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At least 271 records · Page 15Linked to original sources
PubMed1999

Primary vitrectomy with perfluoro-n-octane use in the treatment of pseudophakic retinal detachment with undetected retinal breaks.

PURPOSE: This report describes the results of a prospective trial to evaluate the efficacy of pars plana vitrectomy (PPV) in conjunction with perfluoro-n-octane (PFO) as initial treatment of pseudophakic retinal detachment (RD) with no breaks diagnosed preoperatively. METHODS: Fourteen consecutive eyes presenting with pseudophakic RD in which retinal breaks could not be identified preoperatively underwent primary PPV, internal microsurgical identification of the retinal breaks with endoillumination and noncontact wide angle viewing system, PFO retinal reattachment, transscleral cryopexy or endolaser treatment of breaks, PFO-air exchange, and final injection of 20% sulfur hexafluoride. In five eyes, a scleral buckle was also used. Mean follow-up period was 18 months. RESULTS: In 13 of the 14 eyes in which no breaks had been identified preoperatively, breaks were diagnosed during surgery. Perfluoro-n-octane retinal attachment facilitated accurate microscopic treatment of retinal breaks. The retina was reattached with a single operation in all eyes. Eleven eyes had final visual acuity of 20/60 or better. Complications were minimal. CONCLUSIONS: Pars plana vitrectomy in conjunction with PFO expression of subretinal fluid is effective in the initial treatment of pseudophakic RD with no preoperative diagnosis of retinal breaks.

Adult↗
PubMedDate not supplied

Retinal tears and retinal detachment as factors affecting visual outcome after cataract extraction complicated by posteriorly dislocated lens material.

PURPOSE: To evaluate the incidence and effect on visual acuity of complicating factors such as retinal tears (RTs) and rhegmatogenous retinal detachment (RRD) in eyes with posteriorly dislocated lens fragments after cataract extraction. METHODS: Retrospective consecutive series of patients presenting at a referral vitreoretinal practice with posteriorly dislocated lens material after cataract extraction over a period of 8 years. The presence of RT, RRD, endophthalmitis, and choroidal hemorrhage was noted, and their effect on visual outcome was studied. RESULTS: A total of 307 eyes with posteriorly dislocated lens material after cataract extraction were identified. Fifty-eight eyes (19%) were managed medically (Group I), whereas the other 249 eyes (81%) underwent pars plana vitrectomy for removal of the lens material (Group II). Indications for surgical management included uncontrolled inflammation, elevated intraocular pressure, and large lens fragments. No eyes in Group I developed RT or RRD. Of the 249 Group II eyes, 13 (5%) were found to have RT, and 25 (10%) developed RRD. In Group II, choroidal hemorrhage and endophthalmitis were noted in 12 (5%) and 4 (2%) eyes, respectively. Fifty-one (88%) of 58 eyes in Group I and 138 (55%) of 249 eyes in Group II achieved a final visual acuity of 20/40 or better. Seven (54%) of the 13 eyes with RT and 9 (36%) of the 25 eyes with RRD achieved a final visual acuity of 20/40 or better. In the RRD group, 9 (56%) of the 16 macula-on eyes achieved a final visual acuity of 20/40 or better, whereas none of the 9 macula-off eyes had a final visual acuity of 20/40 or better. None of the 4 eyes with endophthalmitis and only 1 (8%) of the 12 eyes with choroidal hemorrhage had a final visual acuity of 20/40 or better. Five (62%) of eight eyes with retinal detachment treated with pneumatic retinopexy needed further treatment with scleral buckle to achieve anatomical reattachment. CONCLUSION: A good visual outcome (20/40 or better) is possible in eyes with posteriorly dislocated lens fragments after cataract extraction, even when retinal tears or macula-on retinal detachment is present. The presence of a macula-off retinal detachment, however, has a significant adverse effect on the visual outcome. Pneumatic retinopexy is not associated with retinal reattachment in many cases and is not preferred.

