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1.
Pan Afr Med J ; 35: 1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32117517

RESUMO

We report a case of sight threatening vitreous haemorrhage and retinal detachment as complication of sickle cell disease (SCD). A 35 years old female Nigerian patient had presented to ophthalmology clinic of Princess Marina Hospital, Botswana, with two weeks history of poor vision in the left eye. The loss of vision was due to vitreous haemorrhage and retinal detachment which was confirmed by direct and indirect ophthalmoscopy and B-Scan ultrasound. Prior to presentation, patient didn't have any follow up by an ophthalmologist as part of regular medical care for patients with SCD. We emphasize the importance of regular follow up for early detection, treatment and prevention of complication associated with sickle cell disease.


Assuntos
Anemia Falciforme/complicações , Descolamento Retiniano/diagnóstico , Hemorragia Vítrea/diagnóstico , Adulto , Feminino , Humanos , Oftalmoscopia , Descolamento Retiniano/etiologia , Ultrassonografia , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Hemorragia Vítrea/etiologia
2.
Isr Med Assoc J ; 22(2): 89-93, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32043325

RESUMO

BACKGROUND: There are several ways to remove silicone oil (SO) from the vitreous cavity. OBJECTIVES: To describe a simple, safe and inexpensive method of 2-port SO removal. METHODS: Medical charts of 33 patients who underwent SO removal combined with cataract extraction were retrospectively reviewed, from a cohort of 119 patients who had silicone oil removal. The primary outcome was the rate of re-detachment, secondary outcomes included visual acuity (VA) and intraoperative and postoperative complications. RESULTS: Mean follow-up time was 27.6 months (0.25-147 ± 33.1), and mean tamponade duration prior to SO removal was 16.77 months (4-51.5 ± 14.6). The re-detachment rate was 3% (one patient). Postoperatively, seven patients (20%) had epiretinal membrane (ERM), eight patients had posterior capsule opacification (24%), and proliferative vitreoretinopathy (PVR) was diagnosed in two patients (6%). Compared to the mean VA (logarithm of the minimum angle of resolution [LogMAR]) at the preoperative examination, the mean VA (LogMAR) improved significantly at the last visit when including all ranges of VA (n=32, LogMAR 1.52 vs. 1.05 P = 0.0002 [Student's t-test] and P = 0.001 [Wilcoxon test]). CONCLUSIONS: The technique described is fast and simple, keeping the posterior capsule intact in pseudophakic patients, which is advantageous in the event of future re-detachment necessitating SO reinjection. Rates of re-detachment and postoperative ERM and PVR were low. Furthermore, our method does not require the use of a surgical microscope with posterior segment viewing systems, or opening a full disposable vitrectomy set, thus drastically reducing the procedure's cost.


Assuntos
Tamponamento Interno/métodos , Complicações Pós-Operatórias , Descolamento Retiniano , Óleos de Silicone/uso terapêutico , Sucção , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Recidiva , Reoperação/métodos , Reoperação/estatística & dados numéricos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/fisiopatologia , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Sucção/efeitos adversos , Sucção/métodos , Resultado do Tratamento , Acuidade Visual , Cirurgia Vitreorretiniana/métodos
3.
Rom J Ophthalmol ; 63(3): 231-237, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687624

RESUMO

Purpose. Age related macular degeneration (ARMD) remains a serious cause of vision loss in elderly people worldwide. The purpose of the study is to investigate the fellow eye of the patients with exudative ARMD using optical coherence tomography angiography (OCTA). Methods. We conducted a retrospective study from the data of patients with exudative ARMD. Patients undergoing intravitreal anti-VEGF treatment for one eye were selected. OCTA images of both eyes with choroidal neovascularization (CNV) and the fellow eyes were evaluated retrospectively. Midchoroid, choriocapillaris (CC), retina pigment epithelium (RPE), and outer retina levels were evaluated using RTVue XR AVANTI OCTA. Results. There were 5 male and 5 female patients included in this study. We detected drusen and pigment epithelial detachments (PED) in fellow eyes. Six fellow eyes had vascularized PED. Four of them were acute flat irregular type; two of them were chronic dome shaped type. Four patients had soft drusen that had shown signal loss on choriocapillaris level. Conclusion. The follow-up of both eyes of the patients with ARMD is very important. OCTA seems a promising non-invasive method in order to detect subclinical early stage CNV and distinguish among types of PEDs.


