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1.
J. optom. (Internet) ; 17(2): [100502], Abr-Jun, 2024. graf
Artigo em Inglês | IBECS | ID: ibc-231625

RESUMO

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)


Assuntos
Humanos , Masculino , Feminino , Descolamento Retiniano/cirurgia , Óleos de Silicone/administração & dosagem , Óleos de Silicone/efeitos adversos , Eletrorretinografia , Cirurgia Vitreorretiniana , Optometria , Visão Ocular , Retina/cirurgia , Potenciais Evocados Visuais
2.
Klin Monbl Augenheilkd ; 241(4): 472-476, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38653297

RESUMO

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.


Assuntos
Altitude , Descolamento Retiniano , Óleos de Silicone , Acuidade Visual , Vitrectomia , Humanos , Descolamento Retiniano/cirurgia , Óleos de Silicone/administração & dosagem , Pessoa de Meia-Idade , Masculino , Feminino , Adulto , Idoso , Estudos Retrospectivos , Vitrectomia/métodos , Idoso de 80 Anos ou mais , Adulto Jovem , Resultado do Tratamento , Tamponamento Interno/métodos , Seguimentos
3.
BMC Ophthalmol ; 24(1): 184, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38649837

RESUMO

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).


Assuntos
Tamponamento Interno , Descolamento Retiniano , Perfurações Retinianas , Óleos de Silicone , Acuidade Visual , Vitrectomia , Humanos , Vitrectomia/métodos , Óleos de Silicone/administração & dosagem , Masculino , Descolamento Retiniano/cirurgia , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tamponamento Interno/métodos , Acuidade Visual/fisiologia , Idoso , Perfurações Retinianas/cirurgia , Perfurações Retinianas/diagnóstico , Adulto , Macula Lutea , Resultado do Tratamento
4.
Arq Bras Oftalmol ; 87(4): e2022, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38656020

RESUMO

PURPOSE: To clarify the postoperative incidence of macular edema in patients undergoing surgery to repair rhegmatogenous retinal detachment and identify the associated risk factors. METHODS: In this prospective, observational study, 79 patients who underwent surgery to correct rhegmatogenous retinal detachment using pars plana vitrectomy with silicone oil injection were analyzed. Patients were followed up postoperatively at 7, 30, 90, 180, and 365 days. At each visit, optical coherence tomography was performed to assess the presence or absence of macular edema. were analyzed as possible risk factors for macular edema: age, sex, macular status (attached or detached), presence of vitreoretinal proliferation, history of previous intraocular surgery, reported time of symptoms suggestive of rhegmatogenous retinal detachment up to the date of surgery, and the surgical modality performed. RESULTS: The 1-year macular edema prevalence rate was 26.6%. In the adjusted analysis, older patients had a higher risk of macular edema, and each 1-year increase in age increased the risk of macular edema by 6% (95% confidence interval = 1.00-1.12). The macular status, vitreoretinal proliferation, the surgical technique used, prior intraocular surgery, and the intraocular lens status were not identified as risk factors. However, the incidence of macular edema increased up to 180 days after surgery, peaking at 10.6%, and then decreased until 365 days after surgery. CONCLUSION: Macular edema was a common complication after surgery to treat rhegmatogenous retinal detachment, with its incidence peaking between 30 and 180 days after surgery. Age was an important risk factor for macular edema in this cohort.


Assuntos
Edema Macular , Descolamento Retiniano , Tomografia de Coerência Óptica , Vitrectomia , Humanos , Descolamento Retiniano/cirurgia , Descolamento Retiniano/etiologia , Masculino , Feminino , Edema Macular/etiologia , Edema Macular/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Estudos Prospectivos , Vitrectomia/efeitos adversos , Vitrectomia/métodos , Incidência , Adulto , Seguimentos , Tomografia de Coerência Óptica/métodos , Idoso , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Acuidade Visual , Óleos de Silicone/efeitos adversos , Óleos de Silicone/administração & dosagem , Fatores de Tempo , Fatores Etários , Adulto Jovem
5.
Indian J Ophthalmol ; 72(5): 765, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38661275

RESUMO

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.


