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1.
Int Ophthalmol ; 44(1): 304, 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38954136

ABSTRACT

PURPOSE: Our study aims to evaluate the surgical outcomes and clinical features of retinal detachment (RD) cases treated with segmental scleral buckling (SB), elucidating the role of segmental SB as a vital option in specific situations during the current era. METHODS: We retrospectively reviewed 128 eyes with primary rhegmatogenous RD that underwent segmental scleral buckling between November 2008 and December 2020. Clinical features and success rates were recorded and analyzed. RESULTS: A total of 128 eyes were included. The patient's ages ranged from 12 to 72 years, with a median age of 45. Most of the eyes were phakic (97%). Regarding the type of break, 47% were holes, and flap tears were found in 68 cases (53%). The break locations were superior-temporal (54%), inferior-temporal (31%), superior-nasal (9.5%), and inferior-nasal (5.5%). The length of the SB applied ranged from 3.5 to 8.0 clock hours, with a median of 6.0. Primary success was achieved in 121 eyes, and recurrence occurred in 7 eyes. All recurrent RD cases reattached after undergoing secondary VT. The causes of failure included 2 break reopens, 1 missed break, and 4 eyes with proliferative vitreoretinopathy. The single-surgery anatomic success (SSAS) rate for segmental SB was 94.5%. The final success rate was 100%. CONCLUSIONS: For phakic, low complexity retinal detachment in our study, segmental scleral buckling emerges as a surgical option with a high primary success rate and a lower incidence of complications.


Subject(s)
Retinal Detachment , Scleral Buckling , Visual Acuity , Humans , Scleral Buckling/methods , Retinal Detachment/surgery , Retinal Detachment/diagnosis , Retrospective Studies , Male , Female , Adult , Child , Adolescent , Middle Aged , Young Adult , Aged , Follow-Up Studies , Treatment Outcome
2.
J. optom. (Internet) ; 17(2): [100502], Abr-Jun, 2024. graf
Article in English | IBECS | ID: ibc-231625

ABSTRACT

Background: Silicone oil is used as endotamponade following vitreoretinal surgery to maintain the retina reattached when indicated. This study investigates the hypothesis that silicone oil causes insulation effects on the retina by affecting its response to light. Methods: Electrophysiological responses to a flash stimulus were recorded using full-field electroretinography (ERG) and visual evoked potentials (VEP). Recordings were performed in 9 patients who underwent surgery for retinal detachment, before (1–2 days) and after (2–3 weeks) silicone oil removal (SOR) in both the study and the control eye. Flash ERG and VEP recordings were performed according to the ISCEV standard protocol. Results: Statistically significant differences were found in the study eye in the amplitudes of the ERG responses and their corresponding ratios, i.e. the amplitude after SOR over the amplitude before SOR, in all conditions tested. No differences were observed in the control eye. The mean ratio of photopic ERG response was 3.4 ± 2.4 for the study and 1.0 ± 0.3 for the control eye (p<0.001). The mean ratio of ERG flicker response was 3.1 ± 2.4 and 1.0 ± 0.3, respectively (p = 0.003). Scotopic flash ERG ratio was 5.0 ± 4.4 for the study and 1.3 ± 0.6 for the control eye (p = 0.012). No differences were observed for the amplitude and latency of flash VEP response after SOR. Conclusions: Silicone oil causes a reduction in flash ERG responses; no effect was found on flash VEP responses. ERGs in eyes filled with silicone oil should not be considered representative of retinal functionality, in contrast to VEPs, which are not affected by silicone oil presence.(AU)


Subject(s)
Humans , Male , Female , Retinal Detachment/surgery , Silicone Oils/administration & dosage , Silicone Oils/adverse effects , Electroretinography , Vitreoretinal Surgery , Optometry , Vision, Ocular , Retina/surgery , Evoked Potentials, Visual
3.
BMC Ophthalmol ; 24(1): 254, 2024 Jun 13.
Article in English | MEDLINE | ID: mdl-38872161