Assuntos
Diagnóstico Precoce , Angiofluoresceinografia/métodos , Descolamento Retiniano/diagnóstico , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Degeneração Macular Exsudativa/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/etiologia , Estudos Retrospectivos , Degeneração Macular Exsudativa/complicações
4.
Rom J Ophthalmol ; 63(3): 264-267, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687629

RESUMO

Objective. To report a rare presentation of solitary retinal capillary hemangioma manifesting with combined retinal detachment as initial presentation and its successful management. Methods. A 35-year-old healthy Indian male presented with combined retinal detachment associated with solitary retinal capillary hemangioma as initial presentation; a clinical entity still not reported in literature. Patient was managed with pars plana vitrectomy combined with retinectomy, endolaser, & silicon oil tamponade with good visual & anatomical recovery. Results. Patient had good clinical outcome with final best-corrected visual acuity (BCVA) of 6/ 24 and well attached retina at last follow-up. Conclusion. Solitary retinal capillary hemangiomas can rarely present with advanced vitreo-retinal complications like combined retinal detachment as initial manifestation that can be effectively managed with skilled & appropriate surgical intervention.


Assuntos
Angiofluoresceinografia/métodos , Hemangioma Capilar/diagnóstico , Descolamento Retiniano/etiologia , Neoplasias da Retina/diagnóstico , Recurvamento da Esclera/métodos , Acuidade Visual , Vitrectomia/métodos , Adulto , Seguimentos , Fundo de Olho , Hemangioma Capilar/complicações , Hemangioma Capilar/cirurgia , Humanos , Masculino , Retina/patologia , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Neoplasias da Retina/complicações , Neoplasias da Retina/cirurgia
5.
Acta Ophthalmol ; 97 Suppl A114: 1-23, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31709751

RESUMO

BACKGROUND AND OBJECTIVES: Gene-therapy, stem-cell transplantation and surgical robots hold the potential for treatment of currently untreatable retinal degenerative diseases. All of the techniques require entry into the subretinal space, which is a potential space located between the retina and the retinal pigment epithelium (RPE). Knowledge about obstacles and critical steps in relation to subretinal procedures is therefore needed. This thesis explores the functional and histological consequences of separation of the retina from the RPE, extensive RPE damage, a large cut in the retina (retinotomy) and RPE phagocytosis in a porcine model. METHODS: Experiments were performed in 106 female domestic pigs of Danish landrace distributed over five studies. Under general anesthesia, different procedures for expansion of the subretinal space were conducted. Outcomes were visual function measured electrophysiologically with multifocal electroretinogram (mfERG) and retinal morphology examined histologically. Study I: The effect of anesthesia on mfERG was examined by repeated recordings for 3 hr in isoflurane or propofol anesthesia. Outcome was mfERG amplitude. Study II: Consequences of a large separation of the photoreceptors from the RPE were examined by injecting a perfluorocarbon-liquid (decalin) into the subretinal space. Two weeks after, in a second surgery, decalin was withdrawn. Outcomes were mfERG and histology 4 weeks after decalin injection. Study III: Extensive RPE damage was examined by expanding the subretinal space with saline and removing large sheets of RPE-cells through a retinotomy. Outcomes were mfERG and histology 2, 4 and 6 weeks after the procedure. Study IV: Consequences of a large retinotomy were examined by similar procedures as in Study III, but in study IV only a few RPE cells were removed. Outcomes were mfERG and histology 2 and 6 weeks after surgery. Study V: Clearance of the subretinal space was examined by injecting fluorescent latex beads of various sizes into the subretinal space. Outcome was histologic location of the beads at different time intervals after the procedure. RESULTS: Study I: MfERG amplitudes decreased linearly as a function of time in propofol or isoflurane anesthesia. Duration of mfERG recording could be decreased without compromising quality, and thereby could time in anesthesia be reduced. Study II: MfERG and histology remained normal after reattachment of a large and 2-week long separation of the photoreceptors and RPE. Repeated entry into the subretinal space was well tolerated. Fluid injection into the subretinal space constitutes a risk of RPE-damage. Study III: Removal of large sheets of retinal pigment epithelial cells triggered a widespread rhegmatogenous-like retinal detachment resulting in visual loss. Study IV: A large retinotomy with limited damage of the RPE was well tolerated, and visual function was preserved. Study V: Subretinal latex beads up to 4 µm were phagocytosed by the RPE and passed into the sub-RPE space. Beads up to 2 µm travelled further through the Bruch's membrane and were found in the choroid, sclera and inside blood vessels. CONCLUSION: A large expansion of the subretinal space, repeated entry, a large retinotomy and limited RPE damage is well tolerated and retinal function is preserved. Subretinal injection of fluid can damage the RPE and extensive RPE damage can induce a rhegmatogenous-like retinal detachment with loss of visual function. Foreign substances exit the subretinal space and can reach the systemic circulation.