Assuntos
Tamponamento Interno , Oftalmoscopia , Descolamento Retiniano , Perfurações Retinianas , Acuidade Visual , Vitrectomia , Humanos , Masculino , Descolamento Retiniano/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Criança , Vitrectomia/métodos , Perfurações Retinianas/cirurgia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Acuidade Visual/fisiologia , Tamponamento Interno/métodos , Óleos de Silicone/administração & dosagem , Tomografia de Coerência Óptica/métodos , Retina/cirurgia
6.
Eur J Ophthalmol ; 34(3): NP105-NP110, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38291655

RESUMO

PURPOSE: To report a rare case of progressive retinoschisis and retinal detachment after uncomplicated macular hole (MH) surgery. CASE DESCRIPTION: A 67-year-old man with recent onset vision complaints in the right eye (visual acuity - 20/30), was diagnosed with a small idiopathic full-thickness MH. He underwent a 3-port 25G pars plana vitrectomy surgery with internal limiting membrane peeling and air endotamponade. RESULTS: MH closed with a normal foveal contour and intact retinal layers by the 1st post operative week and vision improved to 20/20. At the 7th week follow-up period, the patient complained of visual disturbances in his right eye for 2 days. Optical coherence tomography scans revealed development of peripheral retinoschisis which progressed towards the macula over the next 4 weeks. At the 13th week following the retinal surgery, patient developed sudden profound vision loss to hand motions and a total retinal detachment was noted. He underwent a second retinal surgery with retinectomy to the stiff retina and silicone oil endotamponade. At the last follow-up visit 8 weeks after the second surgery, the visual acuity had improved to 20/120 and the retina was well-attached with silicone oil in place. CONCLUSION: We present a rare case of progressive retinoschisis and retinal detachment caused by residual ILM contraction after MH repair surgery. To the best of our knowledge, no such complication after MH repair surgery has been reported in the literature.


Assuntos
Tamponamento Interno , Descolamento Retiniano , Perfurações Retinianas , Retinosquise , Tomografia de Coerência Óptica , Acuidade Visual , Vitrectomia , Humanos , Retinosquise/cirurgia , Retinosquise/diagnóstico , Retinosquise/etiologia , Masculino , Descolamento Retiniano/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Perfurações Retinianas/cirurgia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Idoso , Acuidade Visual/fisiologia , Progressão da Doença , Óleos de Silicone/administração & dosagem , Complicações Pós-Operatórias
7.
J Glaucoma ; 33(5): 310-316, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38194266

RESUMO

PRCIS: Longer-term studies with a larger sample size are needed to demonstrate the superiority or equivalence of these procedures. OBJECTIVE: To evaluate the outcomes of the PAUL glaucoma implant (PGI) and Ahmed glaucoma valve (AGV) in patients with secondary glaucoma caused due to silicone oil emulsification. PATIENTS AND METHODS: A retrospective examination was conducted using the medical records of 36 patients who developed secondary glaucoma due to silicone oil emulsification after vitreoretinal surgery and then underwent PGI and AGV implantation surgery. The main outcome measures in the PGI and AGV groups were intraocular pressure (IOP) and its change, the number of antiglaucoma medications, and postoperative complications during the 12-month follow-up period. IOP of <6 mm Hg is used to define hypotonia. RESULTS: There was no statistically significant difference among the patients who underwent PGI and AGV surgeries in terms of IOP averages, both preoperatively and postoperatively on day 1, week 1, month 1, month 3, month 6, and month 12 ( P > 0.05). Before PGI and AGV implantation, the mean IOP was 40 ± 13 mm Hg and 39.3 ± 10 mm Hg, and the mean number of medications was 3.8 ± 0.4 and 4 ± 0, respectively. At the end of the 12-month follow-up period, the mean IOP was 13.5 ± 2.2 ( P < 0.001) mm Hg and 14.9 ± 4.2 ( P < 0.001) mm Hg, whereas the mean number of glaucoma medications decreased to 1.7 ± 1.3 ( P < 0.001) and 1.9 ± 1.8 ( P < 0.001) in the PGI and AGV groups, respectively. Surgical success was achieved in 17 of 18 eyes (94%) in the PGI group and 16 of 18 eyes (89%) in the AGV group. CONCLUSIONS: Although the outcomes were similar in both the PGI and AGV groups, complications requiring medical and surgical intervention were less common in the PGI group. Longer-term studies with a larger sample size are needed to demonstrate the superiority or equivalence of these procedures.


