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At least 253 records · Page 14Linked to original sources
PubMed2006

Failure of prophylactic retinopexy in fellow eyes without a posterior vitreous detachment.

OBJECTIVE: To describe adverse sequelae of retinal prophylaxis in fellow eyes of patients with rhegmatogenous retinal detachment. DESIGN: Records were reviewed for 17 patients who had retinal breaks or detachment subsequent to prophylactic retinopexy applied to the fellow eye (without posterior vitreous detachment) at the time of primary rhegmatogenous retinal detachment surgery. Subsequent treatment included cryotherapeutic and laser retinopexy, scleral buckling, and vitrectomy. RESULTS: Of the 17 patients, 12 were male (mean age, 49 years). Laser retinopexy alone was used in 6 cases. Sixteen (94%) developed retinal tears related to acute posterior vitreous detachment, of which 8 (47%) were at the edge of retinopexy and 8 (47%) were in the normal or untreated retina. Thirteen (76%) developed a retinal detachment, of which 11 (85%) did not involve the fovea. Median visual acuity following treatment was 0.18 logMAR (6/9 Snellen equivalent). CONCLUSIONS: Prophylactic retinopexy in fellow eyes without posterior detachment is not completely successful and may cause breaks to develop at the edge of treated areas during subsequent acute posterior vitreous detachment. Patient education alone regarding the symptoms of retinal tear and detachment may be preferable to prophylactic retinopexy of the fellow eye in the absence of a posterior vitreous detachment.

Adolescent↗
PubMed1984

Retinal microincarceration with penetrating diathermy in the management of giant retinal tears.

A technique for repair of giant retinal breaks with detachment involves the performance of lensectomy-sector iridectomy, vitrectomy, and scleral buckling behind the equator. Total fluid-gas exchange is performed while the patient is turned to the prone position on a rotating table. Penetrating diathermy is used to fix the retina and to create retinal microincarceration while air is simultaneously injected into the eye.

Adolescent↗
PubMed1984

Iris retraction associated with rhegmatogenous retinal detachment syndrome and hypotony. A new explanation.

Eyes with rhegmatogenous retinal detachment can occasionally be seen with hypotony and a peculiar retraction of the peripheral iris. Herein I report the following new observations in this syndrome: (1) seclusion of the pupil, (2) resolution of the retraction configuration after disruption of the seclusion, (3) the initial manifestation as angle closure secondary to iris bombé interchangeable with the iris retraction configuration with the addition (to bombé) and the withdrawal (from retraction) of pharmacologic aqueous suppressants, and (4) the rapid cataract formation. The theory that vitreous traction or retraction is the cause of the retrodisplacement of the iris was disproved. A hydrodynamic theory is presented. A lowering of pressure behind the iris, at least partially, due to posterior removal of fluid, presumably from the subretinal space, was shown to be the cause of the iris retraction. The iris retrodisplacement occurred when posterior aqueous removal exceeded aqueous formation. This removal of fluid may be an important factor in the understanding of proliferative vitreoretinopathy as the fluid flow involved may draw cells posteriorly.

Acetazolamide↗
PubMed1985

Experimental retinal detachment. IX. Aqueous, vitreous, and subretinal protein concentrations.

Unilateral rhegmatogenous retinal detachments were created in seven cynomolgus monkeys. Six months later, aqueous, vitreous, and subretinal fluid protein concentrations were measured. In fellow eyes with vitrectomy alone, mean aqueous and vitreous protein concentrations were 0.28 and 0.23 mg/mL, respectively. In eyes with retinal detachments, mean aqueous, vitreous, and subretinal protein levels were 1.46, 2.66, and 4.74 mg/mL, respectively. Eyes with a large retinal hole (greater than or equal to 1 disc diameter) had a subretinal fluid-vitreous protein concentration ratio of 1.1, indicating free diffusional exchange between the vitreous and subretinal space. In eyes with a small retinal hole (less than or equal to 1/4 disc diameter), the corresponding ratio was 4.0. These findings are consistent with the hypothesis that fluid moves from the vitreous cavity through the retinal hole into the subretinal space, preventing back diffusion of protein from the subretinal space into the vitreous, and allowing accumulation of protein in the subretinal space.

Animals↗
PubMed1985

Rhegmatogenous retinal detachment in Labrador retrievers. I. Development of retinal tears and detachment.

We used clinical and pathologic methods to examine ten Labrador retrievers with ocular and skeletal abnormalities. The major ocular findings were axial myopia; cataract; vitreous abnormalities, including liquefaction, detachment, and vitreoretinal traction; retinal tears; rhegmatogenous retinal detachment; and proliferative vitreoretinopathy. The appendicular skeleton showed retarded bone growth, bone dysplasia, and degenerative arthropathy. Vitreoretinal traction appeared to be the cause of the retinal tears because (1) formed vitreous was always attached near the anterior edge of the tear, and (2) vitreous traction caused a retinal ridge adjacent to a retinal tear in a dog that had not yet developed retinal detachment. The pathogenetic sequence of spontaneous vitreous abnormalities, retinal tears, and retinal detachment observed in these dogs has not previously been described in animals, to the best of our knowledge, and mimicked human rhegmatogenous retinal detachment, particularly those associated with giant retinal tears.

Animals↗
PubMed1985

Rhegmatogenous retinal detachment in Labrador retrievers. II. Proliferative vitreoretinopathy.

