Mexican cohort. A total of 380 unrelated subjects were studied, including 98 patients with primary rhegmatogenous RD without PVR, 82 patients with PVR after RD surgery, and 200 healthy, ethnically matched subjects. Genotyping of single-nucleotide polymorphisms rs1042522 (p53 gene) and rs2229094 (LTA gene) was performed by direct nucleotide sequencing. Allele frequencies, genotype frequencies, and Hardy-Weinberg equilibrium were assessed with HaploView software. No significant differences in the allelic distributions of the previously identified risk C allele for LTA rs2229094 were observed between RD subjects and controls (odds ratio [95% confidence interval] = 0.8 [0.5-1.2]; P = 0.3). Conversely, the C allele for rs1042522 in p53 was positively associated with an increased risk for RD (odds ratio [95% confidence interval] = 1.4 [1.01-1.9]; P = 0.04). No significant differences were observed when the subgroup of 82 RD + PVR subjects was compared with the subgroup of 98 patients with RD. The C allele for rs1042522 in p53 was genetically associated with a higher risk for RD but not for PVR in this cohort. This is the first association study attempting replication of PVR-associated risk alleles in a nonwhite population.

  6. Twenty-Three-Gauge Pars Plana Vitrectomy With Inferior Retinectomy and Postoperative Perfluoro-n-Octane Retention for Retinal Detachment Repair.

    Science.gov (United States)

    Rush, Ryan B; Simunovic, Matthew P; Hunyor, Alex P

    2013-01-01

    The objective of this article was to study outcomes following use of perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in patients undergoing pars plana vitrectomy for a recurrent rhegmatogenous retinal detachment (RRD) with advanced proliferative vitreoretinopathy requiring an inferior retinectomy. A retrospective consecutive chart review. The charts of subjects who underwent RRD repair by pars plana vitrectomy with short-term postoperative PFO, vitreous substitution were retrospectively reviewed. The primary outcome was the anatomic success rate following retinectomy and short-term PFO retention. The secondary outcomes were change in best corrected visual acuity (BCVA) and occurrence of complications related to short-term PFO retention. The anatomic success rate at the final follow-up was 91.7% (11/12). A total of 7 (58.3%; confidence interval, 32%-80.7%) of 12 patients achieved a final BCVA better than initial BCVA. There were no significant complications related to short-term PFO retention. Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute for repair of a recurrent RRD with advanced proliferative vitreoretinopathy requiring an inferior retinectomy.

  7. Cushing disease revealed by bilateral atypical central serous chorioretinopathy: case report.

    Science.gov (United States)

    Giovansili, Iama; Belange, Georeges; Affortit, Aude

    2013-01-01

    We report the case of a patient with Cushing disease revealed by bilateral central serous chorioretinopathy (CSCR). We present the clinical history, physical findings, laboratory results, and imaging studies of a 53-year-old Chinese woman with a Cushing disease revealed by bilateral CSCR. The association with CSCR and the pertinent literature are reviewed. A 53-year-old patient initially presented to the Department of Ophthalmology with a 4-week history of decreased vision in the left eye. Standard ophthalmologic examination and fluorescein angiography established the diagnosis of bilateral CSCR. Systemic clinical signs and biochemical analysis indicated hypercortisolism. Magnetic resonance imaging (MRI) of the pituitary gland showed a left-side lesion compatible with a microadenoma. The diagnosis of Adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome secondary to a pituitary microadenoma was selected. Endoscopic endonasal transsphenoidal surgery was performed and the pituitary adenoma was successfully removed. The histology confirmed the presence of ACTH-immunopositive pituitary adenoma. Early postoperative morning cortisol levels indicated early remission. At 6 weeks postoperatively, the patient's morning cortisol remains undetectable, and serous retinal detachments had regressed. CSCR is an uncommon manifestation of endogenous Cushing syndrome. It can be the first presentation of hypercortisolism caused by Cushing disease. CSCR should be considered when assessing patients with Cushing syndrome complaining of visual disorders. On the other hand, it is useful in patients with an atypical form of CSCR to exclude Cushing's syndrome.

  8. Tratamento do hemangioma de coróide e descolamento total da retina com vitrectomia posterior: relato de caso Choroidal hemangioma with extensive retinal detachment treated with posterior vitrectomy: case report

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    Luciana Duarte Rodrigues

    2007-06-01

    Full Text Available Apresentar a evolução de um caso de hemangioma circunscrito da coróide associado a descolamento total da retina tratado com vitrectomia posterior e endofotocoagulação. Relato de caso intervencional. Paciente do sexo feminino, com 41 anos, apresentava mancha escura na visão do olho direito há uma semana, com progressão da mancha para o campo inferior e diminuição súbita da acuidade visual há dois dias. Ao exame oftalmológico, apresentava acuidade visual menor que 20/400 no olho direito. À fundoscopia do olho direito, observava-se elevação da retina neurossensorial nos quatro quadrantes e uma lesão sub-retiniana avermelhada no pólo posterior, com bordas pouco nítidas. O ultra-som do olho direito mostrava membranas móveis de alta refletividade na cavidade vítrea (retina aderidas ao nervo óptico e presença de lesão sólida hiperecogênica, homogênea, no pólo posterior, com picos de média refletividade no seu interior, sugestiva de hemangioma de coróide Todos os exames sistêmicos foram normais. Optou-se pela vitrectomia posterior com endodrenagem, retinopexia, endofotocoagulação do tumor e colocação de gás C3F8. A retina manteve-se aplicada nos quinze primeiros dias da cirurgia, quando então apresentou novo descolamento inferior da retina sobre o tumor. Optou-se por nova vitrectomia posterior com endofotocoagulação e colocação de óleo de silicone. A paciente encontra-se no 6º mês de pós-operatório com a retina aplicada, óleo de silicone na cavidade vítrea, hemangioma com marcas de fotocoagulação (inativo?, acuidade visual igual a 20/400 no olho direito. A vitrectomia posterior surge como opção no tratamento do hemangioma da coróide associado a descolamentos extensos da retina, visando restabelecer a anatomia e diminuir as complicações funcionais tardias na retina.To describe a case of circumscribed choroidal hemangioma with extensive retinal detachment treated with vitrectomy and endolaser

  9. Scleral buckle is good option for treatment of uncomplicated retinal detachment Introflexão escleral é boa opção para tratamento de descolamento de retina não complicado

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    Iuuki Takasaka

    2012-12-01

    Full Text Available OBJETIVE: To describe the reattachment rate and visual acuity results of patients with uncomplicated rhegmatogenous retinal detachment who underwent segmental scleral buckle surgery. METHODS: Prospective case series of 100 patients with visual loss or symptoms (floaters and photopsia of less than 30 days' duration scheduled for surgery. No patient had a retinal break greater than 30°, a retinal detachment larger than 2 quadrants or proliferative vitreoretinopathy. RESULTS: The 1-week, 1-month, and 6-month anatomical success rates were 93%, 100%, and 100%, respectively. Seven patients underwent one additional retinal detachment surgery (pars plan vitrectomy after primary failure at 1-week follow-up. The preoperative, 1-month, and 6-month best correct visual acuity were 20/100, 20/80, and 20/50, respectively. The postoperative complications were: eyelid edema in 10% of the patients, transient ocular hypertension in 5%, macular pucker in 3%, transient diplopia in 3%, and hyphema (OBJETIVO: Descrever a taxa de reaplicação e os resultados da acuidade visual dos pacientes com descolamento de retina regmatogênico simples que se submeteram à cirurgia de introflexão escleral segmentar. MÉTODOS: Uma série de casos prospectivo de 100 pacientes com perda visual ou sintomas (floaters e fotopsia, com duração inferior a 30 dias, agendados para a cirurgia. Nenhum paciente apresentou uma ruptura da retina superior a 30°, um descolamento de retina maior que 2 quadrantes ou vitreorretinopatia. RESULTADOS: As taxas de sucesso anatômico em 1 semana, 1 mês e 6 meses foram de 93%, 100% e 100%, respectivamente. Sete pacientes foram submetidos à cirurgia de descolamento de retina adicional (vitrectomia via pars plana após falha primária em uma semana de seguimento. A melhor acuidade visual pré-operatória, 1 mês, e de 6 meses pós-operatório foram 20/100, 20/80 e 20/50, respectivamente. As complicações pós-operatórias foram: edema palpebral em 10

  10. 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.

  11. Retinoschisis and macular detachment associated with acquired enlarged optic disc cup

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    Moreno-López M

    2012-03-01

    Full Text Available María Moreno-López, Julio José González-López, Elena Jarrín, Josefina BertrandOphthalmology Department, Hospital Universitario Ramón y Cajal, Madrid, SpainAbstract: We describe a case of maculopathy consisting of macular retinoschisis and serous macular detachment occurring in a patient with an acquired enlarged optic disc cup, similar to the maculopathy observed in congenital optic nerve abnormalities, mainly optic nerve pits and colobomas, without vitreomacular traction nor angiographic leak. Pars plana vitrectomy with argon laser endophotocoagulation and gas tamponade was found to be useful. Traction from membranes covering deep optic disc cups may create small retinal dehiscences, as described in congenital optic nerve abnormalities, which will enable the liquefied vitreous to pass, leading to retinoschisis with or without associated neurosensory detachment. Vitrectomy, photocoagulation, and gas tamponade may be a useful therapy for this entity.Keywords: glaucoma, macular detachment, macular surgery, optic disc, retinoschisis

  12. Near infrared autofluorescence imaging of retinal diseases.

    Science.gov (United States)

    Skondra, Dimitra; Papakostas, Thanos D; Hunter, Rebecca; Vavvas, Demetrios G

    2012-01-01

    Near infrared autofluorescence (excitation 787 nm, emission >800 nm) is a non-invasive imaging technology that provides information on the distribution of melanin within the retinal pigment epithelial cell/choroid complex. This review contains an introduction to near infrared autofluorescence imaging methods. Characteristics of near infrared imaging in a variety of retinal diseases, including age-related macular degeneration, choroidal nevus, retinal degenerations, retinal dystrophies, central serous chorioretinopathy, pseudoxanthoma elasticum and chloroquine retinopathy, are summarized.

  13. 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...... breaks. Additional retinal breaks were only revealed at follow-up in patients where a full retinal examination was compromised at presentation by, for example, vitreous haemorrhage. Asymptomatic and symptomatic retinal breaks progressed to rhegmatogenous retinal detachment (RRD) in 0-13.8% and 35...

  14. Acute central serous chorioretinopathy: a correlation study between fundus autofluorescence and spectral-domain OCT.

    Science.gov (United States)

    Iacono, Pierluigi; Battaglia, Parodi Maurizio; Papayannis, Alexandros; La Spina, Carlo; Varano, Monica; Bandello, Francesco

    2015-11-01

    To evaluate the correlation between fundus autofluorescence (FAF) and spectral-domain OCT (SD-OCT) morphological analysis in eyes with acute central serous chorioretinopathy (CSCR). Thirty-one patients with a first episode of CSCR and symptom duration of less than 6 weeks were prospectively enrolled. FAF and SD-OCT examination were performed at baseline and at 2-month intervals. Main outcome measure was the correlation between FAF and SD-OCT retinal morphology. At baseline, 30/31 and 29/31 eyes showed a macular hypo-AF, corresponding to the neurosensory retinal detachment (SRD), on shortwave-FAF (SW-FAF) and near-infrared-FAF (NIR-FAF), respectively. While the SRD resolved, both FAF techniques showed a granular hyper-AF in 31 eyes. At first examination, SD-OCT confirmed the SRD with a photoreceptor outer-segment (OS) elongation in all cases. During SRD resolution, the photoreceptor layer appeared thicker and fragmented. Multiple hyper-reflective precipitates were detected in the outer plexiform and nuclear layer and between the photoreceptors and appeared colocalized with the hyper-AF dots composing the granular hyper-AF. After SRD resolution, the hypo-AF area reverted to a normal pattern on SW-FAF in all eyes and in 25/31 on NIR-FAF. Examination at 12 months showed that the granular hyper-AF was still detectable in 54 % eyes, whereas 6/31 eyes showed hypo-AF dots on NIR-FAF. On SD-OCT, the junction IS/OS was identifiable in 11/31 eyes soon after the SRD resolution and appeared completely restored in all patients at the final visit. The simultaneous acquisition of FAF and SD-OCT provides detailed findings of retinal abnormalities of CSCR and may help to understand the evolving process linked to CSCR.

  15. Central serous chorioretinopathy secondary to corticosteroids in patients with atopic disease.

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    Ricketti, Peter A; Unkle, David W; Cleri, Dennis J; Prenner, Jonathan L; Coluccielo, Michael; Ricketti, Anthony J

    2015-01-01

    Central serous chorioretinopathy (CSCR) is of unknown etiology and is the most common cause of retinopathy after age-related macular degeneration, diabetic retinopathy, and retinal vein occlusion. Vision loss results from fluid leakage and serous detachment in the macula. Five percent of patients develop chronic CSCR. It is predominantly found in middle-aged men (age-adjusted rates per 100,000: 9.9 for men and 1.7 for women) and is usually unilateral and reversible. Three-quarters of CSCR patients resolve within 3 months but 45% have recurrences, usually with only minor visual acuity changes. Risk factors include type A personality, emotional stress, elevated catecholamines, hypertension, pregnancy, organ transplantation, increased levels of endogenous cortisol, psychopharmacologic medication, use of phosphodiesterase 5 inhibitors, obstructive sleep apnea, Helicobacter pylori infection, or treatment with corticosteroids. Five percent of patients develop chronic disease as a result of subretinal fibrin formation within the blister. CSCR is often bilateral, multifocal, and recurrent, and may be associated with subretinal fibrin formation within the blister. Permanent loss of vision may result from subretinal fibrin-fibrosis with scarring of the macula. Corticosteroid-associated CSCR occurs bilaterally in 20% of patients. Steroid-associated therapy may begin days to years after therapy with any form of drug delivery. We present three atopic patients who presented at various times after oral, inhaled, intranasal, and topical corticosteroid therapy. One patient developed CSCR after three separate types of administration of corticosteroids, which, to our knowledge, has not been observed in the literature.

  16. Factores de riesgo del desprendimiento de retina en operados de catarata, 1990 y 1997 Risk factors for retinal detachment in patients operated on of cataract, 1990 and 1997

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    Pamy Stolik Pérez

    2001-12-01

    Full Text Available Se presenta un estudio realizado en 17 762 pacientes operados de catarata con la técnica de extracción extracapsular del cristalino, de los cuales 42 pacientes presentaron desprendimiento de retina (DR después de la cirugía. Se determinó, dentro de un conjunto de presuntos factores de riesgos establecidos, cuáles influyeron en la aparición del DR en estos pacientes. Los resultados obtenidos reflejaron que fue la capsulotomía posterior (Nd Yag Láser la variable que más influyó en la aparición del DR seguida, en orden de frecuencia, por las complicaciones transquirúrgicas, la ausencia de implante de lente intraocular (LIO y finalmente los antecedentes de enfermedades oculares.A study of 17 762 patients that were operated on of cataract by using the extracapsular crystalline lens extraction technique was made. 42 of these patients had retina detachment (RD after surgery. Those factors influencing on the appearance of RD in these patients were determined within a group of presumed established risk factors. The results obtained showed that the posterior capsulotomy (Nd Yag Laser was the variable that influenced the most, followed, in order of frequency, by the transsurgical complications, the absence of intraocular lens implant (IOL and, finally, by the ocular diseases history.

  17. Descolamento regmatogênico de retina: avaliação pós-operatória da mácula Rhegmatogenous retinal detachment: a postoperative study of the macula

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    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

  18. Helicobacter pylori as a potential target for the treatment of central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Antonio Marcelo Barbante Casella

    2012-09-01

    Full Text Available OBJECTIVES: The objective of this study was to evaluate the relationship between the treatment of Helicobacter pylori gastric infection and changes in best-corrected visual acuity and macular detachment in patients with chronic central serous chorioretinopathy. METHODS: Seventeen patients diagnosed with central serous chorioretinopathy were examined for gastric infection with Helicobacter pylori using the urease test and gastric biopsy. Helicobacter pylory-positive patients were treated with the appropriate medication. The response to therapy was monitored by evaluating the best-corrected visual acuity and optical coherence tomography. The data were analyzed using Student's t-test before and after treatment. RESULTS: Fourteen patients (15 eyes aged 30-56 years (mean 43.4 ± 8.3 years were positive for Helicobacter pylori. Most of the positive patients had gastric symptoms (78.5%; one had bilateral central serous chorioretinopathy. The mean baseline best-corrected visual acuity was 20/98 (logMAR = 0.53 ± 0.28. Three months after starting treatment with antibiotics, the serous detachment had resolved in 14 of 15 eyes, but two cases required laser treatment. The follow-up period ranged from 6 to 27 months. The mean final best-corrected visual acuity differed significantly from baseline. CONCLUSION: Our findings suggest that Helicobacter pylori infection may be present in many chronic central serous chorioretinopathy patients and that treatment for the infection may have a favorable effect on the outcome of chronic central serous chorioretinopathy. Due to the possibility of the spontaneous regression of chronic central serous chorioretinopathy and the high prevalence of the infection in the general population, prospective and masked clinical trials are necessary to confirm that treatment for Helicobacter pylori infection may benefit patients with chronic central serous chorioretinopathy.

  19. Autofluorescencia de fondo en pacientes con coriorretinopatía serosa central Fundus autofluorescence in patients with central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Eva R Santana Alas

    2010-01-01

    Chorioretinopathy (CSC, and determine the relationship with functional and anatomic disturbances of the macular region. METHODS: Cross-sectional descriptive study performed in 21 eyes (21 patients, suffering from central serous chorioretinopathy in different statings. The pattern of autofluorecense in the neurosensoral detachment was detected with the Heidelberg´s Retinal Angiograph (HRA2 on 30° position. The optical coherence tomography (3D-OCT-Topcon (Nidek measured the central macular thickness and exposed the anatomic changes. Flourescein angiografy with HRA2 was performed on 12 patients. RESULTS: Hypoautofluorescense was detected in 51,90 % and hyperautofluorescense in 42,86 % of cases respectively; both disorders were present in 4,76 % of the patients. There was no significant difference between hyperautofluorecense and hypoautofluorescense as to the best corrected visual acuity (mean of 0,43 and 0,49, respectively; p= 0.184, and the central macular thickness (mean of 371.3 µm and 388.1 µm, respectively; p= 0.867. However, the difference was significant between time of evolution and the pattern of autoflorescence (p= 0.023. In those eyes affected by hyperautofluorescense, the optical coherence tomography allowed observing irregularities on the external layers and on the retinal pigmentary epithelium. The 83,3 % of cases who needed AGF presented with hyperautofluorescense that matched with hypoautofluorescence in the leakage site. CONCLUSIONS: In the central serous chorioretinopathy, different autofluorescense patterns may be found that reflect changes in the external retina and the retinal pigmentary epithelium. The autofluorescense may help to identify the focal diffusion site.

  20. Role of Bedside Ultrasound in CMV Retinitis: A Case Report

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    Lauren Westafer

    2012-01-01

    Full Text Available We present a case of retinal detachment diagnosed by emergency department bedside ultrasonography in a patient with CMV retinitis. The indications and findings of ocular ultrasonography are discussed.

  1. 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.

  2. Choroidal thickness following extrafoveal photodynamic treatment with verteporfin in patients with central serous chorioretinopathy

    DEFF Research Database (Denmark)

    Pryds, Anders; Larsen, Michael

    2012-01-01

    Purpose: To evaluate the effect of verteporfin photodynamic treatment (PDT) on choroidal thickness in patients with central serous chorioretinopathy (CSC). Methods: Choroidal thickness was measured with enhanced depth imaging- optical coherence tomography (EDI-OCT) before and after verteporfin PDT...... of the fundus using OCT. Results: Complete resolution of the serous detachment was seen in all 16 eyes within 1 month of extrafoveal PDT, while choroidal thickness in the area where PDT was applied decreased from 407 µm [mean; 95% confidence interval (CI(95) ) 356-458 µm] to 349 µm (mean; CI(95) 300-399 µm; p...

  3. Operating room central serous chorioretinopathy.

    Science.gov (United States)

    Mansour, Ahmad M; Hamam, Rola

    2017-01-01

    The operating room is a place of surgical intervention with its accompanying bodily and cognitive strain on the performers. Stress in the operating room may lead to the onset of central serous chorioretinopathy as reported hereby in a retina surgeon and is labeled as operating room central serous chorioretinopathy. The same operator performed the optical coherence tomography scans on one retina surgeon. A masked observer estimated the maximal height of the subretinal fluid. Central serous chorioretinopathy recurred four times over a 1-year period 1 -2 days after a stressful day in the operating room, especially when cases were done under topical or subtenon anesthesia for cataract surgery, vitreous surgery or combined surgeries with complex ocular and medical problems and inability for anesthesia team to intervene. Stress management allowed resolution of subretinal fluid between 3 and 4 weeks. Adopting this strategy, no further attacks were documented by optical coherence tomography for 5 years. (1) This is one of a few optical coherence tomography documentation of resolution of central serous chorioretinopathy within 3-4 weeks of its occurrence and its recurrence induced by stress in the operating room; (2) Unassisted topical anesthesia required in patients with complex medical and ocular problems causes more cognitive stress than when surgery is carried under assisted local or general anesthesia (partly due to unexpected ocular or bodily movements); and (3) the available evidence suggests that those overcommitted surgeons (type A personality) may very well be most susceptible to burnout and central serous chorioretinopathy.

  4. Optimizing the treatment of rhegmatogenous retinal detachment

    DEFF Research Database (Denmark)

    Hajari, Javad Nouri

    2016-01-01

    be performed to attain the most optimal result? In the third paper, we evaluated the progression of posterior RRD with an optical coherence tomography to make an objective assessment of the movement. We found that the risk of a macula on RRD progressing to affect the fovea is small if the patient is postured...

  5. Retinal detachment in black South Africans

    African Journals Online (AJOL)

    presented with a blind or poorly sighted opposite eye. ... both eyes, the presence of myopia greater than 6 dioptres, aphakia or pseudophakia .... surgery with or without subretinal fluid drainage. Anatomical reattachment was achieved initially in 83 cases (72,8%). Most patients did not return for follow-up, and only 30 patients ...

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

    African Journals Online (AJOL)

    Myopia was the predisposing factor for RRD in 78 [28.3%] patients of which 63 had myopia of > 5D. In 57 [20.7%] patients with RRD, there was a history of ocular trauma. Thirty-nine [14.2%] patients had had cataract surgery with lens implantation and 21 [7.6%] patients were surgically aphakic. Macula-off RRD was seen in ...

  7. Factors Influencing Visual Outcome after Surgery for Retinal ...

    African Journals Online (AJOL)

    Dr femi Oderinlo

    ABSTRACT. Aim: To identify the prognostic factors associated with good visual outcome after surgery for retinal detachment in a series of 103 eyes. Materials and methods: Data were obtained from the case files of patients who had retina re-attachment surgery for rhegmatogenous retinal detachment between June.

  8. Factors Influencing Visual Outcome after Surgery for Retinal ...

    African Journals Online (AJOL)

    Aim: To identify the prognostic factors associated with good visual outcome after surgery for retinal detachment in a series of 103 eyes. Materials and methods: Data were obtained from the case files of patients who had retina re-attachment surgery for rhegmatogenous retinal detachment between June 2006 and December ...

  9. Perfluoroctano líquido como tamponante vitreorretiniano de curta duração no pós-operatório de portadores de descolamento de retina por ruptura gigante Perfluoroctane liquid as a short-term vitreous-retinal tamponade in the postoperative period in patients with retinal detachment due to giant tears

    Directory of Open Access Journals (Sweden)

    Marcelo Carvalho Ventura

    2007-06-01

    Full Text Available OBJETIVOS: Relatar os resultados de vitrectomia via pars plana com utilização de perfluocarbono líquido (Perfluoroctano-Ophtalmos®, como tamponante vítreo-retiniano de curta duração, no pós-operatório de portadores de descolamento de retina, por ruptura gigante. MÉTODOS: Estudaram-se dez desses pacientes. Todos os casos eram complicados por vitreorretinopatia proliferativa grau B ou pior com rupturas que variavam em extensão de 90º a 210º. O perfluorocarbono líquido foi introduzido, por via pars plana, com o volume necessário para ultrapassar o limite posterior da ruptura, permanecendo no pós-operatório por cinco dias, estando os pacientes em decúbito dorsal. Após esse período submetiam-se a segunda intervenção para troca do perfluorocarbono líquido para gás ou óleo de silicone. RESULTADOS: Após período de acompanhamento médio de 16,2 ± 12,4 meses (2 a 43 meses, 80% das retinas estavam aplicadas, sendo necessária a repetição desta técnica em 1 caso (10% caso e em 2 casos (20% não houve reaplicação da retina por vitreorretinopatia avançada. Houve melhora da acuidade visual em 5 casos (50%. CONCLUSÃO: Observaram-se bons resultados quanto à aplicação da retina (80% e melhora da acuidade visual (50% quando do uso do perfluorocarbono líquido como tamponante vitreorretiniano de curta duração no pós-operatório de cirurgias de descolamento de retina por rupturas gigantes.PURPOSE: To report pars plana vitrectomy results of intravitreous use of liquid perfluorocarbon as a short-term postoperative tamponade in retinal detachment due to giant tears in a series of patients. METHODS: Ten of those patients, all of them complicated by proliferative vitreoretinopathy grade B or worse, with tear extension varying from 90º to 210º were studied. Perfluorocarbon liquid was injected via pars plana until the posterior tear limit, remaining in the postoperative period during five days, with the patients in supine position

  10. Correlation between morphological characteristics in spectral-domain-optical coherence tomography, different functional tests and a patient's subjective handicap in acute central serous chorioretinopathy.

    Science.gov (United States)

    Gerendas, Bianca S; Kroisamer, Julia-Sophie; Buehl, Wolf; Rezar-Dreindl, Sandra M; Eibenberger, Katharina M; Pablik, Eleonore; Schmidt-Erfurth, Ursula; Sacu, Stefan

    2018-01-16

    The purpose of this study was to identify quantitatively measurable morphologic optical coherence tomography (OCT) characteristics in patients with an acute episode of central serous chorioretinopathy (CSC) and evaluate their correlation to functional and psychological variables for their use in daily clinical practice. Retinal thickness (RT), the height, area and volume of subretinal fluid (SRF)/pigment epithelium detachments were evaluated using the standardized procedures of the Vienna Reading Center. These morphologic characteristics were compared with functional variables [best-corrected visual acuity (BCVA), contrast sensitivity (CS), retinal sensitivity/microperimetry, fixation stability], and patients' subjective handicap from CSC using the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25). Data from 39 CSC patients were included in this analysis. Three different SRF height measures showed a high negative correlation (r = -0.7) to retinal sensitivity within the central 9°, which was also negatively correlated with SRF area and volume (r = -0.6). The CS score and fixation stability (fixation points within 2°) showed a moderate negative correlation (r = -0.4) with SRF height variables. Comparison of the subjective handicap with morphological characteristics in spectral-domain (SD)-OCT showed SRF height had the highest correlation (r = -0.4) with the subjective problems reported and overall NEI VFQ-25 score. In conclusion, SRF height measured in SD-OCT showed the best correlation with functional variables and patients' subjective handicap caused by the disease and therefore seems to be the best variable to look at in daily clinical routine. Even though area and volume also show a correlation, these cannot be so easily measured as height and are therefore not suggested for daily clinical routine. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  11. Cytomegalovirus Retinitis: A Review.

    Science.gov (United States)

    Port, Alexander D; Orlin, Anton; Kiss, Szilard; Patel, Sarju; D'Amico, Donald J; Gupta, Mrinali P

    2017-05-01

    Cytomegalovirus (CMV) is a ubiquitous DNA herpes virus that causes significant morbidity and mortality in immunocompromised individuals. CMV retinitis is a potentially blinding manifestation of CMV infection that was commonly seen in advanced acquired immunodeficiency syndrome (AIDS) in the era before modern combination antiretroviral therapy era, but is also recognized in patients with immune deficiency from multiple causes. The advent of and advances in antiretroviral therapies for human immunodeficiency virus have decreased the incidence of CMV retinitis by over 90% among AIDS patients, and improved visual outcomes in those affected. The diagnosis is generally a clinical one, and treatment modalities include systemic and intravitreal antiviral medications. Retinal detachment and immune recovery uveitis are sight-threatening complications of CMV retinitis that require specific treatments.

  12. Demarcation laser photocoagulation induced retinal necrosis and rupture resulting in large retinal tear formation.

    Science.gov (United States)

    Quezada, Carlos; Pieramici, Dante J; Matsui, Rodrigo; Rabena, Melvin; Graue, Federico

    2015-06-01

    Retinal tears after laser photocoagulation are a rare complication that occurs after intense laser. It is talked about among retina specialist occurring particularly at the end of a surgical case while applying endophotocoagulation; to the best our knowledge, there are no reports in the literature of a large retinal tear induced after attempted in-office demarcation laser photocoagulation (DLP) that simulated a giant retinal tear. DLP has been employed in the management of selected cases of macula sparring rhegmatogenous retinal detachment (RRD). Even though extension of the retinal detachment through the "laser barrier" is considered a failure of treatment, few complications have been described with the use of this less invasive retinal detachment repair technique. We describe a case of a high myopic woman who initially was treated with demarcation laser photocoagulation for an asymptomatic retinal detachment associated with a single horseshoe tear and a full thickness large retinal tear was created where the laser was placed. Intense laser photocoagulation resulted in abrupt laser induced retinal necrosis and rupture creating this large retinal break. Proper laser technique should reduce the risks associated with this procedure. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Long-term chorioretinal changes after photodynamic therapy for chronic central serous chorioretinopathy.