Assuntos
Implantes para Drenagem de Glaucoma , Pressão Intraocular , Óleos de Silicone , Tonometria Ocular , Acuidade Visual , Humanos , Pressão Intraocular/fisiologia , Estudos Retrospectivos , Feminino , Masculino , Óleos de Silicone/administração & dosagem , Pessoa de Meia-Idade , Acuidade Visual/fisiologia , Adulto , Resultado do Tratamento , Glaucoma/cirurgia , Glaucoma/fisiopatologia , Implantação de Prótese , Seguimentos , Idoso , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/uso terapêutico , Complicações Pós-Operatórias , Cirurgia Vitreorretiniana
8.
Eye (Lond) ; 38(7): 1327-1332, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38151526

RESUMO

BACKGROUND/OBJECTIVES: The purpose of this study is to investigate whether history of silicone oil tamponade may predispose to the development of cystoid macular edema (CMO) following uneventful post-vitrectomy cataract surgery. SUBJECTS/METHODS: This is a retrospective study that was conducted at a single academic institution. Records of patients who underwent pars plana vitrectomy (PPV) with or without silicone oil tamponade and subsequent cataract surgery between 2017-2020 were reviewed. Macular optical coherence tomography (OCT) findings up to 4 years after surgery were assessed. RESULTS: A total of 95 eyes were included. Forty-one eyes underwent cataract surgery and had a history of PPV with silicone oil tamponade (Group 1). Fifty-four eyes underwent cataract surgery by phacoemulsification and had a history of PPV with gas tamponade (Group 2). Average follow up time after cataract surgery was 41.1 months. In Group 1, the incidence of OCT-detected CMO was 39.0%, compared to 27.8% in Group 2 (p = 0.247). The incidence of clinically significant CMO in Group 1 was 22.0%, compared to 18.5% in Group 2 (p = 0.679). The duration of CMO was significantly longer in Group 1 (p = 0.041) and cases were less likely to resolve by the last follow up visit (p = 0.040). CONCLUSIONS: The incidence of OCT-detected or clinically significant pseudophakic CMO is not significantly different between eyes with prior PPV with gas tamponade versus silicone oil tamponade. However, CMO after uneventful cataract surgery may have a prolonged course if there is history of silicone oil tamponade, requiring longer treatment.


Assuntos
Tamponamento Interno , Edema Macular , Óleos de Silicone , Tomografia de Coerência Óptica , Acuidade Visual , Vitrectomia , Humanos , Vitrectomia/efeitos adversos , Estudos Retrospectivos , Masculino , Feminino , Edema Macular/etiologia , Óleos de Silicone/efeitos adversos , Óleos de Silicone/administração & dosagem , Idoso , Pessoa de Meia-Idade , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias , Extração de Catarata/efeitos adversos , Incidência , Seguimentos
9.
Cornea ; 41(4): 499-501, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074890

RESUMO

PURPOSE: The purpose of this study was to evaluate the corneal toxicity of intravitreal methotrexate used for the prevention of proliferative vitreoretinopathy (PVR). METHODS: In this retrospective case series, eyes with recurrent retinal detachment secondary to PVR were treated with intravitreal injections of 400 µg methotrexate at an average frequency of every 7 days after vitrectomy with silicone oil tamponade. Corneas were examined for corneal epitheliopathy by slit-lamp biomicroscopy before each injection. RESULTS: Thirteen eyes of 12 patients were reviewed. All had a history of recurrent retinal detachment secondary to PVR treated with vitrectomy and silicone oil. The median age was 35 years (range: 9-83). Four patients (33%) were female. The median follow-up duration was 8 weeks (range: 5-10). The median BCVA (logMAR notation) was 2.00 preoperatively, 2.00 at 1 month postoperatively, and 2.00 at the most recent follow-up (P = 0.969). Ten eyes (77%) were pseudophakic. Nine eyes (69%) had a preexisting ocular comorbidity. The median number of injections was 8 (range: 5-10). The median interval time between each injection was 7.0 days (range: 5.8-10.5), and the median follow-up period beyond last injection was 16 weeks (range: 8-28). Two eyes (15.4%) developed mild corneal epitheliopathy during the course of the treatment. CONCLUSIONS: Most eyes in this small series tolerated methotrexate injections without corneal toxicity. In eyes that developed epitheliopathy, the findings were mild and not treatment-limiting.


