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1.
Clin Exp Dermatol ; 49(8): 841-847, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-38270273

RESUMO

BACKGROUND: Vitiligo is reportedly associated with several ocular abnormalities. However, the relationship between vitiligo and retinal detachment (RD) remains unclear. OBJECTIVES: To examine the risk of RD in patients with vitiligo. METHODS: A nationwide population-based cohort study was conducted using data from the Taiwan National Health Insurance Database from 2007 to 2018. A total of 21 132 patients with vitiligo were matched in a 1 : 4 ratio with people without vitiligo by age, sex and comorbidity propensity score. Cumulative incidence and Cox proportional hazard models were used to investigate the risk of RD in patients with vitiligo. Subgroup analysis was performed. RESULTS: The cohort with vitiligo had a significantly higher rate of RD than the cohort without vitiligo [adjusted hazard ratio (aHR) 1.44, 95% confidence interval (CI) 1.20-1.72; P < 0.001]. Patients with vitiligo who required treatments such as phototherapy, systemic corticosteroids or immunosuppressants exhibited an even greater risk of RD (aHR 1.57, 95% CI 1.16-2.14; P = 0.004). CONCLUSIONS: Our study revealed a 1.44-fold increased risk of RD in patients with vitiligo, with an even higher risk in patients receiving phototherapy, systemic corticosteroids or immunosuppressants. The risk remained consistently higher over a 10-year follow-up period.


Assuntos
Descolamento Retiniano , Vitiligo , Humanos , Vitiligo/epidemiologia , Vitiligo/complicações , Taiwan/epidemiologia , Masculino , Feminino , Adulto , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/etiologia , Pessoa de Meia-Idade , Incidência , Fatores de Risco , Adulto Jovem , Modelos de Riscos Proporcionais , Imunossupressores/uso terapêutico , Imunossupressores/efeitos adversos , Fototerapia , Estudos de Coortes , Adolescente , Bases de Dados Factuais , Corticosteroides/uso terapêutico , Corticosteroides/efeitos adversos , Idoso , Criança
2.
Graefes Arch Clin Exp Ophthalmol ; 261(6): 1723-1729, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36595051

RESUMO

BACKGROUND: Stickler syndrome (STL) is an inherited progressive connective tissue collagen disorder. STL is the most common hereditary cause of retinal complications, retinal tears, and the development of retinal detachment (RD) in childhood. The aim of the study was to evaluate the long-term anatomical and functional results of surgical treatment of retinal complications in children and adolescents affected by STL. METHODS: A retrospective, single-center study was performed a cohort of children with STL who underwent retinal surgery between 2004 and 2021. RESULTS: The study group consisted of nine children; the mean age at the time of the retinal tear with/without retinal detachment was 7.2 (2-10) years, and the mean follow-up period was 9.6 (5-16) years. Pathogenic variants COL2A1 (5 children) and COL11A1 (3 children) were confirmed in our cohort. In total, we operated on 13 eyes, 11 eyes with complicated RD and two eyes with multiple retinal defects, but without RD. At the end of the follow-up period, an attached retina was achieved 77% (10 eyes) with or without silicone oil tamponade: cryopexy alone was successful in one eye (10%), scleral buckling (EB) in five eyes (50%), and vitrectomy with silicone oil tamponade combined with EB in four eyes (40%). The mean number of surgeries was 2.3 per eye. The resulting best corrected visual acuity ranged from 0.03 to 0.1 in one eye, from 0.16 to 0.4 in two eyes, and from 0.5 to 1.0 in 7 eyes. CONCLUSION: Repair of retinal tears with/without retinal detachment in patients with Stickler syndrome often requires multiple surgeries with combinations of cryopexy, scleral buckling, and/or vitrectomy with silicone oil tamponade. Treatment of the ocular complications arising from STL requires long-term comprehensive care.