    Science.gov (United States)

    Vasconcelos, Helena; Marques, Inês; Santos, A Rita; Melo, Pedro; Pires, Isabel; Figueira, João; de Abreu, José Faria; Cachulo, M Luz; Silva, Rufino

    2013-07-01

    To evaluate morphological and functional chorioretinal changes 5 years after standard photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). A retrospective, nonrandomized study, including patients with chronic CSC treated with standard PDT and followed for at least 60 months. All patients underwent a complete ophthalmological examination, and the location and number of treatments were registered. Five or more years after treatment, subfoveal and non-subfoveal treated areas were evaluated with Spectralis optical coherence tomography and microperimetry. Seventeen eyes of 15 patients were included, with mean age of 48.3 ± 8.4 years and a mean follow-up of 80.6 ± 12.4 months (range from 62 to 104 months). All eyes had neurosensory detachment (NSD) at baseline. Treatment was performed under the fovea in 58.8 % and in a non-foveal area in 41.2 % of the eyes. At the final visit all eyes had resolution of the NSD, with a statistical significant reduction in central macular thickness (p = 0.005) and preserved neuroretinal thickness (p = 0.839). There was a statistical difference between initial and final BCVA (p < 0.001) and a mean gain of 8.4 ± 7.8 letters. Subfoveal morphological changes in external limiting membrane (ELM) and in photoreceptor inner and outer segment junction (IS/OS) were correlated with final BCVA (p = 0.015 and p = 0.014 respectively), but not with the variation of BCVA. There was a statistical correlation between morphological changes in IS/OS line and retinal sensitivity in the central 12° and 2° (p = 0.003 and p = 0.002 respectively). The morphological changes in the subfoveal layers were not dependent on treatment location (p = 0.154, p = 0.644, and p = 1.0 for ELM, IS/OS line, and retinal pigment epithelium respectively). Subfoveal final mean choroidal thickness was 295.1 ± 68.7 μm, and showed no statistical difference from the normal population (p

  14. Giant serous microcystic pancreas adenoma

    Directory of Open Access Journals (Sweden)

    Mustafa Kerem

    2012-10-01

    Full Text Available Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11x9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12x11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pan creatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient’s symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases.

  15. Giant serous microcystic pancreas adenoma.

    Science.gov (United States)

    Dikmen, Kursat; Bostanci, Hasan; Yildirim, Ali Cihat; Sakrak, Omer; Kerem, Mustafa

    2012-10-10

    Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11×9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12×11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pancreatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient's symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases.

  16. Fluid vitreous substitutes in vitreo retinal surgery

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    Saxena Sandeep

    1996-01-01

    Full Text Available Advances in the surgical instrumentation and vitreoretinal techniques have allowed intraoperative reapproximation of retina to a more normal position. The use of intravitreally injected liquid materials (viscoelastic liquids, liquid perfluorocarbons and silicone oil, as adjunctive agents to vitreo-retinal surgery play an important role in facilitating retinal reattachment. These materials are used as intraoperative instruments to re-establish intraocular volume, assist in separating membranes adherent to the retina, manipulate retinal detachments and mechanically flatten detached retina. Over the longer term, silicone oil maintains intraocular tamponade. One should be cognizant of the potential uses, benefits and risks of each of these vitreous substitutes.

  17. Chronic central serous chorioretinopathy: long-term follow-up and vision-related quality of life

    Directory of Open Access Journals (Sweden)

    Breukink MB

    2016-12-01

    Full Text Available Myrte B Breukink,1,* Alexander JM Dingemans,1,* Anneke I den Hollander,1,2 Jan EE Keunen,1 Robert E MacLaren,3,4 Sascha Fauser,5 Giuseppe Querques,6 Carel B Hoyng,1 Susan M Downes,3,4 Camiel JF Boon1,7 1Department of Ophthalmology, 2Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; 3Oxford Eye Hospital, Oxford University Hospitals NHS Trust, 4Nuffield Laboratory of Ophthalmology and NIHR Biomedical Research Centre, Department of Clinical Neurosciences, University of Oxford, Oxford, UK; 5Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany; 6Department of Ophthalmology, University Paris Est Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France; 7Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands *These authors contributed equally to this work Purpose: To describe the clinical findings and long-term outcome of patients with chronic central serous chorioretinopathy (cCSC.Materials and methods: This was a retrospective case series in 52 eyes of 36 patients with a follow-up period of at least 1 year. Extensive ophthalmic examination and a validated questionnaire concerning vision-related quality of life (National Eye Institute Visual Function Questionnaire [NEI-VFQ]-39 were analyzed.Results: Mean visual acuity showed a significant decline over time of 0.16 logarithm of minimum angle of resolution ([logMAR] range: -0.22 to 1.3; P=0.009 after a mean follow-up period of 10.6 years. Also, patients reported lower vision-related quality of life based on the NEI-VFQ-39 for almost all categories compared to healthy controls. Macular atrophy was diagnosed more often on optical coherence tomography compared to other diagnostic entities. Retinal pigment epithelium detachments in the macula were documented on optical coherence tomography in 56% of the patients. A significant thinning of foveal thickness was measured over time compared to

  18. Cytomegalovirus retinitis

    Science.gov (United States)

    ... sharing features on this page, please enable JavaScript. Cytomegalovirus (CMV) retinitis is a viral infection of the ... need treatment to prevent its return. Alternative Names Cytomegalovirus retinitis Images Eye CMV retinitis CMV (cytomegalovirus) References ...

  19. Microperimetría y tomografía de coherencia óptica en operados por cirugía convencional del desprendimiento de retina Microperimetry and optical coherente tomography in patients operated on by the convencional retinal detachment surgery

    Directory of Open Access Journals (Sweden)

    Roberto Alejandro Guerra García

    2008-12-01

    Full Text Available INTRODUCCIÓN: Se realizó un estudio descriptivo para determinar la agudeza visual, la microperimetría y la tomografía de coherencia óptica en operados por cirugía convencional de desprendimiento de retina regmatógeno, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" desde octubre de 2006 a marzo de 2007. MÉTODOS: Se estudiaron 26 pacientes que acudieron con oftalmoscopia y biomicroscopia normal y una evolución entre tres y seis meses. Se obtuvo mejor agudeza visual corregida, fijación, sensibilidad media, morfología y grosores maculares. RESULTADOS: La agudeza visual media fue de 0,41 y la fijación fue estable en la mayoría de los pacientes, la sensibilidad retiniana promedio fue de 11 decibeles. El hallazgo más frecuente fue el desprendimiento seroso. El grosor macular promedio fue de 246,3 micras. No se encontró relación estadística entre el tiempo de evolución preoperatorio y las características maculares del desprendimiento con respecto a estas pruebas. CONCLUSIONES: El estado funcional y anatómico de la retina no estuvo totalmente recobrado y pudiera ser monitorizado gracias a la microperimetría y la tomografía de coherencia óptica.INTRODUCTION: 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. METHODS: 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. RESULTS: 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

  20. Evaluación de la arquitectura macular por tomografía de coherencia óptica en pacientes operados de desprendimiento de retina regmatógeno con mácula desprendida Evaluation of the macular architecture of patients operated on from macula-off rhegmatogenous retinal detachment using optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Meisy Ramos López

    2010-12-01

    arquitectura macular posterior a la cirugía del desprendimiento de retina.OBJECTIVE: 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. METHODS: A prospective cross-sectional study was conducted. The sample was finally made up of 40 eyes from 38 patients who met the inclusion and exclusion criteria. This study compared the surgical results from both techniques. The variables such as age, sex, risk factors, retinal and length of evolution of the retinal detachment were analyzed. Physical examination was performed; the best preoperative and postoperative corrected visual acuity was taken in addition to postoperative evaluation based on optical coherence tomography one month and three months after surgery. The statistical sign test was used for the best corrected visual acuity variable in both techniques. Mann Whitney´s statistical test was applied to compare the best postoperative visual acuity in both techniques. RESULTS: Myopia was the prevailing risk factor in both groups followed by aphakia, pseudoaphakia and trauma. The length of evolution of the retinal detachment was under 15 days for both surgical techniques. The best corrected visual acuity after the surgery was statistically significant for both surgical techniques (p= 0,002 for scleral buckling and p= 0,001 for PPV. No statistically significant differences were found in both surgical techniques in terms of anatomical and functional recovery of the macula However, in those patients operated on by scleral buckling technique, the anatomical recovery was slow; the group had 35 % of applied macula after one month and the main finding was subfoveal detachment. The PPV group presented 65 % of applied macula after one month and the main pathological finding was macular edema. CONCLUSIONS: Optical coherence tomography is an important alternative

  1. Central serous chorioretinopathy: a pathogenetic model

    Directory of Open Access Journals (Sweden)

    et al

    2011-02-01

    Full Text Available Antonio Caccavale1, Filippo Romanazzi1, Manuela Imparato1, Angelo Negri2, Anna Morano3, Fabio Ferentini21Department of Ophthalmology, Neuropthalmology and Ocular Immunology Service, 2Department of Ophthalmology, Hospital “C. Cantù”, Abbiategrasso, Milan, Italy; 3University Eye Clinic, Foundation IRCCS San Matteo Hospital, Pavia, ItalyAbstract: Despite numerous studies describing predominantly its demography and clinical course, many aspects of central serous chorioretinopathy (CSCR remain unclear. Perhaps the major impediment to finding an effective therapy is the difficulty of performing studies with large enough cohorts, which has meant that clinicians have focused more on therapy than on a deeper understanding of the pathogenesis of the disease. Hypotheses on the pathogenesis of CSCR have ranged from a basic alteration in the choroid to an involvement of the retinal pigment epithelium (RPE. Starting from evidence that affected subjects often present a personality prone to stress with altered pituitary–hypothalamic axis response (HPA and that they have higher levels of serum and urinary cortisol and catecholamines than healthy subjects, we hypothesize a cascade of events that may lead to CSCR through hypercoagulability and augmented platelet aggregation. In particular we investigated the role of tissue plasminogen activator, increasing plasminogen activator inhibitor 1 (PAI-1, and plasmin-α2- plasmin inhibitor complexes. We reviewed the different therapeutic approaches, including adrenergic antagonists, carbonic anhydrase inhibitors, mifepristone, ketoconazole, laser photocoagulation, intravitreal injection of bevacizumab, and photodynamic therapy with verteporfin (PDT and our model of pathogenesis seems to be in agreement with the clinical effects obtained from these treatments. In accord with our thesis, we began to treat a group of patients affected by CSCR with low-dose aspirin (75–100 mg, because of its effectiveness in other

  2. Choroid Detachment, a Rare Cause of Vision Loss Diagnosed by Point-of-Care Ultrasound.

    Science.gov (United States)

    Jarrett, Brian; Secko, Michael

    2017-04-01

    Choroid detachment is a rare disease process that has a multitude of etiologies; usually related to recent ophthalmological surgery, eye trauma, corneal ulcers, or intraocular pressure-lowering agents. Point-of-care ocular ultrasound has high utility and accuracy in diagnosing pathology of the eye. We present a case of a patient who presented with vision loss caused by a choroid detachment diagnosed on point-of-care ultrasound because fundoscopic examination was limited due to cataracts. Ultrasound findings based on location and appearance during both static and dynamic evaluation that help differentiate a choroid vs. a retinal detachment are also described. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Choroid detachments have a different sonographic appearance, as well as management, compared to a retinal detachment. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Torpedo maculopathy with multifocal central serous chorioretinopathy: A rare case report.

    Science.gov (United States)

    Panigrahi, Pradeep Kumar; Minj, Anita; Satapathy, Jasmita

    2018-02-01

    We present a very rare case of torpedo maculopathy (TM) with multifocal central serous chorioretinopathy. A 26-year-old male presented with painless loss of vision in the right eye of 2 months duration. Clinical examination showed a torpedo-shaped lesion temporal to fovea and subretinal fluid in foveal center. Fluorescein angiography showed multifocal leaks. Optical coherence tomography showed an optically clear space/neurosensory detachment at the site of lesion. Patient underwent focal laser to the leaks. TM is a rare congenital disorder detected accidentally during routine fundus examination. It is usually unilateral and does not affect vision.

  4. Safety detaching hook specification.

    CSIR Research Space (South Africa)

    Roux, JD

    1999-05-01

    Full Text Available not open or detach when tilted horizontally in a slack rope event or when struck by a falling object (as described in paragraph 2.4 (d) (ii)). f) Design Drawings and Calculations Detailed design drawings and calculations shall be compiled for all safety... in a data book (defined in paragraph 2.5 (f)). a) Material Testing Safety detaching hook materials shall conform to the requirements of BS 27723 Part 2 (unless otherwise specified) and test pieces shall also be prepared and tested in accordance...

  5. Transpupillary thermotherapy for central serous chorioretinopathy with parafoveal leaks

    Directory of Open Access Journals (Sweden)

    Qing Xiao

    2014-04-01

    Full Text Available AIM:To explore the clinical effect of transpupillary thermotherapy(TTTfor the treatment of central serous chorioretinopathy(CSCwith parafoveal leaks.METHODS: Twenty-three eyes from nineteen patients with long-standing CSC and parafoveal leaks(50-200μm around the foveawho opted for TTT and observation were enrolled in this study. Eighteen of nineteen patients(23 eyeswere male, fourteen of twenty-three eyes were right eyes. The patients' mean age was 44.00±4.973 years(range from 32-52 years. TTT was performed using 810nm infrared diode laser. All patients underwent Snellen visual acuity measurement(converted to LogMAR for analysisfundus examination, fluorescein angiography(FFAand optical coherence tomography(OCT. Follow-up was scheduled at 1, 2, 6mo. RESULTS:Following treatment of TTT, complete resolution of neurosensory detachment on OCT and disappearance of leakage on FFA was seen in fourteen eyes(61%, twenty-one eyes(91%at the 2mo and twenty-three eyes(100%at the 6mo respectively. A total of 74% had ≥3 lines of improvement after 6mo. Success was defined as resolution of neurosensory on OCT and disappearance of leakage on FFA at the 2mo. Failure was defined as no change at the 6mo and no improvement of visual acuity.CONCLUSION:TTT is safe and effective therapeutic option in patients with CSC and parafoveal leaks. It may improve the visual acuity by shortening the persistent serous elevation of the macula.

  6. Retinitis Pigmentosa.

    Science.gov (United States)

    Carr, Ronald E.

    1979-01-01

    The author describes the etiology of retinitis pigmentosa, a visual dysfunction which results from progressive loss of the retinal photoreceptors. Sections address signs and symptoms, ancillary findings, heredity, clinical diagnosis, therapy, and research. (SBH)

  7. Retinitis Pigmentosa

    Science.gov (United States)

    ... Linked Retinoschisis (XLRS) X-Linked Retinitis Pigmentosa (XLRP) Usher Syndrome Other Retinal Diseases Glossary News & Research News & Research ... degenerate. Forms of RP and related diseases include Usher syndrome, Leber congenital amaurosis, and Bardet-Biedl syndrome, among ...

  8. Retinal Diseases

    Science.gov (United States)

    ... Linked Retinoschisis (XLRS) X-Linked Retinitis Pigmentosa (XLRP) Usher Syndrome Other Retinal Diseases Glossary News & Research News & Research ... central portion of the retina called the macula. Usher Syndrome Usher syndrome is an inherited condition characterized by ...

  9. Pure compared with mixed serous endometrial carcinoma: two different entities?

    NARCIS (Netherlands)

    Roelofsen, T.; Ham, M.A. van; Wiersma van Tilburg, J.M.; Zomer, S.F.; Bol, M.; Massuger, L.F.A.G.; Bulten, J.

    2012-01-01

    OBJECTIVE: : To analyze whether mixed compared with pure uterine papillary serous carcinoma histology affects clinical outcome, and to assess uterine papillary serous carcinoma for its association with the precursor lesion endometrial intraepithelial carcinoma. METHODS: : A multi-institution

  10. Clinical and Echographic Long-Term Follow-Up of a Retinal Macrocyst: A Case Report

    Directory of Open Access Journals (Sweden)

    Juan Carlos Serna-Ojeda

    2014-06-01

    Full Text Available The purpose of this paper is to report the case of a 62-year-old male diagnosed with a retinal macrocyst secondary to a long-standing retinal detachment in his right eye. At fundoscopy examination, an oval, elevated retinal lesion in the superior nasal quadrant was noted. Ultrasonography was performed, with a B-mode echography showing an oval, anechoic image and a standardized A-mode echography with a reflectivity spike higher than 98%, which was compatible with a retinal macrocyst. The patient refused surgical treatment for the retinal detachment and was followed for 14 months with stable visual acuity and no clinical or echographic changes.

  11. Short-term efficacy of intravitreal dobesilate in central serous chorioretinopathy.

    Science.gov (United States)

    Cuevas, Pedro; Outeiriño, Luis A; Azanza, Carlos; Angulo, Javier; Giménez-Gallego, Guillermo

    2012-07-12

    To report the anatomic and functional outcome of intravitreal dobesilate to treat recurrent central serous chorioretinopathy (CSC). This is an interventional case report in which dobesilate was intravitreally injected in a case of recurrent CSC. Main measures included fundoscopy, Snellen visual acuity (VA) testing, fluorescein angiography and optical coherence tomography (OCT). We present anatomical and functional evidences, obtained as early as eleven days after the treatment, of the efficacy of intravitreal dobesilate, in the treatment of chronic CSC condition. The effect after intravitreal dobesilate injection for CSC might be related to the normalization of retinal architecture. Intravitreal dobesilate may be an effective treatment option for recurrent CSC.

  12. 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.

  13. 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.

  14. Retinal imaging by spectral optical coherence tomography.

    Science.gov (United States)

    Kałuzny, J J; Szkulmowska, A; Bajraszewski, T; Szkulmowski, M; Kałuzny, B J; Gorczyńska, I; Targowski, P; Wojtkowski, M

    2007-01-01

    To demonstrate applicability of high speed spectral optical coherence tomography (SOCT) method for imaging retinal pathologies in clinical conditions. SOCT was performed in 67 eyes with different macular diseases. Examinations were carried out with the prototype SOCT instrument constructed in the Institute of Physics, Nicolaus Copernicus University, Toruń, Poland. A broadband superluminescent diode was used as a light source. The disturbances of retinal layer structure concerning mainly outer segments of photoreceptors were observed in case of central serous chorioretinopathy and choroidal neovascularization in age-related macular degeneration. Large drusen were often related to significant changes of outer nuclear layer thickness and reflectivity. SOCT detects small disturbances of the retinal structure and helps to precisely determine layers involved in different pathologies.

  15. 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

  16. Molecular targets in serous gynecologic cancers

    NARCIS (Netherlands)

    Groeneweg, J.W.

    2015-01-01

    In this thesis we describe a series of studies assessing the effectiveness of targeted therapeutics that inhibit Notch signaling or the HER2 receptor in serous gynecologic cancers. In the first part of the thesis, we have confirmed previous data by showing expression of Notch1 and Notch3 in ovarian

  17. Foveomacular retinitis.

    OpenAIRE

    Kuming, B S

    1986-01-01

    A group of patients is described who developed the clinical features of foveomacular retinitis. No causative factors were isolated, and all patients strongly denied any type of sun gazing. It is possible that there is a group of patients who have the features of foveomacular retinitis but have not had any direct exposure to the sun. These patients would then constitute a primary type of foveomacular retinitis, as opposed to a secondary type which has a known cause and is synonymous with solar...

  18. Between Involvement and Detachment

    DEFF Research Database (Denmark)

    Thomasen, Gry

    Between Involvement and Detachment takes grasp with the Johnson administration’s (1963-1969) perceptions of and responses to the Western European realignments. Arguing that the Johnson administration set out to maintain the American unilateralist position in the transatlantic relation, not just...... of the Western world. De Gaulle’s withdrawal from NATO’s integrated command in 1966, and the subsequent British and Belgian calls for a reform of the alliance and a détente with East, contributed to the administration’s fear of alliance disintegration and return to European power politics. The thesis argues...

  19. 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.

  20. In patients suffering from idiopathic central serous chorioretinopathy, anxiety scores are higher than in healthy controls, but do not vary according to sex or repeated central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Bazzazi N

    2015-04-01

    Full Text Available Nooshin Bazzazi,1 Mohammad Ahmadpanah,2 Siamak Akbarzadeh,1 Mohammad Ali Seif Rabiei,3 Edith Holsboer-Trachsler,4 Serge Brand4,5 1Department of Ophthalmology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 2Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences; Hamadan, Iran; 3Department of Social Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; 4Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; 5Department of Sport and Health Science, Sport Science Section, University of Basel, Basel, Switzerland Introduction: Idiopathic central serous chorioretinopathy (CSCR is a relatively common ophthalmic disorder characterized by the development of a serous detachment of the sensory retina. Psychophysiological factors may trigger or maintain CSCR, though, surprisingly, the association between CSCR and anxiety has yet to be studied. The aims of the present study were threefold: to determine whether 1 Iranian patients with CSCR have higher scores for anxiety, 2 anxiety is lower, if CSCR has been experienced twice, and whether 3 anxiety scores differ between sexes.Methods: A total of 30 patients with CSCR and 30 healthy age- and sex-matched controls took part in the study. A brief face-to-face interview was conducted covering demographic variables and history and occurrence of CSCR and assessing anxiety.Results: Compared to healthy controls, anxiety was significantly higher in both first-time and second-time CSCR patients. In CSCR patients, anxiety scores did not differ between sexes.Conclusion: Higher anxiety scores were observed in Iranian patients with CSCR, irrespective of whether this was the first or second occurrence of CSCR. This suggests there is no psychological adaptation in terms of reduced anxiety among patients with repeated CSCR. Keywords: idiopathic central

  1. On detachment asymmetry and stability

    Science.gov (United States)

    Pshenov, A. A.; Kukushkin, A. S.; Krasheninnikov, S. I.

    2017-07-01

    Three issues related to the physics of divertor detachment are analyzed in detail: the criteria for the onset of complete divertor detachment, the role of neutrals in "symmetryzation" of detachment in the inner and outer divertors, and the transition to divertor detachment. The results of comprehensive 2D numerical simulations with the SOLPS4.3 package are compared with some experimental data and predictions based on simplified analytical models. It is shown that it is the ratio of the upstream plasma pressure to the specific power flux entering the recycling region that controls the local onset of detachment on a specific flux tube. Pup/qreclycl≥(Pup/qreclycl) crit remains the valid criterion also in the presence of seeded impurity, if the impurity radiation and hydrogen recycling regions are spatially separated. Detailed analysis indicates that the reverse plasma flow forming on the most heat loaded flux tubes in the outer divertor under the influence of the neutrals coming from the deeply detached inner divertor plays the key role in the detachment "symmetryzation" and allows the outer divertor to reach the detached regime. Finally, it is demonstrated that a gradual increase of the perpendicular heat transport in the edge plasma during transition to the detached regime can make this transition bifurcation-like.

  2. Posterior Vitreous Detachment and the Posterior Hyaloid Membrane.

    Science.gov (United States)

    Fincham, Gregory S; James, Sean; Spickett, Carl; Hollingshead, Michael; Thrasivoulou, Christopher; Poulson, Arabella V; McNinch, Annie; Richards, Allan; Snead, David; Limb, Gloria A; Snead, Martin P

    2017-08-31

    Despite posterior vitreous detachment being a common ocular event affecting most individuals in an aging population, there is little consensus regarding its precise anatomic definition. We investigated the morphologic appearance and molecular composition of the posterior hyaloid membrane to determine whether the structure clinically observed enveloping the posterior vitreous surface after posterior vitreous detachment is a true basement membrane and to postulate its origin. Understanding the relationship between the vitreous (in both its attached and detached state) and the internal limiting membrane of the retina is essential to understanding the cause of rhegmatogenous retinal detachment and vitreoretinal interface disorders, as well as potential future prophylactic and treatment strategies. Clinicohistologic correlation study. Thirty-six human donor globes. Vitreous bodies identified to have posterior vitreous detachment were examined with phase-contrast microscopy and confocal microscopy after immunohistochemically staining for collagen IV basement membrane markers, in addition to extracellular proteins that characterize the vitreoretinal junction (fibronectin, laminin) and vitreous gel (opticin) markers. The posterior retina similarly was stained to evaluate the internal limiting membrane. Findings were correlated to the clinical appearance of the posterior hyaloid membrane observed during slit-lamp biomicroscopy after posterior vitreous detachment and compared with previously published studies. Morphologic appearance and molecular composition of the posterior hyaloid membrane. Phase-contrast microscopy consistently identified a creased and distinct glassy membranous sheet enveloping the posterior vitreous surface, correlating closely with the posterior hyaloid membrane observed during slit-lamp biomicroscopy in patients with posterior vitreous detachment. Immunofluorescent confocal micrographs demonstrated the enveloping membranous structure identified on

  3. Impact of the ovarian microenvironment on serous cancer

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-14-1-0182 TITLE: Impact of the ovarian microenvironment on serous cancer PRINCIPAL INVESTIGATOR: Joanna E. Burdette...Impact of the ovarian microenvironment on serous cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0182 5c. PROGRAM ELEMENT NUMBER 6...for intervention that would block serous cancer while still confined to the fallopian tubes. Using a series of normal, modified, and tumorigenic tubal

  4. Pars plana vitrectomy combined with internal limiting membrane peeling for recurrent macular edema due to branch retinal vein occlusion after antivascular endothelial growth factor treatments.

    Science.gov (United States)

    Shirakata, Yukari; Fukuda, Kouki; Fujita, Tomoyoshi; Nakano, Yuki; Nomoto, Hiroyuki; Yamaji, Hidetaka; Shiraga, Fumio; Tsujikawa, Akitaka

    2016-01-01

    To evaluate the anatomic and functional outcomes of pars plana vitrectomy combined with internal limiting membrane peeling for recurrent macular edema (ME) due to branch retinal vein occlusion (BRVO) after intravitreal injections of antivascular endothelial growth factor (anti-VEGF) agents. Twenty-four eyes of 24 patients with treatment-naive ME from BRVO were treated with intravitreal injections of anti-VEGF agents. Recurred ME was treated with pars plana vitrectomy combined with internal limiting membrane peeling. After the surgery, ME was significantly reduced at 1 month (P=0.031) and the reduction increased with time (P=0.007 at the final visit). With the reduction in ME, treated eyes showed a slow improvement in visual acuity (VA). At the final visit, improvement in VA was statistically significant compared with baseline (P=0.048). The initial presence of cystoid spaces, serous retinal detachment, or subretinal hemorrhage under the fovea, as well as retinal perfusion status, showed no association with VA improvement. However, the presence of epiretinal membrane showed a significant association with the visual recovery. Although eyes without epiretinal membrane showed visual improvement (-0.10±0.32 in logarithm of the minimum angle of resolution [logMAR]), eyes with epiretinal membrane showed greater visual improvement (-0.38±0.12 in logMAR, P=0.012). For recurrent ME due to BRVO after anti-VEGF treatment, particularly when accompanied by epiretinal membrane, pars plana vitrectomy combined with internal limiting membrane peeling might be a possible treatment option.

  5. Foveomacular retinitis.

    Science.gov (United States)

    Kuming, B S

    1986-11-01

    A group of patients is described who developed the clinical features of foveomacular retinitis. No causative factors were isolated, and all patients strongly denied any type of sun gazing. It is possible that there is a group of patients who have the features of foveomacular retinitis but have not had any direct exposure to the sun. These patients would then constitute a primary type of foveomacular retinitis, as opposed to a secondary type which has a known cause and is synonymous with solar retinopathy.

  6. A case of Acute Myeloid Leukemia masquerading as unilateral exudative detachment

    Directory of Open Access Journals (Sweden)

    Hitesh Sharma

    2016-12-01

    Conclusions and Importance: Acute myeloid leukemia can present as an exudative retinal detachment and can mimic similarly presenting conditions like VKH. Hence, this very important differential diagnosis should be kept in mind and it stresses the importance of simple laboratory investigations like whole and differential blood counts.

  7. Retinitis pigmentosa

    Science.gov (United States)

    ... treatments for retinitis pigmentosa, including the use of DHA, which is an omega-3 fatty acid. Other ... counseling and testing may help determine whether your children are at risk for this disease.

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

    African Journals Online (AJOL)

    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 ...

  9. 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 mm2 , 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

  10. Shock detachment from curved wedges

    Science.gov (United States)

    Mölder, S.

    2017-09-01

    Curved shock theory is used to show that the flow behind attached shocks on doubly curved wedges can have either positive or negative post-shock pressure gradients depending on the freestream Mach number, the wedge angle and the two wedge curvatures. Given enough wedge length, the flow near the leading edge can choke to force the shock to detach from the wedge. This local choking can preempt both the maximum deflection and the sonic criteria for shock detachment. Analytical predictions for detachment by local choking are supported by CFD results.

  11. Focal choroidal excavation in eyes with central serous chorioretinopathy.

    Science.gov (United States)

    Ellabban, Abdallah A; Tsujikawa, Akitaka; Ooto, Sotaro; Yamashiro, Kenji; Oishi, Akio; Nakata, Isao; Miyake, Masahiro; Akagi-Kurashige, Yumiko; Ueda-Arakawa, Naoko; Arichika, Shigeta; Yoshitake, Shin; Takahashi, Ayako; Yoshimura, Nagahisa

    2013-10-01

    To study the prevalence and 3-dimensional (3-D) tomographic features of focal choroidal excavations in eyes with central serous chorioretinopathy (CSC) using swept-source optical coherence tomography (OCT). Prospective, cross-sectional study. We examined 116 consecutive eyes with CSC with a prototype 3-D swept-source OCT. 3-D images of the shape of the macular area, covering 6 × 6 mm(2), were reconstructed by segmentation of the outer surface of the retinal pigment epithelium (RPE). The 3-D swept-source OCT detected focal choroidal excavations in 9 eyes (7.8%). The 3-D scanning protocol, coupled with en face scans, allowed for clear visualization of the excavation morphology. In 5 eyes with focal excavations, unusual choroidal tissue was found beneath the excavation, bridging the bottom of the excavation and the outer choroidal boundary. Additionally, 3 of those 5 eyes showed a suprachoroidal space below the excavation, as if the outer choroidal boundary is pulled inward by this bridging tissue. The focal choroidal excavations were located within fluorescein leakage points and areas of choroidal hyperpermeability. Eyes with focal choroidal excavations were more myopic (-4.42 ± 2.92 diopters) than eyes without excavations (-0.27 ± 1.80 diopters, P = .001). Subfoveal choroidal thickness was significantly thinner (301.3 ± 60.1 μm) in eyes with focal excavations than in eyes without the excavations (376.6 ± 104.8 μm, P = .036). Focal choroidal excavations were present in 7.8% of eyes with CSC. In these eyes, focal choroidal excavations may have formed from RPE retraction caused by focal scarring of choroidal connective tissue. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. [Pancreatic serous cystadenoma associated with pancreatic heterotopia].