Assuntos
Doenças da Córnea/induzido quimicamente , Tamponamento Interno , Epitélio Corneano/efeitos dos fármacos , Imunossupressores/toxicidade , Metotrexato/toxicidade , Óleos de Silicone/administração & dosagem , Vitreorretinopatia Proliferativa/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Doenças da Córnea/diagnóstico , Epitélio Corneano/patologia , Feminino , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Microscopia com Lâmpada de Fenda , Acuidade Visual , Vitrectomia
10.
Pediatr. aten. prim ; 23(92): 421-423, oct.- dic. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-222903

RESUMO

El desprendimiento de retina es una patología infrecuente en Pediatría y presenta diferencias con respecto a los casos que se dan en la edad adulta. Predomina en varones escolares. El subtipo más frecuente es el regmatógeno y la principal causa son los traumatismos, sin olvidar otras causas como las sindrómicas y lesiones no accidentales. El abordaje de esta patología es quirúrgico, aunque el éxito anatómico de la cirugía no implica buen resultado funcional. Presentamos el caso de un niño en el que se detectó una disminución unilateral importante de la agudeza visual en consulta programada (AU)


The retinal detachment is an infrequent pathology in pediatrics and presents differences with the cases that occur in adulthood. It predominates in school-age boys. The most frequent subtype is rhegmatogenous and the main cause is trauma, without forgetting other causes such as syndromic and non-accidental injuries. The approach to this pathology is surgical, although the anatomical success of the surgery does not imply a good functional result. We present the case of a child in whom a significant unilateral decrease in visual acuity was detected in a scheduled consultation (AU)


Assuntos
Humanos , Masculino , Criança , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/terapia , Implante de Lente Intraocular , Óleos de Silicone/administração & dosagem , Terapia a Laser , Acuidade Visual , Vitrectomia
11.
Retina ; 41(10): 2079-2087, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34543242

RESUMO

PURPOSE: To ascertain the pathogenesis of macular hole (MH) associated with age-related macular degeneration (AMD) and its surgical outcomes. METHODS: Patients with full-thickness MH associated with AMD (higher grades than intermediate) were enrolled. The mechanism of MH formation and closure rate after vitrectomy (surgical outcome) were determined using optical coherence tomography imaging. RESULTS: The mechanism of MH formation (35 eyes) associated with AMD was classified into four types: vitreomacular traction (42.9%), gradual retinal thinning caused by subretinal drusen or pigment epithelial detachment (22.9%), massive subretinal hemorrhage (20.0%), and combined (14.3%). In the 41 eyes that underwent vitrectomy, the logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.82 (0.10-2.30) preoperative to 0.69 (0.10-2.30) postoperative (P = 0.001). Successful closure of the MH was achieved in 33 eyes (80.5%) after vitrectomy. No significant association was observed between the closure rate of MH after vitrectomy and mechanism of MH formation (P = 0.083). CONCLUSION: The mechanism of MH formation associated with AMD was classified into four types and was not related to its surgical outcome. Considering visual improvement and surgical outcome after vitrectomy in our study, active surgical treatment can be considered for MH associated with AMD.