Assuntos
Eletrorretinografia/métodos , Descolamento Retiniano/diagnóstico , Epitélio Pigmentado da Retina/patologia , Animais , Lâmina Basilar da Corioide/patologia , Lâmina Basilar da Corioide/fisiopatologia , Corioide/patologia , Corioide/fisiopatologia , Modelos Animais de Doenças , Feminino , Descolamento Retiniano/fisiopatologia , Descolamento Retiniano/cirurgia , Epitélio Pigmentado da Retina/fisiopatologia , Suínos , Vitrectomia
6.
Medicine (Baltimore) ; 98(40): e17441, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577766

RESUMO

RATIONALE: Although metastatic tumor is the most common intraocular malignancy, choroidal metastasis from gastric cancer is relatively rare. We present the exact course of a spontaneous rupture of the eyeball with choroidal metastasis from gastric carcinoma (GC) and the applied surgical interventions. PATIENT CONCERNS: A 59-year-old male presented with pain and vision loss on his left eye for 6 months. He was diagnosed with GC, for which he received systemic chemotherapy for a year. DIAGNOSES: Preoperative B-scan, color fundus photography, computed tomography, and magnetic resonance imaging showed a choroidal tumor in his left eye. The spontaneous rupture of the corneoscleral limbus from 2 to 5 o'clock, combined secondary glaucoma, exudative retinal detachment and choroidal detachment were found. INTERVENTIONS: The ruptured corneoscleral limbus was sutured and the orbit was lavaged with 0.4% cisplatin during the enucleation. OUTCOMES: Histopathology confirmed high homology of the choroidal metastasis and GC. He survived for 2 months after surgery, without pain or orbital neoplasms. LESSONS: Choroidal metastasis from GC rapidly progressed to spontaneous rupture of the eyeball. Careful eyeball enucleation followed by orbital lavage with chemotherapeutics may reduce metastasis risk beyond the eyeball. Additional therapeutic interventions should be considered in patients resistant to single systemic chemotherapy.


Assuntos
Neoplasias da Coroide/secundário , Doenças da Córnea/etiologia , Limbo da Córnea , Descolamento Retiniano/etiologia , Neoplasias Gástricas/patologia , Neoplasias da Coroide/diagnóstico , Neoplasias da Coroide/cirurgia , Doenças da Córnea/diagnóstico , Doenças da Córnea/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Ruptura Espontânea
7.
Ophthalmologica ; 242(4): 222-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31533121

RESUMO

PURPOSE: To report the surgical results and technique of perfluorocarbon-assisted neurosensory retinal flap transplantation into macular hole for concomitant macular hole and complicated retinal detachment. METHOD: This is a retrospective, consecutive case series of 7 cases with concomitant macular hole and complicated retinal detachment with proliferative vitreoretinopathy. All eyes had previous vitrectomy and internal limiting membrane peeling, or very large (>1,000 µm) macular holes. Perfluorocarbon liquid-assisted free neurosensory retinal flap transplantation into the macular hole, and subretinal fluid drainage through iatrogenic retinectomy/retinotomy were performed, followed by air-fluid exchange with gas or silicone oil tamponade. RESULTS: All eyes had retina reattached. Macular hole was closed in all eyes, with the graft visualized by optical coherence tomography. The best corrected visual acuity in logarithm of minimal angle of resolution improved from 2.80 ± 0.45 preoperatively to 1.40 ± 0.51 postoperatively (p < 0.01). CONCLUSIONS: Neurosensory retinal flap may be a good option in closing macular holes in eyes with concomitant macular hole and complicated retinal detachment. Because of its specific properties, the flap is easy to handle during the operation. Retinectomy or retinotomy serves to release traction, drain subretinal fluid, and provide retinal flap tissue.