Assuntos
Oftalmopatias Hereditárias , Descolamento Retiniano , Perfurações Retinianas , Humanos , Criança , Adolescente , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Óleos de Silicone , Retina/patologia , Recurvamento da Esclera , Vitrectomia/métodos , Oftalmopatias Hereditárias/cirurgia , Resultado do Tratamento
3.
Altern Ther Health Med ; 29(1): 80-84, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36112791

RESUMO

Context: Epidemiological data has shown that retinal detachment (RD) can occur at any age but has a poor prognosis in the adolescent population, which can cause huge obstacles to their life and learning. Although medications can achieve some curative effect, they have potential side effects and differences in individual efficacy. Objective: • The study intended to explore the clinical significance of visual training in improving recovery of postoperative visual function after external reduction of retinal detachment in adolescent patients. Design: The research team designed a prospective randomized controlled study. Setting: The study took place at Guiyang First People's Hospital in Guiyang, Guizhou, China. Participants: Participants were 110 adolescents with retinal detachments who underwent external reduction surgery, each on one eye for 110 eyes in total, and who were patients at the hospital between June 2015 and June 2019. Intervention: The research team assigned 52 participants to the visual-function training group, the intervention group, and 58 participants to the control group, according to the random-number-table method. Each group participated in training method for six months. Outcome Measures: To compare the groups, the research team measured visual function using the Visual Function scale (VF), binocular fusion function using the Worth Four Light Test (W4LT), and stereoscopic vision using the Titmus Stereo Test. The team obtained preoperative and postoperative data-at baseline, one day before surgery and postoperatively at one month and 3 months, and postintervention at 6 months. Results: Both groups had visual impairment after surgery. For visual function, the intervention group's scores after surgery increased gradually and were significantly higher than those of the control group at each follow-up time (P < .05). No significant difference in binocular fusion function existed between the groups at baseline or at one month after surgery (P > .05). At 3 months after surgery and postintervention, the proportions of participants in the intervention group with normal binocular fusion function were 86.54% and 88.46%, respectively, compared to that of the control group, at 68.97% and 70.69%, respectively. The intervention group's recovery was significantly better than that of the control group at 3 months after surgery and postintervention, at P < .028 and P < .022, respectively. No significant difference existed between the groups in stereoscopic vision at baseline, at 9.62% and 12.07%, respectively (P > .05). The proportion of participants in the intervention group with normal, binocular, stereoscopic vision increased gradually, and at one and 3 months after surgery and postintervention was 67.31%, 82.69%, and 88.46%, respectively. The intervention group's recovery was significantly better than that of the control group at one and 3 months after surgery and postintervention, at P < .028, P < .010, and P < .013, respectively. Conclusions: Visual training can effectively promote the recovery of visual function after external reduction of RD in adolescents and improve patients' prognoses. Moreover, long-term persistence can achieve significant effects, making the training worthy of clinical promotion.


Assuntos
Descolamento Retiniano , Humanos , Adolescente , Descolamento Retiniano/cirurgia , Descolamento Retiniano/etiologia , Estudos Prospectivos , Relevância Clínica , Acuidade Visual , China
4.
Indian J Ophthalmol ; 70(8): 3167, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35919014

RESUMO

Background: A 40-year-old male presented with a complaint of sudden onset diminution of vision in the left eye for 2 weeks. He was a follow-up case with retinal hemangioblastoma in both eyes. He underwent two sittings of fundus fluorescein angiography-guided trans-pupillary thermotherapy 2 years back. Since then, he was regularly followed up for 2 years with stable vision and stable retinal findings. At present, the best-corrected visual acuity (BCVA) in the right eye is 6/6, and in the left eye, it is counting fingers 2 meters. On fundus examination, he had one active hemangioblastoma in the right eye and total retinal detachment in the left eye with multiple active lesions. The right eye was treated with a single sitting of thermotherapy, and the left eye underwent pars plana vitrectomy and angioma excision, followed by silicone oil tamponade. The immediate and late post-operative periods were uneventful, with successful anatomical and functional outcomes. The left eye BCVA on late follow-up was 6/36, no further treatment was advised, and the patient was kept under follow-up and observed closely. Purpose: : To educate regarding the systemic workup, diagnosis, and surgical management of complicated retinal detachment in retinal hemangioblastoma. Synopsis: : Systemic workup, diagnosis, and surgical steps in the management of complicated retinal detachment in retinal hemangioblastoma were performed. Highlights: : Close follow-up, keen observation, and prompt treatment in the early stages of the disease are indispensable to prevent untoward sequelae of retinal hemangioblastoma. A thorough systemic workup is necessary to diagnose the systemic involvements early. Surgery, if indicated for the retinal hemangioblastoma or its associated sequelae, should be performed diligently and with careful handling of blood vessels and anomalous tissues. Online Video Link: https://youtu.be/CkoqWEnaPB8.