Assuntos
Atrofia Geográfica/complicações , Perfurações Retinianas/etiologia , Perfurações Retinianas/cirurgia , Degeneração Macular Exsudativa/complicações , Idoso , Tamponamento Interno , Feminino , Fluorocarbonos/administração & dosagem , Atrofia Geográfica/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Perfurações Retinianas/diagnóstico por imagem , Perfurações Retinianas/fisiopatologia , Estudos Retrospectivos , Óleos de Silicone/administração & dosagem , Hexafluoreto de Enxofre/administração & dosagem , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual/fisiologia , Vitrectomia , Degeneração Macular Exsudativa/fisiopatologia
13.
Ophthalmic Genet ; 42(5): 615-618, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33970758

RESUMO

Introduction: Goldmann Favre Syndrome (GFS) is a vitreoretinal degenerative disease with macular retinoschisis. The current treatment of foveoschisis is topical and oral carbonic anhydrase inhibitors.Case: A 22-year-old male diagnosed with GFS presented a progressive decrease in vision of the right eye. The optical coherence tomography showed a significant macular schisis. A medical treatment with topical and oral carbonic anhydrase inhibitors was ineffective. We performed a pars plana vitrectomy and silicone oil placement which led to an improvement of the visual acuity and a reduction of the foveoschisis.Conclusion: We describe here the first case of surgical treatment for macular schisis in a patient with GFS.


Assuntos
Tamponamento Interno/métodos , Oftalmopatias Hereditárias/cirurgia , Degeneração Retiniana/cirurgia , Retinosquise/cirurgia , Óleos de Silicone/administração & dosagem , Transtornos da Visão/cirurgia , Vitrectomia , Oftalmopatias Hereditárias/diagnóstico , Humanos , Masculino , Degeneração Retiniana/diagnóstico , Retinosquise/diagnóstico , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico , Acuidade Visual , Adulto Jovem
14.
Sci Rep ; 11(1): 9052, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33907301

RESUMO

Recently, we established silicone oil-induced ocular hypertension (SOHU) mouse model with significant glaucomatous neurodegeneration. Here we characterize two additional variations of this model that simulate two distinct glaucoma types. The first is a chronic model produced by high frequency (HF) pupillary dilation after SO-induced pupillary block, which shows sustained moderate IOP elevation and corresponding slow, mild glaucomatous neurodegeneration. We also demonstrate that although SO removal quickly returns IOP to normal, the glaucomatous neurodegeneration continues to advance to a similar degree as in the HF group without SO removal. The second, an acute model created by no pupillary dilation (ND), shows a greatly elevated IOP and severe inner retina degeneration at an early time point. Therefore, by a straightforward dilation scheme, we extend our original SOHU model to recapitulate phenotypes of two major glaucoma forms, which will be invaluable for selecting neuroprotectants and elucidating their molecular mechanisms.


Assuntos
Modelos Animais de Doenças , Glaucoma/patologia , Hipertensão Ocular/fisiopatologia , Degeneração Retiniana/patologia , Células Ganglionares da Retina/patologia , Óleos de Silicone/toxicidade , Doença Aguda , Animais , Feminino , Glaucoma/induzido quimicamente , Pressão Intraocular , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Hipertensão Ocular/induzido quimicamente , Degeneração Retiniana/induzido quimicamente , Células Ganglionares da Retina/efeitos dos fármacos , Óleos de Silicone/administração & dosagem
15.
Medicine (Baltimore) ; 100(11): e25161, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33726001

RESUMO

RATIONALE: An intravitreal dexamethasone (IV-DEX) implant is safe and effective for the treatment of macular edemas; however, the efficacy of IV-DEX implants in silicone oil (SO)-filled eyes remains controversial. There is no previous study comparing an IV-DEX implant in the same eye with and without intravitreal SO. PATIENT CONCERNS: A 72-year-old man with proliferative diabetic retinopathy, macular edema, and rhegmatogenous retinal detachment, treated with pars plana vitrectomy with SO tamponade had refractory macular edema. DIAGNOSIS: Refractory macular edema. INTERVENTION: Subtenon triamcinolone injection, intravitreal anti-vascular endothelial growth factor injection, and IV-DEX implantation were performed; this was followed by intravitreal SO removal combined with IV-DEX implantation. OUTCOMES: The macular edema did not decrease significantly with posterior subtenon triamcinolone injection, intravitreal anti-vascular endothelial growth factor injection, and IV-DEX implantation; however, the edema was relieved after SO removal and a new IV-DEX implantation. LESSONS: IV-DEX implant may be less efficacious in the treatment of macular edema in an SO-filled eye than that in a normal vitreous cavity.