    Science.gov (United States)

    Mohamed, Hedfi; Dorra, Belghachem; Hela, Bouhafa; Cherif, Abdelhedi; Azza, Sridi; Karim, Sassi; Khadija, Bellil; Adnen, Chouchene

    2016-01-01

    Pancreatic heterotopias (HP) are rare. They can occur at any age with a slight male predominance. These lesions are usually asymptomatic and they are often found incidentally during upper or lower GI endoscopy or during the anatomo-pathological examination of an organ which was resected for other reasons; they can be isolated or associated with a digestive pathology. We report, through observation, the association of HP with serous cystadenoma of the pancreas discovered during examinations to identify the etiology of isolated abdominal pain. The aim of this study is to analyse clinical and histological features of this rare pathology.

  13. Short-term efficacy of intravitreal dobesilate in central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Cuevas Pedro

    2012-07-01

    Full Text Available Abstract Purpose To report the anatomic and functional outcome of intravitreal dobesilate to treat recurrent central serous chorioretinopathy (CSC. Methods This is an interventional case report in which dobesilate was intravitreally injected in a case of recurrent CSC. Main measures included fundoscopy, Snellen visual acuity (VA testing, fluorescein angiography and optical coherence tomography (OCT. Results We present anatomical and functional evidences, obtained as early as eleven days after the treatment, of the efficacy of intravitreal dobesilate, in the treatment of chronic CSC condition. The effect after intravitreal dobesilate injection for CSC might be related to the normalization of retinal architecture. Conclusions Intravitreal dobesilate may be an effective treatment option for recurrent CSC.

  14. Solar retinitis.

    Science.gov (United States)

    SHIRLEY, S Y

    1963-07-20

    Retinal burns can be produced by direct gazing at the sun. This lesion is caused by the thermal effects of the visible and near infrared rays focused on the pigment structure behind the retina. It is rarely seen, as the normal eye will tolerate only fleeting glances at the sun, but is fairly common during a solar eclipse. A case of solar retinitis is presented in which treatment with corticosteroids lessened the retinal edema but the patient suffered a bilateral central scotoma and vision reduced to the 20/40 level. In viewing a solar eclipse a No. 4 density filter is recommended; as a rough test this filter will abolish the readability of print on a 60-watt incandescent frosted electric light bulb.

  15. Multiple spots of photodynamic therapy for the treatment of severe chronic central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Tsakonas GD

    2012-10-01

    Full Text Available George D Tsakonas, Athanasios I Kotsolis, Chrysanthi Koutsandrea, Ilias Georgalas, Dimitrios Papakonstantinou, Ioannis D LadasFirst Department of Ophthalmology, Medical School of Athens University, Athens, GreecePurpose: To evaluate the efficacy and safety of fluorescein angiography (FA-guided photodynamic therapy (PDT for the treatment of severe chronic central serous chorioretinopathy (CSC.Methods: Patients presenting with chronic CSC with multiple areas of retinal pigment epithelium decompensation, with or without focal leaks, were treated with FA-guided full-fluence PDT. Best-corrected visual acuity (BCVA, optical coherence tomography (OCT, FA, indocyanine green angiography, and fundus autofluorescence were used to determine functional and anatomic outcomes.Results: Twenty-one eyes (17 patients were treated with PDT and followed for a median of 24 months (range, 12–73. In fourteen eyes (66.66%, two PDT spots were performed within the same session. In three eyes (14.28%, three PDT spots were performed, in two eyes (9.52% four spots, and in two eyes (9.52% five spots. In 17 eyes (80.95%, the leakage in FA and the subretinal fluid in OCT disappeared after only one session of PDT. In four eyes (19.05%, a second session – with only one spot – of PDT was required due to persistent or recurrent leakage and subfoveal SRF. Median BCVA improved significantly from 20/63 at baseline to 20/40 at 3 months (P = 0.0002 and 20/32 at 6 months (P < 0.0001, and remained improved until the last examination (20/25, P < 0.0001. Two patients complained of a transient central scotoma after the treatment.Conclusion: FA-guided full-fluence PDT with multiple PDT spots within the same session seems to be effective and safe for the treatment of chronic CSC cases with multiple areas of retinal pigment epithelium decompensation.Keywords: central serous chorioretinopathy, photodynamic therapy

  16. Controlling marginally detached divertor plasmas

    Science.gov (United States)

    Eldon, D.; Kolemen, E.; Barton, J. L.; Briesemeister, A. R.; Humphreys, D. A.; Leonard, A. W.; Maingi, R.; Makowski, M. A.; McLean, A. G.; Moser, A. L.; Stangeby, P. C.

    2017-06-01

    A new control system at DIII-D has stabilized the inter-ELM detached divertor plasma state for H-mode in close proximity to the threshold for reattachment, thus demonstrating the ability to maintain detachment with minimal gas puffing. When the same control system was instead ordered to hold the plasma at the threshold (here defined as T e  =  5 eV near the divertor target plate), the resulting T e profiles separated into two groups with one group consistent with marginal detachment, and the other with marginal attachment. The plasma dithers between the attached and detached states when the control system attempts to hold at the threshold. The control system is upgraded from the one described in Kolemen et al (2015 J. Nucl. Mater. 463 1186) and it handles ELMing plasmas by using real time D α measurements to remove during-ELM slices from real time T e measurements derived from divertor Thomson scattering. The difference between measured and requested inter-ELM T e is passed to a PID (proportional-integral-derivative) controller to determine gas puff commands. While some degree of detachment is essential for the health of ITER’s divertor, more deeply detached plasmas have greater radiative losses and, at the extreme, confinement degradation, making it desirable to limit detachment to the minimum level needed to protect the target plate (Kolemen et al 2015 J. Nucl. Mater. 463 1186). However, the observed bifurcation in plasma conditions at the outer strike point with the ion B   ×  \

  17. Pathogenesis of Ovarian Serous Carcinoma as the Basis for Immunologic Directed Diagnosis and Treatment. Project 1 - Molecular Characterization of Ovarian Serous Tumors Developing Along Different Pathways

    National Research Council Canada - National Science Library

    Kurman, Robert

    2003-01-01

    The purpose of this study is to elucidate the pathogenesis of serous carcinoma by identifying the molecular genetic changes and preferentially expressed genes of different histological types of serous neoplasms...

  18. 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%.

  19. the detachment of the meaning

    OpenAIRE

    Rakotomalala, Jean Robert

    2014-01-01

    ABSTRACT The rule of the detachment of the meaning that we owe to Benoît de CORNULIER allows any semiotics to incorporate a sense already expressible in a given language. It allows among others to characterize the illocutionary acts. An expression is produced primarily to mean, but from the form of expression, we can agree on an attitude of the speaker. This form is both a Convention that highlights the rule of detachment of the meaning.; La règle du détachement du sens que nous devons à Beno...

  20. Pancreatic tuberculosis masquerading as pancreatic serous cystadenoma

    Science.gov (United States)

    Hong, Seung Goun; Kim, Jae Seon; Joo, Moon Kyung; Lee, Kwang Gyun; Kim, Key Hyeon; Oh, Cho Rong; Park, Jong-Jae; Bak, Young-Tae

    2009-01-01

    Solitary pancreatic involvement of tuberculosis is rare, especially in an immunocompetent individual, and it may be misdiagnosed as pancreatic cystic neoplasms. Pancreatic cystic neoplasms are being identified in increasing numbers, probably because of the frequent use of radiology and advances in endoscopic techniques. However, they are composed of a variety of neoplasms with a wide range of malignant potential, and it is often difficult to differentiate pancreatic tuberculosis mimicking cystic neoplasms from benign or malignant pancreatic cystic neoplasms. Non-surgical diagnosis of pancreatic tuberculosis is inconclusive and continues to be a challenge in many cases. If so, then laparotomy should be employed to establish the diagnosis. Therefore, pancreatic tuberculosis should be kept in mind during the differential diagnosis of solitary cystic masses in the pancreas. We report a patient who had solitary pancreatic tuberculosis masquerading as pancreatic serous cystadenoma. PMID:19248204

  1. Intravitreal bevacizumab combined with plaque brachytherapy reduces melanoma tumor volume and enhances resolution of exudative detachment

    Directory of Open Access Journals (Sweden)

    Houston SK

    2013-01-01

    Full Text Available Samuel K Houston,1 Nisha V Shah,1 Christina Decatur,1 Marcela Lonngi,1 William Feuer,1 Arnold M Markoe,2 Timothy G Murray1–31Department of Ophthalmology, 2Department of Radiation Oncology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 3Murray Ocular Oncology and Retina, Miami, FL, USABackground: The purpose of this study was to evaluate intravitreal bevacizumab as an adjuvant treatment to plaque brachytherapy in the treatment of choroidal melanoma.Methods: This was a retrospective, consecutive study of 124 patients treated from 2007 to 2009 for choroidal melanoma with plaque brachytherapy. Patients were treated with I-125 plaque brachytherapy with 2 mm margins and 85 Gy to the tumor apex. Consecutive patients were injected intravitreally with 2.5 mg/0.1 mL bevacizumab at a site away from the primary tumor and immediately following plaque removal. Choroidal melanomas were observed using indirect ophthalmoscopy, wide-angle photography, and ultrasound. The main outcome measures were tumor volume, resolution of exudative retinal detachment, and visual acuity.Results: One hundred and twenty-four patients met our inclusion criteria and were included in the analysis. The mean patient age was 65.7 years, and the mean apical tumor height was 4.0 ± 2.7 mm and basal diameter was 12.7 ± 3.0 mm. Mean follow-up was 24 months. Prior to treatment, 100% of tumors had exudative retinal detachment, and pretreatment visual acuity was 20/55 (median 20/40. Tumor control was 100%, metastasis was 0% at last follow-up, and 89.8% had complete resolution of exudative retinal detachment, with a mean time to resolution of 3.36 months. At one month, 43% had complete resolution of exudative retinal detachment, which increased to 73% at 4 months. Visual acuity was 20/62 (median 20/40 at 4 months, with stabilization to 20/57 (median 20/40 at 8 months, 20/56 (median 20/30 at 12 months, and 20/68 (median 20/50 at 24 months. Tumor

  2. Characterization of subretinal fluid leakage in central serous chorioretinopathy

    DEFF Research Database (Denmark)

    Pryds, Anders; Sander, Birgit; Larsen, Michael

    2010-01-01

    The purpose of the study was to determine which category of hydrodynamic phenomena the smokestack in central serous chorioretinopathy (CSC) most likely belongs to: leakage by diffusion or bulk flow....

  3. Cervical cytology in serous and endometrioid endometrial cancer

    NARCIS (Netherlands)

    Roelofsen, T.; Geels, Y.P.; Pijnenborg, J.M.A.; Ham, M.A.P.C. van; Zomer, S.F.; Tilburg, J.M. van; Snijders, M.P.; Siebers, A.G.; Bulten, J.; Massuger, L.F.A.G.

    2013-01-01

    The aim of this study was to determine the frequency of abnormal cervical cytology in preoperative cervical cytology of patients diagnosed with uterine papillary serous carcinoma (UPSC) and endometrioid endometrial carcinoma (EEC). In addition, associations between abnormal cervical cytology and

  4. 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.

  5. Retinitis pigmentosa

    Directory of Open Access Journals (Sweden)

    Hamel Christian

    2006-10-01

    Full Text Available Abstract Retinitis pigmentosa (RP is an inherited retinal dystrophy caused by the loss of photoreceptors and characterized by retinal pigment deposits visible on fundus examination. Prevalence of non syndromic RP is approximately 1/4,000. The most common form of RP is a rod-cone dystrophy, in which the first symptom is night blindness, followed by the progressive loss in the peripheral visual field in daylight, and eventually leading to blindness after several decades. Some extreme cases may have a rapid evolution over two decades or a slow progression that never leads to blindness. In some cases, the clinical presentation is a cone-rod dystrophy, in which the decrease in visual acuity predominates over the visual field loss. RP is usually non syndromic but there are also many syndromic forms, the most frequent being Usher syndrome. To date, 45 causative genes/loci have been identified in non syndromic RP (for the autosomal dominant, autosomal recessive, X-linked, and digenic forms. Clinical diagnosis is based on the presence of night blindness and peripheral visual field defects, lesions in the fundus, hypovolted electroretinogram traces, and progressive worsening of these signs. Molecular diagnosis can be made for some genes, but is not usually performed due to the tremendous genetic heterogeneity of the disease. Genetic counseling is always advised. Currently, there is no therapy that stops the evolution of the disease or restores the vision, so the visual prognosis is poor. The therapeutic approach is restricted to slowing down the degenerative process by sunlight protection and vitaminotherapy, treating the complications (cataract and macular edema, and helping patients to cope with the social and psychological impact of blindness. However, new therapeutic strategies are emerging from intensive research (gene therapy, neuroprotection, retinal prosthesis.

  6. Serous degeneration of bone marrow mimics spinal tumor.

    Science.gov (United States)

    Sung, Chih-Wei; Hsieh, Kevin Li-Chun; Lin, Yun-Ho; Lin, Chun-Yi; Lee, Chian-Her; Tsuang, Yang-Hwei; Kuo, Yi-Jie

    2017-05-01

    To present a rare case of serous degeneration of bone marrow which resembles primary spinal tumor or bony metastasis to spine. Serous degeneration of bone marrow or gelatinous marrow transformation is a rare disease characterized by focal marrow hypoplasia, fat atrophy, and accumulation of extracellular mucopolysaccharides abundant in hyaluronic acid. Few literature was reviewed and few clinical case was presented. Two cases of serous marrow transformation were reported. In the first case, a 29-year-old man suffered from severe left buttock pain. Bone metastasis was impressed in radiology examinations. Percutaneous endoscopic lumbar discectomy was performed along with bone biopsy. In the second case, a 49-year-old man presented lower back pain with radiation to bilateral lower legs. Magnetic resonance imaging revealed a water-like signal lesion in sacrum. Serous marrow transformation was confirmed pathologically in both cases. To the best of our knowledge, a case of serous degeneration of bone marrow resembling malignancy has not been reported in the literature. In this report, two cases demonstrate serous transformation of bone marrow mimics spinal tumor.

  7. Pars plana vitrectomy combined with internal limiting membrane peeling for recurrent macular edema due to branch retinal vein occlusion after antivascular endothelial growth factor treatments

    Directory of Open Access Journals (Sweden)

    Shirakata Y

    2016-02-01

    Full Text Available Yukari Shirakata,1 Kouki Fukuda,1 Tomoyoshi Fujita,1 Yuki Nakano,1 Hiroyuki Nomoto,2 Hidetaka Yamaji,3 Fumio Shiraga,4 Akitaka Tsujikawa1 1Department of Ophthalmology, Faculty of Medicine, Kagawa University, Miki-cho, 2Nomoto Eye Clinic, Himeji, 3Department of Ophthalmology, Shirai Eye Hospital, Mitoyo, 4Department of Ophthalmology, Okayama University, Okayama, Japan Purpose: To evaluate the anatomic and functional outcomes of pars plana vitrectomy combined with internal limiting membrane peeling for recurrent macular edema (ME due to branch retinal vein occlusion (BRVO after intravitreal injections of antivascular endothelial growth factor (anti-VEGF agents. Methods: Twenty-four eyes of 24 patients with treatment-naive ME from BRVO were treated with intravitreal injections of anti-VEGF agents. Recurred ME was treated with pars plana vitrectomy combined with internal limiting membrane peeling. Results: After the surgery, ME was significantly reduced at 1 month (P=0.031 and the reduction increased with time (P=0.007 at the final visit. With the reduction in ME, treated eyes showed a slow improvement in visual acuity (VA. At the final visit, improvement in VA was statistically significant compared with baseline (P=0.048. The initial presence of cystoid spaces, serous retinal detachment, or subretinal hemorrhage under the fovea, as well as retinal perfusion status, showed no association with VA improvement. However, the presence of epiretinal membrane showed a significant association with the visual recovery. Although eyes without epiretinal membrane showed visual improvement (-0.10±0.32 in logarithm of the minimum angle of resolution [logMAR], eyes with epiretinal membrane showed greater visual improvement (-0.38±0.12 in logMAR, P=0.012. Conclusion: For recurrent ME due to BRVO after anti-VEGF treatment, particularly when accompanied by epiretinal membrane, pars plana vitrectomy combined with internal limiting membrane peeling might be a

  8. Kinematic Fitting of Detached Vertices

    Energy Technology Data Exchange (ETDEWEB)

    Mattione, Paul [Rice Univ., Houston, TX (United States)

    2007-05-01

    The eg3 experiment at the Jefferson Lab CLAS detector aims to determine the existence of the $\\Xi_{5}$ pentaquarks and investigate the excited $\\Xi$ states. Specifically, the exotic $\\Xi_{5}^{--}$ pentaquark will be sought by first reconstructing the $\\Xi^{-}$ particle through its weak decays, $\\Xi^{-}\\to\\pi^{-}\\Lambda$ and $\\Lambda\\to\\pi^{-}$. A kinematic fitting routine was developed to reconstruct the detached vertices of these decays, where confidence level cuts on the fits are used to remove background events. Prior to fitting these decays, the exclusive reaction $\\gamma D\\rightarrow pp\\pi^{-}$ was studied in order to correct the track measurements and covariance matrices of the charged particles. The $\\Lambda\\rightarrow p\\pi^{-}$ and $\\Xi^{-}\\to\\pi^{-}\\Lambda$ decays were then investigated to demonstrate that the kinematic fitting routine reconstructs the decaying particles and their detached vertices correctly.

  9. Imaging Polarimetry in Central Serous Chorioretinopathy

    Science.gov (United States)

    MIURA, MASAHIRO; ELSNER, ANN E.; WEBER, ANKE; CHENEY, MICHAEL C.; OSAKO, MASAHIRO; USUI, MASAHIKO; IWASAKI, TAKUYA

    2006-01-01

    PURPOSE To evaluate a noninvasive technique to detect the leakage point of central serous chorioretinopathy (CSR), using a polarimetry method. DESIGN Prospective cohort study. METHODS SETTING Institutional practice. PATIENTS We examined 30 eyes of 30 patients with CSR. MAIN OUTCOME MEASURES Polarimetry images were recorded using the GDx-N (Laser Diagnostic Technologies). We computed four images that differed in their polarization content: a depolarized light image, an average reflectance image, a parallel polarized light image, and a birefringence image. Each polarimetry image was compared with abnormalities seen on fluorescein angiography. RESULTS In all eyes, leakage area could be clearly visualized as a bright area in the depolarized light images. Michelson contrasts for the leakage areas were 0.58 ± 0.28 in the depolarized light images, 0.17 ± 0.11 in the average reflectance images, 0.09 ± 0.09 in the parallel polarized light images, and 0.11 ± 0.21 in the birefringence images from the same raw data. Michelson contrasts in depolarized light images were significantly higher than for the other three images (P < .0001, for all tests, paired t test). The fluid accumulated in the retina was well-visualized in the average and parallel polarized light images. CONCLUSIONS Polarization-sensitive imaging could readily localize the leakage point and area of fluid in CSR. This may assist with the rapid, noninvasive assessment of CSR. PMID:16376644

  10. 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.

  11. Foveal function and thickness after verteporfin photodynamic therapy in central serous chorioretinopathy with hyperautofluorescent subretinal deposits

    DEFF Research Database (Denmark)

    Pryds, Anders; Larsen, Michael

    2013-01-01

    : To assess the prognostic effect of subretinal deposits in eyes with central serous chorioretinopathy (CSC).......: To assess the prognostic effect of subretinal deposits in eyes with central serous chorioretinopathy (CSC)....

  12. Serous ovarian, fallopian tube and primary peritoneal cancers

    DEFF Research Database (Denmark)

    Sørensen, Rie D; Schnack, Tine H; Karlsen, Mona A

    2015-01-01

    OBJECTIVE: The aim of this systematic review is to analyze data on risk factors, epidemiology, clinicopathology and molecular biology from studies comparing primary peritoneal cancer, fallopian tube cancer and ovarian cancer of serous histology, in order to achieve a greater understanding...... of whether or not these disorders should be considered as separate entities. METHODS: A systematic literature search was conducted in PubMed and MEDLINE. Case-control studies comparing primary serous peritoneal or fallopian tube carcinomas with primary serous ovarian carcinomas or a control group were...... included. RESULTS: Twenty-eight studies were found eligible. Primary peritoneal cancer patients were older, had higher parity, were more often obese and had poorer survival compared to ovarian cancer patients. Differences in protein expression patterns of Her2/neu, estrogen and progestin receptors...

  13. 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.

  14. Impact of the Ovarian Microenvironment on Serous Cancer

    Science.gov (United States)

    2015-08-01

    AWARD NUMBER: W81XWH-14-1-0182 TITLE: Impact of the Ovarian Microenvironment on Serous Cancer PRINCIPAL INVESTIGATOR: Burdette, Joanna E... Impact of the Ovarian Microenvironment on Serous Cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0182 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...results were verified to show repression of CTGF similar to the qPCR. The results are shown in Figure 9. The volcano plot in Figure 9A shows the most

  15. Col4a1 mutations cause progressive retinal neovascular defects and retinopathy

    Science.gov (United States)

    Alavi, Marcel V.; Mao, Mao; Pawlikowski, Bradley T.; Kvezereli, Manana; Duncan, Jacque L.; Libby, Richard T.; John, Simon W. M.; Gould, Douglas B.

    2016-01-01

    Mutations in collagen, type IV, alpha 1 (COL4A1), a major component of basement membranes, cause multisystem disorders in humans and mice. In the eye, these include anterior segment dysgenesis, optic nerve hypoplasia and retinal vascular tortuosity. Here we investigate the retinal pathology in mice carrying dominant-negative Col4a1 mutations. To this end, we examined retinas longitudinally in vivo using fluorescein angiography, funduscopy and optical coherence tomography. We assessed retinal function by electroretinography and studied the retinal ultrastructural pathology. Retinal examinations revealed serous chorioretinopathy, retinal hemorrhages, fibrosis or signs of pathogenic angiogenesis with chorioretinal anastomosis in up to approximately 90% of Col4a1 mutant eyes depending on age and the specific mutation. To identify the cell-type responsible for pathogenesis we generated a conditional Col4a1 mutation and determined that primary vascular defects underlie Col4a1-associated retinopathy. We also found focal activation of Müller cells and increased expression of pro-angiogenic factors in retinas from Col4a1+/Δex41mice. Together, our findings suggest that patients with COL4A1 and COL4A2 mutations may be at elevated risk of retinal hemorrhages and that retinal examinations may be useful for identifying patients with COL4A1 and COL4A2 mutations who are also at elevated risk of hemorrhagic strokes. PMID:26813606

  16. Dynamic changes of photorecrptor layer in eyes with acute central serous chorioretinopathy after laser treatment by fourier-domain optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Li-Qin Zhou

    2014-10-01

    Full Text Available AIM: To dynamically observe the feeling change of the photorecrptor layer in the eyes with acute central serous chorioretinopathy(CSCRkrypton laser treatment by fourier-domain optical coherence tomography(FD-OCT, and to study their correlation with the chang of vision.METHODS: This is a retrospective case series study. The clinical diagnosis of 52 patients with monocular initial onset of central serous chorioretinopathy, krypton laser photocoagulation before treatment, after 1, 2, 4, 6, 8wk, 6mo, FD-OCT were performed to observe the morphological changes characteristic of photoreceptor layer and changes in vision. RESULTS: After 1wk treatment, all cases were improved; 2wk, 6 cases were cured; 4wk, 38 cases were cured; 6wk, 41 cases were cured; 8wk, 45 cases were cured, the OCT showed macular retinal neuroepithelial layer(RNLfrom fully absorbed; 6mo with the same 8wk. Before and after treatment in patients with best corrected visual acuity and from the height difference between the macular region of RNL was statistically significant(PPPCONCLUSION: FD-OCT can dynamicaly observed acute central serous chorioretinopathy krypton laser treatment of photoreceptor ultrastruture changes. Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant(P<0.01.

  17. Transcriptomic Analysis of Human Retinal Surgical Specimens Using jouRNAl

    Science.gov (United States)

    Delyfer, Marie-Noëlle; Aït-Ali, Najate; Camara, Hawa; Clérin, Emmanuelle; Korobelnik, Jean-François; Sahel, José-Alain; Léveillard, Thierry

    2013-01-01

    Retinal detachment (RD) describes a separation of the neurosensory retina from the retinal pigmented epithelium (RPE). The RPE is essential for normal function of the light sensitive neurons, the photoreceptors. Detachment of the retina from the RPE creates a physical gap that is filled with extracellular fluid. RD initiates cellular and molecular adverse events that affect both the neurosensory retina and the RPE since the physiological exchange of ions and metabolites is severely perturbed. The consequence for vision is related to the duration of the detachment since a rapid reapposition of the two tissues results in the restoration of vision 1. The treatment of RD is exclusively surgical. Removal of vitreous gel (vitrectomy) is followed by the removal non essential part of the retina around the detached area to favor retinal detachment. The removed retinal specimens are res nullius (nothing) and consequently normally discarded. To recover RNA from these surgical specimens, we developed the procedure jouRNAl that allows RNA conservation during the transfer from the surgical block to the laboratory. We also standardized a protocol to purify RNA by cesium chloride ultracentrifugation to assure that the purified RNAs are suitable for global gene expression analysis. The quality of the RNA was validated both by RT-PCR and microarray analysis. Analysis of the data shows a simultaneous involvement of inflammation and photoreceptor degeneration during RD. PMID:23979175

  18. Transcriptomic analysis of human retinal surgical specimens using jouRNAI.

    Science.gov (United States)

    Delyfer, Marie-Noëlle; Aït-Ali, Najate; Camara, Hawa; Clérin, Emmanuelle; Korobelnik, Jean-François; Sahel, José-Alain; Léveillard, Thierry

    2013-08-14

    Retinal detachment (RD) describes a separation of the neurosensory retina from the retinal pigmented epithelium (RPE). The RPE is essential for normal function of the light sensitive neurons, the photoreceptors. Detachment of the retina from the RPE creates a physical gap that is filled with extracellular fluid. RD initiates cellular and molecular adverse events that affect both the neurosensory retina and the RPE since the physiological exchange of ions and metabolites is severely perturbed. The consequence for vision is related to the duration of the detachment since a rapid reapposition of the two tissues results in the restoration of vision (1). The treatment of RD is exclusively surgical. Removal of vitreous gel (vitrectomy) is followed by the removal non essential part of the retina around the detached area to favor retinal detachment. The removed retinal specimens are res nullius (nothing) and consequently normally discarded. To recover RNA from these surgical specimens, we developed the procedure jouRNAl that allows RNA conservation during the transfer from the surgical block to the laboratory. We also standardized a protocol to purify RNA by cesium chloride ultracentrifugation to assure that the purified RNAs are suitable for global gene expression analysis. The quality of the RNA was validated both by RT-PCR and microarray analysis. Analysis of the data shows a simultaneous involvement of inflammation and photoreceptor degeneration during RD.

  19. 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.

  20. A Review of the Changes in the Ophthalmic and Visual System in ...

    African Journals Online (AJOL)

    Erah

    ... segment changes include worsening of diabetic retinopathy, central serous chorioretinopathy, increased risk of peripheral vitreochorioretinal dystrophies and retinal detachment, and a beneficial effect on non-infectious uveitis. Systemic disorders of importance include preeclampsia, Graves disease and multiple sclerosis.

  1. Multimodal Imaging and Choroidal Volumetric Changes After Half-fluence PDT in Central Serous Chorioretinopathy.

    Science.gov (United States)

    Munk, Marion R; Shah, Ronil; Pappas, Frankie; Baddar, Dina; Wong, Brandon; Jampol, Lee M; Fawzi, Amani A

    2016-01-01

    The purpose of this study was to identify SD-OCT changes that correspond to leakage on fluorescein (FA) and indocyanine angiography (ICGA) and evaluate effect of half-fluence photodynamic therapy (PDT) on choroidal volume in chronic central serous choroidoretinopathy (CSC). Retrospective analysis of patients with chronic CSC who had undergone PDT. Baseline FA and ICGA images were overlaid on SD-OCT to identify OCT correlates of FA or ICGA hyperfluorescence. Choroidal volume was evaluated in a subgroup of eyes before and after PDT. Twenty eyes were evaluated at baseline, of which seven eyes had choroidal volume evaluations at baseline and 3 months following PDT. SD-OCT changes corresponding to FA hyperfluorescence were subretinal fluid (73%), RPE microrip (50%), RPE double-layer sign (31%), RPE detachment (15%), and RPE thickening (8%). ICGA hyperfluoresence was correlated in 93% with hyperreflective spots in the superficial choroid. Choroidal volume decreased from 9.35 ± 1.99 to 8.52 ± 1.92 and 8.04 ± 1.7 mm(3) (at 1 and 3 months post PDT, respectively, p ≤ 0.001). We identified specific OCT findings that correlate with FA and ICGA leakage sites. SD-OCT is a valuable tool to localize CSC lesions and may be useful to guide PDT treatment. Generalized choroidal volume decrease occurs following PDT and extends beyond PDT treatment site.

  2. Temperament and Character Personality Profile and Illness-Related Stress in Central Serous Chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Rupert Conrad

    2014-01-01

    Full Text Available Psychological stress is a risk factor as well as a consequence of central serous chorioretinopathy (CSC. Impulsiveness, overachievement, emotional instability, and hard-driving competitiveness have been discussed as personality features in CSC patients. We investigated 57 consecutive CSC patients and 57 age- and gender-matched controls by means of the Symptom Checklist 90-R and the Temperament and Character Inventory. Somatic risk factors, illness characteristics, subjective assessment of severity of illness, and illness-related stress in different areas of life (work, private life were evaluated. CSC patients showed significantly higher emotional distress as measured by the Global Severity Index. The CSC personality was characterized by lower scoring on the character dimension cooperativeness and the temperament dimension reward dependence. Cooperativeness as well as subjective assessment of severity of CSC has been recognized as significant predictors of illness-related work stress accounting for 30% of variance. Implicating competitiveness, hostility and emotional detachment, lower level of cooperativeness, and reward dependence support the existence of specific aspects of type A behaviour in CSC patients. Low perceived social support and loss of control may explain the significant contribution of this personality dimension to illness-related work stress. Treatment of CSC should thus incorporate psychoeducation about factors contributing to illness-related stress.