ABSTRACT

OBJECTIVE: The aim of this study is to elucidate the factors contributing to the occurrence of retinal detachment (RD) following prophylactic vitrectomy in cases of acute retinal necrosis (ARN) syndrome. METHODS: A retrospective examination was undertaken, encompassing the medical records of patients diagnosed with ARN who underwent prophylactic vitreous intervention at the Ophthalmology Department of Wuhan University Renmin Hospital East Campus between October 2019 and September 2023. Subsequently, patients who manifested RD in the postoperative period were identified, and a comprehensive analysis was conducted to ascertain the factors underlying the occurrence of RD post-surgery. RESULTS: This study comprised 14 cases (involving 14 eyes) of patients diagnosed with ARN who underwent prophylactic vitreous intervention. The findings revealed that 4 patients experienced postoperative RD, resulting in an incidence rate of 28.57%. Notably, among these cases, 3 cases of RD manifested in the presence of silicone oil, while 1 case occurred subsequent to the removal of silicone oil. All 4 cases of RD exhibited varied degrees of proliferative vitreoretinopathy. Following the occurrence of RD, all patients underwent a secondary vitreous intervention coupled with silicone oil tamponade, leading to successful reattachment of the retina. However, despite these interventions, there was no significant enhancement observed in postoperative visual outcomes when compared to preoperative levels. CONCLUSION: RD following prophylactic vitrectomy in cases of ARN is not an infrequent occurrence and is primarily linked to the postoperative onset of proliferative vitreoretinopathy.


Subject(s)
Postoperative Complications , Retinal Detachment , Retinal Necrosis Syndrome, Acute , Visual Acuity , Vitrectomy , Humans , Vitrectomy/methods , Retinal Detachment/surgery , Retinal Detachment/etiology , Retinal Necrosis Syndrome, Acute/diagnosis , Retrospective Studies , Male , Female , Middle Aged , Adult , Visual Acuity/physiology , Postoperative Complications/prevention & control , Endotamponade , Aged , Young Adult , Silicone Oils/administration & dosage , Incidence
4.
PLoS One ; 19(6): e0297419, 2024.
Article in English | MEDLINE | ID: mdl-38848326

ABSTRACT

Retinal detachment (RD) is the separation of the neural layer from the retinal pigmented epithelium thereby preventing the supply of nutrients to the cells within the neural layer of the retina. In vertebrates, primary photoreceptor cells consisting of rods and cones undergo daily renewal of their outer segment through the addition of disc-like structures and shedding of these discs at their distal end. When the retina detaches, the outer segment of these cells begins to degenerate and, if surgical procedures for reattachment are not done promptly, the cells can die and lead to blindness. The precise effect of RD on the renewal process is not well understood. Additionally, a time frame within which reattachment of the retina can restore proper photoreceptor cell function is not known. Focusing on rod cells, we propose a mathematical model to clarify the influence of retinal detachment on the renewal process. Our model simulation and analysis suggest that RD stops or significantly reduces the formation of new discs and that an alternative removal mechanism is needed to explain the observed degeneration during RD. Sensitivity analysis of our model parameters points to the disc removal rate as the key regulator of the critical time within which retinal reattachment can restore proper photoreceptor cell function.


Subject(s)
Retinal Detachment , Retinal Detachment/pathology , Retinal Detachment/surgery , Humans , Models, Biological , Animals , Models, Theoretical , Rod Cell Outer Segment/metabolism , Rod Cell Outer Segment/physiology , Retinal Rod Photoreceptor Cells/physiology , Retinal Rod Photoreceptor Cells/pathology , Retina
5.
Arch Soc Esp Oftalmol (Engl Ed) ; 99(7): 281-287, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38852669

ABSTRACT

BACKGROUND AND OBJECTIVE: To describe visual function, macular integrity, and fixation stability using MAIA microperimetry (macular integrity assessment) after retinal detachment surgery. Evaluate if there are statistically significant differences between surgical approaches. MATERIALS AND METHODS: A prospective, comparative, interventional study was conducted, recruiting a total of 21 patients with rhegmatogenous retinal detachment and macula-off. Eleven patients underwent surgery using pars plana vitrectomy (PPV), and 10 patients underwent scleral buckle surgery. Clinical examinations and optical coherence tomography (OCT) were performed post-surgery. MAIA microperimetry was conducted at 6 months. RESULTS: Best-corrected visual acuity (BCVA) and the number of letters read improved over time in the operated eye but did not reach the level of the control eye (p = 0.001). No significant differences were found between the two surgical approaches in BCVA (p = 0.230) or the number of letters read (p = 0.608). Macular integrity in the operated eye did not match that of the control eye in both procedures (p = 0.05). No differences were detected between the two surgeries, either in macular integrity (p = 0.512) or fixation stability (p = 0.835). CONCLUSIONS: Following retinal detachment surgery, a decrease in BCVA and the number of letters read occurs, which does not reach the level of the control eye. No significant differences were observed between the two surgical approaches. Macular integrity in the operated eye does not match that of the control eye.