Assuntos
Hemangioblastoma , Descolamento Retiniano , Neoplasias da Retina , Adulto , Hemangioblastoma/complicações , Hemangioblastoma/diagnóstico , Hemangioblastoma/cirurgia , Humanos , Masculino , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Neoplasias da Retina/complicações , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/cirurgia , Estudos Retrospectivos , Óleos de Silicone , Acuidade Visual , Vitrectomia/efeitos adversos
5.
Ophthalmic Surg Lasers Imaging Retina ; 52(7): 400-402, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34309433

RESUMO

A 9-year-old female with a history of Bohring-Opitz syndrome (BOS), Down syndrome, and autism initially presented with bilateral cataracts and a total retinal detachment in her left eye secondary to chronic self-injurious behavior. The authors report the first case of self-induced retinal detachment and traumatic cataracts in a patient with BOS. For patients who present with self-injurious behavior, the authors advocate for behavioral modifications at home, including the use of "no-no's," supplemental medication if necessary, and behavioral therapy to reduce the risk of self-induced visual injury. The authors also suggest the use of 25-gauge vitrectomy with silicone oil for retinal detachment repair. Finally, given the high risk of irreversible vision loss from amblyopia and recurrent retinal detachments in children with BOS and self-injurious behavior, the authors recommend regular 2-month interval ophthalmic follow-up. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:400-402.].


Assuntos
Catarata , Craniossinostoses , Descolamento Retiniano , Catarata/complicações , Catarata/diagnóstico , Criança , Feminino , Humanos , Deficiência Intelectual , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Óleos de Silicone , Resultado do Tratamento , Vitrectomia
6.
Medicine (Baltimore) ; 100(11): e25189, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33726010

RESUMO

RATIONALE: In this report, we present an extremely rare case of recurrent monocular exudative retinal detachment without concomitant ocular metastases. This turned out to be the first symptom of squamous cell lung cancer. PATIENT CONCERNS: A 63-year-old woman was referred to our ophthalmology clinic by her primary care physician with a complaint of deteriorating vision in her right eye that had started four months prior, without concomitant pain. DIAGNOSES: We observed a detachment in the lower part of the retina during her ophthalmoscopy. We did not find any tears, holes, or degenerative changes in the periphery of the retina of the right eye during the surgery. In addition, plaques, tumor masses, and metastases were absent. Therefore, we diagnosed her with unilateral paraneoplastic exudative retinal detachment. Imaging tests performed before surgery revealed perihilar density with a visible air bronchogram in the middle field of the left lung. This turned out to be squamous cell carcinoma. INTERVENTIONS: Patient underwent pars plana vitrectomy and routine laboratory and imaging tests before the procedure that utilized 20-gauge instrumentation. The subretinal fluid and was drained and a tamponade using Densiron (Fluoron Co, Neu-Ulm, Germany) was applied. After ophthalmic treatment, patient underwent complex oncological treatment based on chemotherapy and radiotherapy. OUTCOMES: Despite the application of heavy silicone oil (Densiron) into the vitreous chamber, we observed a recurrence of retinal detachment in the right eye during the follow-up visit, 13 months after the first ophthalmic surgery. Following subsequent pars plana vitrectomy, the Densiron and subretinal membranes were removed. Despite oncological treatment, the patient died, twenty months after the appearance of the first ocular symptoms. LESSONS: Exudative retinal detachment without tumor metastasis to the eyeball can be one of the first signs of lung cancer in rare cases. Multidisciplinary care and imaging methods with greater accuracy will provide comprehensive care to the patients. It will not only facilitate timely detection and treatment of lung tumors but also for a plethora of oncological diseases.