  3. 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.

  4. Detached divertor plasmas in JET

    Energy Technology Data Exchange (ETDEWEB)

    Horton, L.D.; Borrass, K.; Corrigan, G.; Gottardi, N.; Lingertat, J.; Loarte, A.; Simonini, R.; Stamp, M.F.; Taroni, A. [Commission of the European Communities, Abingdon (United Kingdom). JET Joint Undertaking; Stangeby, P.C. [Toronto Univ., ON (Canada). Inst. for Aerospace Studies

    1994-07-01

    In simulations with high radiated power fractions, it is possible to produce the drop in ion current to the divertor targets typical of detached plasmas. Despite the fact that these experiments are performed on beryllium target tiles, radiation from deuterium and beryllium cannot account for the measured power losses. The neutral deuterium levels in the SOL in these plasmas are higher than the model predicts. This may be due to leakage from the divertor or to additional wall sources related to the non-steady nature of these plasmas. In contrast, a surprisingly high level of carbon is present in these discharges; higher even than would be predicted are the divertor target tiles pure carbon. This level may well be large enough to produce the measured radiation. (authors). 6 refs., 2 figs., 1 tab.

  5. Retinal Imaging with Smartphone

    African Journals Online (AJOL)

    2017-03-06

    Mar 6, 2017 ... lens in patients with dilated pupils by activating the video mode of the camera. Results: Clear retinal images were obtained ... The aim of this study is to explore the use of smartphone. (Blackberry Z-10) for retinal ... Figure 2 a shows fibrous proliferation in a case of branch retinal vein occlusion, and Figure 2 ...

  6. Progression of choroidal metastasis of ovarian serous cystoadenocarcinoma after intravitreal bevacizumab treatment

    Directory of Open Access Journals (Sweden)

    Victor E. Reviglio

    2013-02-01

    Full Text Available A 57-year-old woman presented to her ophthalmologist because of rapid deterioration in vision. Dilated funduscopic examination of the right eye showed an elevated, yellow-orange choroidal mass temporal to the fovea; a complete retinal detachment was present in the left eye. The patient was referred to an oncologist. Computerized tomography of the brain, thorax, abdomen, and pelvis were obtained. They revealed an 11-mm mass in the right parietal lobe, a 30-mm mass in the left temporal lobe, 23-mm mass in the right kidney, and multiple nodules in both lungs. Supported by published experience with intravitreal bevacizumab for choroidal metastasis, the patient was injected into the vitreous through the pars plana of the left eye. The tumor mass did not show signs of regression and the visual acuity was unchanged. The patient suffered from end-state complications tumor metastasis and expired one month after the invitreal injection.

  7. Diffuse retinal injury from a non-penetrating TASER dart.

    Science.gov (United States)

    Sayegh, Rony R; Madsen, Kimberly A; Adler, Jason D; Johnson, Mary A; Mathews, Michaela K

    2011-10-01

    To describe a non-penetrating TASER gun injury resulting in a small exudative retinal detachment but significant visual acuity and retinal function loss as demonstrated by electroretinography (ERG). A 39-year-old man presented to the emergency department with a TASER barb embedded in his right lower lid. A complete clinical ophthalmologic examination and surgical extrication were performed, as well as radiologic imaging and Ganzfeld electroretinography. No scleral penetration was observed on surgical exploration. Retinal examination showed a peripheral exudative detachment. Subsequent follow-up revealed progressive resolution of the detachment and improvement in visual acuity. The ERG showed a 63-70% decrease in rod a- and b-waves, while isolated cone responses were reduced by only 10%, with a minimal increase in implicit time. This case shows that periocular TASER injuries, even if apparently superficial, may result in significant ocular damage. ERG may be useful in the diagnosis of visual loss attributed to disturbance in photoreceptor function, in the absence of anatomically evident damage.

  8. Retinal ischaemia and delayed fibrovascular proliferation associated with an optic nerve coloboma.

    Science.gov (United States)

    Pastora, N; Peralta, J; Abelairas, J

    2016-04-01

    A patient with a left optic nerve coloboma with late development (at 15 years of age) of vitreoretinal fibrovascular proliferation and tractional retinal detachment (TRD). Sectorial retinal photocoagulation was performed with regression of the proliferative tissue and exudation. Congenital optic nerve anomalies may be associated with significant retinal avascularity, ischaemia and late fibrovascular proliferation. Laser is effective for regression of the neovascular tissue and preventing TRD progression. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  9. A nationwide study of ovarian serous borderline tumors in Denmark 1978-2002. Risk of recurrence, and development of ovarian serous carcinoma.

    Science.gov (United States)

    Hannibal, Charlotte Gerd; Vang, Russell; Junge, Jette; Frederiksen, Kirsten; Kurman, Robert J; Kjaer, Susanne K

    2017-01-01

    Absolute risk and risk factors for recurrence and ovarian serous carcinoma following ovarian serous borderline tumors (SBTs) is not well-established. We included all women with SBTs in Denmark, 1978-2002. Diagnoses were confirmed by centralized pathology review and classified as atypical proliferative serous tumor (APST) or noninvasive low-grade serous carcinoma (LGSC). Implants were classified as noninvasive or invasive. Medical records were collected and reviewed, and follow-up was obtained. Subsequent diagnoses were also confirmed by centralized pathology review. We examined absolute risk and risk factors for recurrent APST and serous carcinoma using Cox regression. The absolute serous carcinoma risk after, respectively, 5 and 20years was 5.0% and 13.9% for noninvasive LGSC, and 0.9% and 3.7% for APST. Serous carcinoma risk was significantly higher following noninvasive LGSC compared with APST among stage I patients/patients without implants (HR=5.3; 95% CI: 1.7-16.3), whereas no significant association with tumor type was found in advanced stage patients/patients with implants. Advanced stage - notably invasive implants - bilaterality, surface involvement, and residual disease increased serous carcinoma risk. However, women with stage I APST also had a higher risk than the general population. This largest population-based cohort of verified SBTs revealed that women with noninvasive LGSC are significantly more likely to develop serous carcinoma than women with APST, which could not entirely be explained by invasive implants. Although invasive implants was a strong risk factor for serous carcinoma, even women with stage I APST were at increased risk compared with the general population. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Incidence and natural course of symptomatic central serous chorioretinopathy in pregnant women in a maternity hospital in Kuwait.

    Science.gov (United States)

    Said-Ahmed, Khaled; Moustafa, Gamal; Fawzy, Medhat

    2012-01-01

    To report the incidence, clinical features and natural course of central serous chorioretinopathy (CSR) in pregnant women in Kuwait. Patients were actively recruited from a private maternity hospital. Out of the 17,000 pregnant women who visited the antenatal care clinics (Al-Orf Hospital, Kuwait) over 3 years, 900 had visual complaints. Patients with visual complaints underwent complete ophthalmological assessment. Medical records of patients with CSR were reviewed, and a full clinical ophthalmological assessment was performed including measurement of best corrected visual acuity, intraocular pressure, slit lamp biomicroscopy, dilated indirect ophthalmoscopy and Amsler grid screening, color and red free fundus photography and retinal optical coherence tomography. All patients were evaluated throughout the course of pregnancy and for 6 months after delivery. Four patients had CSR among the 17,000 pregnant women reviewed over 3 years corresponding to an incidence of 0.008 % per year. Two patients (50%) had CSR with white subretinal exudates and 2 (50%) had no exudates. There was complete resolution in all patients (100%) within 3 months after delivery. In pregnant women, CSR can present with or without retinal exudates and completely resolves in either case. Further studies with a larger sample size are warranted to investigate the risk factors in pregnant women.

  11. Spleen preservation in a caudal pancreatic serous cystadenoma - case report.

    Science.gov (United States)

    Dina, I; Ginghina, O; Iacobescu, C; Vrabie, C; Gidea, C; Munteanu, R; Iosifescu, R; Iordache, N

    2015-01-01

    Cystic lesions of the pancreas are relatively rare entities but have been increasingly diagnosed in recent years due to advanced imaging techniques. This category encompasses pancreatic pseudocyst as well as a wide range of pancreatic tumors with benign behavior, borderline or primary malignant. Serous cystadenoma of the pancreas represents the most common benign pancreatic tumor, with a very low but well recognized malignant potential. The clinical presentation varies according to its size; small tumors may be asymptomatic and discovered incidentally, while large tumors are more likely symptomatic. We report the case of a female patient presenting with non-specific left abdominal pain, who was diagnosed through a CT scan with a caudal pancreatic tumor. The patient underwent spleen-preserving distal pancreatectomy. The result of the histopathological examination revealed a serous cystadenoma.

  12. Dealings between Cataract and Retinal Reattachment Surgery in PVR

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    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.

  13. Impact of the Ovarian Microenvironment on Serous Cancer

    Science.gov (United States)

    2016-10-01

    AWARD NUMBER: W81XWH-14-1-0182 TITLE: Impact of the Ovarian Microenvironment on Serous Cancer PRINCIPAL INVESTIGATOR: Joanna Burdette...FORM TO THE ABOVE ADDRESS. 1. REPORT DATE October 2016 2. REPORT TYPE Annual 3. DATES COVERED 1Aug2015 - 31Jul2016 4. TITLE AND SUBTITLE Impact of...indirectly. Future research will use fast- protein liquid chromatography (FPLC) to narrow down the list of proteins potentially stimulated migration

  14. Neuropeptides degranulate serous cells of ferret tracheal glands

    Energy Technology Data Exchange (ETDEWEB)

    Gashi, A.A.; Borson, D.B.; Finkbeiner, W.E.; Nadel, J.A.; Basbaum, C.B.

    1986-08-01

    To determine whether serous or mucous cells in tracheal submucosal glands respond to the neuropeptides substance P (SP) and vasoactive intestinal peptide (VIP). The authors studied the peptide-induced changes in gland cell morphology accompanying release of TVSO4-labeled macromolecules from tracheal explants of ferrets. Explants were labeled for 1 h in medium containing TVSO4 and washed for 3.5 additional hours. Base-line secretion in the absence of drugs declined between 1.5 and 3.5 h after the pulse. Between 2.5 and 3.5 h, the average percent change in counts per minute recovered per sample period was not significantly different from zero. Substance P and VIP added 4 h after labeling each increased greatly the release of TVSO4-labeled macromolecules above base line. Bethanechol, a muscarinic-cholinergic agonist, increased secretion by an average of 142% above base line. Light and electron microscopy of the control tissues showed glands with narrow lumens and numerous secretory granules. Glands treated with SP or VIP had enlarged lumens and the serous cells were markedly degranulated. These phenomena were documented by morphometry and suggest that SP and VIP cause secretion from glands at least partially by stimulating exocytosis from serous cells.

  15. Oxidatively Modified Proteins in the Serous Subtype of Ovarian Carcinoma

    Directory of Open Access Journals (Sweden)

    Sharifeh Mehrabi

    2014-01-01

    Full Text Available Serous subtype of ovarian cancer is considered to originate from fallopian epithelium mucosa that has been exposed to physiological changes resulting from ovulation. Ovulation influences an increased in inflammation of epithelial ovarian cells as results of constant exposure of cells to ROS. The imbalance between ROS and antioxidant capacities, as well as a disruption of redox signaling, causes a wide range of damage to DNA, proteins, and lipids. This study applied spectrophotometric, dinitrophenylhydrazone (DNPH assay, two-dimensional gel electrophoresis, and Western blot analyses to assess the levels of oxidatively modified proteins in 100 primary serous epithelial ovarian carcinoma and normal/surrounding tissues. These samples were obtained from 56 Caucasian and 44 African-American patients within the age range of 61±10 years. Analyses showed that the levels of reactive protein carbonyl groups increased as stages progressed to malignancy. Additionally, the levels of protein carbonyls in serous ovarian carcinoma among African Americans are 40% (P<0.05 higher relative to Caucasian at similar advanced stages. Results suggest that oxidative stress is involved in the modification of carbonyl protein groups, leading to increased aggressiveness of epithelial ovarian tumors and may contribute to the disease's invasiveness among African Americans.

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

    African Journals Online (AJOL)

    tulyasys

    Byer N. Long-term natural history of lattice degeneration of the retina. Ophthalmology 1989;96:1396-402. 14. Folk JC, Bennett SR, Klugman MR, Arrindell EL, Boldt HC. Prophylactic treatment to the fellow eye of patients with phakic lattice retinal detachment: Analysis of failures and risks of treatment. Retina. 1990;10:165-9.

  17. Vitrectomy for optic disc pit-associated maculopathy with or without preoperative posterior vitreous detachment

    Science.gov (United States)

    Haruta, Masatoshi; Kamada, Rika; Umeno, Yumi; Yamakawa, Ryoji

    2012-01-01

    Background The purpose of this study was to evaluate the efficacy of pars plana vitrectomy for the treatment of optic disc pit-associated maculopathy with or without preoperative posterior vitreous detachment. Methods We reviewed the clinical records of four consecutive patients who underwent pars plana vitrectomy in one eye for the treatment of optic disc pit-associated maculopathy, with an emphasis on the preoperative condition of the posterior hyaloid membrane. Results Two of four eyes were confirmed to have an attached posterior hyaloid membrane, which was subsequently removed during surgery. Following vitrectomy, these two eyes experienced an improvement in visual acuity with complete retinal attachment of the macula. However, the other two eyes, which already had a posterior vitreous detachment at the time of surgery, showed a decrease in visual acuity with persistent maculopathy postoperatively. Conclusion Pars plana vitrectomy for optic disc pit-associated maculopathy was beneficial for improving visual acuity in two eyes without preoperative posterior vitreous detachment but not in two eyes with preoperative posterior vitreous detachment. Our study suggests that preoperative assessment of a posterior hyaloid membrane is clinically important in predicting the surgical outcome of optic disc pit-associated maculopathy. PMID:22973089

  18. Rescue vitrectomy with blocked artery massage and bloodletting for branch retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Chun-Ju Lin

    2017-01-01

    Full Text Available A 61-year-old male suffered from sudden blurred vision and superior visual field defect oculus dexter. His vision was counting fingers at 20 cm. Fundoscopy demonstrated inferior pale retina and a large embolus located at the proximal inferior retinal artery. Branch retinal artery occlusion (BRAO was diagnosed. Initial paracentesis, topical brimonidine tartrate, oral pentoxifylline, and hyperbaric oxygen therapy were performed but showed limited improvement. Hence, he received 25-gauge vitrectomy, artificial posterior vitreous detachment, blocked retinal artery massage, and bloodletting 5 days after onset. After the surgery, his vision improved to 20/25. Fundoscopy showed reperfused retina, and optical coherence tomography revealed resolved retinal edema. RAO is an ophthalmological emergency; however, no standard guideline is available. Vitrectomy with blocked retinal artery massage and bloodletting showed favorable results in this case of BRAO with a large embolus. More prospective clinical trials are needed for setting up the standard treatment.

  19. 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.

  20. Psammocarcinoma of ovary with serous cystadenofibroma of contralateral ovary: a case report

    Directory of Open Access Journals (Sweden)

    Aggarwal Pallavi

    2009-12-01

    Full Text Available Abstract Introduction Psammocarcinoma of ovary is a rare serous neoplasm characterized by extensive formation of psammoma bodies, invasion of ovarian stroma, peritoneum or intraperitoneal viscera, and moderate cytological atypia. Extensive medlar search showed presence of only 28 cases of psammocarcinoma of ovary reported till date. Case presentation We herein report a case of psammocarcinoma of ovary with serous cystadenofibroma of contralateral ovary in a 55 year old Asian Indian female. Conclusion To the best of author's knowledge, ours is the rare case describing coexistence of this very rare malignant serous epithelial tumor with a benign serous cystadenofibroma of contralateral ovary.

  1. Obstructive Jaundice as a Complication of Macrocystic Serous Cystadenoma of the Pancreas.

    Science.gov (United States)

    Koncoro, Hendra; Putra, I Komang W D; Wibawa, I Dewa N

    2016-04-01

    Macrocystic serous cystadenoma is an unusual and essentially benign pancreatic tumor. Herein, we report on a 40-year-old woman diagnosed with macrocystic serous cystadenoma who presented with obstructive jaundice. A cystic lesion in the head and body of the pancreas was revealed by abdominal computed tomography. Intraoperative pancreatic cyst aspiration ruled out mucinous cystic neoplasm which has a malignant potential. The pancreatic cyst fluid cytology was basophilic amorph materials concluded as benign cystic lesion. Internal drainage was performed instead of pancreatic resection which showed good outcome. Biliary obstruction is a rare complication of serous cystadenoma. This case describes an unusual clinical presentation of macrocystic serous cystadenoma.

  2. Obstructive Jaundice as a Complication of Macrocystic Serous Cystadenoma of the Pancreas

    Directory of Open Access Journals (Sweden)

    Hendra Koncoro

    2016-09-01

    Full Text Available Macrocystic serous cystadenoma is an unusual and essentially benign pancreatic tumor. Herein, we report on a 40-year-old woman diagnosed with macrocystic serous cystadenoma who presented with obstructive jaundice. A cystic lesion in the head and body of the pancreas was revealed by abdominal computed tomography. Intraoperative pancreatic cyst aspiration ruled out mucinous cystic neoplasm which has a malignant potential. The pancreatic cyst fluid cytology was basophilic amorph materials concluded as benign cystic lesion. Internal drainage was performed instead of pancreatic resection which showed good outcome. Biliary obstruction is a rare complication of serous cystadenoma. This case describes an unusual clinical presentation of macrocystic serous cystadenoma.

  3. Retinal remodeling in human retinitis pigmentosa.

    Science.gov (United States)

    Jones, B W; Pfeiffer, R L; Ferrell, W D; Watt, C B; Marmor, M; Marc, R E

    2016-09-01

    Retinitis Pigmentosa (RP) in the human is a progressive, currently irreversible neural degenerative disease usually caused by gene defects that disrupt the function or architecture of the photoreceptors. While RP can initially be a disease of photoreceptors, there is increasing evidence that the inner retina becomes progressively disorganized as the outer retina degenerates. These alterations have been extensively described in animal models, but remodeling in humans has not been as well characterized. This study, using computational molecular phenotyping (CMP) seeks to advance our understanding of the retinal remodeling process in humans. We describe cone mediated preservation of overall topology, retinal reprogramming in the earliest stages of the disease in retinal bipolar cells, and alterations in both small molecule and protein signatures of neurons and glia. Furthermore, while Müller glia appear to be some of the last cells left in the degenerate retina, they are also one of the first cell classes in the neural retina to respond to stress which may reveal mechanisms related to remodeling and cell death in other retinal cell classes. Also fundamentally important is the finding that retinal network topologies are altered. Our results suggest interventions that presume substantial preservation of the neural retina will likely fail in late stages of the disease. Even early intervention offers no guarantee that the interventions will be immune to progressive remodeling. Fundamental work in the biology and mechanisms of disease progression are needed to support vision rescue strategies. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Acute Retinal Necrosis in Childhood

    Directory of Open Access Journals (Sweden)

    Yoav Y. Pikkel

    2014-05-01

    Full Text Available Background: Acute retinal necrosis (ARN is a viral syndrome consisting of uveitis/vitritis, occlusive vasculitis and peripheral necrosis. Few incidents are reported in children. The etiology is reactivated herpes simplex virus (HSV or varicella-zoster virus (VZV. Treatment with acyclovir is often used. The administration of oral glucocorticosteroids is of unproven benefit. Prognosis is variable but poor. Methods: Three weeks after contracting mild chickenpox, a healthy 4-year-old girl developed blurred vision in her right eye. Severely reduced visual acuity was noted, together with anterior uveitis, ‘mutton-fat' precipitates and vitral flare. Retinal vasculitis with necrosis was present. Serology for toxoplasma, cytomegalovirus and HIV was negative, while HSV and VZV IgG antibodies were positive. She was treated with 30 mg/kg of intravenous methylprednisolone (3 days, 30 mg of oral prednisone (3 days, and tapering for 8 weeks. Intravenous acyclovir was given for 10 days, followed by oral acyclovir for 4 months. Aspirin (100 mg/day was given for 4 months. Results: At 12 months, the girl felt good. Her right eye acuity was 6/9, with an intraocular pressure of 17 mm Hg. The peripheral retina showed scarring but no detachment. Conclusions: This is the first report of a once-daily high-dose methylprednisolone pulse therapy in one of the youngest known ARN cases. Pulsed steroid therapy was based on its known effectiveness in vasculitis, which is the main pathophysiology in ARN. There was no evidence of steroid-related viral over-replication. Our case achieved an excellent clinical and ophthalmic recovery in spite of the poor prognosis. The positive result of this case report provides a basis for further evaluation of high-dose steroid pulse therapy in ARN.

  5. Correlation of spectral domain optical coherence tomography findings in acute central serous chorioretinopathy with visual acuity

    Directory of Open Access Journals (Sweden)

    Nair U

    2012-11-01

    Full Text Available Unnikrishnan Nair,1 Sunil Ganekal,2 Manoj Soman,1 KGR Nair11Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India; 2Nayana Super Specialty Eye Hospital and Research Center, Davangere, Karnataka, IndiaPurpose: To evaluate the structural changes in the acute phase of central serous chorioretinopathy and after its resolution, using spectral domain optical coherence tomography, to correlate these tomographic changes with visual acuity (VA.Method: This was a prospective study of 100 consecutive patients with acute central serous chorioretinopathy. It was based on presenting the best-corrected VA, divided into three groups (Group 1, n = 36, VA 6/6; Group 2, n = 49, VA 6/9–6/18; Group 3, n = 15, VA > 6/18. All patients underwent fundus evaluation followed by fluorescein angiography and spectral domain optical coherence tomography.Results: The mean age of the patients was 40 ± 7.17 years. The mean log MAR VA was 0.176 ± 0.0185. Single pigment epithelial detachment (PED, and multiple discrete and multiple confluent PEDs were seen in 21%, 17%, and 32% of the eyes, respectively. The location of the PED was subfoveal in 35% of the eyes. The presence of subretinal fibrin and a rough undersurface of the neurosensory retina were noted in 61% and 64% of the eyes, respectively. On en-face scanning, a break in the walls of the PED and overlying fibrin were seen in 32.8% and 45% of the eyes, respectively. The mean subretinal fluid height at the fovea was 279.11 ± 148.78 µ. The mean outer nuclear layer thickness during the active stage was 95.10 µ and during the resolved stage, it was 77.69 µ (P = 0.012. The average photoreceptor lengths were 73.1 µ, 84.6 µ, and 94.9 µ in groups 1, 2, and 3, respectively, in the acute phase; and 69.5 µ, 70.8 µ, and 61.6 µ, respectively, after resolution (P = 0.013, P = 0.010, and P = 0.011.Conclusion: In the acute phase of the disease, poorer VA showed statistically significant association with

  6. Genetics Home Reference: retinitis pigmentosa

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Retinitis pigmentosa Retinitis pigmentosa Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Retinitis pigmentosa is a group of related eye disorders that ...

  7. Outcomes and complications associated with giant retinal tear management using perfluoro-n-octane.

    Science.gov (United States)

    Scott, Ingrid U; Murray, Timothy G; Flynn, Harry W; Feuer, William J; Schiffman, Joyce C

    2002-10-01

    To report visual acuity and anatomic outcomes, as well as complications, associated with giant retinal tear management using intraoperative perfluoro-n-octane and to investigate clinical features associated with anatomic and visual acuity outcomes. A prospective, noncomparative, observational, multicenter study. Two hundred twelve patients (212 eyes) > or =15 months of age who underwent giant retinal tear management with intraoperative perfluoro-n-octane at 24 study sites between April 1994 and February 1996. Giant retinal tear was defined as a retinal tear extending > or =90 degrees. Vitrectomy with perfluoro-n-octane intraoperative retinal tamponade. Visual acuity and rates of retinal reattachment, reoperation, retained perfluoro-n-octane, corneal edema, elevated intraocular pressure (IOP > 25 mmHg), hypotony (IOP or =20/200 was measured in 56 (27%) patients preoperatively and 67 (47%) patients at 6 months. Postoperative visual acuity improved in 107 (59%) eyes, remained stable in 44 (24%) eyes, and worsened in 29 (16%) eyes (percentages are based on the number of patients for whom the data were available at these time points). Of the 124 patients with visual acuity n-octane was noted in 8 (6%) eyes. Throughout follow-up, 64 (30%) eyes underwent reoperation for recurrent retinal detachment. At 6 months, corneal edema, elevated IOP, and hypotony were noted in 5 (4%), 4 (3%), and 12 (9%) eyes, respectively. Of the 72 phakic eyes without cataract preoperatively, 61 (85%) had a cataract or underwent cataract extraction during study follow-up. Factors significantly (P or =20/200 include male gender, no prior vitrectomy, better preoperative vision, and no need for relaxing retinotomy. After adjusting for recurrent detachment, factors significantly associated with vision > or =20/200 include no prior vitrectomy, better preoperative vision, and no need for relaxing retinotomy. Retinal reattachment and preserved visual acuity were achieved in most eyes that underwent

  8. Causes of visual acuity loss among patients with AIDS and cytomegalovirus retinitis in the era of highly active antiretroviral therapy.

    Science.gov (United States)

    Thorne, Jennifer E; Jabs, Douglas A; Kempen, John H; Holbrook, Janet T; Nichols, Charles; Meinert, Curtis L

    2006-08-01

    To quantitate the frequencies of the common causes of visual acuity loss for patients with AIDS and cytomegalovirus (CMV) retinitis in the era of highly active antiretroviral therapy (HAART). Multicenter prospective observational study. Three hundred seventy-nine patients (494 eyes) with CMV retinitis. Follow-up every 3 months with medical history, ophthalmologic examination, and laboratory testing. Loss of visual acuity across the 20/50 or worse and 20/200 or worse thresholds and doubling of the visual angle; frequencies of causes of such vision loss. Overall, involvement of the posterior pole with CMV retinitis (zone 1 retinitis) accounted for approximately one half of incident visual acuity loss of 20/50 or worse, 20/200 or worse, and of doubling of the visual angle. Cataract and retinitis-related retinal detachment were the second and third most common causes of vision loss, accounting for 22% to 33% and 13% to 20% of vision loss for the 3 outcomes, respectively. In subset analysis, cataract and cystoid macular edema (CME) accounted for approximately 50% of incident vision loss in eyes of patients with longstanding CMV retinitis and immune recovery at baseline, but these complications accounted for visual impairment (20/50 or worse vision) and 42% of eyes developing legal blindness (20/200 or worse vision) at 12 months after diagnosis of the retinal detachment. In the HAART era, zone 1 involvement and retinal detachment remain the most common causes of visual acuity loss among patients with CMV retinitis. Cataract and CME also are common causes of loss of visual acuity, primarily in those patients with HAART-induced immune recovery.

  9. Retinal oximetry in patients with ischaemic retinal diseases

    DEFF Research Database (Denmark)

    Rilvén, Sandra; Torp, Thomas Lee; Grauslund, Jakob

    2017-01-01

    retinal oxygen saturation and retinal ischaemic diseases. We used PubMed and Embase to search for retinal oxygen saturation and retinal ischaemic diseases. Three separate searches identified a total of 79 publications. After two levels of manual screening, 10 studies were included: six about diabetic......The retinal oximeter is a new tool for non-invasive measurement of retinal oxygen saturation in humans. Several studies have investigated the associations between retinal oxygen saturation and retinal diseases. In the present systematic review, we examine whether there are associations between...... retinopathy (DR) and four about retinal vein occlusion. No studies about retinal artery occlusion were included. In diabetes, all studies found that increases in retinal venous oxygen saturation (rvSatO2 ) were associated with present as well as increasing levels of DR. Four of six studies also found...

  10. Nondamaging Retinal Laser Therapy: Rationale and Applications to the Macula.

    Science.gov (United States)

    Lavinsky, Daniel; Wang, Jenny; Huie, Philip; Dalal, Roopa; Lee, Seung Jun; Lee, Dae Yeong; Palanker, Daniel

    2016-05-01

    Retinal photocoagulation and nondamaging laser therapy are used for treatment of macular disorders, without understanding of the response mechanism and with no rationale for dosimetry. To establish a proper titration algorithm, we measured the range of tissue response and damage threshold. We then evaluated safety and efficacy of nondamaging retinal therapy (NRT) based on this algorithm for chronic central serous chorioretinopathy (CSCR) and macular telangiectasia (MacTel). Retinal response to laser treatment below damage threshold was assessed in pigmented rabbits by expression of the heat shock protein HSP70 and glial fibrillary acidic protein (GFAP). Energy was adjusted relative to visible titration using the Endpoint Management (EpM) algorithm. In clinical studies, 21 eyes with CSCR and 10 eyes with MacTel were treated at 30% EpM energy with high spot density (0.25-diameter spacing). Visual acuity, retinal and choroidal thickness, and subretinal fluid were monitored for 1 year. At 25% EpM energy and higher, HSP70 was expressed acutely in RPE, and GFAP upregulation in Müller cells was observed at 1 month. Damage appeared starting at 40% setting. Subretinal fluid resolved completely in 81% and partially in 19% of the CSCR patients, and visual acuity improved by 12 ± 3 letters. Lacunae in the majority of MacTel patients decreased while preserving the retinal thickness, and vision improved by 10 letters. Heat shock protein expression in response to hyperthermia helps define the therapeutic window for NRT. Lack of tissue damage enables high-density treatment to boost clinical efficacy, therapy in the fovea, and retreatments to manage chronic diseases.