Subject(s)
Macula Lutea , Retinal Detachment , Scleral Buckling , Visual Acuity , Visual Field Tests , Vitrectomy , Humans , Retinal Detachment/surgery , Prospective Studies , Middle Aged , Female , Male , Macula Lutea/diagnostic imaging , Aged , Tomography, Optical Coherence , Adult
6.
Sci Rep ; 14(1): 13044, 2024 06 06.
Article in English | MEDLINE | ID: mdl-38844441

ABSTRACT

High intraocular pressure (IOP) is one of the early complications after pars plana vitrectomy (PPV), which may cause glaucoma and poor visual prognosis secondary to surgery. Proliferative vitreoretinopathy (PVR) is one of the complications of retinal detachment (RD) and is the main reason for the poor prognosis, which is related to different kinds of cytokines. It's essential for the basic mechanism to analyze the relative aqueous humor cytokine profiles with IOP after PPV for RD. In this study, we have collected the aqueous humor of 16 patients and qualified 27 cytokines using Luminex and compared biomarkers with the high IOP group and the normal group. As a result, the concentrations of VEGF, IL-6, FGF2, and G-CSF upregulated significantly (P < 0.05), while VEGFR2 downregulated significantly (P < 0.05) in the high IOP group. IL-6 was positively correlated with high IOP (r = 0.561, P = 0.041). Meanwhile, the concentrations of IL-6 (r = 0.543, P = 0.03), IL-5 (r = 0.576, P = 0.019), IL-15 (r = 0.614, P = 0.011), IL-4 (r = 0.517, P = 0.04), ICAM-1 (r = 0.611, P = 0.012), and G-CSF (r = 0.636, P = 0.008) were significantly associated with preoperative PVR classification, and the aqueous humor levels of IL-4 (r = 0.567, P = 0.022), HGF (r = 0.701, P = 0.005), and MCP-1 (r = 0.565, P = 0.035) are significant relative to laser points. Hence, cytokines might potentially be the therapeutic target of high IOP after PPV.


Subject(s)
Aqueous Humor , Cytokines , Intraocular Pressure , Retinal Detachment , Vitrectomy , Humans , Retinal Detachment/surgery , Retinal Detachment/metabolism , Aqueous Humor/metabolism , Female , Male , Cytokines/metabolism , Intraocular Pressure/physiology , Middle Aged , Vitrectomy/adverse effects , Aged , Adult , Biomarkers/metabolism , Vitreoretinopathy, Proliferative/metabolism , Vitreoretinopathy, Proliferative/etiology
7.
Korean J Ophthalmol ; 38(3): 236-248, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38712388

ABSTRACT

PURPOSE: This study sought to compare the long-term outcomes of surgeries for retinal detachment (RD) secondary to viral or parasitic infectious retinitis. METHODS: A total of 47 eyes that received pars plana vitrectomy with or without scleral buckling due to RD secondary to polymerase chain reaction-proven viral (cytomegalovirus, varicella zoster virus, and herpes zoster virus) or parasitic (toxoplasma and toxocara) retinitis from October 1, 2006, to June 30, 2023, in a single medical center were retrospectively enrolled. RESULTS: Mean follow-up period was 59.03 ± 55.24 months in viral retinitis and 34.80 ± 33.78 months in parasitic retinitis after primary reattachment surgery. During follow-up, nine eyes (24.3%) with viral retinitis and five eyes (50.0%) with parasitic retinitis developed retinal redetachment. Visual acuity success at final follow-up was achieved in 19 eyes (51.4%) with viral retinitis and six eyes (60.0%) with parasitic retinitis (p = 0.64). The incidence of retinal redetachment during the 1st postoperative year was significantly higher in parasitic retinitis compared with viral retinitis (crude incidence, 0.21 vs. 0.85; p = 0.02). Hazard ratio analysis adjusted for age and sex showed 4.58-fold (95% confidence interval, 1.22-17.27; p = 0.03) increased risk of retinal redetachment in parasitic retinitis compared with viral retinitis during the 1st postoperative year. Tamponade with silicone oil and preoperative diagnostic vitrectomy were associated with significantly decreased risk of retinal redetachment in patients with parasitic retinitis. CONCLUSIONS: Compared with RD secondary to viral retinitis, RD secondary to parasitic retinitis showed higher incidence of retinal redetachment during the 1st postoperative year. Tamponade with silicone oil and preoperative diagnostic vitrectomy were associated with significantly decreased risk of retinal redetachment in patients with parasitic retinitis.