Assuntos
Carcinoma de Células Escamosas/complicações , Neoplasias Pulmonares/complicações , Síndromes Paraneoplásicas Oculares/patologia , Descolamento Retiniano/patologia , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Síndromes Paraneoplásicas Oculares/etiologia , Recidiva , Descolamento Retiniano/etiologia
7.
Rev. cuba. oftalmol ; 33(2): e855, graf
Artigo em Espanhol | CUMED, LILACS | ID: biblio-1139079

RESUMO

RESUMEN Los drusen de nervio óptico fueron descritos por primera vez por Liebreich en el año 1868. Otros términos para designar esta entidad incluyen cuerpos hialinos y cuerpos coloides del disco óptico. Tienen una prevalencia de 1 por 500 y el 60 por ciento de los casos se encuentran profundos en la cabeza del nervio óptico. La patogenia primaria de los drusen puede ser una displasia hereditaria del canal óptico del disco óptico y su vasculatura, lo que predispone a la formación de estos. La evolución natural de los drusen es un proceso dinámico que transcurre durante toda la vida. Entre las complicaciones asociadas se presentan defectos de campo visual, pérdida de visión central (rara pero bien documentada), neuropatía óptica isquémica, oclusiones vasculares retinales, pérdidas transitorias de la visión, neovascularización subretinal peripapilar, corioretinopatia serosa central peripapilar y hemorragias pre y peripapilares. Se presenta una paciente de 64 años de edad con antecedente de haber sido operada de desprendimiento de retina del ojo izquierdo, y en el ojo derecho presentaba una hemorragia peripapilar subretinal profunda asociada a drusen(AU)


ABSTRACT Optic nerve drusens were first described by Liebreich in the year 1868. Other terms to designate this condition are optic disc hyaline bodies and colloid bodies. They have a prevalence of 1 per 500 and 60 percent of the cases occur deep in the optic nerve head. The primary pathogenesis of drusens may be an inherited dysplasia of the optic canal of the disc and its vasculature, which leads to their formation. The natural evolution of drusens is a lifelong dynamic process. Associated complications include visual field defects, central vision loss (rare but well documented), ischemic optic neuropathy, retinal vascular occlusion, transient sight loss, peripapillary subretinal neovascularization, central serous peripapillary chorioretinopathy, and pre- and peripapillary bleeding. A case is reported of a 64-year-old female patient with a history of surgery for retinal detachment of the left eye. In the right eye the patient presented deep peripapillary subretinal bleeding associated to drusen(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Descolamento Retiniano/etiologia , Patogenesia Homeopática/epidemiologia , Neuropatia Óptica Isquêmica/diagnóstico por imagem , Neoplasias do Nervo Óptico/epidemiologia
8.
Acta Ophthalmol ; 97(2): e271-e276, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30284388

RESUMO

PURPOSE: To evaluate the outcomes of pars plana vitrectomy with silicone oil tamponade in the management of retinal detachment associated with giant retinal tears. METHODS: We reviewed 45 eyes of 42 patients with primary retinal detachment associated with giant retinal tears over 10 years at a tertiary referral centre. Patients underwent 23-gauge vitrectomy without adjuvant scleral buckling by a single surgeon and had follow-up at least 6 months after silicone oil removal. RESULTS: Mean follow-up was 37 ± 35 months. Seven eyes (16%) had grade C proliferative vitreoretinopathy, and 16 (36%) had a giant retinal tear ≥180° at baseline. The primary reattachment rate was 84%, and the overall final anatomical success rate was 98%. The mean Snellen visual acuity equivalent at the final visit was 20/58. Final visual acuity ≥20/40 was achieved in 64%. The mean duration of silicone oil tamponade was 10.5 ± 4 weeks. By the final visit, silicone oil had been removed from 44 eyes (98%). CONCLUSION: The high rates of anatomical and functional success support management of giant retinal tears-associated retinal detachment with vitrectomy without adjuvant scleral buckling. Removal of silicone oil at the earliest possible time helps to avoid complications such as keratopathy, glaucoma and visual loss without apparent reason.