  11. Número, tipo e topografia dos pontos de vazamento em pacientes com coriorretinopatia serosa central Number, shape, and topography of leakage points in patients with central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Remo Turchetti

    2005-06-01

    . METHODS: Digital photographic files of fluorescein angiography with the diagnosis of CSC were reviewed by the author. The cases considered in remission and the examinations related to the same episode were excluded. The author filled out a form containing medical record number, initials, sex, age, date of the examination and leakage point characteristics (number, shape, and topography of the selected cases. RESULTS: The examinations of 418 patients (455 eyes were included, with a male:female ratio of 2.32:1. Ninety-one point fifteen percent of the patients presented the disease unilaterally and 8.85% bilaterally. The mean age was 43.04 years (range, 19-68 years. Among the 455 selected eyes, 88.35% presented typical forms of CSC while 10.11% decompensation of the retinal pigment epithelium and 1.54% with isolated retinal pigment epithelium (RPE detachment. The evaluation of typical forms of CSC showed a leakage point with uniform dye spread (inkblot in 88.81% and 11.19% with a smoke-stack phenomenon. Regarding the leakage points, 46.01% were located in the upper nasal quadrant, 23.27% in the upper temporal quadrant, 19.18% in the lower nasal quadrant, 11.01% in the lower temporal quadrant and 0.53% in the subfoveal area. CONCLUSIONS: In our series men were affected approximately two times more often then women, most of them with a unilateral involvement and in around the fourth decade of life. About 90% of the patients presented the typical forms, with 1 or 2 inkblot points or leakage. The superior nasal quadrant was the most affected. The isolated RPE detachment rarely occurred. Decompensation of RPE affected about 10% of the patients.

  12. Keratin 5 overexpression is associated with serous ovarian cancer recurrence and chemotherapy resistance.

    Science.gov (United States)

    Ricciardelli, Carmela; Lokman, Noor A; Pyragius, Carmen E; Ween, Miranda P; Macpherson, Anne M; Ruszkiewicz, Andrew; Hoffmann, Peter; Oehler, Martin K

    2017-03-14

    This study investigated the clinical significance of keratin 5 and 6 expression in serous ovarian cancer progression and chemotherapy resistance. KRT5 and KRT6 (KRT6A, KRT6B & KRT6C) gene expression was assessed in publically available serous ovarian cancer data sets, ovarian cancer cell lines and primary serous ovarian cancer cells. Monoclonal antibodies which detect both K5/6 or only K5 were used to assess protein expression in ovarian cancer cell lines and a cohort of high grade serous ovarian carcinomas at surgery (n = 117) and after neoadjuvant chemotherapy (n = 21). Survival analyses showed that high KRT5 mRNA in stage III/IV serous ovarian cancers was significantly associated with reduced progression-free (HR 1.38, P ovarian cancer cells compared to chemotherapy sensitive cells. The proportion of serous ovarian carcinomas with high K5/6 or high K5 immunostaining was significantly increased following neoadjuvant chemotherapy. K5 can be used to predict serous ovarian cancer prognosis and identify cancer cells that are resistant to chemotherapy. Developing strategies to target K5 may therefore improve serous ovarian cancer survival.

  13. A nationwide study of ovarian serous borderline tumors in Denmark 1978-2002

    DEFF Research Database (Denmark)

    Hannibal, Charlotte Gerd; Vang, Russell; Junge, Jette

    2017-01-01

    OBJECTIVE: Absolute risk and risk factors for recurrence and ovarian serous carcinoma following ovarian serous borderline tumors (SBTs) is not well-established. METHODS: We included all women with SBTs in Denmark, 1978-2002. Diagnoses were confirmed by centralized pathology review and classified...

  14. [Changes in serous acinar cells of the tracheal gland in diabetic rats].

    Science.gov (United States)

    Tsuda, T

    1993-08-01

    Histochemical and ultrastructural changes in tracheal glands of rats with artificially induced diabetes were studied. The diabetic condition was induced by streptozotocin. The tracheal gland is composed of a duct and secretory units, mucus tubules and serous acini in diabetic as well as normal rats. In normal rats, the serous acinar cells contained only neutral polysaccharides. In diabetic rats, on the other hand, the serous acinar cells contained not only neutral but also moderate amounts of what appeared to be sialic acid containing compounds. On the ultrastructural level, two kinds of serous cells were observed in diabetic rats, one of which contained homogeneous granules while the other containing heterogeneous granules. The ratio between the number of cells containing heterogeneous granules and cells with homogeneous granules increased with the duration of the diabetic condition in the rat. Changes within the serous cells of diabetic rats might depress tracheal host defense mechanisms and could explain why airway infections are common in patients suffering from diabetes.

  15. Mutation of NRAS is a Rare Genetic Event in Ovarian Low-Grade Serous Carcinoma

    DEFF Research Database (Denmark)

    Xing, Deyin; Rahmanto, Yohan Suryo; Zeppernick, Felix

    2017-01-01

    Activating mutations involving the members of the RAS signaling pathway, including KRAS, NRAS, and BRAF, have been reported in ovarian low-grade serous carcinoma and its precursor lesion, serous borderline tumor (SBT). Whether additional genetic alterations in the RAS oncogene family accumulate...... during the progression of serous borderline tumor (SBT) to invasive low grade serous carcinoma (LGSC) remains largely unknown. While mutations of KRAS and BRAF occur at a very early stage of progression, even preceding the development of SBT, additional driving events, such as NRAS mutations, have been...... postulated to facilitate progression. In this study, we analyzed NRAS exon 3 mutational status in 98 cases that were diagnosed with SBT/atypical proliferative serous tumor (SBT/APST), non-invasive LGSC (niLGSC), or invasive LGSC (iLGSC). Of the latter, NRAS Q61R (CAA to CGA) mutations were detected in only 2...

  16. Adrenocortical Adenoma and Central Serous Chorioretinopathy: A Rare Association

    Directory of Open Access Journals (Sweden)

    S. Pastor-Idoate

    2011-10-01

    Full Text Available A 28-year-old man with bilateral central serous chorioretinopathy (CSCR and body weight gain was diagnosed with Cushing’s syndrome secondary to an adrenocortical adenoma. The patient had high levels of free cortisol and the tumor was confirmed by histopathology. After surgery, cortisol levels decreased and the CSCR spontaneously resolved. This case highlights the role of cortisol in the pathogenesis of CSCR. A diagnosis of endogenous Cushing’s syndrome should be considered in patients with CSCR as an initial symptom.

  17. Retinal capillaritis in a CRB1-associated retinal dystrophy.

    Science.gov (United States)

    Murro, Vittoria; Mucciolo, Dario Pasquale; Sodi, Andrea; Vannozzi, Lorenzo; De Libero, Cinzia; Simonini, Gabriele; Rizzo, Stanislao

    2017-12-01

    To report a case of CRB1-associated retinal dystrophy characterized by vitritis, retinal capillaritis, and cystoid macular edema (CME). A case report. An 8-year-old boy was diagnosed with intermediate uveitis and treated with corticosteroids. He was subsequently diagnosed with retinal dystrophy and found to have two CRB1 mutations. Retinal capillaritis, vitritis, and CME could be inflammatory features of CRB1 retinal dystrophy in our young patient.

  18. Inner limiting membrane barriers to AAV-mediated retinal transduction from the vitreous.

    Science.gov (United States)

    Dalkara, Deniz; Kolstad, Kathleen D; Caporale, Natalia; Visel, Meike; Klimczak, Ryan R; Schaffer, David V; Flannery, John G

    2009-12-01

    Adeno-associated viral gene therapy has shown great promise in treating retinal disorders, with three promising clinical trials in progress. Numerous adeno-associated virus (AAV) serotypes can infect various cells of the retina when administered subretinally, but the retinal detachment accompanying this injection induces changes that negatively impact the microenvironment and survival of retinal neurons. Intravitreal administration could circumvent this problem, but only AAV2 can infect retinal cells from the vitreous, and transduction is limited to the inner retina. We therefore sought to investigate and reduce barriers to transduction from the vitreous. We fluorescently labeled several AAV serotype capsids and followed their retinal distribution after intravitreal injection. AAV2, 8, and 9 accumulate at the vitreoretinal junction. AAV1 and 5 show no accumulation, indicating a lack of appropriate receptors at the inner limiting membrane (ILM). Importantly, mild digestion of the ILM with a nonspecific protease enabled substantially enhanced transduction of multiple retinal cell types from the vitreous, with AAV5 mediating particularly remarkable expression in all retinal layers. This protease treatment has no effect on retinal function as shown by electroretinogram (ERG) and visual cortex cell population responses. These findings may help avoid limitations, risks, and damage associated with subretinal injections currently necessary for clinical gene therapy.

  19. KRAS/BRAF Analysis in Ovarian Low-Grade Serous Carcinoma Having Synchronous All Pathological Precursor Regions

    Directory of Open Access Journals (Sweden)

    Kohei Nakamura

    2016-04-01

    Full Text Available Ovarian low-grade serous carcinoma is thought to begin as a serous cystadenoma or adenofibroma that progresses in a slow stepwise fashion. Among the low-grade serous carcinomas, there is a high frequency of activating mutations in the KRAS or BRAF genes; however, it remains unclear as to how these mutations contribute to tumor progression. This is the first report to track the histopathological progression of serous adenofibroma to low-grade serous carcinoma. Each stage was individually analyzed by pathological and molecular genetic methods to determine what differences occur between the distinct stages of progression.

  20. Retinal Changes Induced by Epiretinal Tangential Forces

    Directory of Open Access Journals (Sweden)

    Mario R. Romano

    2015-01-01

    Full Text Available Two kinds of forces are active in vitreoretinal traction diseases: tangential and anterior-posterior forces. However, tangential forces are less characterized and classified in literature compared to the anterior-posterior ones. Tangential epiretinal forces are mainly due to anomalous posterior vitreous detachment (PVD, vitreoschisis, vitreopapillary adhesion (VPA, and epiretinal membranes (ERMs. Anomalous PVD plays a key role in the formation of the tangential vectorial forces on the retinal surface as consequence of gel liquefaction (synchysis without sufficient and fast vitreous dehiscence at the vitreoretinal interface. The anomalous and persistent adherence of the posterior hyaloid to the retina can lead to vitreomacular/vitreopapillary adhesion or to a formation of avascular fibrocellular tissue (ERM resulting from the proliferation and transdifferentiation of hyalocytes resident in the cortical vitreous remnants after vitreoschisis. The right interpretation of the forces involved in the epiretinal tangential tractions helps in a better definition of diagnosis, progression, prognosis, and surgical outcomes of vitreomacular interfaces.

  1. Detachment evolution on the TCV tokamak

    Directory of Open Access Journals (Sweden)

    J.R. Harrison

    2017-08-01

    Full Text Available Divertor detachment in the TCV tokamak has been investigated through experiments and modelling. Density ramp experiments were carried out in ohmic heated L-mode pulses with the ion ∇B drift directed away from the primary X-point, similar to previous studies [1]. Before the roll-over in the ion current to the outer strike point, C III and Dα emission from the outer leg recede slowly from the strike point toward the X-point, at a rate of ∼2.0 × 10−19m/m−3 along the magnetic field as the electron temperature along the leg reduces with increasing density. Around the onset of detachment, the upstream density profile and outer target Dα profiles broaden, possibly leading to an increase in radiation in the SOL by increased interaction between the SOL and the carbon tiles lining the outer wall. The plasma conditions upstream and at various locations along the detached outer divertor leg have been characterised, and the consistency of this data has been checked with the interpretive OSM-EIRENE-DIVIMP suite of codes [2] and are broadly found to be consistent with measured Dγ/Dα emissivity profiles along the detached outer divertor leg.

  2. Detachment evolution on the TCV tokamak

    NARCIS (Netherlands)

    Harrison, J. R.; Vijvers, W. A. J.; Theiler, C.; Duval, B. P.; Elmore, S.; Labit, B.; Lipschultz, B.; van Limpt, S. H. M.; Lisgo, S. W.; Tsui, C. K.; Reimerdes, H.; Sheikh, U.; Verhaegh, K. H. A.; Wischmeier, M.

    2017-01-01

    Divertor detachment in the TCV tokamak has been investigated through experiments and modelling. Density ramp experiments were carried out in ohmic heated L-mode pulses with the ion ∇B drift directed away from the primary X-point, similar to previous studies [1]. Before the roll-over in the ion

  3. Spectroscopic investigations of divertor detachment in TCV

    Directory of Open Access Journals (Sweden)

    K. Verhaegh

    2017-08-01

    The inferred magnitude of recombination is small compared to the target ion current at the time detachment (particle flux drop starts at the target. However, recombination may be having more localized effects (to a flux tube which we cannot discern at this time. Later, at the highest densities achieved, the total recombination does reach levels similar to the particle flux.

  4. Shoreline response to detached breakwaters in prototype

    NARCIS (Netherlands)

    Khuong, T.C.

    2016-01-01

    An accurate prediction of shoreline changes behind detached breakwaters is, in regard to the adjustment to the environmental impact, still a challenge for designers and coastal managers. This research is expected to fill the gaps in the estimation of shoreline changes by developing new and

  5. Bevacizumab Therapy and Multimodal Ultra-widefield Imaging in Immunogammopathy Maculopathy Secondary to Waldenstrom’s Macroglobulinemia

    Science.gov (United States)

    Xu, Lucy T.; Courtney, Robert J.; Ehlers, Justis P

    2015-01-01

    Waldenstrom’s macroglobulinemia (WM) is associated with retinal findings of hyperviscosity such as venous dilation, and findings of immunogammopathy maculopathy such as serous macular detachment. The report describes a case of bilateral serous macular detachment with intraretinal schisis-like fluid in a patient with WM. Enhanced depth imaging OCT revealed a thickened choroid with hyper-reflective accumulations in the RPE layer. The ultra-widefield fundus autofluorescence demonstrated a central area of hyperautofluorescence corresponding to the area of serous macular detachment. Ultra-widefield fluorescein angiography was characteristically silent. Intravitreal bevacizumab therapy resulted in significant reduction in intraretinal fluid, but minimal change in subretinal fluid. Long-term follow-up demonstrated alterations in retinal architecture and improved serous detachments. PMID:25707055

  6. Learning about Retinitis Pigmentosa

    Science.gov (United States)

    Skip to main content Learning about Retinitis Pigmentosa Enter Search Term(s): Español Research Funding An Overview Bioinformatics Current Grants Education and Training Funding Extramural Research ...

  7. Unilateral retinitis pigmentosa.

    Science.gov (United States)

    Bhattarai, D; Paudel, N; Adhikari, P; Gnyawali, S; Joshi, S N

    2015-01-01

    To report a rare case of unilateral retinitis pigmentosa and to present the clinical features, and findings of multifocal ERG and visual field of this case. A 70-year-old-female diagnosed as Retinitis Pigmentosa in right eye 7 years back, presented with further gradual painless diminution of vision in the very eye and without any similar symptoms in left eye. On examination, the findings (including multifocal ERG and visual field) suggested the features of retinitis pigmentosa in her right eye, while the other eye being unaffected. In this rare case, the distinct features of retinitis pigmentosa are seen only in one eye, and this can be further confirmed from multifocal ERG and visual field. © NEPjOPH.

  8. Retinal artery occlusion

    Science.gov (United States)

    ... angiography Intraocular pressure Pupil reflex response Refraction Retinal photography Slit lamp examination Testing of side vision (visual ... commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer ...

  9. Retinal vein occlusion

    Science.gov (United States)

    ... person's prescription for eyeglasses or contact lenses Retinal photography Slit lamp examination Testing of side vision (visual ... commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer ...

  10. Photochemical Thrombosis Of Retinal And Choroidal Vessels Using Rose Bengal

    Science.gov (United States)

    Lewis, Mary Lou; Winward, Kirk; Watson, Brant D.; Hernandez, Eleut

    1989-09-01

    Rose bengal is an effective photosensitizing agent which interacts with argon green light to induce photochemical thrombosis of irradiated vessels. We used focal, low energy irradiation to occlude retinal and choroidal vessels in both albino and pigmented rabbits. Immediately after intravenous injection of rose bengal at concentrations of 10 and 20 mg/kg, irradiation was performed via a slit lamp-delivered argon green laser (514.5 nm) with the aid of fundus contact lens. In 11 eyes, arteries were treated with 50-100 interrupted bursts of 75u spot size at 0.2 sec and 40-100 mW (9 retinal vessels for 1-12 days and variable closure of the surrounding capillaris. Eight eyes were treated with continuous irradiation 2-5 minutes at 7.5-40 mW, 75u spot size (35 retinal and choroidal vessels, serous elevation of the retina, and disc neovascularization. In eight eyes choroidal vessels were irradiated with 10-20 mW, 15-60 sec, 500u spot size (31 retinal edema at 24 hours and permanent closure of choroidal vessels. There was minimal damage to surrounding tissue. Control eyes in all three groups irradiated utilizing the same parameters, but without rose bengal, demonstrated no evidence of thermal injury.

  11. Detachment variants of Chinese hamster cells. Hyaluronic acid as a modulator of cell detachment

    Energy Technology Data Exchange (ETDEWEB)

    Barnhart, B.J.; Cox, S.H.; Kraemer, P.M.

    1979-01-01

    Variants of the Chinese hamster cell line CHO have been isolated and characterized with respect to attachment and trypsin- or EGTA-mediated detachment kinetics, cell morphologies, and the complex carbohydrates (labeled with (/sup 3/H)glucosamine) of the cell surface. The variant which was more readily detached from the substratum exhibited a more rounded cell shape and had three times more label as hyaluronic acid on the cell surface than the parental cell. The slowly detaching variant had a morphology similar to the parental cell but only half the radioactivity ascribable to hyaluronic acid. Endogenous levels of cAMP were unaltered in the variants. Exogenous db-cAMP caused the cells to elongate and flatten but did not alter the characteristic detachment kinetics. The role of hyaluronic acid as a modulator of the cell substratum interface is discussed.

  12. LONG-TERM EVOLUTION OF DOME-SHAPED MACULA: Increased Macular Bulge is Associated With Extended Macular Atrophy.

    Science.gov (United States)

    Soudier, Guillaume; Gaudric, Alain; Gualino, Vincent; Massin, Pascale; Nardin, Mathieu; Tadayoni, Ramin; Speeg-Schatz, Claude; Gaucher, David

    2016-05-01

    Dome-shaped macula (DSM) may cause impaired vision. This study analyzed the long-term evolution of DSM, most particularly macular changes: serous retinal detachment, retinal pigment epithelium atrophy, and DSM bulge increase. Twenty-nine eyes presenting with DSM were retrospectively studied. Clinical data, color photographs, fluorescein angiographs, and optical coherence tomography examinations were reviewed. Patients were followed up from 6 months to 111 months (mean, 37.89 months). The height of the macular bulge, the size of retinal pigment epithelium macular atrophy, and serous retinal detachment progression were studied. Other macular changes were noted. Mean vision remained stable. Dome-shaped macula height increased significantly from 338.9 μm to 364.3 μm (P = 0.007). Serous retinal detachment was present initially in 15 of 29 eyes; it increased in 4 cases and resolved spontaneously in 7. Macular retinal pigment epithelium atrophy correlated with the bulge height (P = 0.015), and it enlarged during follow-up (1.12 vs. 1.34, P = 0.04). Other macular anomalies were present initially or appeared during follow-up: macular pucker, choroidal neovascularization (CNV), subretinal pigmentary clumps, and flat irregular pigmented epithelium detachment. A few treatments were proven in serous retinal detachment cases but were ineffective in restoring vision. In DSM, vision may be stable for years while macular changes progress: the macular bulge increases as does retinal pigment epithelium atrophy.

  13. Three cases of large retinal capillary hemangiomas treated with verteporfin and photodynamic therapy.

    Science.gov (United States)

    Aaberg, Thomas M; Aaberg, Thomas M; Martin, Daniel F; Gilman, James P; Myles, Robert

    2005-03-01

    To investigate the efficacy of verteporfin and photodynamic therapy in the treatment of large retinal capillary hemangiomas. Case reports of 3 patients with large retinal capillary hemangiomas treated with photodynamic therapy using verteporfin. Standard verteporfin dosages (6 mg/m(2) of body surface area) were given. Both standard and modified photodynamic protocols were followed. Modified protocols included shorter verteporfin infusion times and longer light exposure times. Pretreatment best-corrected Snellen visual acuity of the 3 affected eyes were 20/100, 20/50, and 2/200, respectively. All cases had associated exudative retinal detachments involving the macula. Cases 1 and 2 were classic endophytic retinal capillary hemangiomas. Case 3 was a reactive retinal capillary hemangioma. Case 1 had 2 photodynamic therapy treatments, and after 8 months, visual acuity improved to 20/40. Two years after initiating photodynamic therapy, the visual acuity was 20/30 and there was no reperfusion of the hemangioma. Case 2 had 3 photodynamic therapy treatments. The hemangioma was fibrotic, and 20 months after initiating photodynamic therapy visual acuity improved to 20/30. Case 3 had 1 treatment, 11 weeks later and visual acuity improved to 20/400. Four months after treatment, visual acuity returned to counting fingers because of tractional elevation of the macula as the capillary hemangioma fibrosed. Vitrectomy surgery was performed, and choroidal and retinal neovascularization was discovered. Three months after vitrectomy visual acuity was 20/400. In cases 1 and 2, the capillary hemangioma ultimately regressed, and the exudative detachment resolved. Verteporfin and photodynamic therapy were effective in achieving closure of large retinal capillary hemangiomas. In all cases, the hemangioma underwent fibrosis with consequent macular puckering due to retinal traction. In all cases, the visual acuity improved.

  14. Solid Serous Adenoma of the Pancreas: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Anastasios Katsourakis

    2016-01-01

    Full Text Available Herein, we report a case of a solid-type serous cystadenoma of the pancreas which is the 16th case reported worldwide and the first ever reported in Greece. Magnetic resonance imaging showed a hypervascular mass in the tail of the pancreas of a 72-year-old female who presented with mild abdominal pain. Distal pancreatectomy was performed by laparotomy and histological and immunohistochemical examination revealed a solid-type serous cystadenoma of the pancreas. Preoperative diagnosis of a solid-type serous cystadenoma of the pancreas is difficult, and, due to its benign nature, simple excision of the tumor is the recommended treatment.

  15. Posterior vitreous detachment induced by nattokinase (subtilisin NAT): a novel enzyme for pharmacologic vitreolysis.

    Science.gov (United States)

    Takano, Akiomi; Hirata, Akira; Ogasawara, Kazuya; Sagara, Nina; Inomata, Yasuya; Kawaji, Takahiro; Tanihara, Hidenobu

    2006-05-01

    To investigate the effects of intravitreal injection of nattokinase (subtilisin NAT), a serine protease that is produced by Bacillus subtilis (natto), for induction of posterior vitreous detachment (PVD). Different doses of nattokinase (1, 0.1, or 0.01 fibrin-degradation units [FU]) or physiologic saline as a control were injected into the vitreous cavity of rabbit eyes. Scanning electron microscopy was used to observe the retinal surfaces of four rabbit eyes per concentration. Histologic alterations were assessed by light microscopy, using four eyes from each group. Electroretinography (ERG) was performed to observe retinal function, ranging from 1 hour to 1 week after the nattokinase (1 or 0.1 FU) or saline solution administration, using four eyes from each group at each time point. Also, findings in all rabbits were monitored by slit lamp examination and by indirect ophthalmoscopy with a 20-D lens. Scanning electron microscopy showed smooth retinal surfaces, indicating the occurrence of PVD at 30 minutes after intervention in all the experimental eyes injected with 0.1 or 1.0 FU nattokinase, but none of the control eyes. Light microscopy and ERG analysis showed no critical change even after the use of 0.1 FU nattokinase, an amount sufficient to induce PVD. However, toxicity in the forms of preretinal hemorrhage and ERG changes was noted with the higher dose (1 FU) of nattokinase. The results suggested that nattokinase is a useful enzyme for pharmacologic vitreolysis because of its efficacy in inducing PVD.

  16. Oral mineralocorticoid antagonists for recalcitrant central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Chin EK

    2015-08-01

    Full Text Available Eric K Chin, David RP Almeida, C Nathaniel Roybal, Philip I Niles, Karen M Gehrs, Elliott H Sohn, H Culver Boldt, Stephen R Russell, James C FolkDepartment of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USAPurpose: To evaluate the effect and tolerance of oral mineralocorticoid antagonists, eplerenone and/or spironolactone, in recalcitrant central serous chorioretinopathy.Methods: Retrospective consecutive observational case series. Primary outcome measures included central macular thickness (CMT, µm, macular volume (MV, mm3, Snellen visual acuity, and prior treatment failures. Secondary outcomes included duration of treatment, treatment dosage, and systemic side effects.Results: A total of 120 patients with central serous chorioretinopathy were reviewed, of which 29 patients were treated with one or more mineralocorticoid antagonists. The average age of patients was 58.4 years. Sixteen patients (69.6% were recalcitrant to other interventions prior to treatment with oral mineralocorticoid antagonists, with an average washout period of 15.3 months. The average duration of mineralocorticoid antagonist treatment was 3.9±2.3 months. Twelve patients (52.2% showed decreased CMT and MV, six patients (26.1% had increase in both, and five patients (21.7% had negligible changes. The mean decrease in CMT of all patients was 42.4 µm (range, -136 to 255 µm: 100.7 µm among treatment-naïve patients, and 16.9 µm among recalcitrant patients. The mean decrease in MV of all patients was 0.20 mm3 (range, -2.33 to 2.90 mm3: 0.6 mm3 among treatment-naïve patients, and 0.0 mm3 among recalcitrant patients. Median visual acuity at the start of therapy was 20/30 (range, 20/20–20/250, and at final follow-up it was 20/40 (range, 20/20–20/125. Nine patients (39.1% experienced systemic side effects, of which three patients (13.0% were unable to continue therapy.Conclusion: Mineralocorticoid antagonist treatment had a positive treatment

  17. Joint Segmentation of Retinal Layers and Focal Lesions in 3-D OCT Data of Topologically Disrupted Retinas.

    Science.gov (United States)

    Novosel, Jelena; Vermeer, Koenraad A; de Jong, Jan H; Ziyuan Wang; van Vliet, Lucas J

    2017-06-01

    Accurate quantification of retinal structures in 3-D optical coherence tomography data of eyes with pathologies provides clinically relevant information. We present an approach to jointly segment retinal layers and lesions in eyes with topology-disrupting retinal diseases by a loosely coupled level set framework. In the new approach, lesions are modeled as an additional space-variant layer delineated by auxiliary interfaces. Furthermore, the segmentation of interfaces is steered by local differences in the signal between adjacent retinal layers, thereby allowing the approach to handle local intensity variations. The accuracy of the proposed method of both layer and lesion segmentation has been evaluated on eyes affected by central serous retinopathy and age-related macular degeneration. In addition, layer segmentation of the proposed approach was evaluated on eyes without topology-disrupting retinal diseases. Good agreement between the segmentation performed manually by a medical doctor and results obtained from the automatic segmentation was found for all data types. The mean unsigned error for all interfaces varied between 2.3 and 11.9 μm (0.6-3.1 pixels). Furthermore, lesion segmentation showed a Dice coefficient of 0.68 for drusen and 0.89 for fluid pockets. Overall, the method provides a flexible and accurate solution to jointly segment lesions and retinal layers.

  18. Techniques for Processing Eyes Implanted With a Retinal Prosthesis for Localized Histopathological Analysis

    Science.gov (United States)

    Nayagam, David A. X.; McGowan, Ceara; Villalobos, Joel; Williams, Richard A.; Salinas-LaRosa, Cesar; McKelvie, Penny; Lo, Irene; Basa, Meri; Tan, Justin; Williams, Chris E.

    2013-01-01

    With the recent development of retinal prostheses, it is important to develop reliable techniques for assessing the safety of these devices in preclinical studies. However, the standard fixation, preparation, and automated histology procedures are not ideal. Here we describe new procedures for evaluating the health of the retina directly adjacent to an implant. Retinal prostheses feature electrode arrays in contact with eye tissue. Previous methods have not been able to spatially localize the ocular tissue adjacent to individual electrodes within the array. In addition, standard histological processing often results in gross artifactual detachment of the retinal layers when assessing implanted eyes. Consequently, it has been difficult to assess localized damage, if present, caused by implantation and stimulation of an implanted electrode array. Therefore, we developed a method for identifying and localizing the ocular tissue adjacent to implanted electrodes using a (color-coded) dye marking scheme, and we modified an eye fixation technique to minimize artifactual retinal detachment. This method also rendered the sclera translucent, enabling localization of individual electrodes and specific parts of an implant. Finally, we used a matched control to increase the power of the histopathological assessments. In summary, this method enables reliable and efficient discrimination and assessment of the retinal cytoarchitecture in an implanted eye. PMID:23963336

  19. Criteria for early etiological diagnosis of serous meningitis in children

    Directory of Open Access Journals (Sweden)

    Лариса Анатольевна Ходак

    2015-06-01

    Full Text Available To improve early etiological diagnosis of serous meningitis in children, the differential diagnostic algorithms have been developed.Methods. 220 children with serous meningitis(SM aged 1 to 17 years were divided into 3 groups depending on the etiological factor: 1 enterovirus SM (n=130; 2 herpesvirus SM (n=14; 3 enterovirus SM combined with persistent herpes virus infection (n=76. In the alternative groups of patients (in all combinations, the differential diagnostic significance of clinical and laboratory parameters has been evaluated by means of Wald–Genkin heterogeneous sequential procedure. All studied traits were divided into gradations and then differential diagnostic coefficients (DC and diagnostic information (I were obtained separately for the clinical indicators, CSF indicators and full blood count. The indicators were distributed in the descending order of their self-descriptiveness that, in future, taking into account the most significant of them, allowed to form a generalized diagnostic algorithms in each comparison group.Results. Differential algorithmic diagnosis is obtained by means of algebraic summation of DC until the diagnostic threshold is reached. For 95 percent confidence level, the threshold sum is DK≥13,0. Etiologic diagnosis of SM involves the use of all three algorithms, that is, differentiation is conducted between SM herpesvirus, enterovirus etiology and SM enterovirus etiology in combination with persistent herpes virus infection. When reaching the diagnostic threshold in favor of certain etiology, the appropriate diagnosis is made. In case the diagnostic threshold for two etiological factors is reached, the final diagnosis is formulated on the basis of the differential diagnosis data.Conclusions. The developed algorithms of early etiological diagnosis of SM in children are highly reliable (≥95% and minimize the number of indicators required for diagnosis with a given level of reliability

  20. The fixed/detachable implant provisional prosthesis.

    Science.gov (United States)

    Cibirka, R M; Linebaugh, M L

    1997-06-01

    Interim modification and management of a complete denture following surgical uncovering of dental implants can be time-intensive and may fail to provide adequate patient benefit until the definitive prosthesis can be completed. Inadequate interim management can result in functional and tissue difficulties. Modification of the conventional complete denture to a fixed/detachable provisional prosthesis in a one-stage procedure provides the patient an opportunity to experience a fixed prosthesis. The incorporation of fixed, provisional cylinders to the existing denture base using autopolymerizing acrylic resin with a closed-mouth technique is described. The peripheral regions are reduced and the distal extension shortened to resemble a fixed/detachable prosthesis. This conversion technique can provide patient satisfaction and comfort until delivery of the definitive prosthesis. Esthetic concerns, home care problems, or patient difficulties with the provisional prosthesis can be rectified in the final prosthesis.