Assuntos
Dexametasona/administração & dosagem , Retinopatia Diabética/tratamento farmacológico , Edema Macular/tratamento farmacológico , Descolamento Retiniano/tratamento farmacológico , Óleos de Silicone/administração & dosagem , Idoso , Remoção de Dispositivo , Implantes de Medicamento/administração & dosagem , Humanos , Injeções Intravítreas , Masculino , Triancinolona/administração & dosagem , Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Vitrectomia/métodos
16.
Optom Vis Sci ; 98(3): 206-211, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33633018

RESUMO

SIGNIFICANCE: Acute retinal necrosis (ARN) may occur after intravitreal ranibizumab (IVR) treatment for patients with exudative age-related macular degeneration (AMD). Awareness of this unusual but devastating complication after IVR is needed. Early identification may help provide timely antiviral treatment and prevent irreversible visual loss. PURPOSE: This study aimed to report a case of ARN after IVR in a patient with exudative AMD. CASE REPORT: A 67-year-old male patient complained of blurred vision in his left eye for 1 month. The patient was diagnosed with exudative AMD after detailed ophthalmic clinical evaluations. He received IVR once in his left eye. Three days after IVR, he developed varicella-zoster virus-associated ARN, which was treated with systemic and intravitreal antiviral therapy. Because of progressive inflammation, the patient underwent 25G pars plana vitrectomy with silicone oil tamponade. Seven months later, the patient was administered intravitreal aflibercept once in his left eye. Three months after intravitreal aflibercept, he underwent removal of silicone oil, and retinal detachment occurred 2 weeks after the surgery because of low IOP, and the patient eventually discontinued treatment. CONCLUSIONS: This study reports the first case of varicella-zoster virus-associated ARN after IVR. Early ARN may be very difficult to distinguish from intraocular inflammation after IVR. Therefore, early detection of viral DNA in the intraocular fluid using polymerase chain reaction is recommended. Immediate antiviral treatment may be beneficial to prevent severe visual loss.


Assuntos
Inibidores da Angiogênese/efeitos adversos , Neovascularização de Coroide/tratamento farmacológico , Infecções Oculares Virais/etiologia , Herpes Zoster Oftálmico/etiologia , Ranibizumab/efeitos adversos , Síndrome de Necrose Retiniana Aguda/virologia , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Antivirais/uso terapêutico , Tamponamento Interno , Exsudatos e Transudatos , Infecções Oculares Virais/diagnóstico , Infecções Oculares Virais/tratamento farmacológico , Herpes Zoster Oftálmico/diagnóstico , Herpes Zoster Oftálmico/tratamento farmacológico , Herpesvirus Humano 3/isolamento & purificação , Humanos , Injeções Intravítreas , Masculino , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico , Óleos de Silicone/administração & dosagem , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual , Vitrectomia
17.
Ocul Immunol Inflamm ; 29(5): 922-925, 2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-32735477

RESUMO

Purpose: The objective of this study was to report a case of bilateral necrotizing retinitis following viral encephalitis caused by the pseudorabies virus.Case report: A 49-year-old male had decreased bilateral visual acuity after the recovery of consciousness for one month. He had been in an unconsciousness status due to encephalitis for two months before the ocular symptoms developed. He was a pig slaughterer. Ocular ultrasound showed bilateral vitreous haze and retinal detachment. A vitrectomy and silicone oil tamponade were performed on the left eye. During surgery, massive periphery retinal necrosis appearing as a tattered fish net, and multiple retinal holes were observed. The pseudorabies virus was detected by next-generation sequencing in the vitreous specimen.Conclusion: The pseudorabies virus may cause bilateral necrotizing retinitis following viral encephalitis among those with close contact to pigs. Intraocular fluid provides a greater selection of samples and a longer time window for pathogenic detection.