Adult↗
PubMed1977

Clinical copper metabolism parameters in patients with retinitis pigmentosa and other tapeto-retinal degenerations.

Reports have appeared of abnormal copper metabolism in retinitis pigmentosa, and of a family with vitelliform retinal degeneration in which other members suffered from hepatolenticular degeneration. In the present study 15 patients with retinitis pigmentosa, 4 with various other retinal degenerations, and 1 with a family disposition to retinitis pigmentosa were examined. The copper concentration in serum and the coeruloplasmin concentration in plasma were found to be within normal limits. In 9 of the patients with retinitis pigmentosa the urinary excretion of copper per 24 hours was determined and was found to be normal. The results of the present study lend no support to the hypothesis of abnormal copper metabolism in retinitis pigmentosa.

Adolescent↗
PubMedDate not supplied

Increased TRPM-2/clusterin mRNA levels during the time of retinal degeneration in mouse models of retinitis pigmentosa.

Retinitis pigmentosa (RP) is a genetically and clinically heterogeneous group of human disorders that is characterized by diminished retinal function, visual cell loss, and blindness. Elevated levels of TRPM-2/clusterin mRNA, a marker for the apoptotic process, have been reported in retinas from patients with advanced stage RP. In the present study we examine TRPM-2/clusterin expression in two genetically distinct mouse models of RP, the rd (retinal degeneration) and rds (retinal degeneration slow) mice. We establish that in advanced postretinal degenerative stages of the rd mutant the retinal TRPM-2/clusterin mRNA levels are highly elevated, as is seen in the case of human RP. Examination of TRPM-2/clusterin mRNA levels in retina and whole eyes from the rd mouse and morphologically normal controls during the period of retinal degeneration (postnatal days 8-21) in the rd phenotype shows that TRPM-2/clusterin mRNA levels are elevated in the rd animal, and this increase begins just after postnatal day 10 and remains high for the remainder of the time course examined. Northern analysis of rds retina and whole eyes shows a delayed increase in TRPM-2/clusterin mRNA levels relative to the rd profile, coinciding with the known period of rds retinal degeneration (postnatal day 14 to 1 year). In each case, the onset of increased TRPM-2/clusterin mRNA levels coincides with the time of photoreceptor cell death.

Animals↗
PubMed1998

Inner retinal function in hereditary retinal dystrophies.

Hereditary retinal dystrophies are most often disorders of photoreceptors and/or the retinal pigment epithelium. Structures secondary to the photoreceptor layer such as bipolar, horizontal, amacrine and ganglion cells are secondarily involved. In later stages of the disease a mild to moderate loss of inner retina occurs, but the second and third neurons remain surprisingly viable even in late and severe stages of retinal dystrophies. The function of the inner retina in patients suffering from hereditary retinal dystrophies is not easy to determine because it depends on the input of photoreceptors. The electroretinogram (ERG) offers several possibilities in this respect: b-wave, off-response (off-ERG), oscillatory potentials, scotopic threshold response of the flash ERG and the pattern ERG (PERG). We looked at two ERG tests: the PERG and the off-ERG. The PERG is an indicator of ganglion cell function. Its amplitude is related to the photoreceptor input determined by the flash ERG and visual field testing. But in cases of an undetectable flash ERG response the PERG can be recorded in some patients, but not in others. This may be an indication of a different effect on inner retinal function in different groups of patients. On- and off-responses are related to the function of depolarizing and hyperpolarizing bipolar cells. Evaluation of 301 patients with various retinal dystrophies revealed that most hereditary disorders primarily affect the photoreceptors or the pigment epithelium. In some patients, alterations of the on- and off-response amplitudes or implicit times were indicative of inner retinal disorders and different pathophysiologic mechanisms. However, interpretation has to be made carefully, as on- and off-responses may be influenced by dysfunction of photoreceptor synapses to bipolar cells, bipolar cells, Müller cells and intercellular matrix.

Adolescent↗
PubMed1994

Branch retinal vein occlusion and exudative retinal detachment: pathogenetical aspects.