Subject(s)
Eye Infections, Parasitic , Eye Infections, Viral , Retinal Detachment , Retinitis , Visual Acuity , Vitrectomy , Humans , Retinal Detachment/surgery , Retinal Detachment/etiology , Retinal Detachment/diagnosis , Female , Male , Retrospective Studies , Vitrectomy/methods , Adult , Follow-Up Studies , Middle Aged , Eye Infections, Parasitic/diagnosis , Eye Infections, Parasitic/parasitology , Eye Infections, Parasitic/surgery , Eye Infections, Parasitic/complications , Eye Infections, Viral/diagnosis , Eye Infections, Viral/virology , Eye Infections, Viral/complications , Retinitis/diagnosis , Retinitis/parasitology , Retinitis/surgery , Retinitis/virology , Scleral Buckling/methods , Young Adult , Adolescent , Incidence , Aged , Treatment Outcome , Time Factors , Child
8.
Int Ophthalmol ; 44(1): 210, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38691217

ABSTRACT

PURPOSE: To evaluate the effect of adjuvant Mitomycin C (MMC) use on the anatomical and functional success of vitreoretinal surgery (VRS) in severe diabetic tractional retinal detachment (dTRD) patients. METHODS: A retrospective analysis of consecutive patients undergoing VRS due to severe dTRD was conducted. Patients were categorized into those who received 20 µg/0.1 mL MMC via MMC sandwich method (Group 1) and those who did not (Group 2). Demographics, surgical characteristics, visual outcomes, and complications that may related to MMC were analyzed. RESULTS: A total of 25 eyes were included, 13 in Group 1 and 12 in Group 2. No statistical difference was observed in baseline characteristics between the groups. The mean best-corrected visual acuity was 1.90 ± 0.43 logMAR and 1.93 ± 0.41 logMAR preoperatively and 1.60 ± 0.78 logMAR and 1.56 ± 0.78 logMAR postoperatively in Groups 1 and 2, respectively (p = 0.154). The postoperative mean intraocular pressure was 16.23 ± 2.55 mmHg and 13.08 ± 4.94 mmHg in Groups 1 and 2, respectively (p = 0.225). The rate of re-surgery was significantly lower in Group 1 (0% vs. 41.7% in Group 2, p = 0.015). Retina was attached in all patients at the last visit. No MMC-related complication was recorded. CONCLUSION: Intraoperative adjuvant MMC application for severe dTRD significantly reduces re-surgery rates with good anatomical and functional outcomes safely.


Subject(s)
Diabetic Retinopathy , Mitomycin , Retinal Detachment , Visual Acuity , Vitrectomy , Humans , Retrospective Studies , Male , Female , Mitomycin/administration & dosage , Vitrectomy/methods , Middle Aged , Diabetic Retinopathy/complications , Diabetic Retinopathy/physiopathology , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/surgery , Retinal Detachment/surgery , Retinal Detachment/diagnosis , Aged , Treatment Outcome , Chemotherapy, Adjuvant/methods , Alkylating Agents/administration & dosage , Follow-Up Studies , Adult
9.
Transl Vis Sci Technol ; 13(5): 17, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38776109

ABSTRACT

Purpose: This study aimed to develop artificial intelligence models for predicting postoperative functional outcomes in patients with rhegmatogenous retinal detachment (RRD). Methods: A retrospective review and data extraction were conducted on 184 patients diagnosed with RRD who underwent pars plana vitrectomy (PPV) and gas tamponade. The primary outcome was the best-corrected visual acuity (BCVA) at three months after the surgery. Those with a BCVA of less than 6/18 Snellen acuity were classified into a vision impairment group. A deep learning model was developed using presurgical predictors, including ultra-widefield fundus images, structural optical coherence tomography (OCT) images of the macular region, age, gender, and preoperative BCVA. A fusion method was used to capture the interaction between different modalities during model construction. Results: Among the participants, 74 (40%) still had vision impairment after the treatment. There were significant differences in age, gender, presurgical BCVA, intraocular pressure, macular detachment, and extension of retinal detachment between the vision impairment and vision non-impairment groups. The multimodal fusion model achieved a mean area under the curve (AUC) of 0.91, with a mean accuracy of 0.86, sensitivity of 0.94, and specificity of 0.80. Heatmaps revealed that the macular involvement was the most active area, as observed in both the OCT and ultra-widefield images. Conclusions: This pilot study demonstrates that artificial intelligence techniques can achieve a high AUC for predicting functional outcomes after RRD surgery, even with a small sample size. Machine learning methods identified The macular region as the most active region. Translational Relevance: Multimodal fusion models have the potential to assist clinicians in predicting postoperative visual outcomes prior to undergoing PPV.