  1. Simultaneous adaptation of retinal and extra-retinal motion signals.

    Science.gov (United States)

    Freeman, Tom C A

    2007-12-01

    A number of models of motion perception include estimates of eye velocity to help compensate for the incidental retinal motion produced by smooth pursuit. The 'classical' model uses extra-retinal motor command signals to obtain the estimate. More recent 'reference-signal' models use retinal motion information to enhance the extra-retinal signal. The consequence of simultaneously adapting to pursuit and retinal motion is thought to favour the reference-signal model, largely because the perception of motion during pursuit ('perceived stability') changes despite the absence of a standard motion aftereffect. The current experiments investigated whether the classical model could also account for these findings. Experiment 1 replicated the changes to perceived stability and then showed how simultaneous motion adaptation changes perceived retinal speed (a velocity aftereffect). Contrary to claims made by proponents of the reference-signal model, adapting simultaneously to pursuit and retinal motion therefore alters the retinal motion inputs to the stability computation. Experiment 2 tested the idea that simultaneous motion adaptation sets up a competitive interaction between two types of velocity aftereffect, one retinal and one extra-retinal. The results showed that pursuit adaptation by itself drove perceived stability in one direction and that adding adapting retinal motion drove perceived stability in the other. Moreover, perceived stability changed in conditions that contained no mismatch between adapting pursuit and adapting retinal motion, contrary to the reference-signal account. Experiment 3 investigated whether the effects of simultaneous motion adaptation were directionally tuned. Surprisingly no tuning was found, but this was true for both perceived stability and retinal velocity aftereffect. The three experiments suggest that simultaneous motion adaptation alters perceived stability based on separable changes to retinal and extra-retinal inputs. Possible

  2. Tonic shock induces detachment of Giardia lamblia.

    Directory of Open Access Journals (Sweden)

    Wendy R Hansen

    Full Text Available BACKGROUND: The parasite Giardia lamblia must remain attached to the host small intestine in order to proliferate and subsequently cause disease. However, little is known about the factors that may cause detachment in vivo, such as changes in the aqueous environment. Osmolality within the proximal small intestine can vary by nearly an order of magnitude between host fed and fasted states, while pH can vary by several orders of magnitude. Giardia cells are known to regulate their volume when exposed to changes in osmolality, but the short-timescale effects of osmolality and pH on parasite attachment are not known. METHODOLOGY AND PRINCIPAL FINDINGS: We used a closed flow chamber assay to test the effects of rapid changes in media osmolality, tonicity, and pH on Giardia attachment to both glass and C2(Bbe-1 intestinal cell monolayer surfaces. We found that Giardia detach from both surfaces in a tonicity-dependent manner, where tonicity is the effective osmolality experienced by the cell. Detachment occurs with a characteristic time constant of 25 seconds (SD = 10 sec, n = 17 in both hypo- and hypertonic media but is otherwise insensitive to physiologically relevant changes in media composition and pH. Interestingly, cells that remain attached are able to adapt to moderate changes in tonicity. By exposing cells to a timed pattern of tonicity variations and adjustment periods, we found that it is possible to maximize the tonicity change experienced by the cells, overcoming the adaptive response and resulting in extensive detachment. CONCLUSIONS AND SIGNIFICANCE: These results, conducted with human-infecting Giardia on human intestinal epithelial monolayers, highlight the ability of Giardia to adapt to the changing intestinal environment and suggest new possibilities for treatment of giardiasis by manipulation of tonicity in the intestinal lumen.

  3. Electron detachment dissociation (EDD) pathways in oligonucleotides

    Science.gov (United States)

    Kinet, Catherine; Gabelica, Valérie; Balbeur, Dorothée; de Pauw, Edwin

    2009-06-01

    Electron detachment dissociation (EDD) and electron photodetachment dissociation (EPD) are two novel fragmentation methods yielding radicals from negatively charged ions. With the goal of comparing EDD, EPD and the more traditional collision-induced dissociation (CID) and infrared multiphoton dissociation (IRMPD) fragmentation processes in oligonucleotides, we studied here the EDD fragmentation pathways of oligonucleotides of varying length. We chose polythymine oligonucleotides because these are the least prone to secondary structure formation, and found complete sequence coverage by EDD for up to dT20. We also found that the fragmentation pathways change with oligonucleotide length: electron detachment is a mandatory step in the fragmentation of larger sequences, while shorter oligonucleotides can also fragment via direct electronic or vibrational excitation by the electrons. This is supported by (1) the fact that continuous ejection of the charge-reduced species does not totally prevent fragmentation of short oligonucleotides dT5 and dT6, (2) the fact that CID and EDD fragments are more similar for small oligonucleotides (although double resonance experiments show that they are not all issued from the same mechanisms), and (3) the fact that electron-induced dissociation (EID) of singly charged dT3 and dT4 gives similar fragments as EDD of doubly charged dT5 and dT6. Finally, the detachment efficiency as a function of the nature of the nucleobase was studied. The effect of base on electron detachment in EDD (G > T > A > C) is different than in EPD (G > A > C > T), indicating different electron loss mechanisms.

  4. Fibrotic scar formation in central serous chorioretinopathy developed during systemic treatment with corticosteroids

    NARCIS (Netherlands)

    Hooymans, JMM

    1998-01-01

    Background: The purpose of the study is to demonstrate the development of subretinal fibrotic scar formation in central serous chorioretinopathy (CSCR) that developed during systemic corticosteroid treatment. Methods: The clinical and photographic records of a patient in whom an unusual

  5. Pancreatic Serous Cystadenoma with Compression of the Main Pancreatic Duct: An Unusual Entity

    Directory of Open Access Journals (Sweden)

    Stéphanie Truant

    2011-01-01

    Full Text Available Serous cystadenoma is a common benign neoplasm that can be managed without surgery in asymptomatic patients provided that the diagnosis is certain. We describe a patient, whose pancreatic cyst exhibited a radiological appearance distinct from that of typical serous cystadenoma, resulting in diagnostic difficulties. CT and MRI showed a 10 cm-polycystic tumor with upstream dilatation of the main pancreatic duct (MPD, suggestive of intraductal papillary mucinous tumor (IPMT. Ultrasonographic aspect and EUS-guided fine-needle aspiration gave arguments for serous cystadenoma. ERCP showed a communication between cysts and the dilated MPD, compatible with IPMT. The patient underwent left pancreatectomy with splenectomy. Pathological examination concluded in a serous cystadenoma, with only a ductal obstruction causing proximal dilatation.

  6. Mixed microcystic and macrocystic serous cystadenoma of the pancreas: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, So Hee; Rha, Sung Eun; Byun, Jae Young; Cho, Song Mee [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-07-01

    Serous cystadenomas of the pancreas are generally considered to be microcystic adenomas. Typical serous cystadenomas of the pancreas are encapsulated tumors composed of tiny cysts less than 2 cm in size showing sponge-like appearance with a central stellate scar or calcification on the cross-section. It has been recently reported, however, that serous cystadenomas may have macrocystic variants (major cysts more than 2 cm in size) that are radiologically indistinguishable from mucinous cystadenomas of the pancreas. We report the CT and MR imagings findings in a patient with mixed microcystic and macrocystic serous cystadenoma of the pancreas, indicating the histopathologic correlation. The mass was composed of two different types of cyst: multiple, small (< 2 cm) with central calcification; and large ( > 2cm) with peripheral calcification.

  7. Serous Cystadenoma of the Pancreas Presenting as a Third Primary Neoplasm

    Directory of Open Access Journals (Sweden)

    Aydın Şeref Köksal

    2003-01-01

    Full Text Available Serous cystadenomas are the most common cystic neoplasms of the pancreas. They may occur solely or coexist with other neoplasms. A 10 cm mass involving the body of the pancreas was observed in the computed tomography of a 61-year-old man with a previous history of bladder and prostate carcinoma. Ultrasonography and computed tomography of the mass demonstrated multiple small cysts associated with a central calcified scar. A distal pancreatectomy was performed. Pathological examination confirmed the diagnosis of serous microcystic adenoma. This is the first report of a serous cystadenoma of the pancreas with two metachronous neoplasms. This feature should be kept in mind during the diagnosis and evaluation of patients with serous cystadenoma.

  8. Advances in the treatment of retinal angiomatous proliferation

    Directory of Open Access Journals (Sweden)

    Wang-Yi Fang

    2017-12-01

    Full Text Available Retinal angiomatous proliferation(RAP, also known as “type 3 neovascularization”, is a well-recognized variation of neovascular age-related macular degeneration(nARMD. Neovascularization is the basic pathological characteristic. Current view on the origin of the neovascularization is the deep retinal capillaries. The main clinical features include retinal pigment epithelium detachment(PEDand reticular pseudodrusen. These two features have close relation to the retinal pigment epithelium(RPEtear and geographic atrophy(GA, respectively, which may ultimately result in severe irreversible visual impairment. The disease has a rapid natural course and the majority of patients in early stage can develop into vision loss within 6mo. However, classical therapeutic managements, such as laser therapy, have limited efficacy and poor prognosis. Recently, RAP has been further understood with the application of OCT angiography and other new technologies in diagnosing, staging and monitoring RAP. Varieties of research on intravitreal injection of anti-vascular endothelial growth factor(VEGFtreatment to RAP have also revealed its promising results and proved its safety as well as effectiveness. All these have provided new knowledge on choosing the optimal treatment regimen in clinical.

  9. Extinguishing ELMs in detached radiative divertor plasmas

    Science.gov (United States)

    Pigarov, Alexander; Krasheninnikov, Sergei; Rognlien, Thomas

    2016-10-01

    In order to avoid deleterious effects of ELMs on PFCs in next-step fusion devices it has been suggested to operate with small-sized ELMs naturally extinguishing in the divertor. Our modeling effort is focusing at extinguishing type-I ELMs: conditions for expelled plasma dissipation; efficiency of ELM power handling by detached radiative divertors; and the ELM impact on detachment state. Here time-dependent modeling of a sequence of many ELMs was performed with 2-D edge plasma transport code UEDGE-MB-W which incorporates the Macro-Blob (MB) approach to simulate non-diffusive filamentary transport and various ``Wall'' (W) models for time-dependent hydrogen wall inventory and recycling. Three cases were modeled, in which extinguishing ELMs are achieved due to: (i) intrinsic impurities via graphite sputtering, (ii) extrinsic impurity gas puff (Ne), and (iii) =(i) +(ii). For each case, we performed a series of UEDGE-MB-W runs scanning the deuterium and impurity inventories, pedestal losses and ELM frequency. Temporal variations of the degree of detachment, ionization front shape, recombination sink strength, radiated fraction, peak power loads, OSP, impurity charge states, and in/out asymmetries were analyzed. We discuss the onset of extinguishing ELMs, conditions for not burning through and enhanced plasma recombination as functions of scanned parameters. Efficiencies of intrinsic and extrinsic impurities in ELM extinguishing are compared.

  10. A nationwide study of serous “borderline” ovarian tumors in Denmark 1978–2002

    DEFF Research Database (Denmark)

    Hannibal, Charlotte Gerd; Vang, Russell; Junge, Jette

    2014-01-01

    diagnosed with SBTs from 1978 to 2002. The histologic slides were collected from Danish pathology departments and reviewed by expert pathologists and classified as SBT/atypical proliferative serous tumor (APST) or noninvasive low-grade serous carcinoma (LGSC). Associated implants were classified......, overall survival of women with SBT/APST (pdate this is the largest nationwide cohort of SBTs where all tumors have been verified by expert pathologists. Only in women with advanced stage SBT...

  11. Clinical and immunological features of retinal vasculitis in systemic diseases

    Directory of Open Access Journals (Sweden)

    Paović Jelena

    2009-01-01

    Full Text Available Background/Aim. Vasculitis is a clinical, pathologic process characterized by inflammation and necrosis of blood vessel occurring anywhere in the body. The aim of the study was to present some clinical and immunologic features of retinal vasculitis in systemic diseases: systemic lupus erythematosus, multiple sclerosis, sarcoidosis, Behcet's diseases, and others. Methods. A total of 1 254 patients with uveitis were included in the study. The immunochemical diagnostic methods were used to determine the pathogenesis of ocular manifestations. Ocular manifestations were examined using biomicroscope, direct or indirect ophtalmoscopy. Results. Primary retinal vasculitis was diagnosed in 85/1254 (6.8% of total uveitis. In more than half of the cases of vasculitis (58.8%, both arteries and veins were involved in inflammatory process. Periphlebitis was diagnosed far more commonly (36.5% than periarteritis (4.7%. Retinal vasculitis associated with systemic lupus erythematosus was characterized by microinfarctions and the consequent foci of inflammatory cells or diseases of large arteries manifesting in vasospasm and occlusions. Cotton wool spots occurred in 38.3% and retinal hemorrhages in 34% of the cases. In this study periphlebitis of the retina was one of the less frequent ocular manifestations of multiple sclerosis. Comparing with the other changes of the retinal blood vessels, venous sheating occurred in 25.1% and occlusion and vein trombosis in 43.75% of the cases. Retinal vasculitis associated with chronic sarcoidosis occured in 37.5% of patients with sarcoidosis. The most frequent manifestation of ocular sarcoidosis was intermediary uveitis (43.75%. Anterior granulomatous uveitis occured in 37.5% of patients with sarcoidoses. Immune complexes occurred in 13/20 (65% of the patients. Antiretinal anti-S antibody in the serum occurred in 73% of the patients with retinal detachment as a complication of primary disease and in 25% those with vasculitis

  12. Pseudovitelliform Subfoveal Deposit in Waldenström's Macroglobulinemia.

    Science.gov (United States)

    Brolly, Aurélie; Janon, Claire; Precausta, Flavien; Baudet, Jean-Marie; Cohen, Salomon Yves

    2012-05-01

    Waldenström's macroglobulinemia may be complicated by retinal hemorrhages, retinal vein occlusion, serous macular detachment or macular edema. We report a patient with pseudovitelliform subfoveal deposit complicating Waldenström's macroglobulinemia. A 56-year-old man presented with hyperviscosity syndrome due to Waldenström's macroglobulinemia. After systemic therapy, a large serous retinal detachment persisted in the left eye. A pseudovitelliform subfoveal deposit was observed in the right eye. Pseudovitelliform subfoveal deposits may be part of the spectrum of ocular complications in Waldenström's macroglobulinemia. They could be due to accumulation of macroglobulins.

  13. A New Scaling for Divertor Detachment

    Science.gov (United States)

    Goldston, Robert

    2017-10-01

    The ITER design and future fusion power plant designs depend on divertor detachment, whether partial, pronounced or complete, both to limit heat flux to plasma-facing components and to limit surface erosion due to sputtering. Generally the parallel heat flux, estimated as proportional to Psep / R or Psep B / R , is used as a proxy for the difficulty of achieving detachment. Here we argue that the impurity cooling required for detachment is strongly dependent on the upstream separatrix density, which is limited by Greenwald scaling. Taking this into account self-consistently, along with the Heuristic Drift (HD) model for the SOL width, and using a Lengyel radiation model that includes non-coronal effects, we find that the relative impurity concentration, cz ≡nz /ne , required for detachment scales dominantly as cz Psep /Bp(nsep /nGW) 2 . The absence of any explicit favorable size scaling is concerning, as Psep must increase by an order of magnitude from present experiments to an economic fusion power system, while increases in the poloidal magnetic field strength are limited by magnet technology and MHD stability. This result should not be surprising, as it follows from the simplest scaling, Psep czne2VSOL , taking into account the Greenwald density limit and the HD SOL volume scaling. Reinke has combined a similar approach with the requirement to maintain H-mode, which sets a lower limit on Psep, and also arrives at an incentive for high field and disincentive for large size. These results should be challenged by comparison with 2D divertor codes and with measurements on existing experiments. In particular measurements are required for extrinsic divertor impurity concentration over a range of power and density conditions far from the regime where detachment can be achieved with deuterium puffing and intrinsic impurities alone. Nonetheless, these results suggest that higher magnetic field, stronger shaping, double-null operation, `advanced' divertor magnetic and

  14. Coastal Response, a system of detached breakwaters

    Science.gov (United States)

    García Ortiz, Isabelo; Negro Valdecantos, Vicente; Santos López, Jose; Esteban, María Dolores

    2017-04-01

    The coastline's sedimentary response in the form of a tombolo or semi-tombolo (salient) as a result of the construction of detached breakwaters is an aspect that should be known in the design phase so that these marine structures may be properly designed. In achieving an ecological, social and economic value, such areas must also be properly managed. All design methods in existence since Dean (1978) are mainly based on hypotheses formulated from geometric studies on existing formations. No relationship at all is established with climate and littoral dynamics typical of the location (only Suh and Darlymple (1987) and the Japanese Ministry of Construction (1986) present relationships depending on wave variables). Neither has the influence on systems with more than two breakwaters been studied. These methods are not fully adapted to the cases existing on the Spanish Mediterranean littoral. The lines of investigation as proposed by L. Bricio and V. Negro (2010) were continued with for this study. These researchers developed a method for dimensioning isolated, detached breakwaters and their semi-tombolo or tombolo associated formations using all the characteristics of the site (energy, geometric and structural), specific climate and geomorphology and littoral dynamics' characteristics. This methodology is currently acknowledged and accepted in works undertaken on the Spanish Mediterranean littoral. A linear regression was obtained in the investigation undertaken on the 18 detached breakwater systems along the whole of the 1670 km of the Spanish Mediterranean littoral using the proposals made by L. Bricio and V. Negro. The adjustment of R2 ≥ 0.90 was used for the sandy, tombolo formations behind all the detached breakwater systems between several non-dimensional monomials displaying the most representative characteristics of the site. L/H12 + (2ṡB)/G =12,15ṡ(X/Xc)+7,3231 X: Distance of breakwaters from coastline Xc: Distance from coastline where the closure depth

  15. The retinal readout array

    Science.gov (United States)

    Litke, Alan; Meister, Markus

    1991-12-01

    We have fabricated and tested a set of electrode arrays for the study of information processing in the retina. Live retinal tissue is placed on top of an array with the output neurons directly above the electrodes. Absorption of light by the photoreceptor cells leads to the generation of electrical pulses in the output neurons. These pulses, in turn, produce voltage signals on the electrodes which are recorded simultaneously by external electronics. Thus, for the first time, the spatial and temporal firing patterns of a large set of retinal nerve cells can be studied. The arrays are fabricated on quartz wafers coated with a transparent conducting layer of indium tin oxide. The electrodes are electroplated with platinum black. Polyimide is used for insulation. The fabrication and properties of these arrays, and illustrative results with retinal tissue, are described.

  16. Psychological Detachment in the Relationship between Job Stressors and Strain.

    Science.gov (United States)

    Safstrom, My; Hartig, Terry

    2013-09-01

    We investigated the mediating versus moderating role of psychological detachment in the relationship between job stressors and psychological strain. Our sample consisted of 173 university students invested in challenging programs of advanced professional studies, who could find it difficult to detach from work. Hierarchical regression analyses of cross-sectional survey data affirmed the role of psychological detachment as a mediator in the relationship between job demands and perceived stress. Detachment also mediated the relationship between job demands and satisfaction with life, although the association disappeared when controlling for negative affectivity. Detachment did not mediate relationships between job demands and cognitive failures. Psychological detachment did not moderate any of the investigated relationships. The study contributes to a view of psychological detachment as less subject to individual differences than to the imposition of stressors in the given context.

  17. Oral mineralocorticoid antagonists for recalcitrant central serous chorioretinopathy.

    Science.gov (United States)

    Chin, Eric K; Almeida, David Rp; Roybal, C Nathaniel; Niles, Philip I; Gehrs, Karen M; Sohn, Elliott H; Boldt, H Culver; Russell, Stephen R; Folk, James C

    2015-01-01

    To evaluate the effect and tolerance of oral mineralocorticoid antagonists, eplerenone and/or spironolactone, in recalcitrant central serous chorioretinopathy. Retrospective consecutive observational case series. Primary outcome measures included central macular thickness (CMT, μm), macular volume (MV, mm(3)), Snellen visual acuity, and prior treatment failures. Secondary outcomes included duration of treatment, treatment dosage, and systemic side effects. A total of 120 patients with central serous chorioretinopathy were reviewed, of which 29 patients were treated with one or more mineralocorticoid antagonists. The average age of patients was 58.4 years. Sixteen patients (69.6%) were recalcitrant to other interventions prior to treatment with oral mineralocorticoid antagonists, with an average washout period of 15.3 months. The average duration of mineralocorticoid antagonist treatment was 3.9±2.3 months. Twelve patients (52.2%) showed decreased CMT and MV, six patients (26.1%) had increase in both, and five patients (21.7%) had negligible changes. The mean decrease in CMT of all patients was 42.4 μm (range, -136 to 255 μm): 100.7 μm among treatment-naïve patients, and 16.9 μm among recalcitrant patients. The mean decrease in MV of all patients was 0.20 mm(3) (range, -2.33 to 2.90 mm(3)): 0.6 mm(3) among treatment-naïve patients, and 0.0 mm(3) among recalcitrant patients. Median visual acuity at the start of therapy was 20/30 (range, 20/20-20/250), and at final follow-up it was 20/40 (range, 20/20-20/125). Nine patients (39.1%) experienced systemic side effects, of which three patients (13.0%) were unable to continue therapy. Mineralocorticoid antagonist treatment had a positive treatment effect in half of our patients. The decrease in CMT and MV was much less in the recalcitrant group compared to the treatment-naïve group. An improvement in vision was seen only in the treatment-naïve group. Systemic side effects, even at low doses, may limit its usage

  18. Mediterranean detachment zones : thermicity vs heritage.

    Science.gov (United States)

    Labrousse, Loic; Huet, Benjamin; Le Pourhiet, Laetitia; Jolivet, Laurent; Burov, Evgenii

    2017-04-01

    Even if the seminal comprehensive descriptions of Metamorphic Core Complexes (MCCs) in the American Cordillera mentionned lower plates constituted of gneiss and intruded by granites (e. g. Snake Range, Whipple Mountains), the actual definition of MCCs : « Cordilleran metamorphic core complexes appear to be bodies from the middle crust that have been dragged out from beneath fracturing and extending upper crustal rocks, and exposed beneath shallow-dipping (normal slip) faults of large areal extent » {as in Lister & Davis, 1989, Journal of Structural Geology, v. 11, pp. 65-94} refers to rocks exhumed from the middle crust whatever their thermal history. The fundamental property of this middle crust resides in its ability fo flow lateraly toward the forming dome, to accommodate stretching of the upper plate and preserve a relatively flat moho. Even though thermal reequilibration can induce weakening of the lower crust, a similar strength profile can also be inherited from pre-extension evolution of the continental crust and promote development of the original structure of MCCs : their detachment. In order to unravel the rheological meaning of detachments, we propose here a review of extensional shear zones described as detachments in the Mediterranean realm, and establish a three end-members typology with « hot MCCs » as one end-member, and two cold MCC end-members with a weak middle crust due to stacking of high pressure metapelitic nappes or a strong upper crust responsible for the strength contrast exaggeration between the upper and lower crust. New fully coupled thermo-mechanical modeling experiments together with a review of comparable published results allow to test this three end-member typology and determine the critical strength constrast for the perennial development of a detachment zone. A 1000 ratio between the strength at the brittle-ductile transition and the strength at the base of the crust seems a boundary value between localized extensional modes

  19. Nanomaterials and Retinal Toxicity

    Science.gov (United States)

    The neuroretina should be considered as a potential site of nanomaterial toxicity. Engineered nanomaterials may reach the retina through three potential routes of exposure including; intra­ vitreal injection of therapeutics; blood-borne delivery in the retinal vasculature an...

  20. Retinal Imaging with Smartphone

    African Journals Online (AJOL)

    2016-08-23

    Aug 23, 2016 ... professionals is increasing, especially with the availability of different applications. On account of cost, fundus cameras are ... Of particular advantage is the ability of Smartphones to acquire and store the images, and ... Samsung phones with additional apps/software such as the Filmic pro to obtain retinal ...

  1. The case of ichthyosis follicularis, alopecia and photophobia syndrome with retinal detachment

    Directory of Open Access Journals (Sweden)

    Bengü Nisa Akay

    2014-06-01

    Full Text Available Ichtiyosis follicularis, alopecia and photophobia (IFAP syndrome is a rare congenital ectodermal syndrome with X-linked inheritance. It occurs as a result of missense mutation in chromosome Xp22.11-Xp22.13 locus of MBTPS2 gene. It usually affects men and family history is always negative. Ichtiyosis follicularis and alopecia starts with birth. Photophobia and eye symptoms begin in early infancy or childhood. Other manifestations of the syndrome include short stature, mental retardation and seizures. There are no spesific histopathological findings specific for ichtyosis follicularis. A 29 years old male patient was admitted to outpatient clinic. Dermatological examination revealed keratosis pilaris localized to scalp, extremities and anterolateral of the body. Patient had xerosis, diffuse alopecia and prominent folicular appereance. Eye examination revealed cataracts and vision loss. These findings led us to IFAP syndrome diagnosis. The patient is presented for the rarity of the syndrome in the literature.

  2. Functional implications of short-term retinal detachment in porcine eyes

    DEFF Research Database (Denmark)

    Kyhn, Maria Voss; Kiilgaard, Jens Folke; Lopez, Ana Garcia

    2008-01-01

    The aim of the study was to determine the type and magnitude of detectable changes in pig multifocal electroretinography (mfERG) induced by the vitreoretinal surgical procedures necessary to gain access to the subretinal space....

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

    DEFF Research Database (Denmark)

    Bjerrum, Søren Solborg

    2015-01-01

    -operated fellow eyes up to 10 years after cataract surgery. The epidemiology of RD in the non-operated fellow eyes was different from the epidemiology of RD in the background population as young men had the highest risk of RD in the non-operated fellow eyes. This means that the absolute risk of PRD was highest...... for young men because they had a higher risk of RD before they underwent cataract surgery. In the second study (paper II), we used data from the NPR and reviewed patient charts to assess the risk of PE after cataract surgery performed in public eye departments and private hospitals/clinics in the study......, and the risk among the private hospitals/clinics was heterogeneous. Most private hospitals/clinics had a risk of PE that was lower than or similar to the risk of PE after registered cataract surgery in public eye departments, but six private hospitals/clinics had a statistically significantly higher risk of PE...

  4. High grade serous ovarian carcinoma with serous tubal intraepithelial carcinoma in a case presented with atypical glandular cell favor neoplasm cervical cytology and dermatomyositis

    Directory of Open Access Journals (Sweden)

    Mun-Kun Hong

    2015-04-01

    Conclusion: The patient had serous carcinoma of the ovary with tubal STIC, which presented as dermatomyositis. The AGC-FN identified from a Pap smear hinted at a diagnosis of ovarian carcinoma. These presentations point to an occult malignancy in the genital tract and demand careful diagnostic workup.

  5. Protection of retinal function by sulforaphane following retinal ischemic injury.

    Science.gov (United States)

    Ambrecht, Lindsay A; Perlman, Jay I; McDonnell, James F; Zhai, Yougang; Qiao, Liang; Bu, Ping

    2015-09-01

    Sulforaphane, a precursor of glucosinolate in cruciferous vegetables such as broccoli and cauliflower, has been shown to protect brain ischemic injury. In this study, we examined the effect of systemic administration of sulforaphane on retinal ischemic reperfusion injury. Intraocular pressure was elevated in two groups of C57BL/6 mice (n = 8 per group) for 45 min to induce retinal ischemic reperfusion injury. Following retinal ischemic reperfusion injury, vehicle (1% DMSO saline) or sulforaphane (25 mg/kg/day) was administered intraperitoneally daily for 5 days. Scotopic electroretinography (ERG) was used to quantify retinal function prior to and one-week after retinal ischemic insult. Retinal morphology was examined one week after ischemic insult. Following ischemic reperfusion injury, ERG a- and b-wave amplitudes were significantly reduced in the control mice. Sulforaphane treatment significantly attenuated ischemic-induced loss of retinal function as compared to vehicle treated mice. In vehicle treated mice, ischemic reperfusion injury produced marked thinning of the inner retinal layers, but the thinning of the inner retinal layers appeared significantly less with sulforaphane treatment. Thus, sulforaphane may be beneficial in the treatment of retinal disorders with ischemic reperfusion injury. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Pancreatic serous cystic neoplasms accompanying other pancreatic tumors.

    Science.gov (United States)

    Kim, So-Woon; Song, In Hye; An, Soyeon; Kim, So Yeon; Kim, Hyoung Jung; Song, Ki-Byung; Hwang, Dae Wook; Lee, Sang Soo; Byun, Jae Ho; Seo, Dong-Wan; Kim, Song Cheol; Yu, Eunsil; Hong, Seung-Mo

    2017-02-01

    Serous cystic neoplasms (SCNs) are benign cystic neoplasms that predominantly occur in the tail of the pancreas in elderly women. It is well known that patients with von Hippel-Lindau syndrome can develop SCNs and neuroendocrine tumors in the pancreas. However, our understanding on SCNs accompanying other pancreatic tumors (SCNAOPTs) is limited. We compared the clinicopathological features of 15 surgically resected SCNAOPTs with 259 conventional SCNs. The prevalence of SCNAOPT was 5%. The SCNAOPTs were significantly smaller than conventional solitary SCNs, and they were more commonly observed in the head of the pancreas, whereas conventional solitary SCNs were more frequently noted in the body and tail. However, no differences were found in terms of sex, patient age, or the gross patterns of the SCNs. Accompanying neoplasms included 7 intraductal papillary mucinous neoplasms, 1 colloid carcinoma arising from intraductal papillary mucinous neoplasm, 6 neuroendocrine tumors, and 1 solid pseudopapillary neoplasm. Four neuroendocrine tumors associated with von Hippel-Lindau syndrome occurred as multiples, whereas 2 neuroendocrine tumors without von Hippel-Lindau syndrome were solitary. In summary, SCNAOPTs comprise 5% of all SCNs and tend to be smaller and located in the head of the pancreas. Common accompanying tumors include intraductal papillary mucinous neoplasms, neuroendocrine tumors, and other neoplasms such as colloid carcinoma and solid pseudopapillary neoplasm. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Central serous chorioretinopathy associated with unusual routes of steroid administration.