Assuntos
Tamponamento Interno/métodos , Fluorcarbonetos/farmacologia , Retalhos de Tecido Biológico , Retina/transplante , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Vitrectomia/métodos , Idoso , Feminino , Seguimentos , Humanos , Macula Lutea/patologia , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico , Perfurações Retinianas/complicações , Perfurações Retinianas/diagnóstico , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Vitreorretinopatia Proliferativa/complicações , Vitreorretinopatia Proliferativa/diagnóstico , Vitreorretinopatia Proliferativa/cirurgia
9.
Invest Ophthalmol Vis Sci ; 60(10): 3310-3319, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31369033

RESUMO

Purpose: To analyze the evolution of type 1 neovascularization associated with vascularized serous pigment epithelial detachment (vsPED) using three-dimensional, volumetric, en face optical coherence tomography angiography (OCTA). Methods: This was a retrospective case series from four tertiary medical centers. OCTA images were analyzed at baseline and at the 3-, 6-, 12-, 18-, and 24-month follow-up visit when available. Visual acuity, number of injections, PED maximal height and PED area and volume, and choroidal neovascularization (CNV) flow area and progression were determined at each visit. Qualitative and quantitative analysis of CNV progression (including CNV/PED flow area) and final PED morphology was performed to determine anatomic outcomes. Results: Twenty-four eyes in 22 patients were studied. Median follow-up was 20 months. Across all eyes, maximum PED height decreased from 395.5 to 369.5 µm while CNV/PED flow ratio increased from 27.3% to 40.2%. Median visual acuity was unchanged at 20/40. Final PED outcomes included filled fibrovascular versus persistent vsPED. Filled vsPEDs decreased in PED height and volume and displayed a multilayered morphology in contrast to persistent vsPEDs. Fibrovascular PEDs received on average seven less injections as compared to persistent vsPEDs. Conclusions: Three-dimensional, volumetric, en face OCTA analysis of vsPED progression illustrated two anatomic outcomes: filled, typically multilayered fibrovascular PED versus persistent vsPED. The filled multilayered PED displayed a reduction in PED height and volume, greater CNV/PED flow ratio, and fewer anti-VEGF injections versus the persistent vsPED and may represent a more stable anatomic outcome while the persistent vsPED may indicate a more unstable morphology.


Assuntos
Neovascularização de Coroide/diagnóstico , Descolamento Retiniano/diagnóstico , Epitélio Pigmentado da Retina/patologia , Degeneração Macular Exsudativa/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Progressão da Doença , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Humanos , Imageamento Tridimensional , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Epitélio Pigmentado da Retina/diagnóstico por imagem , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia , Degeneração Macular Exsudativa/tratamento farmacológico
10.
Ophthalmic Surg Lasers Imaging Retina ; 50(8): e203-e210, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31415705

RESUMO

BACKGROUND AND OBJECTIVE: Knobloch syndrome is a genetic disorder defined by occipital defect, high myopia, and vitreoretinal degeneration. The authors studied retinal changes in patients with Knobloch syndrome using optical coherence tomography (OCT). PATIENTS AND METHODS: The authors report patients with Knobloch syndrome who received OCT testing during their care from 2011 to 2016. Diagnosis was based on high myopia, characteristic fundus, and occipital scalp or skull abnormalities with/without featureless irides and/or ectopia lentis. When available, diagnosis was confirmed by the detection of COL18A1 mutations. RESULTS: The authors studied eight eyes from five patients. Two eyes were excluded due to chronic retinal detachment. OCT findings included epiretinal membrane, peripapillary vitreoretinal traction with retinoschisis, absent or rudimentary foveal pits, mean macular thickness of 113.4 µm, poor lamination, retinal pigment epithelium (RPE) atrophy, photoreceptor depletion, and mean choroidal thickness of 168.5 µm with enlarged choroidal vessels. CONCLUSION: OCT findings in Knobloch syndrome include abnormal vitreoretinal traction, poor foveal differentiation, poor retinal lamination, retinal thinning, RPE attenuation, myopic choroidal thinning, and pachychoroid. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e203-e210.].