Subject(s)
Artificial Intelligence , Retinal Detachment , Tomography, Optical Coherence , Visual Acuity , Vitrectomy , Humans , Retinal Detachment/surgery , Female , Male , Retrospective Studies , Middle Aged , Visual Acuity/physiology , Vitrectomy/methods , Tomography, Optical Coherence/methods , Aged , Adult , Endotamponade , Treatment Outcome , Deep Learning
10.
JAMA Ophthalmol ; 142(5): e235766, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38770957

ABSTRACT

This case report describes a woman aged 43 years with Stickler syndrome and bilateral vitreopapillary traction who presented with shadows and ghosting of vision in both eyes.


Subject(s)
Retinal Detachment , Humans , Male , Retinal Detachment/diagnosis , Retinal Detachment/surgery , Collagen Type IV/genetics , Vitreous Body/pathology , Vitreous Body/diagnostic imaging , Vitrectomy , Female , Eye Diseases/diagnosis , Vitreous Detachment/diagnosis
13.
Indian J Ophthalmol ; 72(5): 765, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38661275

ABSTRACT

BACKGROUND: A 7-year-old male child was brought by his parents with a complaint of low vision in both eyes for 2 months. The child had low vision in both the eyes for 1.5 years, but the parents noticed when it worsened further 2 months back, leading to profound vision loss. On ophthalmic evaluation, the child did not perceive light in the right eye. Furthermore, anterior segment examination showed complicated cataract and open funnel retinal detachment with intra-retinal cysts in ultrasound (USG) B scan. In the left eye, he could appreciate light but with poor fixation. Fundus evaluation of the left eye showed total retinal detachment on indirect ophthalmoscopy, which was confirmed on USG B scan. Since the right eye had poor visual potential, no intervention was done. The left eye underwent pars plana vitrectomy with silicone oil tamponade, which led to successful anatomical outcomes. The immediate and late postoperative periods were uneventful, and the child was kept under follow-up and was observed closely. PURPOSE: To educate regarding the surgical management of giant retinal tears in a pediatric patient. SYNOPSIS: To inform regarding the surgical challenges faced and steps adopted to manage such cases. HIGHLIGHTS: Through this case, we want to highlight the challenges faced, such as delayed presentation, difficult preoperative evaluation, intraoperative difficulties such as mobile retina, absence of posterior vitreous detachment, and tenacious vitreous gel. We also want to emphasize on the steps taken to overcome the challenges. CONCLUSION: In such challenging situations, effective planning, careful manipulation, and persistence are essential for success. VIDEO LINK: https://youtu.be/T0Gy6Wj13zI.


Subject(s)
Endotamponade , Ophthalmoscopy , Retinal Detachment , Retinal Perforations , Visual Acuity , Vitrectomy , Humans , Male , Retinal Detachment/surgery , Retinal Detachment/diagnosis , Retinal Detachment/etiology , Child , Vitrectomy/methods , Retinal Perforations/surgery , Retinal Perforations/diagnosis , Retinal Perforations/etiology , Visual Acuity/physiology , Endotamponade/methods , Silicone Oils/administration & dosage , Tomography, Optical Coherence/methods , Retina/surgery
14.
Int Ophthalmol ; 44(1): 167, 2024 Apr 02.
Article in English | MEDLINE | ID: mdl-38565753