Assuntos
Tamponamento Interno/métodos , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Óleos de Silicone/administração & dosagem , Acuidade Visual , Vitrectomia/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Perfurações Retinianas/complicações , Perfurações Retinianas/diagnóstico , Estudos Retrospectivos , Recurvamento da Esclera , Resultado do Tratamento , Adulto Jovem
9.
Int J Mol Sci ; 18(3)2017 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-28335520

RESUMO

Chondrocytes of the growth plate undergo apoptosis during the process of endochondral ossification, as well as during the progression of osteoarthritis. Although the regulation of this process is not completely understood, alterations in the precisely orchestrated programmed cell death during development can have catastrophic results, as exemplified by several chondrodystrophies which are frequently accompanied by early onset osteoarthritis. Understanding the mechanisms that underlie chondrocyte apoptosis during endochondral ossification in the growth plate has the potential to impact the development of therapeutic applications for chondrodystrophies and associated early onset osteoarthritis. In recent years, several chondrodysplasias and collagenopathies have been recognized as protein-folding diseases that lead to endoplasmic reticulum stress, endoplasmic reticulum associated degradation, and the unfolded protein response. Under conditions of prolonged endoplasmic reticulum stress in which the protein folding load outweighs the folding capacity of the endoplasmic reticulum, cellular dysfunction and death often occur. However, unfolded protein response (UPR) signaling is also required for the normal maturation of chondrocytes and osteoblasts. Understanding how UPR signaling may contribute to cartilage pathophysiology is an essential step toward therapeutic modulation of skeletal disorders that lead to osteoarthritis.


Assuntos
Apoptose , Cartilagem/metabolismo , Cartilagem/patologia , Estresse do Retículo Endoplasmático , Osteoartrite/metabolismo , Osteoartrite/patologia , Resposta a Proteínas não Dobradas , Idade de Início , Animais , Artrite/etiologia , Artrite/metabolismo , Artrite/patologia , Proteínas Morfogenéticas Ósseas/metabolismo , Calcificação Fisiológica , Condrócitos/metabolismo , Condrócitos/patologia , Condrogênese , Colágeno/genética , Colágeno/metabolismo , Doenças do Tecido Conjuntivo/etiologia , Doenças do Tecido Conjuntivo/metabolismo , Doenças do Tecido Conjuntivo/patologia , Retículo Endoplasmático/metabolismo , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/metabolismo , Perda Auditiva Neurossensorial/patologia , Humanos , Terapia de Alvo Molecular , Osteoartrite/epidemiologia , Osteoartrite/etiologia , Osteoblastos/metabolismo , Descolamento Retiniano/etiologia , Descolamento Retiniano/metabolismo , Descolamento Retiniano/patologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-25423643

RESUMO

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.


Assuntos
Glaucoma de Ângulo Fechado/complicações , Doenças do Nervo Óptico/complicações , Descolamento Retiniano/etiologia , Feminino , Glaucoma de Ângulo Fechado/diagnóstico , Humanos , Pressão Intraocular , Macula Lutea , Pessoa de Meia-Idade , Disco Óptico/patologia , Doenças do Nervo Óptico/diagnóstico , Descolamento Retiniano/diagnóstico , Líquido Sub-Retiniano , Tomografia de Coerência Óptica , Acuidade Visual
11.
Eye (Lond) ; 27(11): 1263-8, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23949489