Assuntos
Encefalocele/complicações , Membrana Epirretiniana/diagnóstico , Degeneração Retiniana/complicações , Descolamento Retiniano/congênito , Descolamento Retiniano/diagnóstico , Retinosquise/diagnóstico por imagem , Adolescente , Adulto , Criança , Pré-Escolar , Corioide/patologia , Feminino , Humanos , Lactente , Masculino , Descolamento Retiniano/complicações , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica , Adulto Jovem
11.
BMJ Case Rep ; 12(8)2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434672

RESUMO

A rare case of Staphylococcus gallinarum endophthalmitis with intraocular foreign body (IOFB) was managed successfully by vitrectomy, IOFB removal and intravitreal antibiotics with steroids. Intraoperatively, the inferior retina was noted to be pale, possibly secondary to arteriolar occlusion/inflammation. This pale retina detached while peeling the vitreous, but spontaneously reattached postoperatively within a week. The case report describes the natural course of an iatrogenic detachment of pallid retina and the outcome of an uncommon ocular infection.


Assuntos
Antibacterianos/uso terapêutico , Endoftalmite/diagnóstico , Infecções Oculares Bacterianas/terapia , Ferimentos Oculares Penetrantes/terapia , Descolamento Retiniano/diagnóstico , Acidentes de Trabalho , Adulto , Endoftalmite/terapia , Corpos Estranhos no Olho , Infecções Oculares Bacterianas/patologia , Infecções Oculares Bacterianas/fisiopatologia , Ferimentos Oculares Penetrantes/patologia , Ferimentos Oculares Penetrantes/fisiopatologia , Humanos , Masculino , Descolamento Retiniano/fisiopatologia , Descolamento Retiniano/cirurgia , Resultado do Tratamento , Acuidade Visual , Vitrectomia
12.
Indian J Ophthalmol ; 67(9): 1448-1454, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31436190

RESUMO

Purpose: To compare the anatomic success of pars plana vitrectomy (PPV) after internal limiting membrane (ILM) peeling at macular area and macular plus peripapillary area versus no peeling in rhegmatogenous retinal detachments (RRD). Methods: A prospective observational study between July 2014 and March 2017 conducted on 289 eyes of 287 patients with RRD were randomly assigned to three treatment procedures, viz., PPV with no ILM peeling, PPV with macular peeling, and PPV with macular plus peripapillary peeling. Recurrent RD (ReRD) was treated as an event and accordingly the overall primary (PS) and final success (FS) rates were obtained. The risk of ReRD associated with peeling procedures after adjusting for risk factors were obtained using Cox-proportional hazard analysis. Results: The PS percentage for no peel, macular, and macular plus peripapillary procedures were 77.78% (70/90), 82.18% (83/101), and 94.89% (93/98; maximum), respectively, which was statistically significant with a P value of 0.003. The FS percentage for no peel, macular, and macular plus peripapillary were 93.33%, 95.04%, and 100%, respectively, which was significantly different with a P value of 0.048. With reference to no peeling, the adjusted hazard ratio for macular peeling was 0.841 [95% CI: 0.44-1.60] while 0.235 [95% CI: 0.088-0.626] for macular plus peripapillary peeling. Conclusion: The anatomic success rate of PPV with macular plus peripapillary ILM peeling was significantly higher as compared to no peel category. The hazard of ReRD in patients undergoing macular plus peripapillary peel was significantly reduced as compared to no peel procedure.


Assuntos
Membrana Basal/cirurgia , Retina/patologia , Descolamento Retiniano/cirurgia , Acuidade Visual , Vitrectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Descolamento Retiniano/diagnóstico , Tomografia de Coerência Óptica/métodos , Resultado do Tratamento
13.
Invest Ophthalmol Vis Sci ; 60(8): 3054-3063, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31348823

RESUMO

Purpose: To investigate fluorescence lifetime imaging ophthalmoscopy (FLIO) in neovascular AMD and pigment epithelial detachments (PEDs). Methods: A total of 46 eyes with PEDs (>350 µm) as well as age-matched healthy controls were included in this study. We found 28 eyes showed neovascular AMD (nvAMD), and 17 had nonneovascular (dry) AMD (dAMD). The Heidelberg Engineering FLIO excited fluorescence at 473 nm. Fluorescence decays were detected in two spectral channels (498-560 nm; 560-720 nm) to determine fluorescence lifetimes of endogenous fluorophores in their specific spectral emission ranges. Mean fluorescence lifetimes (τm) were investigated. Multimodal imaging was reviewed by two ophthalmologists who circumscribed and classified PEDs as either serous (n = 4), hemorrhagic (n = 4), fibrovascular (n = 16), drusenoid (n = 17), or mixed (n = 5). Blood samples from a healthy subject and a patient with PED were investigated in a quartz cuvette. Results: Eyes with nvAMD show similar FLIO patterns to dAMD: ring-shaped prolongations of τm 3 to 6 mm from the fovea. Different PED-forms show characteristic τm, while serous and hemorrhagic PEDs exhibit shortened τm, drusenoid PEDs show prolonged τm, and τm in fibrovascular PEDs is variable. Areas corresponding to sub-/intraretinal fluid display shortened τm. Ex vivo studies of blood also show short τm. Conclusions: The previously described dAMD-related FLIO pattern is also present in nvAMD. Short τm in serous, fibrovascular, and hemorrhagic PEDs as well as sub/intraretinal fluid may disrupt this pattern. FLIO appears to differentiate between PEDs, hemorrhage, and fluid. Additionally, ex vivo studies of human blood help to better interpret FLIO images.