ABSTRACT

PURPOSE: To detect and analyze the influence of the duration of tamponade with silicone oil on the foveal and parafoveal thickness in cases of rhegmatogenous retinal detachment. METHODS: This is a retrospective cohort study of 64 eyes with rhegmatogenous retinal detachment in one eye who underwent pars plana vitrectomy (PPV) with silicone oil injection during the period between January 2019 and December 2021. The patients were divided into 2 groups. Group A with early removal of the silicone oil after 3-4 months and Group B with late removal of the silicone oil (SOR) after 6-8 months. The 2 groups were compared as regards the central foveal (CFT) and parafoveal (PFT) thickness changes from baseline, just before SOR, and after SOR. Changes in best corrected visual acuity (BCVA), relative risk of severe thinning. It was conducted at Kasr Alainy Hospital. RESULTS: 64 eyes were enrolled in the study. Group A included 36 eyes, and group B included 28 eyes. The mean CFT changed insignificantly from 253 ± 52 µm to 252 ± 48 µm after SOR in group A; while it changed significantly from 211 ± 52 µm to 202 ± 46 µm after SOR in group B. The mean PFT decreased insignificantly from 299 ± 39 µm to 297 ± 40 µm in group A, while it decreased significantly from 284 ± 46 µm to 273 ± 44 µm in group B. Lines of improvement of BCVA were 4.11 ± 1.88 in group A, and 2.00 ± 1.24 in group B. Relative risk of severe foveal thinning after SOR was 14.3, and severe parafoveal thinning was 15.43, in group B compared to group A. CONCLUSION: Longer period of silicone oil tamponade may carry a higher risk for severe foveal and parafoveal thinning after silicone oil removal. TRIAL REGISTRATION: The study was registered at clinical trial.gov under the title of (Duration of silicone oil tamponade on foveal and parafoveal thickness in Rhegmatogenous Retinal Detachment) with an ID NCT05817630 at April 2023 "retrospectively registered".


Subject(s)
Retinal Detachment , Humans , Fovea Centralis , Retinal Detachment/diagnosis , Retinal Detachment/surgery , Retrospective Studies , Silicone Oils/pharmacology , Visual Acuity , Vitrectomy
15.
BMC Ophthalmol ; 24(1): 184, 2024 Apr 22.
Article in English | MEDLINE | ID: mdl-38649837

ABSTRACT

BACKGROUND: To compare the outcome of eyes with a macula-on giant retinal tear (GRT) detachment treated with pars-plana-vitrectomy (PPV) depending on the used endotamponade. METHODS: All consecutive cases with a macula-on GRT-associated rhegmatogenous retinal detachment (RRD) managed with PPV between 2007 and 2022 were retrospectively assessed depending on the selected endotamponade. By reviewing medical charts and surgical protocols the pre- and intraoperative parameters were analysed in detail. The number of vitreoretinal (VR) procedures needed for reattachment, the redetachment rate and the functional outcome were evaluated. Eyes treated with primary silicone oil (SO) tamponade were compared to eyes with primary gas tamponade. Cases with pre-existing conditions affecting outcome e.g. macula-off situation, history of trauma, status after complicated cataract surgery, former VR surgery or proliferative vitreoretinopathy grade C or higher were excluded. RESULTS: Overall, 51 eyes of 45 patients with a macula-on GRT detachment were treated with PPV and SO (n = 32; 63%) or gas (n = 19; 37%) endotamponade in the observed period. Eyes with primary SO tamponade underwent on average 2.3 (SD 0.8) VR procedures and had a redetachment rate of 13% (n = 4). Eyes with gas tamponade showed a higher redetachment rate of 32% (n = 6) with a mean number of 1.6 (SD 1.0) PPV procedures. Postoperative best-corrected visual acuity (BCVA) was significantly better in eyes with primary gas tamponade (mean logMAR BCVA 0.32; SD 0.30) compared to eyes with SO (mean logMAR BCVA 0.60; SD 0.42; p = 0.008). CONCLUSIONS: Surgical management of GRT-associated RRDs is complex. In clinical routine often SO is used as endotamponade. Because of known disadvantages (second procedure necessary for SO removal, unexplained SO-related visual loss, secondary glaucoma, SO emulsification) some VR surgeons prefer a gas tamponade. In our cohort, eyes with a gas compared to SO tamponade showed higher redetachment rates. However, the final postoperative BCVA was significantly better in eyes with gas compared to SO tamponade. TRIAL REGISTRATION: The trial protocol was approved by the local ethics committee on 25th of November 2022 (Ethikkommission der Universität Regensburg, Votum 22-3166-104).


Subject(s)
Endotamponade , Retinal Detachment , Retinal Perforations , Silicone Oils , Visual Acuity , Vitrectomy , Humans , Vitrectomy/methods , Silicone Oils/administration & dosage , Male , Retinal Detachment/surgery , Female , Middle Aged , Retrospective Studies , Endotamponade/methods , Visual Acuity/physiology , Aged , Retinal Perforations/surgery , Retinal Perforations/diagnosis , Adult , Macula Lutea , Treatment Outcome
16.
Sci Rep ; 14(1): 7795, 2024 04 02.
Article in English | MEDLINE | ID: mdl-38565682