We observed proliferative vitreoretinopathy in Labrador retrievers with spontaneous rhegmatogenous retinal detachment. Cellular membranes and their associated connective tissue matrix were prominent on the surfaces of the detached formed vitreous and on the retina. Membrane contraction folded the underlying vitreous and retina and exerted traction on the structures to which they attached. Proliferation occurred in the retinal pigment epithelium under the detached retina and in the nonpigmented ciliary epithelium when it became detached. Retinal pigment epithelial cells, nonpigmented ciliary epithelial cells, macrophages, and glial cells appeared to contribute to the membranes. Our findings suggested a sequence that began with vitreous abnormalities and ended with fibrocellular membranes on the surfaces of the vitreous and the totally detached retina. Because a similar sequence can develop in humans, these dogs may be useful in future studies of proliferative vitreoretinopathy.

Animals↗
PubMed1985

Experimental retinal detachment. X. Effect of acetazolamide on vitreous fluorescein disappearance.

Retinal detachments were created in one eye of each of eight cynomolgus monkeys. Total vitrectomy was performed in the fellow eyes. Fluorophotometry was used to study the rate of disappearance of fluorescein injected into the vitreous cavity. The rate of fluorescein loss via the anterior chamber accounted for only 1% to 3% of the total rate of vitreous fluorescein loss in eyes with retinal detachment or in fellow eyes. Posterior loss of fluorescein (presumably across the retinal pigment epithelium) increased by 25% following intravenous acetazolamide in eyes with retinal detachment and 22% in fellow eyes. It is concluded that acetazolamide increases the rate of fluid absorption across the retinal pigment epithelium.

Acetazolamide↗
PubMed1985

Simultaneous external subretinal fluid drainage and intravitreal gas injection.

Simultaneous external subretinal fluid drainage and intravitreal gas injection was performed in 12 patients requiring a large or near-total internal gas tamponade (eight eyes with proliferative vitreo-retinopathy following vitrectomy and four eyes without proliferative vitreoretinopathy that had not undergone vitrectomy). None of the patients had a preexisting or intentional posterior retinal break. The retina was attached six or more months postoperatively in nine of the 12 patients. In one patient, an iatrogenic retinal break occurred without retinal incarceration. In selected cases, this procedure is an alternative to internal fluid-gas exchange through a posterior retinal break, thus avoiding the necessary postoperative facedown position, which is difficult for some patients to maintain. This method may also be used for preventing "fish-mouthed" retinal breaks in selected cases.

Body Fluids↗
PubMed1986

Fellow eyes in cases of macular hole. Biomicroscopic study of the vitreous.

One hundred thirty eyes of 126 patients with idiopathic macular holes were studied by means of indirect ophthalmoscopy, biomicroscopy, color fundus photography, and fluorescein angiography. Posterior vitreous detachment was absent in 61% of these eyes; opacities interpreted as opercula were found in 78 eyes (60%). Forty-nine fellow eyes were followed up for a mean period of 47 months. Eight of 28 fellow eyes without posterior vitreous detachment and none of 21 fellow eyes with posterior vitreous detachment developed macular holes, suggesting that vitreous attachment to the macula is closely related to the development of macular holes. The difference between the incidences of macular hole development in eyes with and without posterior vitreous detachment is statistically significant.

Adult↗
PubMed1986

Retinal wound healing. Cellular activity at the vitreoretinal interface.

Cellular activity at the vitreoretinal interface after full-thickness retinal wounds was studied in rabbit eyes, using light and electron microscopy. Glial cell extensions grew initially on the retinal surface around the wound site. This brief period of glial proliferation was associated with the posttraumatic inflammatory response and, more specifically, with phagocytic monocyte accumulation at the vitreoretinal interface. Once the inflammation subsided, this abortive attempt to grow membranes on the retinal surface stopped and true epiretinal membranes did not develop. Our observations suggest that intraocular inflammation and macrophage response determine the extent of healing and scarring on an injured retinal surface, and thus may play a key role in the pathogenesis of epiretinal membranes.

Animals↗
PubMed1986

Congenital hereditary (juvenile X-linked) retinoschisis. Histopathologic and ultrastructural findings in three eyes.

One surgically enucleated and two postmortem eyes were obtained from two related men with congenital hereditary retinoschisis. A periodic acid-Schiff-positive amorphous material was identified within the retina adjacent to the schisis cavities. Ultrastructural examination of this material showed numerous extracellular filaments, measuring approximately 11 nm in diameter. Similar filaments were found in the vitreous in all three globes and in a normal globe. We believe that the intraretinal filaments are produced by defective Müller cells and that their extracellular accumulation may lead to degeneration of cells and subsequent schisis formation.

Adolescent↗
PubMed1987

Vitrectomy for progressive proliferative diabetic retinopathy.

We analyzed the results of 105 diabetic vitrectomy cases. The vitrectomies were performed for progressive fibrovascular proliferation that caused epiretinal membranes, vitreopapillary traction, florid neovascularization, or subhyaloid hemorrhage, with or without substantial preoperative visual loss. Eyes with inactive retinal neovascularization, dense vitreous hemorrhage, traction retinal detachment involving the macula, or combined traction and rhegmatogenous retinal detachment were excluded. Seventy-four eyes (70%) had improved final vision. The final vision was unchanged in eight eyes (8%) and was worse in 23 eyes (22%). Factors associated with a favorable visual prognosis included the following: age of 40 years or less, preoperative visual acuity of 5/200 or better, absence of preoperative iris neovascularization, preoperative panretinal photocoagulation, and absence of an iatrogenic retinal break.

Adult↗