Assuntos
Oftalmoscopia/métodos , Descolamento Retiniano/diagnóstico , Epitélio Pigmentado da Retina/patologia , Degeneração Macular Exsudativa/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Angiofluoresceinografia/métodos , Fluorescência , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Descolamento Retiniano/etiologia , Estudos Retrospectivos , Fatores de Tempo , Tomografia de Coerência Óptica/métodos , Degeneração Macular Exsudativa/complicações
14.
BMC Ophthalmol ; 19(1): 150, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311513

RESUMO

BACKGROUND: Morning glory syndrome is a relatively rare congenital optic disc anomaly that is often difficult to identify when associated with additional congenital ocular anomalies. This case report describes the diagnosis, treatment, and postoperative follow-up care of a young girl with morning glory syndrome accompanied by persistent fetal vasculature, retinal fold, and retinal detachment. Here, we also give a brief review of the relevant literature. CASE PRESENTATION: A 5-year-old girl was referred to our clinic for a complaint of decreased vision for 6 months in the right eye. The best corrected visual acuity was hand motion in her right eye and 0.8 in her left eye. A fundus examination indicated vitreous opacities and scattered hemorrhages, as well as striped folds in the temporal retina of the affected eye. B-ultrasound and magnetic resonance imaging scans suggested that it could be a congenital dysplasia of the right eye. Pars plana vitrectomy was performed in the right eye. Morning glory syndrome associated with persistent fetal vasculature was confirmed in subsequent follow-up observation according to the fundus appearance, optical coherence tomography, and fundus fluorescein angiography imaging. CONCLUSIONS: The patient was diagnosed as morning glory syndrome associated with persistent fetal vasculature and retinal fold. The morning glory disc with the presence of retinal folds did not seem quite typical and that made the diagnosis difficult. This report stresses the importance of considering concurrent morning glory syndrome and persistent fetal vasculature. Vitrectomy may be beneficial in the management of the morning glory syndrome and persistent fetal vasculature if accompanied by retinal detachment in similar cases.


Assuntos
Disco Óptico/anormalidades , Nervo Óptico/anormalidades , Vítreo Primário Hiperplásico Persistente , Descolamento Retiniano , Pré-Escolar , Feminino , Humanos , Vítreo Primário Hiperplásico Persistente/diagnóstico , Vítreo Primário Hiperplásico Persistente/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Resultado do Tratamento , Vitrectomia/métodos
17.
Medicine (Baltimore) ; 98(29): e16422, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335693

RESUMO

RATIONALE: Managing retinal detachment due to posterior retinal holes is problematic since standard laser retinopexy or scleral buckling may be difficult to apply and may have brought serious complication. Another surgical method in treating posterior hole related retinal detachment is desired. PATIENT CONCERNS: Three high myopia patients with previous vitrectomy and membrane peeling history suffered from blurred vision and retinal detachment due to posterior pole retinal holes was diagnosed. DIAGNOSES: Patient diagnosed retinal detachment due to posterior retinal holes either as paracentral retinal breaks or macular hole from both indirect ophthalmoscope exam and fundus photography INTERVENTIONS:: The patient underwent lens capsular flap insertion into all the retinal holes, along with gas tamponade or silicone oil tamponade. No laser retinopexy was performed around the retinal holes. OUTCOMES: Of 3 included patients, 1 patient had insertion of the lens capsular flap, an incomplete air-fluid exchange, and 24% sulfur hexafluoride gas tamponade. The other 2 patients, after lens capsular flap insertion, had air-fluid exchange and subretinal fluid drainage with extrusion via soft needle through superior drainage retinotomy and silicon oil tamponade. The retinal holes of all eyes were sealed with retina attached postoperatively. LESSONS: Lens capsular flap is effective in sealing posterior retinal holes and treating the associated retinal detachment without the complication resulting from laser retinopexy, especially in eyes without sufficient internal limiting membrane (ILM) tissue due to previous ILM peeling.