Exudative retinal detachment (ERD) is an uncommon complication of branch retinal vein occlusion (BRVO). The ERD pathogenesis has been mainly related to the haemodynamic overload and to an impairment in the function of the retinal pigment epithelium. Data relative to 98 cases of BRVO without ERD were compared with the correspondent data of 10 cases of BRVO with ERD. Venous leakage showed a substantial equivalency between the two groups, while evaluation of retinal venous collaterals demonstrated a lower amount in the BRVO cases with ERD, with a statistically significant difference. Moreover, considering the various ERD localizations, we suggest that the ERD pathogenesis is mainly ascribable to the scant development of retinal venous collaterals but that an important role may also be played by the retinal pigment epithelium impairment consequent to the retinal ischaemia.

Adult↗
PubMed2000

Exudative retinal detachment and retinitis associated with acquired syphilitic uveitis.

PURPOSE: To describe three cases of exudative retinal detachment and focal retinitis associated with acquired syphilitic uveitis. METHODS: Three patients who were referred for evaluation of uveitis were examined. Slit-lamp examination, ophthalmoscopy, B-scan ultrasonography, fundus photography, and fluorescein angiography were performed before and after therapy. RESULTS: Each patient had uveitis with exudative retinal detachment, periphlebitis, and focal retinitis. Laboratory testing (fluorescent treponemal antibody absorption) revealed positive serology for active syphilis in all cases. Human immunodeficiency virus antibody testing was negative in all patients. Retinal detachment resolved in all cases after treatment with intravenous penicillin. Despite resolution of subretinal fluid, visual acuity remained poor in eyes in which the macula was detached. CONCLUSION: Syphilis is a cause of exudative retinal detachment. Antibiotic therapy can lead to retinal reattachment. Early recognition and treatment may prevent severe vision loss.

Adult↗
PubMed2002

Increased spontaneous retinal ganglion cell activity in rd mice after neural retinal transplantation.

PURPOSE: To study the functional success of neural retinal transplantation by means of retinal surface ganglion cell recordings. METHODS: Eight-week-old C3H/HeJ (rd/rd) retinal degeneration mice received transplants (subretinal) in one eye only of neural retinal tissue isolated from newborn normal C57/BL6J mice. Four weeks after transplantation, ganglion cell responses were recorded directly from the retinal surface over the transplant, with a differential bipolar surface electrode. Measurements were performed, both with and without light stimulation. Similar recordings were performed in nontransplant areas of the transplant-recipient eyes, and in age-matched sham-treated and untreated control eyes. After the recordings, the eyes were processed for light and transmission electron microscopy. RESULTS: Histologic examination showed that in some areas, transplanted cells were organized into small sheets and differentiated into photoreceptors with outer segments in intimate contact with the host RPE. No light-driven ganglion cell responses were recordable from the transplant-recipient or control eyes. However, the spontaneous ganglion cell activity was higher in the transplant areas (mean: 10.8 +/-12.0 spikes/1.6 sec) compared with nontransplant areas of these recipient eyes (mean: 2.4 +/- 5.7spikes/1.6 sec; P < 0.001), sham-treated eyes (mean: 2.5 +/- 4.8 spikes/1.6 sec; P < 0.001), and the untreated control eyes (mean: 2.2 +/- 4.4 spikes/1.6 sec; P < 0.001). CONCLUSIONS: Subretinal transplantation of neural retinal tissue results in a local increase of spontaneous ganglion cell activity. The increased activity may be due to the release of neurochemically active substances as a result of the presence of the transplant. Although light responses were not recordable, the technique of retinal surface ganglion cell recording may be useful for assessing the functional success of transplantation.

Action Potentials↗
PubMed2000

[Effect of Panax notoginseng saponins combined isovolumic haemodilution on the retinal microcirculation of patients with retinal vein occlusion].