    Science.gov (United States)

    Mirza, Rukhsana G; Gill, Manjot

    2009-01-01

    To report three cases in which unusual routes of administration were associated with subsequent central serous chorioretinopathy (CSR). All three cases occurred in patients who were being treated for dermatologic conditions. Retrospective review of three cases of patients who presented with a diagnosis of CSR and use of steroids in an unusual route for treatment of various dermatologic conditions (intradermal injection to the scalp for keloids, topical cream for psoriasis, and topical solution for cradle cap). Patient 1 had complete resolution and restoration of baseline visual acuity at the follow-up examination. This patient had no further injections to his keloids. Patient 2 drastically decreased the dose of topical cream and had resolution of symptoms. Patient 3 discontinued use of the steroid solution and had no new episodes of visual decline. This case series suggests that occult steroid use should be suspected for patients presenting with CSR who are concurrently being treated for dermatologic conditions. The knowledge gained from this thorough history is vital to the management and long-term counseling of the patient.

  8. Psychological factors associated with acute and chronic central serous chorioretinopathy.

    Science.gov (United States)

    Lahousen, Theresa; Painold, Annamaria; Luxenberger, Wolfgang; Schienle, Anne; Kapfhammer, Hans-Peter; Ille, Rottraut

    2016-01-01

    Central serous chorioretinopathy (CSC) has been associated with several psychological factors. But previous psychological data are limited and mainly restricted to male patients and small sample size. In this study we investigated psychosomatic complaints, personality factors, life events, and stress coping in acute and chronic recurrent CSC patients. Ninety-five patients (71 men, 24 women) with either acute or chronic CSC were evaluated regarding critical life events before diagnosis, psychosomatic complaints, personality traits and coping style. The characteristics of CSC patients were compared with a control group comprising 75 patients (46 men, 29 women) suffering from acute or chronic ophthalmic disorders other than CSC. Compared with patients of the control group, CSC patients reported more psychosomatic problems, unfavourable stress coping strategies and critical life events as well as elevated tension, aggression, strain, emotional instability and achievement orientation. Except for aggression the observed characteristics were more pronounced in acute than in chronic CSC patients. The appearance of CSC may be associated with an accumulation of stressful life events with an unfavourable coping style and distinctive personality factors. Acute CSC is related to more unfavourable stress coping and more physical complaints compared to its chronic course. Elevated aggression may imply one potential risk factor for CSC manifestation and also may have an adverse effect with its chronification.

  9. Axial length in unilateral idiopathic central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Hoseok Moon

    2016-05-01

    Full Text Available AIM: To evaluate the axial length (AXL in unilateral idiopathic central serous chorioretinopathy (CSC. METHODS: This retrospective case-control study was comprised of a consecutive case series of 35 patients with acute unilateral idiopathic CSC, and age- and sex-matched 50 control eyes. AXL of both eyes of unilateral CSC patients and the control eyes were investigated. AXL was measured by ultrasonic biometry, and the adjusted AXL was calculated for CSC eyes as measured AXL plus differences of foveal thickness between CSC and normal fellow eyes in millimeters. The main outcome measures were comparison of AXL between CSC, fellow and control eyes. RESULTS: The mean age of 35 CSC patients was 45.5y, and 31 males were included. The adjusted AXL of CSC eyes was 23.52 mm, and the AXL of fellow eyes was 23.46 mm, and of control eyes 23.94 mm. The AXL of both CSC and fellow eyes were significantly shorter than control eyes (CSC vs control, P=0.044; fellow vs control, P=0.026. There was no statistically significant difference in AXL between CSC and fellow eyes. CONCLUSION: In unilateral idiopathic CSC, the AXL of CSC and fellow eyes are shorter than that of control eyes. Short AXL may be related with choroidal circulation abnormality in CSC.

  10. A Sensitivity Analysis of SOLPS Plasma Detachment

    Science.gov (United States)

    Green, D. L.; Canik, J. M.; Eldon, D.; Meneghini, O.; AToM SciDAC Collaboration

    2016-10-01

    Predicting the scrape off layer plasma conditions required for the ITER plasma to achieve detachment is an important issue when considering divertor heat load management options that are compatible with desired core plasma operational scenarios. Given the complexity of the scrape off layer, such predictions often rely on an integrated model of plasma transport with many free parameters. However, the sensitivity of any given prediction to the choices made by the modeler is often overlooked due to the logistical difficulties in completing such a study. Here we utilize an OMFIT workflow to enable a sensitivity analysis of the midplane density at which detachment occurs within the SOLPS model. The workflow leverages the TaskFarmer technology developed at NERSC to launch many instances of the SOLPS integrated model in parallel to probe the high dimensional parameter space of SOLPS inputs. We examine both predictive and interpretive models where the plasma diffusion coefficients are chosen to match an empirical scaling for divertor heat flux width or experimental profiles respectively. This research used resources of the National Energy Research Scientific Computing Center, a DOE Office of Science User Facility, and is supported under Contracts DE-AC02-05CH11231, DE-AC05-00OR22725 and DE-SC0012656.

  11. Is the two-tier ovarian serous carcinoma grading system potentially useful in stratifying uterine serous carcinoma? A large multi-institutional analysis.

    Science.gov (United States)

    Ahmed, Quratulain; Hussein, Yaser; Hayek, Kinda; Bandyopadhyay, Sudeshna; Semaan, Assaad; Abdul-Karim, Fadi; Al-Wahab, Zaid; Munkarah, Adnan R; Elshaikh, Mohamed A; Alosh, Baraa; Nucci, Marisa R; Van de Vijver, Koen K; Morris, Robert T; Oliva, Esther; Ali-Fehmi, Rouba

    2014-02-01

    A subset of uterine serous carcinoma (USC) may have better clinical behavior bringing up the possibility that there may be morphologic features, which would help in their categorization. The aim of this study is to evaluate the potential use of the MD Anderson Cancer Center 2-tier grading system for ovarian carcinoma in USC. Tumors assigned a combined score included in this analysis were 1) low-grade: tumors without marked atypia and 12 mitoses/10 high power field (HPF) and 2) high grade: tumors with severe nuclear atypia and >12 mitoses/10 HPF. Clinicopathologic parameters evaluated included patients' age, tumor size, myometrial invasion (MI), lymphovascular invasion (LVI), lymph node (LN), FIGO stage, and patient outcome. 140 patients with USC were included, 30 low grade uterine serous carcinoma (LGUSC) and 110 high grade uterine serous carcinoma (HGUSC). Of all parameters only 2 (MI and stage IA) reached statistical significance. 67% of LGUSC cases showed myometrial invasion versus 93.6% HGUSC cases (p = 0.003). A higher percentage of LGUSC (63.3%) versus HGUSC (32.7%) were in stage IA (p = 0.01). However, by multivariate analysis including age, LVI, stage and tumor grade only stage was an independent prognostic factor. The presence of atypia and mitosis across a uterine serous carcinoma is notoriously variable in magnitude and extent, potentially making evaluation of these features difficult and subsequent grading subjective. Our findings thus show that actual prognostic utility of application of MDACC two-tier grading system to uterine serous carcinoma may not be applicable. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Peripapillary retinal thermal coagulation following electrical injury

    Directory of Open Access Journals (Sweden)

    Manjari Tandon

    2013-01-01

    Full Text Available In this study, we have presented the case report of a 20 year old boy who suffered an electric injury shock, following which he showed peripapillary retinal opacification and increased retinal thickening that subsequently progressed to retinal atrophy. The fluorescein angiogram revealed normal retinal circulation, thus indicating thermal damage to retina without any compromise to retinal circulation.

  13. Psychological Detachment in the Relationship between Job Stressors and Strain

    OpenAIRE

    My Safstrom; Terry Hartig

    2013-01-01

    We investigated the mediating versus moderating role of psychological detachment in the relationship between job stressors and psychological strain. Our sample consisted of 173 university students invested in challenging programs of advanced professional studies, who could find it difficult to detach from work. Hierarchical regression analyses of cross-sectional survey data affirmed the role of psychological detachment as a mediator in the relationship between job demands and perceived stress...

  14. Retinal dysplasia in American pit bull terriers--phenotypic characterization and breeding study.

    Science.gov (United States)

    Rodarte-Almeida, Ana Carolina Veiga; Petersen-Jones, Simon; Langohr, Ingeborg M; Occelli, Laurence; Dornbusch, Peterson T; Shiokawa, Naoye; Montiani-Ferreira, Fabiano

    2016-01-01

    The purpose of this study was to investigate the inheritance and phenotype of retinal dysplasia (RD) in the American pit bull terrier. A breeding colony established from a single female pure-bred American pit bull terrier dog with RD. A female pure-bred American pit bull terrier with RD was donated to the Veterinary Hospital of Federal University of Paraná, Curitiba, Brazil. A breeding colony was established and the phenotype and inheritance of the condition investigated. Regular ophthalmic examinations and fundus photography were performed on three generations of offspring from the founder animal. Some animals were additionally studied by optical coherence tomography. Ocular histopathology was performed on some animals from the colony. Fifty-seven offspring were produced in two generations from the affected founder female. Thirty-two were diagnosed with RD and showed a spectrum of severity of lesions including multifocal, and or geographic lesions and some developed retinal detachment. Histologic examination demonstrated retinal folds, rosettes, and areas of retinal detachment. The affected dogs were shorter in stature than the unaffected littermates. Breeding studies suggested the trait has an autosomal dominant mode of inheritance. DNA testing showed that the affected dogs were negative for the known gene mutations for canine dwarfism with RD. This is a report of a novel inherited form of RD that affects American pit bull terriers. © 2014 American College of Veterinary Ophthalmologists.

  15. The preclinical natural history of serous ovarian cancer: defining the target for early detection.

    Directory of Open Access Journals (Sweden)

    Patrick O Brown

    2009-07-01

    Full Text Available Ovarian cancer kills approximately 15,000 women in the United States every year, and more than 140,000 women worldwide. Most deaths from ovarian cancer are caused by tumors of the serous histological type, which are rarely diagnosed before the cancer has spread. Rational design of a potentially life-saving early detection and intervention strategy requires understanding the lesions we must detect in order to prevent lethal progression. Little is known about the natural history of lethal serous ovarian cancers before they become clinically apparent. We can learn about this occult period by studying the unsuspected serous cancers that are discovered in a small fraction of apparently healthy women who undergo prophylactic bilateral salpingo-oophorectomy (PBSO.We developed models for the growth, progression, and detection of occult serous cancers on the basis of a comprehensive analysis of published data on serous cancers discovered by PBSO in BRCA1 mutation carriers. Our analysis yielded several critical insights into the early natural history of serous ovarian cancer. First, these cancers spend on average more than 4 y as in situ, stage I, or stage II cancers and approximately 1 y as stage III or IV cancers before they become clinically apparent. Second, for most of the occult period, serous cancers are less than 1 cm in diameter, and not visible on gross examination of the ovaries and Fallopian tubes. Third, the median diameter of a serous ovarian cancer when it progresses to an advanced stage (stage III or IV is about 3 cm. Fourth, to achieve 50% sensitivity in detecting tumors before they advance to stage III, an annual screen would need to detect tumors of 1.3 cm in diameter; 80% detection sensitivity would require detecting tumors less than 0.4 cm in diameter. Fifth, to achieve a 50% reduction in serous ovarian cancer mortality with an annual screen, a test would need to detect tumors of 0.5 cm in diameter.Our analysis has formalized

  16. Mutation of NRAS is a rare genetic event in ovarian low-grade serous carcinoma.

    Science.gov (United States)

    Xing, Deyin; Suryo Rahmanto, Yohan; Zeppernick, Felix; Hannibal, Charlotte G; Kjaer, Susanne K; Vang, Russell; Shih, Ie-Ming; Wang, Tian-Li

    2017-10-01

    Activating mutations involving the members of the RAS signaling pathway, including KRAS, NRAS, and BRAF, have been reported in ovarian low-grade serous carcinoma and its precursor lesion, serous borderline tumor (SBT). Whether additional genetic alterations in the RAS oncogene family accumulate during the progression of SBT to invasive low-grade serous carcinoma (LGSC) remains largely unknown. Although mutations of KRAS and BRAF occur at a very early stage of progression, even preceding the development of SBT, additional driving events, such as NRAS mutations, have been postulated to facilitate progression. In this study, we analyzed NRAS exon 3 mutational status in 98 cases that were diagnosed with SBT/atypical proliferative serous tumor, noninvasive LGSC, or invasive LGSC. Of the latter, NRAS Q61R (CAA to CGA) mutations were detected in only 2 of 56 (3.6%) cases. The same mutation was not detected in any of the SBTs (atypical proliferative serous tumors) or noninvasive LGSCs. Mutational analysis for hotspots in KRAS and BRAF demonstrated a wild-type pattern of KRAS and BRAF in one of the NRAS-mutated cases. Interestingly, another LGSC case with NRAS mutation harbored a concurrent BRAF V600L mutation. These findings indicate that, although recurrent NRAS mutations are present, their low prevalence indicates that NRAS plays a limited role in the development of LGSC. Further studies to identify other oncogenic events that drive LGSC progression are warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Radiative detached divertor with acceptable separatrix Zeff

    Science.gov (United States)

    Pigarov, A. Yu.

    2017-10-01

    The feasibility study is performed for the radiative detached divertor (RDD) concept, which characterizes a variety of detached plasmas with impurity amounts providing the highest levels of divertor radiation without X-point MARFE (XPM), based on a set of restrictive criteria for the leading plasma parameters (LPPs) including, e.g., tolerable peak power loads below 1 MW/m2, low separatrix densities, allowable impurity concentrations, and acceptable Zeff values for a DIII-D like tokamak. For this, extensive simulations with the 2-D edge plasma transport code were done scanning the deuterium and impurity inventories practically for all impurity elements from beryllium to neon and the analysis of LPP variations in these scans is presented. It is shown that, for a given D inventory, the total radiation fraction with an increase in the impurity inventory reaches a flat top level, frad = 0.85 ± 0.01, whereas the higher frad corresponds to XPM. This critical fraction is the same for all elements and values of the D inventory. Successful RDD solutions with a flat top radiation meeting all ad hoc LPP criteria are found for some elements. Boron and nitrogen are shown to be the most promising elements for seeding, since they are capable of providing alone the successful RDD at the lowest concentrations. Several important effects on impurity radiation are considered including: cross-field impurity transport in regions with strong temperature gradients, multi-species thermal force, charge-exchange of impurity ions with D atoms originating from recombination, impurity entrainment by parallel flows, flows caused by inner/outer divertor asymmetries, and Mach ˜ 1 flows reached inside radiation-ionization fronts. The impurity radiation profiles of various elements are analyzed suggesting three patterns differing in the radiation front position with respect to the D ionization source. The modeled relocation of D from the pedestal into divertor regions; an enhanced pedestal

  18. [Navigated retinal laser therapy].

    Science.gov (United States)

    Kernt, M; Ulbig, M; Kampik, A; Neubauer, A S

    2013-08-01

    Navigated laser therapy introduces for the first time computerized assistance systems for retinal laser therapy. The Navilas system offers high precision and safety and provides additional benefits regarding standardization of planning, execution, documentation and quality assurance. The current focus of clinical application for navigated laser therapy besides laser treatment after retinal vein occlusion and panretinal laser photocoagulation in proliferative diabetic retinopathy (PDR) is diabetic macular edema. Recent data indicate that combined initial anti-vascular endothelial growth factor (anti-VEGF) and navigated macular laser therapy allows achievement and maintenance of treatment success with a minimum number of interventions. Despite very promising results the current assessment of navigated laser therapy is still limited by the evidence available worldwide.

  19. Small Animal Retinal Imaging

    Science.gov (United States)

    Choi, WooJhon; Drexler, Wolfgang; Fujimoto, James G.

    Developing and validating new techniques and methods for small animal imaging is an important research area because there are many small animal models of retinal diseases such as diabetic retinopathy, age-related macular degeneration, and glaucoma [1-6]. Because the retina is a multilayered structure with distinct abnormalities occurring in different intraretinal layers at different stages of disease progression, there is a need for imaging techniques that enable visualization of these layers individually at different time points. Although postmortem histology and ultrastructural analysis can be performed for investigating microscopic changes in the retina in small animal models, this requires sacrificing animals, which makes repeated assessment of the same animal at different time points impossible and increases the number of animals required. Furthermore, some retinal processes such as neurovascular coupling cannot be fully characterized postmortem.

  20. Inherited Retinal Degenerative Disease Registry

    Science.gov (United States)

    2017-09-13

    Eye Diseases Hereditary; Retinal Disease; Achromatopsia; Bardet-Biedl Syndrome; Bassen-Kornzweig Syndrome; Batten Disease; Best Disease; Choroidal Dystrophy; Choroideremia; Cone Dystrophy; Cone-Rod Dystrophy; Congenital Stationary Night Blindness; Enhanced S-Cone Syndrome; Fundus Albipunctatus; Goldmann-Favre Syndrome; Gyrate Atrophy; Juvenile Macular Degeneration; Kearns-Sayre Syndrome; Leber Congenital Amaurosis; Refsum Syndrome; Retinitis Pigmentosa; Retinitis Punctata Albescens; Retinoschisis; Rod-Cone Dystrophy; Rod Dystrophy; Rod Monochromacy; Stargardt Disease; Usher Syndrome

  1. Elevated vitreous body glial fibrillary acidic protein in retinal diseases.

    Science.gov (United States)

    Jünemann, Anselm Gerhard Maria; Rejdak, Robert; Huchzermeyer, Cord; Maciejewski, Ryszard; Grieb, Pawel; Kruse, Friedrich E; Zrenner, Eberhart; Rejdak, Konrad; Petzold, Axel

    2015-12-01

    Increased expression of glial fibrillary acidic protein (GFAP) is a characteristic of gliotic activation (Müller cells and astrocytes) in the retina. This study assessed vitreous body GFAP levels in various forms of retinal pathology. This prospective study included 82 patients who underwent vitrectomy (46 retinal detachments (RDs), 13 macular hole (MHs), 15 epiretinal glioses (EGs), 8 organ donors). An established enzyme-linked immunosorbent assay (ELISA, SMI26) was used for quantification of GFAP. The highest concentration of vitreous body GFAP in organ donors was 20 pg/mL and it was used as the cutoff. A significant proportion of patients suffering from RD (65 %) to EG (53 %) had vitreous body GFAP levels above this cutoff when compared to organ donors (0 %, p vitreous body GFAP levels were correlated with axial length (R = 0.69, R = 0.52, p vitreous body GFAP is a protein biomarker for glial activation in response to retinal pathologies. Vitreous body GFAP levels may be of interest as a surrogate outcome for experimental treatment strategies in translational studies.

  2. Clinical features and etiology of retinal vasculitis in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Supanut Apinyawasisuk

    2013-01-01

    Full Text Available Purpose: To report on the clinical features and etiology of patients with retinal vasculitis (RV. Materials and Methods: We reviewed medical records of 47 patients (75 affected eyes diagnosed with RV. Clinical presentations, ocular complications, associated systemic diseases, and treatment regimens were registered. Results: Etiology of RV included infectious causes in 10/47, (21% while an association with systemic and/or ocular non-infectious disorders was noted in 22/47 (47%. Eales′ disease and Behcet′s disease represented the most common clinical entities in non-infectious group while tuberculosis-associated RV was diagnosed in 6/10 (60% among those with infectious disorders. RV was bilateral in 28/47 (60% patients. Retinal veins were most commonly affected (72%, 34/47. Involvement of arteries was present in 12/47 (25% and was associated with viral infections and Behcet′s disease. Ocular complications developed in 60/75 (80% eyes. The most common complications were elevated intraocular pressure and/or glaucoma (33/75, 44%. Retinal detachment, vitreous hemorrhage, and cystoid macular edema developed in similar percentages (15%. Conclusions: RV in Thailand manifested mostly in male patients, was typically bilateral and involved mostly veins. Involvement of arteries was observed in patients with viral infections and Behcet′s disease. Tuberculosis was the most common infectious cause.

  3. Maritime Training Serbian Autonomous Vessel Protection Detachment

    Directory of Open Access Journals (Sweden)

    Šoškić Svetislav D.

    2014-06-01

    Full Text Available The crisis in Somalia has caused appearance of piracy at sea in the Gulf of Aden and the Western Indian Ocean. Somali pirates have become a threat to economic security of the world because almost 30 percent of world oil and 20 percent of global trade passes through the Gulf of Aden. Solving the problem of piracy in this part of the world have included international organizations, institutions, military alliances and the states, acting in accordance with international law and UN Security Council resolutions. The European Union will demonstrate the application of a comprehensive approach to solving the problem of piracy at sea and the crisis in Somalia conducting naval operation — EU NAVFOR Atalanta and operation EUTM under the Common Security and Defense Policy. The paper discusses approaches to solving the problem of piracy in the Gulf of Aden and the crisis in Somalia. Also, the paper points to the complexity of the crisis in Somalia and dilemmas correctness principles that are applied to solve the problem piracy at sea. One of goals is protections of vessels of the World Food Programme (WFP delivering food aid to displaced persons in Somalia. Republic of Serbia joined in this mission and trained and sent one a autonomous team in this military operation for protection WFP. This paper consist the problem of modern piracy, particularly in the area of the Horn of Africa became a real threat for the safety of maritime ships and educational process of Serbian Autonomous vessel protection detachment. Serbian Military Academy adopted and developed educational a training program against piracy applying all the provisions and recommendations of the IMO conventions and IMO model courses for Serbian Autonomous vessel protection detachment.

  4. Risk of Cataract in Persons with Cytomegalovirus Retinitis and the Acquired Immune Deficiency Syndrome

    Science.gov (United States)

    Kempen, John H.; Sugar, Elizabeth A.; Lyon, Alice T.; Lewis, Richard Alan; Jabs, Douglas A.; Heinemann, Murk-Hein; Dunn, James P.

    2012-01-01

    Objective To evaluate cataract risk in eyes of patients with AIDS and cytomegalovirus (CMV) retinitis and to identify risk factors. Design Prospective cohort study. Participants Patients with AIDS and CMV retinitis. Methods Patients 13 years of age and older were enrolled between 1998 and 2008. Demographic and clinical characteristics, slit-lamp biomicroscopy findings, and dilated ophthalmoscopy results were documented at quarterly visits. Cataract status was determined at the initial visit (prevalence) and at follow-up visits (incidence). Main Outcome Measures For cataract, a high grade of lens opacity by biomicroscopy to which best-corrected visual acuity worse than 20/40 was attributed. Eyes that had undergone cataract surgery before enrollment or between visits also were counted as having cataract. Results Seven hundred twenty-nine eyes of 489 patients diagnosed with CMV retinitis were evaluated. Higher prevalence was observed for patients with bilateral versus unilateral CMV retinitis (adjusted odds ratio [aOR], 2.74; 95% confidence interval [CI], 1.76–4.26) and, among unilateral CMV retinitis cases, for eyes with retinitis versus without retinitis (15% vs. 1.4%; Pcataract among CMV retinitis cases was higher than that in a population-based sample (PCataract prevalence increased with age (aOR, 11.77; 95% CI, 2.28–60.65 for age ≥60 years vs. younger than 40 years) and longer duration of retinitis (aOR, 1.36; 95% CI, 1.20–1.54 per year). Among eyes with CMV retinitis initially free of cataract, the cataract incidence was 8.1%/eye-year (95% CI, 6.7%–10.0%). Prior retinal detachment was associated with higher cataract risk (if repaired with silicone oil: adjusted hazard ratio [aHR], 10.37; 95% CI, 6.51–16.52; otherwise: aHR, 2.90; 95% CI, 1.73–4.87). Large CMV retinitis lesions also were associated with higher risk of cataract (for involvement of 25–49% retinal area: aHR, 2.30; 95% CI, 1.51–3.50; for ≥50% involvement: aHR, 3.63; 95% CI, 2.18

  5. Finasteride is effective for the treatment of central serous chorioretinopathy.

    Science.gov (United States)

    Moisseiev, E; Holmes, A J; Moshiri, A; Morse, L S

    2016-06-01

    PurposeTo evaluate the safety and efficacy of finasteride treatment in patients with central serous chorioretinopathy (CSC).MethodsRetrospective review of 29 eyes of 23 patients who were treated with finasteride for CSC. Previous medical and ocular history, steroid use, length of finasteride treatment, additional treatments for CSC, visual acuity (VA), central macular thickness (CMT), and presence of subretinal fluid (SRF) throughout the follow-up period, and the occurrence of any complications were recorded.ResultsInitial VA was 0.29±0.31 logMAR, and a trend towards improved VA was noted after 3 months (0.25±0.36 logMAR; P=0.07). VA was significantly improved at the final follow-up (0.23±0.27 logMAR; P=0.024). Initial CMT was 354±160 μm, and was significantly reduced after 1 month of treatment (284±77 μm; P=0.002) and this was maintained to the end of follow-up (247±85 μm; P=0.001). A significant reduction in SRF presence was found at all time points, with an overall 75.9% rate of complete resolution. Following discontinuation, SRF recurrence was noted in 37.5% of cases. No adverse events were recorded.ConclusionsFinasteride is a safe and effective treatment for CSC. It may be a possible new option for the initial management of patient with CSC, and a suggested treatment approach is presented.

  6. Frequency of fibromyalgia syndrome in patients with central serous chorioretinopathy

    Directory of Open Access Journals (Sweden)

    Ayse Balkarli

    Full Text Available ABSTRACT Purpose: To ınvestigate frequency of fibromyalgia syndrome (FMS among patients with central serous chorioretinopathy (CSCR. Methods: The study included 83 patients with CSCR and 201 age- and sex-matched healthy controls; the mean age was 47.5 ± 11.3 years in the CSCR group (18 women; 21.7% and 47.2 ± 11.2 years in the control group (44 women; 21.9%. All participants were assessed for FMS based on 2010 American College of Rheumatology diagnostic criteria and for depression and anxiety with the Beck Anxiety Inventory (BAI and Beck Depression Inventory (BDI. Results: FMS was diagnosed in 35 patients (42.2% from the CSCR group and in 21 individuals (10.4% from the control group (p<0.001. It was found in 77.77% of the women (14/18 and 32.3% of the men (21/65 in the CSCR group and in 22.7% of the women (10/44 and 7.0% of the men (11/157 in the control group. Familial stress, BDI and BAI scores were higher in the patients with FMS than in those without. When independent risk factors were evaluated by logistic regression analysis, it was found that only the presence of familial stress was a significant risk factor for FMS. Conclusions: Patients with CSCR should be assessed for the presence of FMS, and this should be taken into consideration when developing a treatment plan. Further studies with a larger sample size are needed to clarify the relationship between FMS and CSCR.

  7. Precursor Lesions of High-Grade Serous Ovarian Carcinoma: Morphological and Molecular Characteristics

    Directory of Open Access Journals (Sweden)

    Amy L. Gross

    2010-01-01

    Full Text Available The lack of proven screening tools for early detection and the high mortality of ovarian serous carcinoma (OSC, particularly high grade, have focused attention on identifying putative precursor lesions with distinct morphological and molecular characteristics. The finding of occult invasive and intraepithelial fallopian tube carcinomas in prophylactically removed specimens from asymptomatic high-risk BRCA 1/2-mutation carriers supports the notion of an origin for OSC in the fallopian tube. The intraepithelial carcinomas have been referred to as serous intraepithelial carcinomas (STICs but our own findings (unpublished data and recent reports have drawn attention to a spectrum of changes that fall short of STICs that we have designated serous tubal intraepithelial lesions (STILs.

  8. Ovarian serous cystadenoma associated with Sertoli-Leydig cell tumor--a case report.

    Science.gov (United States)

    Seo, E. J.; Kwon, H. J.; Shim, S. I.

    1996-01-01

    We Describe a case of ovarian serous cystadenoma having Sertoli-Leydig cell tumor, well differentiated, in the cystic septum. Well differentiated Sertoli-Leydig cell tumor coexisting with other tumor, including serous tumor, has not yet been described. In all cases of Sertoli-Leydig cell tumor with heterologous components or other tumors, the androblastomatous components are intermediately or poorly differentiated. The present case revealed a well differentiated Sertoli-Leydig cell tumor arising in a septum of serous cystadenoma, as a circumscribed nodule. With these findings, we discuss the possibility of this Sertoli-Leydig cell tumor, considered a mural nodule, which is well established in cystic common epithelial tumors of the ovary. PMID:8703377

  9. Coexistent borderline serous cystadenoma with multifocal hydatidosis in a young female: lessons learnt.

    Science.gov (United States)

    Khalid, Saifullah; Jamal, Faisal; Rafat, Dalia; Ahmed, Murad; Narayanasamy, Sabarish; Obaid, Amber; Shadan, Mariam

    2016-10-01

    Hydatid disease (HD) is a commonly occurring zoonotic disease caused by tapeworms of the genus Echinococcus. It is endemic in many parts of the world and can involve almost any organ of the body. Although HD of the liver and lungs is quite common, ovarian involvement is rare. We present a case of a 24-year-old female patient who was diagnosed with multifocal hydatidosis involving the liver and bilateral ovaries on imaging. Postoperative histopathology confirmed the hydatid disease in the liver and one ovary. However, the cystic lesion in the other ovary turned out to be a borderline serous cystadenoma. This case highlights the limitation of imaging in differentiating between simple hydatid cysts and serous cystadenomas of the ovaries. Another point we learnt is that even in the presence of multifocal hydatidosis in endemic regions, serous cystadenoma needs to be considered in imaging differential diagnosis.