Assuntos
Encefalite Viral/virologia , Infecções Oculares Virais/virologia , Herpesvirus Suídeo 1/isolamento & purificação , Pseudorraiva/virologia , Síndrome de Necrose Retiniana Aguda/virologia , Doenças dos Suínos/virologia , Zoonoses/transmissão , Animais , Encefalite Viral/diagnóstico , Encefalite Viral/terapia , Tamponamento Interno , Infecções Oculares Virais/diagnóstico , Infecções Oculares Virais/terapia , Genoma Viral/genética , Herpesvirus Suídeo 1/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Pseudorraiva/diagnóstico , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/terapia , Descolamento Retiniano/virologia , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/terapia , Óleos de Silicone/administração & dosagem , Suínos , Doenças dos Suínos/transmissão , Acuidade Visual/fisiologia , Vitrectomia , Corpo Vítreo/virologia , Zoonoses/virologia
19.
Acta Ophthalmol ; 99(3): 240-250, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32930501

RESUMO

Silicone oil (SO) has been used as a long-term tamponade agent in the treatment of complicated vitreoretinal diseases for about half a century, during which time many advances in surgical techniques and technologies have been made. This review summarizes the chemical and physical properties of SO, its indications and complications, including particularly emulsification. The mechanisms and risk factors for emulsification are discussed, as well as novel strategies for its effective removal. Finally, the review focuses on new improved formulations of SO, including research into slow-release pharmacological agents within SO and provides an overview of alternatives to SO for the purpose of long-term tamponade that are being developed.


Assuntos
Tamponamento Interno/métodos , Óleos de Silicone/administração & dosagem , Humanos , Óleos de Silicone/efeitos adversos , Óleos de Silicone/química , Cirurgia Vitreorretiniana/métodos
20.
Retina ; 41(2): 423-430, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32467482

RESUMO

PURPOSE: To evaluate the visual outcome associated with intravitreal antibiotics (IVA) and pars plana vitrectomy (PPV) for acute postprocedure endophthalmitis. METHODS: Data from 237 eyes presenting with acute postprocedure endophthalmitis were collected from 57 retina specialists in 28 countries. All eyes were treated with IVA on the day of presentation. We classified eyes according to the method of treatment used as IVA and early PPV (IVA + PPV within 1 week of presentation) groups. RESULTS: After exclusion of ineligible eyes, data from 204 eyes were analyzed. The mean (SD) age of patients was 62.7 (21.8) years and 69.3 (12.7) years in the IVA and PPV groups, respectively (P = 0.18). Endophthalmitis secondary to cataract, intravitreal injections, PPV, and other intraocular procedures represented 64.2%, 16.2%, 13.7%, and 5.9% of cases, respectively. Intravitreal antibiotics alone were administered in 55 eyes (27.0%), and early PPV was performed in 149 eyes (73.0%). No difference was found between groups in the final visual acuity of ≥20/60 (43.6%, 65 eyes vs. 34.5%, 19 eyes) and ≤counting fingers (30.9%, 46 eyes vs. 36.4%, 20 eyes) for IVA versus early PPV groups, respectively. Vision of light perception (odds ratio = 12.2; 95% confidence interval: 2.0-72.6) and retinal detachment (odds ratio = 7.7; 95% confidence interval: 1.5-409) at baseline were predictive of vision of ≤counting fingers. Retinal detachment at baseline (odds ratio = 20.4; 95% confidence interval: 1.1-372.1) was predictive of final retinal detachment status. CONCLUSION: The current retrospective multicenter cohort of eyes with acute postprocedure endophthalmitis reports similar outcomes after treatment with IVA alone when compared with IVA and early PPV within 1 week of presentation.


Assuntos
Antibacterianos/efeitos adversos , Endoftalmite/fisiopatologia , Infecções Oculares Bacterianas/fisiopatologia , Descolamento Retiniano/terapia , Acuidade Visual , Vitrectomia/efeitos adversos , Doença Aguda , Idoso , Antibacterianos/administração & dosagem , Endoftalmite/diagnóstico , Endoftalmite/etiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/etiologia , Infecções Oculares Bacterianas/terapia , Feminino , Seguimentos , Humanos , Injeções Intravítreas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Descolamento Retiniano/diagnóstico , Estudos Retrospectivos , Óleos de Silicone/administração & dosagem , Óleos de Silicone/efeitos adversos
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