OBJECTIVE: To study the effect of Panax notoginseng saponins (PNS) or isovolumic haemodilution (IHD) and combination of PNS with IHD on retinal microcirculation of patients with retinal vein occlusion (RVO). METHOD: Seventy three patients with RVO were allocated at random to three groups which were treated with PNS, IHD, or PNS + IHD respectively. The retinal circulation time (RCT) and retinal hemorrhage, edema, leakage of capillary, cystoid macular edema (CME), and nonperfusion area of capillary in retina were observed before and after treatment. RESULT: RCT of patients with RVO was shortened by three treating methods. RCT in the patients who treated by PNS + IHD was the shortest, especially in the patients with nonischemic RVO and branch retinal vein occlusion(BRVO). The retinal hemorrhage, edema, leakage of capillary, and CME in the patients treated by PNS + IHD disappeared quicker than those treated by PNS or IHD. At the same time, the incidence of nonperfusion area in patients whose course of disease was shorter than fourteen days was decreased. The perfusion of capillaries was increased at the edge of nonperfusion area which existed before the treatment. But the effect for nonperfusion area which existed before the treatment in the type of ischemic RVO was not obvious. CONCLUSION: The treatment of PNS + IHD can both shorten RCT of patients with RVO, and promote absorption of retinal hemorrhage, edema, leakage of capillary, and CME. It is possible that PNS + IHD treatment also has an effect to decrease the forming of nonperfusion area in patients whose course of disease is at early stage.

Female↗
PubMed2003

[Prognosis of surgery in epimacular membranes after retinal break or rhegmatogenous retinal detachment].

INTRODUCTION: The prognosis of the formation of epiretinal membranes after retinal break or rhegmatogenous retinal detachment, treated or not treated, does not seem as favorable as that of the idiopathic membranes, but has not yet been extensively studied. Our goal was to analyze the functional result and the retinal complications of the treatment of these membranes. METHODS: The retrospective study deals with a consecutive series of 28 patients operated on for epimacular membranes, with a minimum follow-up of 3 months. The outcome measures were the postoperative visual acuity at 3-6 months compared with the preoperative visual acuity, taking into account the condition of the crystalline lens as well as the incidence of membrane recurrence and new or recurrent retinal detachment. RESULTS: A 2-line or more visual improvement was achieved in 57% of the cases (16/28), i.e., 36% of eyes with progressive cataract (4/11), 50% of primary pseudophakic eyes (3/6), and 80% of eyes with unchanged lens (8/10). There was no recurrent epimacular membrane formation, with a mean follow-up of 8.7 months. A new or recurrent retinal detachment was observed in 25% of the cases (7/28). DISCUSSION AND CONCLUSION: These results, compared with those achieved in the treatment of idiopathic membranes, as the literature reports, confirm the fair surgical prognosis of epimacular membrane formation after retinal break or rhegmatogenous retinal detachment.

Adult↗
PubMed2006

Mutation screening of the peropsin gene, a retinal pigment epithelium specific rhodopsin homolog, in patients with retinitis pigmentosa and allied diseases.

PURPOSE: To investigate the peropsin gene (RRH), encoding a retinal pigment epithelium homolog of the rod-expressed opsin (rhodopsin), for the presence of pathogenic mutations causing retinitis pigmentosa (RP) or other retinal degenerations. METHODS: All seven exons composing the RRH open reading frame and the immediate intron sequences were analyzed by direct nucleotide sequencing of 613 patients with forms of retinal degeneration. RESULTS: One patient with retinitis punctata albescens was a heterozygote with the missense change Cys98Tyr (TGT>TAT, c.293G>A). This change affects the homologous residue that is the target of the rhodopsin mutation Cys110Tyr, a reported cause of dominant RP. Unfortunately, none of the patient's relatives were available for a segregation analysis to determine if this change is unambiguously associated with disease. No definite pathogenic mutation was found in any of the other 612 patients who were evaluated. CONCLUSIONS: The Cys98Tyr is a possible cause of retinitis punctata albescens, although this conclusion is tentative because the change was found in only one patient. Our results indicate that the peropsin gene is not a common cause of RP or some related retinal degenerations, at least in the set of patients we analyzed.