ABSTRACT

We investigated the impact of drainage retinotomy on the outcome of pars plana vitrectomy for repair of rhegmatogenous retinal detachment (RRD). This study was a retrospective observational multicenter study. All patients were registered with the Japan-Retinal Detachment Registry. We analyzed 1887 eyes with RRD that had undergone vitrectomy and were observed for 6 months between February 2016 and March 2017. We compared the baseline characteristics and postoperative outcomes between eyes with and without drainage retinectomy. We then performed propensity score matching using preoperative findings as covariates to adjust for relevant confounders. Of 3446 eyes, 1887 met the inclusion criteria. Among them, 559 eyes underwent vitrectomy with drainage retinotomy, and 1328 eyes underwent vitrectomy without drainage retinotomy. After propensity score matching, each group comprised 544 eyes. There was no significant difference between the two groups in BCVA at 6 months after vitrectomy (0.181 vs. 0.166, P = 0.23), the primary anatomical success rate (6.3% vs. 4.4%, P = 0.22), or the rate of secondary surgery for ERM within 6 months (1.5% vs. 1.3%, P = 1.0). Drainage retinectomy does not increase the risk of decreased postoperative BCVA, surgical failure, or secondary surgery for ERM within six months outcomes.


Subject(s)
Retinal Detachment , Humans , Retinal Detachment/surgery , Retrospective Studies , Japan/epidemiology , Postoperative Complications/surgery , Visual Acuity , Vitrectomy , Treatment Outcome
17.
Jpn J Ophthalmol ; 68(3): 216-224, 2024 May.
Article in English | MEDLINE | ID: mdl-38598145

ABSTRACT

PURPOSE: We introduce selective internal limiting membrane (ILM) peeling, a guideline procedure to determine whether to remove the ILM during vitrectomy for rhegmatogenous retinal detachment (RRD). STUDY DESIGN: Retrospective case series METHODS: Patients who underwent pars plana vitrectomy for RRD and were followed up for 12 months or longer were included. When vitreous cortex remnants (VCRs) were detected with triamcinolone acetonide, the ILM was removed; otherwise, the ILM was preserved ("selective ILM peeling"). The factors associated with the presence of VCRs and incidence of secondary epiretinal membrane (ERM) were analyzed. RESULTS: VCRs were detected in 87 of 133 eyes (65.4%) in which the ILM was removed. Younger age, better preoperative visual acuity, and vitreous hemorrhage were negatively correlated with the presence of VCRs. No ERM occurred in the eyes after ILM peeling. Among the eyes with ILM preservation, subclinical ERM was noticed in 4 eyes (8.7%), and 1 eye (2.1%) required additional surgery owing to ERM. ERM occurred more commonly in eyes with the ILM preserved (P = .004). However, no differences in the rate of additional surgeries were found between the 2 groups. CONCLUSION: Selective ILM peeling offers an alternative option to reduce the burden of ILM peeling or additional surgery.


Subject(s)
Basement Membrane , Epiretinal Membrane , Retinal Detachment , Tomography, Optical Coherence , Visual Acuity , Vitrectomy , Humans , Vitrectomy/methods , Retrospective Studies , Retinal Detachment/surgery , Retinal Detachment/diagnosis , Retinal Detachment/prevention & control , Retinal Detachment/etiology , Epiretinal Membrane/surgery , Epiretinal Membrane/diagnosis , Female , Male , Middle Aged , Basement Membrane/surgery , Aged , Follow-Up Studies , Postoperative Complications/prevention & control , Adult , Aged, 80 and over
18.
Klin Monbl Augenheilkd ; 241(4): 472-476, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38653297

ABSTRACT

BACKGROUND: Uncomplicated rhegmatogenous retinal detachment (RRD) is mainly treated with vitrectomy and gas tamponade or, alternatively, scleral buckling surgery. However, gas tamponade inflates at high altitudes, causing significant complications. Silicone oil (SO) tamponade volume is unaffected by atmospheric pressure and may be used in patients who live or must undertake travel at high altitudes. PURPOSE: To determine the anatomical and functional outcomes after pars plana vitrectomy (PPV) with SO tamponade in primary uncomplicated RRD. METHODS: Twenty-eight consecutive cases of patients operated between January 2017 and December 2022 in Jules-Gonin University Eye Hospital in Lausanne were included in this retrospective study. All patients had a follow-up of at least 3 months after SO removal. RESULTS: Primary reattachment was achieved in all 28 eyes. Mean follow-up was 17.2 months (range: 3 - 51 months) after SO removal. Mean age at the time of intervention was 60 years (range: 21 - 80 years). Vision was stabilized or improved in 27 eyes (96%). One patient demonstrated a slight visual acuity decrease due to cataract formation at the last follow-up. In all patients, SO was removed 2 to 5 months after primary repair. In 14 of the 21 phakic patients, concomitant cataract surgery was performed. No surgical complications were encountered. Postoperatively, 5 (18%) patients had ocular hypertension, presumably steroid related, that was successfully controlled with topical treatment. CONCLUSION: PPV with SO injection seems to be a safe and efficient surgical approach in the treatment of primary uncomplicated RRD in patients living at high altitudes and was associated with good anatomical and functional outcome in our series. However, the need for a follow-up surgery to remove SO should be weighed in these cases.