RESUMO

PURPOSE: The purpose of this study is to evaluate the efficacy of preoperative intravitreal bevacizumab (IVB) for improving outcomes in vitrectomy for diabetic retinopathy-related non-clearing vitreous haemorrhage and/or tractional retinal detachment. METHODS: Medical record from patients undergoing vitrectomy for proliferative diabetic retinopathy (PDR) were retrospectively analysed (2003-2011). From 2007, IVB (1.25 mg 2-4 days before operating) was used on all eyes. Eyes receiving IVB were compared with those that did not receive IVB. Intraoperative complications, reoperation rates, and final visual acuity were the core outcome measures. RESULTS: Data were analysed for 88 patients (101 eyes). In all, 41 (41%) patients had received IVB, whereas 60 (59%) patients had not. Significant intraoperative haemorrhage occurred in six eyes (10%) in the non-IVB group and in one (2.4%) IVB eyes (P=0.24). Silicon oil was used in 29 (48%) non-IVB eyes and in 11 (27%) IVB eyes (P=0.03). The non-IVB eyes underwent significantly more vitreoretinal reoperations (P=0.01) and were significantly more likely to lose two or more lines of vision at the final follow-up (P=0.03). The numbers needed to treat (NNT) blindness (<3/60) was four for non-IVB eyes and two for the IVB group. CONCLUSIONS: IVB reduces surgical complications, the use of silicon oil, and the need for further retinal surgery. The NNT to restore useful vision (≥3/60) to a blind eye were significantly lower in the IVB group. Vitreoretinal surgery for the complications of PDR is effective in an East African context, and IVB should be considered a valuable adjunct.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Retinopatia Diabética/terapia , Descolamento Retiniano/terapia , Cirurgia Vitreorretiniana/métodos , Hemorragia Vítrea/terapia , Adulto , África Oriental , Idoso , Análise de Variância , Bevacizumab , Estudos de Casos e Controles , Quimioterapia Adjuvante/métodos , Retinopatia Diabética/complicações , Feminino , Humanos , Complicações Intraoperatórias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Reoperação/estatística & dados numéricos , Descolamento Retiniano/etiologia , Estudos Retrospectivos , Acuidade Visual , Hemorragia Vítrea/etiologia , Adulto Jovem
12.
Arch. Soc. Esp. Oftalmol ; 88(5): 197-200, mayo 2013. ilus
Artigo em Espanhol | IBECS | ID: ibc-112664

RESUMO

Caso clínico: Varón de 59 años con melanoma coroideo en ojo izquierdo. Se realiza tratamiento con braquiterapia mediante placa (iodo-125), apareciendo exudación masiva, desprendimiento de retina y grandes placas de depósitos lipídicos una semana después. Se monitoriza la evolución mediante funduscopia y ecografía mensualmente y una vez reabsorbido el fluido subretiniano se realiza termoterapia transpupilar (TTT) de la masa tumoral irradiada, 9 meses tras la intervención. Tres meses después se producen roturas retinianas con siembra vítrea que hacen necesaria la enucleación. Discusión: La terapia combinada con placas de braquiterapia y TTT puede asociar complicaciones severas que requieran la enucleación (AU)


Case report: A 59 year-old male with choroidal melanoma in the left eye who underwent plaque brachytherapy (iodine 125). One week after surgery, massive exudation with retinal detachment and lipid exudation was observed. Evolution was assessed with funduscopy and ultrasound every month. Nine months after surgery transpupillary thermotherapy (TTT) was performed over the fluid-free irradiated residual tumour. Three months after this procedure, new retinal breaks appeared in the treated area with vitreous seeding that required enucleation. Discussion: Combined treatment with plaque brachytherapy and TTT may associate severe complications that may require enucleation of the involved eye (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Coroide/terapia , Braquiterapia/efeitos adversos , Hipertermia Induzida/efeitos adversos , Descolamento Retiniano/etiologia , Lipidoses/etiologia , Enucleação Ocular , Fatores de Risco
13.
Ophthalmology ; 120(9): 1809-13, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23601805

RESUMO

OBJECTIVE: To study the outcome of the treatment of complex rhegmatogenous retinal detachments (RRDs). DESIGN: Nonrandomized, multicenter, retrospective study. PARTICIPANTS: One hundred seventy-six surgeons from 48 countries spanning 5 continents reported primary procedures for 7678 RRDs. METHODS: Reported data included clinical manifestations, the method of repair, and the outcome. MAIN OUTCOME MEASURES: Failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachments (level 3 failure rate). RESULTS: The main categories of complex retinal detachments evaluated in this investigation were: (1) grade B proliferative vitreoretinopathy (PVR; n = 917), (2) grade C-1 PVR (n = 637), (3) choroidal detachment or significant hypotony (n = 578), (4) large or giant retinal tears (n = 1167), and (5) macular holes (n = 153). In grade B PVR, the level 1 failure rate was higher when treated with a scleral buckle alone versus vitrectomy (P = 0.0017). In grade C-1 PVR, there was no statistically significant difference in the level 1 failure rate between those treated with vitrectomy, with or without scleral buckle, and those treated with scleral buckle alone (P = 0.7). Vitrectomy with a supplemental buckle had an increased failure rate compared with those who did not receive a buckle (P = 0.007). There was no statistically significant difference in level 1 failure rate between tamponade with gas versus silicone oil in patients with grade B or C-1 PVR. Cases with choroidal detachment or hypotony treated with vitrectomy had a significantly lower failure rate versus treatment with scleral buckle alone (P = 0.0015). Large or giant retinal tears treated with vitrectomy also had a significantly lower failure rate versus treatment with scleral buckle (P = 7×10(-8)). CONCLUSIONS: In patients with retinal detachment, when choroidal detachment, hypotony, a large tear, or a giant tear is present, vitrectomy is the procedure of choice. In retinal detachments with PVR, tamponade with either gas or silicone oil can be considered. If a vitrectomy is to be performed, these data suggest that a supplemental buckle may not be helpful. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.