Cysteine↗
PubMed1994

Management of retinal detachments secondary to cytomegalovirus retinitis.

Nine patients with acquired immune deficiency syndrome underwent surgery for rhegmatogenous retinal detachments related to cytomegalovirus (CMV) retinitis. The patients were followed for at least 6 months or until death. Two patients with localized peripheral detachments for 3 to 4 clock hours or less initially underwent laser retinopexy. Although in both cases the treatment ultimately failed, one patient maintained 20/20 vision for 5 months. In four patients in whom the retinal detachment was more extensive but could be explained on the basis of a single or multiple well-defined peripheral break(s), a scleral buckle procedure was performed, with anatomic success in three, two of whom maintained 20/40 vision for 7 and 8 months. Six patients with retinal detachments associated with multiple atrophic holes that were not amenable to scleral buckling were treated with pars plana vitrectomy, air-fluid exchange and endolaser, with anatomic success in three; the visual acuity ranged from 20/30 to 20/400. One patient with failed pars plana vitrectomy underwent repeat vitrectomy with long-term internal tamponade by silicone oil, and he regained hand movements vision. We suggest a graduated approach to the management of retinal detachments secondary to CMV retinitis tailored to each patient based on the number and location of the retinal breaks, the extent of the detachment, the extent of necrotic retina and the overall health of the patient.

AIDS-Related Opportunistic Infections↗
PubMed1979

Infrequency of retinal neovascularization following central retinal vein occlusion attributed to endothelial death.

48 patients with central retinal vein occlusion by clinical diagnosis and 10 eyes by histopathological documentation were studied and reviewed. Only 1 eye developed retinal neovascularization. Rubeosis iridis occurs in 14% of clinical cases and all of histopathologic cases. 10 long-standing neovascular glaucoma enucleated eyes following central retinal vein occlusion show absence of retinal endothelial cells. The absence of retinal capillary endothelial cells seems to be significant in explaining the rare occurrence of retinal neovascularization following central retinal vein occlusion. However, the small number sampling may reflect a biased result. Further prospective studies with more cases and time observation are required to draw the final conclusion.

Capillaries↗
PubMed2007

Retinal organization in the retinal degeneration 10 (rd10) mutant mouse: a morphological and ERG study.

Retinal degeneration 10 (rd10) mice are a model of autosomal recessive retinitis pigmentosa (RP), identified by Chang et al. in 2002 (Vision Res. 42:517-525). These mice carry a spontaneous mutation of the rod-phosphodiesterase (PDE) gene, leading to a rod degeneration that starts around P18. Later, cones are also lost. Because photoreceptor degeneration does not overlap with retinal development, and light responses can be recorded for about a month after birth, rd10 mice mimic typical human RP more closely than the well-known rd1 mutants. The aim of this study is to provide a comprehensive analysis of the morphology and function of the rd10 mouse retina during the period of maximum photoreceptor degeneration, thus contributing useful data for exploiting this novel model to study RP. We analyzed the morphology and survival of retinal cells in rd10 mice of various ages with quantitative immunocytochemistry and confocal microscopy; we also studied retinal function with the electroretinogram (ERG), recorded between P18 and P30. We found that photoreceptor death (peaking around P25) is accompanied and followed by dendritic retraction in bipolar and horizontal cells, which eventually undergo secondary degeneration. ERG reveals alterations in the physiology of the inner retina as early as P18 (before any obvious morphological change of inner neurons) and yet consistently with a reduced band amplification by bipolar cells. Thus, changes in the rd10 retina are very similar to what was previously found in rd1 mutants. However, an overall slower decay of retinal structure and function predicts that rd10 mice might become excellent models for rescue approaches.

Animals↗
PubMed1981

Cystic retinal tufts and their relationship to retinal detachment.