Assuntos
Miopia Degenerativa , Descolamento Retiniano , Perfurações Retinianas , Cirurgia Vitreorretiniana , Idoso , Técnicas de Diagnóstico Oftalmológico , Tamponamento Interno/métodos , Feminino , Humanos , Cristalino/cirurgia , Masculino , Pessoa de Meia-Idade , Miopia Degenerativa/complicações , Miopia Degenerativa/diagnóstico , Miopia Degenerativa/fisiopatologia , Retina/diagnóstico por imagem , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Óleos de Silicone/uso terapêutico , Resultado do Tratamento , Acuidade Visual , Cirurgia Vitreorretiniana/instrumentação , Cirurgia Vitreorretiniana/métodos
18.
Ophthalmologica ; 242(2): 113-117, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31163427

RESUMO

PURPOSE: To evaluate the effects of repeated intra-silicone oil (SO) injections of methotrexate (MTX) on the outcomes of surgery for rhegmatogenous retinal detachment (RRD) with grade C proliferative vitreoretinopathy (PVR-C). METHODS: In this prospective pilot case series, eyes with RRD and PVR-C underwent pars plana vitrectomy and intraocular injection of SO. At the conclusion of the procedure, 250 µg of MTX was injected into the SO-filled vitreous cavity. Intra-SO injection was repeated at weeks 3 and 6; the minimum follow-up period was 6 months. The main outcome measure was retinal reattachment rate. RESULTS: Eleven eyes of 11 patients (mean age, 52.73 ± 18.01 years) were included. The mean follow-up period was 9 ± 3 months (range, 6-15 months). Total retinal detachment with anterior and/or posterior PVR-C was present in all eyes before surgery. Mean preoperative best-corrected visual acuity (BCVA) was 2.62 ± 0.04 logMAR. All operated eyes exhibited retinal reattachment posterior to the equator during the follow-up period. Mean postoperative BCVA was significantly improved to 1.02 ± 0.51 logMAR (p = 0.003). No ocular or systemic side effects were observed. CONCLUSION: Repeated intra-SO injection of MTX as an adjunctive therapy for RRD complicated by PVR showed promising results and was not associated with adverse effects. Further studies are needed to confirm its possible beneficial effects on the final anatomic and functional outcomes in these cases.


Assuntos
Metotrexato/administração & dosagem , Descolamento Retiniano/terapia , Óleos de Silicone , Acuidade Visual , Vitrectomia/métodos , Vitreorretinopatia Proliferativa/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Tamponamento Interno , Feminino , Humanos , Imunossupressores/administração & dosagem , Injeções Intraoculares , Fotocoagulação a Laser , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Retina/patologia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Tomografia de Coerência Óptica , Resultado do Tratamento , Vitreorretinopatia Proliferativa/complicações , Vitreorretinopatia Proliferativa/diagnóstico , Adulto Jovem
20.
Indian J Ophthalmol ; 67(7): 1223-1226, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31238475

RESUMO

Sturge-Weber syndrome (SWS) includes facial, leptomeningeal and choroidal hemangioma. The retinal vasculature is essentially normal. Rare cases of retinal vascular tortuosity and arterio-venous malformations have been reported. We report two cases with rare concomitant retinal vascular abnormalities along with SWS. Both the patients had nevus flammeus, hemifacial hypertrophy, and choroidal hemangioma. In one case, retinal cavernous hemangioma was seen in the affected eye. The other case revealed retinal neovascularization secondary to proliferative diabetic retinopathy in the eye with choroidal hemangioma.


Assuntos
Neoplasias da Coroide/etiologia , Hemangioma/etiologia , Descolamento Retiniano/etiologia , Doenças Retinianas/etiologia , Vasos Retinianos/patologia , Síndrome de Sturge-Weber/complicações , Neoplasias da Coroide/diagnóstico , Angiofluoresceinografia , Fundo de Olho , Hemangioma/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/diagnóstico , Doenças Retinianas/diagnóstico , Tomografia de Coerência Óptica , Adulto Jovem
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