Assuntos
Doenças da Coroide/cirurgia , Tamponamento Interno/métodos , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Recurvamento da Esclera/métodos , Vitrectomia/métodos , Vitreorretinopatia Proliferativa/cirurgia , Doenças da Coroide/complicações , Europa (Continente) , Fluorocarbonos/administração & dosagem , Pesquisas sobre Atenção à Saúde , Humanos , Oftalmologia , Descolamento Retiniano/etiologia , Perfurações Retinianas/complicações , Estudos Retrospectivos , Óleos de Silicone/administração & dosagem , Sociedades Médicas , Resultado do Tratamento , Vitreorretinopatia Proliferativa/complicações
14.
Arch Soc Esp Oftalmol ; 88(5): 197-200, 2013 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-23623022

RESUMO

CASE REPORT: A 59 year-old male with choroidal melanoma in the left eye who underwent plaque brachytherapy (iodine 125). One week after surgery, massive exudation with retinal detachment and lipid exudation was observed. Evolution was assessed with funduscopy and ultrasound every month. Nine months after surgery transpupillary thermotherapy (TTT) was performed over the fluid-free irradiated residual tumour. Three months after this procedure, new retinal breaks appeared in the treated area with vitreous seeding that required enucleation. DISCUSSION: Combined treatment with plaque brachytherapy and TTT may associate severe complications that may require enucleation of the involved eye.


Assuntos
Braquiterapia/efeitos adversos , Neoplasias da Coroide/terapia , Hipertermia Induzida/efeitos adversos , Melanoma/terapia , Descolamento Retiniano/etiologia , Terapia Combinada , Exsudatos e Transudatos , Humanos , Hipertermia Induzida/métodos , Masculino , Pessoa de Meia-Idade , Pupila
15.
Indian J Ophthalmol ; 61(3): 131-2, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23514652

RESUMO

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.


Assuntos
Anestesia Local/efeitos adversos , Ferimentos Oculares Penetrantes/complicações , Complicações Intraoperatórias , Procedimentos Cirúrgicos Oftalmológicos/métodos , Retina/cirurgia , Descolamento Retiniano/cirurgia , Ferimentos Oculares Penetrantes/diagnóstico , Ferimentos Oculares Penetrantes/cirurgia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Retina/lesões , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia
16.
J AAPOS ; 16(1): 100-1, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22370676

RESUMO

A 14-year-old girl presented with a recurrent retinal detachment secondary to optic nerve coloboma in her left eye with a small retinal hole in the bed of the coloboma, confirmed by optical coherence tomography. The patient was treated by injection of 0.05 mL of autologous platelet concentrate into the coloboma along with vitrectomy and gas exchange. After 8 months, the retina was attached and optical coherence tomography revealed closure of the retinal hole. Considering our experience, autologous platelet injection may be considered a treatment option for recurrent retinal detachment secondary to optic nerve coloboma.