Cystic retinal tuft, a lesion of the peripheral retina that has been described histologically, is herein described clinically and illustrated by fundus photographs. It is a congenital developmental vitreoretinal abnormality associated with firm vitreoretinal adhesions and can lead to acute tractional retinal tears at the time of an acute posterior vitreous detachment. It has been reported to be present in 5% of autopsy cases. In a consecutive series of 200 retinal detachment cases, 6.5% seemed to be causally related to cystic retinal tufts. The risk of a cystic retinal tuft leading to retinal detachment was computed to be less than 1% (range, 0.18% to 0.28%). Prophylactic treatment of cystic retinal tufts is therefore not advised.

Adult↗
PubMed1985

Experimental retinal detachment. VIII. Retinochoroidal horseradish peroxidase diffusion across the blood-retinal barrier.

Unilateral rhegmatogenous retinal detachments in 13 cynomolgus monkeys were studied with horseradish peroxidase (HRP). When injected subretinally in six eyes, HRP did not diffuse anteriorly into the sensory retina and penetrated posteriorly through the zonulae occludentes of the retinal pigment epithelium (RPE) in only two eyes. In seven eyes, tracer was detected after intravitreal HRP injection throughout the sensory retina, the basal lamina of retinal blood vessels, and the subretinal space, but did not penetrate through the RPE. In 13 control eyes (with vitrectomy), intravitreal HRP penetrated the sensory retina and the basal lamina surrounding inner retinal blood vessels. These results confirm that the zonulae occludentes of the RPE and retinal blood vessels remain intact in most eyes after rhegmatogenous retinal detachment. Furthermore, the HRP staining patterns suggest a posteriorly directed movement of fluid across the RPE and possible fluid absorption by retinal blood vessels.

Animals↗
PubMed1992

Cellular immune responses to retinal antigens in retinitis pigmentosa.

Patients with retinitis pigmentosa and a group of controls were tested for their cellular immune response toward two retinal proteins, S-antigen and interphotoreceptor retinoid-binding protein (IRBP), as well as their reaction against two synthetic peptides ("M" and "N") derived from the sequence of S-antigen and peptide "R14", derived from IRBP. Positive responses to the retinal antigens were found in larger proportions and with higher levels in the patient group than in the controls. The difference between the two groups was statistically significant in their response to S-antigen, but the patients reacted better than the controls against the other antigens as well. Of particular interest was the finding that several patients responded to both retinal proteins and/or to their peptides. These patients suffered from severe retinal changes and the data are thus interpreted as suggesting that the responses to the retinal antigens are secondary to these changes and to nonphysiological release of retinal antigens.

Adult↗
PubMed1994

Decreased inner retinal activity in branch retinal vein occlusion.

The electroretinogram, electro-oculogram and electroretinogram oscillatory potential all reflect the mass activity of the retina. The electroretinogram usually remains normal after branch retinal vein occlusion, whereas the electro-oculogram and oscillatory potential often show abnormalities. These tests thus have a differential sensitivity to branch retinal vein occlusion. However, whether the inner layer of the retina is affected in branch retinal vein occlusion has not been determined. In this study, conventional electroretinographic and oscillatory potential data were compared in 34 patients with branch retinal vein occlusion, while electroretinographic and electro-oculographic data were compared in 30 patients with branch retinal vein occlusion, in an attempt to determine whether the inner retina was affected in this disorder. None of the conventional electroretinographic variables showed any significant difference between the eyes with branch retinal vein occlusion and the fellow eyes. In the oscillatory potential test, however, the sum of the amplitudes of O1, O2, O3 and O4 showed a significant difference (p < 0.02). In addition, the light peak-dark trough ratio and the light peak showed a significant difference in the electro-oculogram (p < 0.05 and p < 0.05, respectively). Since the oscillatory potential and the electro-oculogram light rise potential reflect the activity of the inner retina, our data suggest that the inner retina was affected by branch retinal vein occlusion and that these variables are more sensitive indicators than the electroretinogram.

Acute Disease↗