  10. Retinal Thickening and Photoreceptor Loss in HIV Eyes without Retinitis.

    Directory of Open Access Journals (Sweden)

    Cheryl A Arcinue

    Full Text Available To determine the presence of structural changes in HIV retinae (i.e., photoreceptor density and retinal thickness in the macula compared with age-matched HIV-negative controls.Cohort of patients with known HIV under CART (combination Antiretroviral Therapy treatment were examined with a flood-illuminated retinal AO camera to assess the cone photoreceptor mosaic and spectral-domain optical coherence tomography (SD-OCT to assess retinal layers and retinal thickness.Twenty-four eyes of 12 patients (n = 6 HIV-positive and 6 HIV-negative were imaged with the adaptive optics camera. In each of the regions of interest studied (nasal, temporal, superior, inferior, the HIV group had significantly less mean cone photoreceptor density compared with age-matched controls (difference range, 4,308-6,872 cones/mm2. A different subset of forty eyes of 20 patients (n = 10 HIV-positive and 10 HIV-negative was included in the retinal thickness measurements and retinal layer segmentation with the SD-OCT. We observed significant thickening in HIV positive eyes in the total retinal thickness at the foveal center, and in each of the three horizontal B-scans (through the macular center, superior, and inferior to the fovea. We also noted that the inner retina (combined thickness from ILM through RNFL to GCL layer was also significantly thickened in all the different locations scanned compared with HIV-negative controls.Our present study shows that the cone photoreceptor density is significantly reduced in HIV retinae compared with age-matched controls. HIV retinae also have increased macular retinal thickness that may be caused by inner retinal edema secondary to retinovascular disease in HIV. The interaction of photoreceptors with the aging RPE, as well as possible low-grade ocular inflammation causing diffuse inner retinal edema, may be the key to the progressive vision changes in HIV-positive patients without overt retinitis.

  11. Effect of Tubal Sterilization Technique on Risk of Serous Ovarian and Primary Peritoneal Carcinoma

    Science.gov (United States)

    LESSARD-ANDERSON, Collette R.; HANDLOGTEN, Kathryn S.; MOLITOR, Rochelle J.; DOWDY, Sean C.; CLIBY, William A.; WEAVER, Amy L.; SAUVER, Jennifer ST.; BAKKUM-GAMEZ, Jamie N.

    2014-01-01

    Objective To determine the effect of excisional tubal sterilization on subsequent development of serous epithelial ovarian cancer (EOC) or primary peritoneal cancer (PPC). Methods We performed a population-based, nested case-control study using the Rochester Epidemiology Project. We identified all patients with a diagnosis of serous EOC or PPC from 1966 through 2009. Each case was age-matched to 2 controls without either diagnosis. Odds ratios (ORs) and corresponding 95% CIs were estimated from conditional logistic regression models. Models were adjusted for prior hysterectomy, prior salpingo-oophorectomy, oral contraceptive use, endometriosis, infertility, gravidity, and parity. Results In total, we identified 194 cases of serous EOC and PPC during the study period and matched them with 388 controls (mean [SD] age, 61.4 [15.2] years). Fourteen cases (7.2%) and 46 controls (11.9%) had undergone tubal sterilization. Adjusted risk of serous EOC or PPC was slightly lower after any tubal sterilization (OR, 0.59 [95% CI, 0.29–1.17]; P=.13). The rate of excisional tubal sterilization was lower in cases than controls (2.6% vs 6.4%). Adjusted risk of serous EOC and PPC was decreased by 64% after excisional tubal sterilization (OR, 0.36 [95% CI, 0.13–1.02]; P=.054) compared with those without sterilization or with nonexcisional tubal sterilization. Conclusions We present a population-based investigation of the effects of excisional tubal sterilization on the risk of serous EOC and PPC. Excisional methods may confer greater risk reduction than other sterilization methods. PMID:25316178

  12. Psychological detachment and savoring in adaptation to cancer caregiving.

    Science.gov (United States)

    Hou, Wai Kai; Lau, Kam Man; Ng, Sin Man; Lee, Tatia Mei Chun; Cheung, Hester Yui Shan; Shum, Tracy Chui Yu; Cheng, Ashley Chi Kin

    2016-07-01

    Recovery experience including psychological detachment from caregiving and savoring positive moments in life could be complementary coping processes for cancer caregivers. This study aims to examine the nature of their associations with caregiving burden and anxiety and depressive symptoms among Chinese cancer caregivers in Hong Kong. A total of 155 Chinese caregivers of recently diagnosed cancer patients (mean time since diagnosis = 42.57 days, SD = 39.25) were recruited from two major government-funded hospitals and administered a questionnaire assessing psychological detachment, savoring, caregiving burden, anxiety and depressive symptoms, and demographics. Controlling for demographic and medical covariates, structural equation modeling revealed significant associations of detachment, savoring, and their interaction term with caregiving burden and anxiety and depressive symptoms. Detachment and savoring were inversely associated with caregiving burden only when the other was at lower/medium levels. Detachment was inversely associated with anxiety and depressive symptoms at lower/medium levels of savoring, but savoring was inversely associated with anxiety and depressive symptoms across all levels of detachment. Detachment and savoring could overshadow the positive impact of the other on caregiving burden if either one is at higher levels, while they could demonstrate concurrent positive impact on burden when both are at lower/medium levels. Savoring could have a prioritized role in ameliorating caregivers' anxiety and depressive symptoms, supplemented by detachment. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  13. Recalcitrance of Streptococcus mutans biofilms towards detergent-stimulated detachment

    NARCIS (Netherlands)

    Landa, AS; van de Belt-Gritter, B; van der Mei, HC; Busscher, HJ

    The biofilm mode of growth protects the plaque microorganisms against environmental attacks, such as from antimicrobials or detergents. Detergents have a demonstrated ability to detach initially adhering bacteria from enamel surfaces, but the ability of detergent components to detach plaque bacteria

  14. Frictional and elastic energy in gecko adhesive detachment.

    Science.gov (United States)

    Gravish, Nick; Wilkinson, Matt; Autumn, Kellar

    2008-03-06

    Geckos use millions of adhesive setae on their toes to climb vertical surfaces at speeds of over 1 m s(-1). Climbing presents a significant challenge for an adhesive since it requires both strong attachment and easy, rapid removal. Conventional pressure-sensitive adhesives are either strong and difficult to remove (e.g. duct tape) or weak and easy to remove (e.g. sticky notes). We discovered that the energy required to detach adhering tokay gecko setae (W(d)) is modulated by the angle (theta) of a linear path of detachment. Gecko setae resist detachment when dragged towards the animal during detachment (theta = 30 degrees ) requiring W(d) = 5.0+/-0.86(s.e.) J m(-2) to detach, largely due to frictional losses. This external frictional loss is analogous to viscous internal frictional losses during detachment of pressure-sensitive adhesives. We found that, remarkably, setae possess a built-in release mechanism. Setae acted as springs when loaded in tension during attachment and returned elastic energy when detached along the optimal path (theta=130 degrees ), resulting in W(d) = -0.8+/-0.12 J m(-2). The release of elastic energy from the setal shaft probably causes spontaneous release, suggesting that curved shafts may enable easy detachment in natural, and synthetic, gecko adhesives.

  15. BRENNER TUMOR WITH SEROUS CYSTADENOMA- AN UNUSUAL COMBINATION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Syam Sundar B, Shanthi V, Mohan Rao N, Bhavana Grandhi, Chidananda Reddy V, Swathi S

    2015-01-01

    Full Text Available Surface epithelial tumors are most common, which comprise 58% of all ovarian tumors. Serous and mucinous cystadenoma are the most common epithelial tumors which accounts for about 35% of ovarian tumors. Different combinations of epithelial tumors can occur in ovary most common among them is Mucinous cystadenoma and Brenner tumor. We report a case of an ovarian tumor with rare combination Brenner tumor with serous cyst adenoma of ovary in 56 year old female patient. Only a few cases with this combination are very rarely reported in the literature.

  16. Testicular papillary serous cystadenocarcinoma: a rare case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sharhriar Zeighami

    2011-10-01

    Full Text Available Papillary serous cystadenocarcinoma of the ovary is a common tumor but occurrence of ovarian type papillary serous cystadenocarcinoma in the testis is very rare. Herein we report such a case in a 49-year-old man presenting with testicular swelling. In this tumor, mesothelioma of tunica vaginalis should be excluded by immunohistochemistry. The best treatment is radial orchiectomy and it is very resistant to chemoradiation. Our case was well after orchiectomy and now after a year he is doing well and completely symptom free.

  17. Ovarian serous cystadenofibroma with signet ring-stromal cells: report of 2 cases.

    Science.gov (United States)

    Shah, Rajeev; Shah, Varsha; McCluggage, W Glenn

    2010-09-01

    We report 2 ovarian serous cystadenofibromas with signet ring cells within the stromal component. The signet ring-stromal cells were widespread in 1 case and focal in the other. Immunohistochemically, they were negative with cytokeratin and other epithelial markers and positive with mesenchymal markers. The occurrence of signet ring-stromal cells in ovarian serous cystadenofibromas is an unusual pseudoneoplastic phenomenon, which has not been reported previously, although signet ring cells may occur within a variety of ovarian stromal neoplasms, including fibromas, sclerosing stromal tumors, and signet ring-stromal tumors. In reporting these cases, we review ovarian stromal neoplasms and other lesions with signet ring cells.

  18. Tracing detached and attached care practices in nursing education

    DEFF Research Database (Denmark)

    Soffer, Ann Katrine B.

    2014-01-01

    The implementation of skills labs in Danish nursing education can, in itself, be viewed as a complexity. The students are expected to eventually carry out their work in a situated hospital practice, but they learn their professional skills in a different space altogether, detached and removed from...... to attachments. Yet empirical cases from the skills lab and hospitals illustrate how students sometimes felt emotionally attached to plastic dummies and how experienced nurses sometimes practised a degree of detachment in relation to human patients. Detached engagements will therefore be presented as part...... of care practices of nurses rendering the ability to detach in engagement with patients a professional skill that students also need to learn. In the analysis to follow, attached and detached engagements are located on an equal plane by integrating both in to the same conceptual framework, rather than...

  19. Spontaneous Solitaire™ AB Thrombectomy Stent Detachment During Stroke Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Akpinar, Suha, E-mail: akpinarsuha@hotmail.com; Yilmaz, Guliz, E-mail: glz.yilmaz@hotmail.com [Near East University Hospital, Department of Radiology, Faculty of Medicine (Turkey)

    2015-04-15

    Spontaneous Solitaire™ stent retriever detachment is a rarely defined entity seen during stroke treatment, which can result in a disastrous clinical outcome if it cannot be solved within a critical stroke treatment time window. Two solutions to this problem are presented in the literature. The first is to leave the stent in place and apply angioplasty to the detached stent, while the second involves surgically removing the stent from the location at which it detached. Here, we present a case of inadvertent stent detachment during stroke treatment for a middle cerebral artery M1 occlusion resulting in progressive thrombosis. The detached stent was removed endovascularly by another Solitaire stent, resulting in the recanalization of the occluded middle cerebral artery.

  20. Choroidal thickness and retinal abnormalities by optical coherence tomography in endogenous Cushing’s syndrome

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Abalem

    2016-12-01

    Full Text Available Context: Cortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes. Objective: To compare choroidal thickness measurements using optical coherence tomography (OCT in patients with endogenous active Cushing’s syndrome and to evaluate the occurrence of retinal abnormalities in the same group of patients. Design: Cross-sectional study.Setting: Outpatient clinic.Patients: Eleven female patients with Cushing’s syndrome in hypercortisolism state as determined by the presence of at least two abnormal measurements from urinary cortisol 24h, no suppression of cortisol with low dose dexamethasone suppression test and nocturnal salivary cortisol levels and 12 healthy controls.Methods: Choroidal and retinal morphology was assessed using OCT. Main outcome measures: Choroidal thickness measurements and the presence of retinal changes. Results: The mean subfoveal choroidal thickness was 372.96 ± 73.14 μm in the patients with Cushing’s syndrome and 255.63 ± 50.70 μm in the control group, (p<0.001. One patient (9.09% presented with central serous chorioretinopathy and one patient (9.09% with pachychoroid pigment epitheliopathy. Conclusions: Choroidal thickness is increased in the eyes of patients with active Cushing’s syndrome compared to healthy and matched control. Also, 18.18% of patients presented with macular changes, possibly secondary to choroidal thickening. While further studies are necessary to confirm our findings excess corticosteroid levels seems to have a significant effect on the choroid and might be associated with secondary retinal diseases.

  1. Clinicopathology of graft detachment after Descemet's membrane endothelial keratoplasty.

    Science.gov (United States)

    Brockmann, Tobias; Brockmann, Claudia; Maier, Anna-Karina; Schroeter, Jan; Pleyer, Uwe; Bertelmann, Eckart; Joussen, Antonia M; Torun, Necip

    2014-11-01

    To investigate pathomechanisms involved in graft detachment after Descemet's membrane endothelial keratoplasty (DMEK) and its clinical implications. In a prospective case series, 30 eyes with Fuchs' endothelial dystrophy underwent DMEK. Intraoperatively obtained recipients' endothelium-Descemet's membranes (EDMs) were investigated histologically and immunohistochemically. The postoperative donor graft status was categorized as attached or detached. Clinical and morphological parameters were analysed between the study groups. The detachment rate was 40% (12/30). There was no significant difference in postoperative visual acuity between the groups, but visual recovery was delayed in eyes with initially detached grafts. Gender, age, preoperative central corneal thickness or best corrected visual acuity did not influence the detachment rate. However, separation and disruption of the anterior banded layer (ABL) were frequently observed in patients with graft detachment, and ABL thickness was identified as a significant predictor for graft detachment. The ABL thickness was 2.5 ± 0.9 μm and 3.5 ± 1.6 μm in patients with attached and detached grafts, respectively. Immunohistologically, a deficiency of fibronectin and cytokeratin was observed within the ABL of patients with detached grafts. In contrast, a complete removal of the EDM with residual stromal collagen fragments was observed in patients with adherent grafts. Incomplete removal of the EDM, with residual ABL fragments on the recipients' corneal stroma, may be a risk factor for graft detachment after DMEK. The separation and disruption of the ABL might be promoted by a deficiency of matrix proteins, stronger biomechanical properties and a firm adherence to the posterior corneal stroma. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  2. Retinal astrocytoma in a dog.

    Science.gov (United States)

    Kuroki, Keiichi; Kice, Nathan; Ota-Kuroki, Juri

    2017-09-01

    A miniature schnauzer dog presenting with hyphema and glaucoma of the right eye had a retinal neoplasm. Neoplastic cells stained positively for glial fibrillary acidic protein, vimentin, and S-100 and largely negatively for oligodendrocyte transcription factor 2 by immunohistochemistry. The clinical and histopathological features of canine retinal astrocytomas are discussed.

  3. Perceptual Fading without Retinal Adaptation

    Science.gov (United States)

    Hsieh, Po-Jang; Colas, Jaron T.

    2012-01-01

    A retinally stabilized object readily undergoes perceptual fading and disappears from consciousness. This startling phenomenon is commonly believed to arise from local bottom-up sensory adaptation to edge information that occurs early in the visual pathway, such as in the lateral geniculate nucleus of the thalamus or retinal ganglion cells. Here…

  4. Spectrophotometric retinal oximetry in pigs

    DEFF Research Database (Denmark)

    Traustason, Sindri; Kiilgaard, Jens Folke; Karlsson, Robert

    2013-01-01

    PURPOSE: To assess the validity of spectrophotometric retinal oximetry, by comparison to blood gas analysis and intra-vitreal measurements of partial pressure of oxygen (pO2). METHODS: Female domestic pigs were used for all experiments (n=8). Oxygen fraction in inspired air was changed using...... a mixture of room air, pure oxygen and pure nitrogen, ranging from 5% to 100% oxygen. Femoral arterial blood gas analysis and retinal oximetry was performed at each level of inspiratory oxygen fraction. Retinal oximetry was performed using a commercial instrument, the Oxymap Retinal Oximeter T1 (Oxymap ehf......, Reykjavik, Iceland). The device simultaneously acquires images at two wavelengths (570 nm and 600 nm) and specialized software automatically detects retinal blood vessels. In three pigs, invasive pO2-measurements were performed after the initial non-invasive measurements. RESULTS: Comparison of femoral...

  5. Heritability of Retinal Vascular Fractals

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Broe, Rebecca; Kessel, Line

    2017-01-01

    , the branching pattern of the retinal vessels demonstrated a higher structural similarity in monozygotic than in dizygotic twin pairs. The retinal vascular fractal dimension was mainly determined by genetic factors, which accounted for 54% of the variation. The genetically predetermination of the retinal......Purpose: To determine the genetic contribution to the pattern of retinal vascular branching expressed by its fractal dimension. Methods: This was a cross-sectional study of 50 monozygotic and 49 dizygotic, same-sex twin pairs aged 20 to 46 years. In 50°, disc-centered fundus photographs......, the retinal vascular fractal dimension was measured using the box-counting method and compared within monozygotic and dizygotic twin pairs using Pearson correlation coefficients. Falconer's formula and quantitative genetic models were used to determine the genetic component of variation. Results: The mean...

  6. 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.

  7. Spontaneous Cerebrospinal Fluid Otorrhea from a Persistent Tympanomeningeal Fissure Presenting as Recurrent Serous Otitis Media

    DEFF Research Database (Denmark)

    Zakaryan, Arman; Poulsgaard, Lars; Hollander, Camilla

    2015-01-01

    We describe spontaneous cerebrospinal fluid (CSF) otorrhea through a patent tympanomeningeal (Hyrtl) fissure presenting as recurrent serous otitis media. The CSF leak was observed when a drain was placed through the tympanic membrane by an otologist. The diagnosis was then confirmed by computed...

  8. OCT Angiography Compared to Fluorescein and Indocyanine Green Angiography in Chronic Central Serous Chorioretinopathy

    NARCIS (Netherlands)

    Teussink, M.M.; Breukink, M.B.; Grinsven, M.J.J.P. van; Hoyng, C.B.; Klevering, B.J.; Boon, C.J.F.; Jong, E.K.; Theelen, T.

    2015-01-01

    PURPOSE: Abnormal choroidal blood flow is considered important in the pathogenesis of chronic central serous chorioretinopathy (CSC). Optical coherence tomography (OCT) angiography can image ocular blood cell flow and could thus provide novel insights in disease mechanisms of CSC. We evaluated

  9. Organizing the Cellular and Molecular Heterogeneity in High-Grade Serous Ovarian Cancer by Mass Cytometry

    Science.gov (United States)

    Tumor heterogeneity in high grade serous ovarian cancer (HG-SOC) represents a significant barrier for successful therapeutic intervention. To further...understand the cell types contributing to this heterogeneity we performed a comprehensive phenotypic characterization of 22 primary ovarian tumor...also showed greater overall phenotypic heterogeneity quantified by Simpsons Diversity Index. Importantly the novel cell types identified have the

  10. Serous cystadenocarcinoma of the pancreas: report of a case and management reflections

    Directory of Open Access Journals (Sweden)

    Bramis K

    2012-03-01

    Full Text Available Abstract Background Serous adenomas represent 1-2% of pancreatic neoplasms and typically are asymptomatic not requiring any treatment and simple observation is the option of choice. Although, they carry a realistic risk of malignancy despite the general view that they never become malignant. We report a case, which, according to our best knowledge is the 27th case reported in the literature. Methods We reviewed the literature by performing a search in Pub Med and Medline. Results A 86-year old patient known to have a serous cystadenoma of the pancreas treated conservatively through a close clinical and radiological follow up which was unattended for 4 years ending up to our emergency department suffering an acute abdomen. Exploratory laparotomy revealed a perforated prepyloric ulcer which was treated accordingly. Patient died some weeks later due to severe medical co morbidities. Conclusion Serous cystic neoplasms of the pancreas carry a realistic risk of malignancy despite the general view that they never become malignant. In our opinion the treatment strategy of serous cystic neoplasms of the pancreas should be aggressive even in cases of remote metastases since prognosis of the disease is satisfactory

  11. Borderline papillary serous tumor of the ovary: the authors’ observation and a concise review of literature

    Directory of Open Access Journals (Sweden)

    Z. N. Shavladze

    2012-01-01

    Full Text Available The paper presents a case of borderline papillary serous cystadenoma in a 34-year-old female patient, by describing the magnetic resonance image of borderline ovarian tumors in detail and reviewing the data available in the literature on the specific features of their imaging and diagnosis.

  12. Enrichment of putative PAX8 target genes at serous epithelial ovarian cancer susceptibility loci

    DEFF Research Database (Denmark)

    Kar, Siddhartha P; Adler, Emily; Tyrer, Jonathan

    2017-01-01

    BACKGROUND: Genome-wide association studies (GWAS) have identified 18 loci associated with serous ovarian cancer (SOC) susceptibility but the biological mechanisms driving these findings remain poorly characterised. Germline cancer risk loci may be enriched for target genes of transcription facto...

  13. Ruptured Ectopic Pregnancy with Contralateral Ovarian Serous Cyst Adenoma Torsion: Laparoscopic Management of Double Trouble.

    Science.gov (United States)

    Ganesh, Deepa; Rajkumar, Anirudh; Rajkumar, J S; Guru, Venkatesan

    2016-01-01

    Adnexal torsion is responsible for 2.7% of all gynecological emergencies. Ectopic pregnancy is relatively common, occurring in 2% of all pregnancies. We report the second case of ruptured right tubal ectopic gestation with torsion of serous cystadenoma of left ovary. This was diagnosed after emergency laparoscopy done for acute abdomen. Right salpingectomy and left ovarian detorsion followed by cystectomy were done laparoscopically.

  14. Profiles of Genomic Instability in High-Grade Serous Ovarian Cancer Predict Treatment Outcome

    DEFF Research Database (Denmark)

    Wang, Zhigang C.; Birkbak, Nicolai Juul; Culhane, Aedín C.

    2012-01-01

    Purpose: High-grade serous cancer (HGSC) is the most common cancer of the ovary and is characterized by chromosomal instability. Defects in homologous recombination repair (HRR) are associated with genomic instability in HGSC, and are exploited by therapy targeting DNA repair. Defective HRR cause...

  15. Molecular Analysis of Mixed Endometrioid and Serous Adenocarcinoma of the Endometrium.

    Directory of Open Access Journals (Sweden)

    Kate Lawrenson

    Full Text Available The molecular biology and cellular origins of mixed type endometrial carcinomas (MT-ECs are poorly understood, and a Type II component of 10 percent or less may confer poorer prognoses.We studied 10 cases of MT-EC (containing endometrioid and serous differentiation, 5 pure low-grade endometrioid adenocarcinoma (EAC and 5 pure uterine serous carcinoma (USC. Endometrioid and serous components of the MT-ECs were macrodissected and the expression of 60 candidate genes compared between MT-EC, pure USC and pure EAC. We found that four genes were differentially expressed when MT-ECs were compared to pure low-grade EAC: CDKN2A (P = 0.006, H19 (P = 0.010, HOMER2 (P = 0.009 and TNNT1 (P = 0.006. Also while we found that even though MT-ECs closely resembled the molecular profiles of pure USCs, they also exhibit lower expression of PAX8 compared to all pure cases combined (P = 0.035.Our data suggest that MT-EC exhibits the closest molecular and epidemiological similarities to pure USC and supports clinical observations that suggest patients with MT-EC should receive the same treatment as patients with pure serous carcinoma. Novel specific markers of MT-EC could be of diagnostic utility and could represent novel therapeutic targets in the future.

  16. Population-based treatment and outcomes of Stage I uterine serous carcinoma

    NARCIS (Netherlands)

    Putten, L.J.M. van der; Hoskins, P.; Tinker, A.; Lim, P.; Aquino-Parsons, C.; Kwon, J.S.

    2014-01-01

    OBJECTIVE: Uterine serous carcinoma (USC) is a rare type of endometrial cancer that often recurs in patients with Stage I disease. Our objective was to evaluate treatment and outcomes in Stage I USC in the context of a population-based study. METHODS: This was a population-based retrospective cohort

  17. Rare Association of Perivascular Granulomatous Lesions in a Patient with Acute Retinal Necrosis

    Directory of Open Access Journals (Sweden)

    Takahiro Sogawa

    2015-11-01

    Full Text Available Purpose: The aim of this study was to examine sequential changes in perivascular granulomatous lesions with acute retinal necrosis (ARN. Methods: A healthy 46-year-old Japanese woman, who developed floaters and pain in her left eye, underwent optical coherence tomography (OCT, fluorescein angiography, and routine ophthalmological examinations. Treatment-associated changes in perivascular granulomatous lesions were monitored using spectral-domain (SD-OCT. Results: The patient had no previous ophthalmic history, and her general condition was good. A slit-lamp examination revealed keratic precipitates and aqueous cells (2+ in the left eye. A fundus examination showed yellow-white patches of necrotizing retinal lesions in the temporal upper area, retinal arteritis, retinal hemorrhage, and vitreous opacities. The patient was diagnosed with ARN according to diagnostic criteria. SD-OCT images confirmed high-intensity and uniform granulomatous deposits in the perivascular area and fovea. Systemic corticosteroids and antiviral therapy were initiated, resulting in the gradual resolution of granulomatous lesions. The patient continues to be followed untreated without evidence of recurrence, retinal detachment, or active inflammation. Conclusions: This is the first report of perivascular granulomatous lesions in a patient with ARN. Our results showed that the formation of granulomas may be induced in the retina of ARN patients without fulminant inflammation.

  18. The artificial silicon retina microchip for the treatment of vision loss from retinitis pigmentosa.

    Science.gov (United States)

    Chow, Alan Y; Chow, Vincent Y; Packo, Kirk H; Pollack, John S; Peyman, Gholam A; Schuchard, Ronald

    2004-04-01

    To determine the safety and efficacy of the artificial silicon retina (ASR) microchip implanted in the subretinal space to treat vision loss from retinitis pigmentosa. The ASR microchip is a 2-mm-diameter silicon-based device that contains approximately 5000 microelectrode-tipped microphotodiodes and is powered by incident light. The right eyes of 6 patients with retinitis pigmentosa were implanted with the ASR microchip while the left eyes served as controls. Safety and visual function information was collected. During follow-up that ranged from 6 to 18 months, all ASRs functioned electrically. No patient showed signs of implant rejection, infection, inflammation, erosion, neovascularization, retinal detachment, or migration. Visual function improvements occurred in all patients and included unexpected improvements in retinal areas distant from the implant. Subjective improvements included improved perception of brightness, contrast, color, movement, shape, resolution, and visual field size. No significant safety-related adverse effects were observed. The observation of retinal visual improvement in areas far from the implant site suggests a possible generalized neurotrophic-type rescue effect on the damaged retina caused by the presence of the ASR. A larger clinical trial is indicated to further evaluate the safety and efficacy of a subretinally implanted ASR.

  19. Outcome of cytomegalovirus retinitis in immunocompromised patients without Human Immunodeficiency Virus treated with intravitreal ganciclovir injection.

    Science.gov (United States)

    Agarwal, Aniruddha; Kumari, Neha; Trehan, Amita; Khadwal, Alka; Dogra, Mangat R; Gupta, Vishali; Sharma, Aman; Gupta, Amod; Singh, Ramandeep

    2014-09-01

    To study the outcomes of treatment with intravitreal ganciclovir injection for cytomegalovirus (CMV) retinitis in patients without Human Immunodeficiency Virus (HIV) infection. In this retrospective cohort study, demographic and clinical characteristics of patients with CMV retinitis without HIV were noted. Patients received intravitreal ganciclovir injection (2 mg/0.1 ml) alone until quiescence. The outcome measures were time taken for the lesions to heal, number of injections, change in best-corrected visual acuity (BCVA), recurrence of retinitis, occurrence of immune recovery uveitis (IRU) or injection-related complications and retinal detachment (RD). 18 eyes of ten patients (six males) with mean age of 33.7 years from June 2004 to March 2013 were included. Thirteen eyes with active lesions (mean BCVA of 0.51 ± 0.41) received 5.54 ± 3.36 intravitreal ganciclovir injections with complete healing within 1.81 ± 1.25 months. The final BCVA was 0.43 ± 0.52. IRU was observed in six eyes (33.33%) and RD developed in one eye. One eye had recurrence 1 month after stopping ganciclovir injections. The rest of the patients had recurrence-free follow-up at 9.46 ± 12.42 months. Non-HIV patients with CMV retinitis can be successfully treated with intravitreal ganciclovir injection alone, avoiding the systemic side effects of systemic anti-CMV therapy.

  20. Pathological vitreous causes cell line-derived (but not donor-derived) retinal pigment epithelial cells to display proliferative vitreoretinopathy-like features in culture.

    Science.gov (United States)

    Sharma, Maryada; Tiwari, Anil; Sharma, Shweta; Bansal, Reema; Gupta, Vishali; Gupta, Amod; Luthra-Guptasarma, Manni

    2014-11-01

    It is well understood that epithelial mesenchymal transformation occurs when retinal pigment epithelial cells, sourced from either a cell line or cadaver eye, are cultured in the presence of cadaver-derived vitreous. We sought to study the changes in retinal pigment epithelial cells when cell line-derived retinal pigment epithelial cells are cultured in the presence of pathological vitreous. Prospective study. 42 patients with rhegmatogenous retinal detachments. D407 retinal pigment epithelial cells were cultured in the presence of cadaver-derived vitreous or vitreous/subretinal fluid derived from patients undergoing retinal reattachment surgeries. Besides the changes in phenotypic characteristics, the viability, proliferation, migration, mesenchymal marker expression and changes in the extracellular matrix components were also evaluated. Fibrotic phenotype in cell culture. Our study clearly demonstrates that cell line-derived retinal pigment epithelial cells (unlike donor-derived retinal pigment epithelial cells) cultured in the presence of patient-derived vitreous/subretinal fluid, exhibit characteristic features of proliferative vitreoretinopathy. We propose that it is the synergistic effect of the combined use of (i) pathological vitreous, rather than cadaver-derived vitreous (since rhegmatogenous retinal detachment-derived pathological vitreous and subretinal fluid contain exaggerated amounts of growth factors, which could predispose to proliferative vitreoretinopathy development) and (ii) cells from an immortal cell culture (cell line), rather than from primary cell cultures (since cells subjected to continuous serial passaging acquire some mesenchymal characteristics), which together result in not only a unique phenotype, but also prime these cells towards display of features associated with proliferative vitreoretinopathy. © 2014 Royal Australian and New Zealand College of Ophthalmologists.