Assuntos
Coloboma/complicações , Transfusão de Plaquetas/métodos , Descolamento Retiniano/terapia , Perfurações Retinianas/terapia , Vitrectomia/métodos , Adolescente , Transfusão de Sangue Autóloga/métodos , Feminino , Humanos , Injeções Intraoculares , Nervo Óptico/anormalidades , Descolamento Retiniano/etiologia , Perfurações Retinianas/etiologia
18.
Optom Vis Sci ; 87(3): E205-17, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20125057

RESUMO

PURPOSE: To describe features associated with the development and resolution of peripapillary retinoschisis with an underlying serous detachment in a patient with primary open angle glaucoma. This presentation occurred in the absence of an observed optic nerve coloboma, congenital, or acquired optic nerve head pit. CASE REPORT: A patient with advanced glaucomatous optic nerve cupping developed a temporally localized peripapillary serous detachment in the right eye which spontaneously resolved. RESULTS: Optical coherence tomography demonstrated an area of retinoschisis with underlying serous detachment contiguous with the temporal disc margin. Although fluorescein angiography was not performed and the presence of a peripapillary subretinal neovascular membrane could not be ruled out, an atypical coloboma, optic nerve head pit, or peripapillary subretinal neovascular membrane was not observed during biomicroscopy or scanning laser ophthalmoscopy. The retinoschisis and detachment resolved without intervention. CONCLUSION: Peripapillary retinoschisis with an underlying serous detachment may develop in subjects with advanced glaucoma. Although the occurrence of the findings in this case may be unrelated to glaucomatous optic neuropathy, the likelihood that a pathogenic mechanism linked to advanced glaucoma may be responsible for the development of peripapillary schisis and serous detachment should alternatively be taken into consideration. This case documents its spontaneous resolution without intervention.


Assuntos
Glaucoma de Ângulo Aberto/complicações , Disco Óptico/patologia , Descolamento Retiniano/etiologia , Retinosquise/etiologia , Idoso , Feminino , Angiofluoresceinografia , Humanos , Pressão Intraocular/fisiologia , Remissão Espontânea , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/fisiopatologia , Retinosquise/diagnóstico , Retinosquise/fisiopatologia , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Campos Visuais/fisiologia
20.
J Fr Ophtalmol ; 31(8): 751-63, 2008 Oct.
Artigo em Francês | MEDLINE | ID: mdl-19107040

RESUMO

PURPOSE: To analyze the angiographic and tomographic results and the visual acuity of a group of patients presenting acute or chronic serous central chorioretinopathy (CSCR) treated with dynamic phototherapy. This treatment was guided by ICG angiography data. PATIENTS AND METHOD: We conducted a retrospective/prospective nonrandomized study on 31 eyes of 27 patients, including eight acute forms and 23 chronic forms. One or more spots were treated according to the age-related macular degeneration standard protocol on the zones of choroidal hyperpermeability highlighted by ICG angiography. The criteria for success were based on functional signs, visual acuity, persistence of a point of leakage in angiofluorographic follow-up at 3 months, and the OCT study of serous retinal detachment. RESULTS: An increase in visual acuity (3.58+/-3.22 lines, p<0.0001) was observed for all forms of treated CSCR; 90.32% patients presented a reapplication of serous retinal detachment within a period of 7.28+/-3.93 weeks. No retinal pigmentary epithelium tear or choroidal neovascularization was observed. Recurrence occurred in 12.9% patients within a period of 28+/-16.24 weeks; only chronic CSCR cases were concerned. At 8+/-4.2 months, the visual acuity of the patients who had no recurrence remained unchanged (0.356+/-0.4 LogMAR or 20/50-20/40). CONCLUSION: Although the number of patients included in this study is limited, dynamic phototherapy currently seems to be an effective and sure treatment of CRSC. A randomized study on a large series is necessary to confirm these results.


Assuntos
Coriorretinite/tratamento farmacológico , Fotoquimioterapia , Fármacos Fotossensibilizantes/uso terapêutico , Porfirinas/uso terapêutico , Córtex Suprarrenal/metabolismo , Adulto , Idoso , Angiografia , Coriorretinite/complicações , Coriorretinite/diagnóstico por imagem , Feminino , Humanos , Verde de Indocianina , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Recidiva , Descolamento Retiniano/tratamento farmacológico , Descolamento Retiniano/etiologia , Estudos Retrospectivos , Estresse Psicológico/complicações , Estresse Psicológico/fisiopatologia , Tomografia de Coerência Óptica , Resultado do Tratamento , Verteporfina , Acuidade Visual
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