Subject(s)
Altitude , Retinal Detachment , Silicone Oils , Visual Acuity , Vitrectomy , Humans , Retinal Detachment/surgery , Silicone Oils/administration & dosage , Middle Aged , Male , Female , Adult , Aged , Retrospective Studies , Vitrectomy/methods , Aged, 80 and over , Young Adult , Treatment Outcome , Endotamponade/methods , Follow-Up Studies
19.
BMC Ophthalmol ; 24(1): 153, 2024 Apr 08.
Article in English | MEDLINE | ID: mdl-38589883

ABSTRACT

BACKGROUND: To report a case with bilateral Terson syndrome presented with a unique mushroom-like mass lesion on the optic disc along with proliferative vitreoretinopathy and tractional retinal detachment. CASE PRESENTATION: A 33-year-old man was injured during a traffic accident and had diffuse brain swelling and intraocular hemorrhage. Poor vision in both eyes was noted after the patient regained consciousness. B-scan ultrasonography showed extensive vitreous opacity with a posterior vitreous detachment and without obvious retinal detachment. Vitrectomy was performed in both eyes five months after the accident. After clearing up the vitreous opacity, a peculiar pigmented mushroom-like mass lesion was noted in the posterior pole and had severe adhesion to the underneath optic disc. Extensive multilayered peripapillary epiretinal membrane was found covering the posterior pole and led to tractional retinal detachment around the macula. The mass was presumed to be an organized vitreous hemorrhage originated from the optic disc. The extensive and adherent epiretinal membrane together with the mass lesion were removed as much as possible and silicon oil was injected for tamponade. However, in the right eye, the retina redetached under silicon oil, whereas in the left eye, his vision improved to 20/100. CONCLUSIONS: Terson syndrome usually has a favorable prognosis but may be complicated by proliferative vitreoretinopathy and tractional retinal detachment. Careful monitoring is warranted and early vitrectomy should be considered in cases suspecting additional pathologies.


Subject(s)
Epiretinal Membrane , Orbital Diseases , Retinal Detachment , Vitreoretinopathy, Proliferative , Adult , Humans , Male , Epiretinal Membrane/complications , Epiretinal Membrane/diagnosis , Epiretinal Membrane/surgery , Retina/pathology , Retinal Detachment/diagnosis , Retinal Detachment/etiology , Retinal Detachment/surgery , Vitrectomy , Vitreoretinopathy, Proliferative/surgery , Vitreous Hemorrhage/diagnosis , Vitreous Hemorrhage/etiology
20.
Chin Med Sci J ; 39(1): 74-78, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38623049

ABSTRACT

Atopic dermatitis is usually associated with various ocular complications. We report a 21-year-old Chinese male who presented to our ophthalmology clinic with bilateral retinal detachment and cataracts. The patient had a clear medical history of atopic dermatitis, which had been diagnosed eight years earlier and had been treated with loratadine and pimecrolimus. Cataract surgery was performed for both eyes, combined with scleral buckling for the right eye and pars plana vitrectomy for the left eye. During postoperative follow-up, fundus fluorescein angiography showed retinal vasculitis in both eyes and macular edema in the left eye, which coincided with an exacerbation of atopic dermatitis. Macular edema improved after four months of regular dupilumab treatment in the dermatology department. The ocular condition remained stable three years postoperatively.


Subject(s)
Dermatitis, Atopic , Macular Edema , Retinal Detachment , Retinal Vasculitis , Male , Humans , Young Adult , Adult , Retinal Detachment/etiology , Retinal Detachment/surgery , Retinal Detachment/diagnosis , Dermatitis, Atopic/complications , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/surgery , Retinal Vasculitis/drug therapy , Retinal Vasculitis/complications , Retinal Vasculitis/surgery , Macular Edema/etiology , Macular Edema/complications , Scleral Buckling/adverse effects , Retrospective Studies
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