Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Retinal Perforations”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1989

Vitrectomy for complicated retinal detachments secondary to branch retinal vein occlusions.

Combined rhegmatogenous and traction retinal detachments associated with branch vein occlusions occurred in five eyes of five patients between Jan. 1, 1986 and Dec. 31, 1987. Four patients underwent surgery with pars plana vitrectomy and intravitreal gas, with or without scleral buckling. One patient refused treatment. All operated on eyes had attached retinas at a mean follow-up of seven months. Because posterior traction plays an important role in these unusual detachments, consideration should be given to pars plana vitrectomy and air-fluid exchange rather than scleral buckling alone.

Adult↗
PubMed1987

Prevalence, pathophysiology, and treatment of rhegmatogenous retinal detachment in treated cytomegalovirus retinitis.

Seventeen patients with the acquired immune deficiency syndrome and cytomegalovirus retinitis were treated with the antiviral drug ganciclovir (9-[1,3-dihydroxy-2-propoxy-methyl]-guanine, DHPG). Eight eyes of five patients developed rhegmatogenous retinal detachment after initiation of treatment. Multiple breaks in areas of peripheral, healed, atrophic retina accounted for the detachments. All seven eyes that underwent surgery had extensive retinal detachments that were reattached with vitrectomy and silicone oil. Retinotomy and retinal tacks were necessary in two cases that were complicated by severe proliferative vitreoretinopathy. In the fellow eye of one patient, laser treatment was used prophylactically to wall off a peripheral patch of healed retinitis. Endoretinal biopsies and culture were taken in five eyes; evidence of persistent cytomegalovirus was seen in two cases despite concurrent and clinically effective antiviral therapy.

AIDS-Related Complex↗
PubMed1985

Fluid dynamics in eyes with rhegmatogenous retinal detachments.

Inward and outward permeabilities to sodium fluorescein at the blood-retinal barrier were measured by kinetic vitreous fluorophotometry in ten eyes with rhegmatogenous retinal detachments. Fellow eyes were used as controls. Inward permeability of eyes with detachments was significantly larger than that of controls (P less than .005), suggesting damage to the blood-retinal barrier in eyes with detachments. Outward permeability of eyes with detachment and retinal holes was slightly less than that of controls, but the difference was not statistically significant. However, outward permeability of eyes with detachments and with retinal tears was significantly larger than that of controls (P less than .05). This increased outward permeability may be attributed to the increased fluid flow posteriorly through the break across the retinal pigment epithelium.

Adolescent↗
PubMedDate not supplied

Studies on vitrectomy cases associated with complicated branch retinal vein occlusion.

PURPOSE: To study the preoperative factors leading to vitrectomy, and to demonstrate the postoperative conditions causing the decreased visual acuity that results from branch retinal vein occlusion (BRVO). METHODS: In 113 patients (114 eyes) with BRVO, the following data were analyzed: age, general complications, distribution of occluding vessels, location of retinal breaks, classification of vitreoretinal pathology, and the number of cases, period from onset of BRVO to vitreous hemorrhage and from vitreous hemorrhage to vitrectomy, number of operations, relationship between posterior vitreous detachment (PVD) and number of operations, preoperative photocoagulations, pre- and postoperative visual acuity, and cases with poor visual outcome. RESULTS: The visual prognosis was much better in cases with vitreous hemorrhage only than in those with proliferative membrane and retinal detachment (P =.0023). Repeated surgeries were needed in the cases where there was only partial PVD (P =.0029). Macular disorders and optic nerve atrophy were the main causes of postoperative visual acuity < 0.1. CONCLUSIONS: Early vitrectomy before development of vitreo retinal proliferation and retinal detachment, especially in cases where there is only partial PVD, seems to be essential for case management and treatment to attain better visual acuity for the patient.

Aged↗
PubMed2002

A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery.

OBJECTIVES: To introduce and evaluate the infusion and aspiration rates and operative times of the 25-gauge transconjunctival sutureless vitrectomy system (TSV) DESIGN: In vitro experimental and comparative interventional study. PARTICIPANTS AND CONTROLS: Twenty eyes of 20 patients underwent a variety of vitreoretinal procedures using the 25-gauge TSV, including idiopathic epiretinal membrane (n = 10), macular hole (n = 4), rhegmatogenous retinal detachment (n = 3), branch retinal vein occlusion (n = 2), diabetic vitreous hemorrhage (n = 1), and 20 cases similar in diagnosis and severity were matched to provide comparison between duration of individual portions of the surgical procedures with the existing 20-gauge vitrectomy system. METHODS: Description of the 25-gauge TSV is provided; infusion and aspiration rates of the 25-gauge and standard 20-gauge vitrectomy system were measured in vitro using balanced saline solution and porcine vitreous for several levels of aspirating power and bottle height, and operating times of individual portions of surgical procedures were measured for the 25-gauge and 20-gauge vitrectomy system. MAIN OUTCOME MEASURES: Infusion, aspiration rates, and operative times of the 20-gauge and 25-gauge vitrectomy system. RESULTS: Infusion and aspiration rates of the 25-gauge TSV system were reduced by an average of 6.9 and 6.6 times, respectively, compared with the 20-gauge system when balanced saline solution was used. The average flow rate of the Storz 25-gauge cutter (at 500 mmHg, 1500 cuts per minute [cpm]) was 40% greater than that of the 20-gauge pneumatic cutter (at 250 mmHg, 750 cpm) but about 2.3 times less than the 20-gauge high-speed cutter (at 250 mmHg, 1500 cpm). Mean total operative time was significantly greater for the 20-gauge high-speed cutter (26 minutes, 7 seconds) than for the 25-gauge vitrectomy system (17 minutes, 17 seconds) (P = 0.011). CONCLUSIONS: Although the infusion and aspiration rates of the 25-gauge instruments are lower than those for the 20-gauge high-speed vitrectomy system, the use of 25-gauge TVS may effectively reduce operative times of select cases that do not require the full capability of conventional vitrectomy.

Diabetes Complications↗
PubMed1984

Retinal detachment following the acute retinal necrosis syndrome.

Twenty-six patients with the acute retinal necrosis involving 32 eyes have been followed at the Bascom Palmer Eye Institute. Sixteen eyes developed retinal detachment and surgical repair was attempted in thirteen. Ten eyes were successfully reattached. Vitreous surgery was necessary in ten eyes and was performed in eight of the ten successful eyes. The clinical characteristics of the retinal detachments as well as the surgical procedures and results are presented.

Acute Disease↗
PubMed1984

Complications of krypton red laser photocoagulation to subretinal neovascular membranes.

The use of krypton red laser photocoagulation (KRLPC) to treat subretinal neovascular membranes (SRNVM) is increasing. The complications of this treatment in a large series of patients have not been reported. Over a 15-month period, 195 patients had KRLPC to SRNVM of the following etiologies: senile macular degeneration (151), presumed ocular histoplasmosis (33), miscellaneous (11). Fourteen patients had the following complications attributable to KRLPC: choroidal hemorrhage (9), retinal pigment epithelial tears (3), choroidal ischemia (1) and choroidal folds (1). The visually significant complication rate was 3.6%. Proper patient selection and treatment technique may decrease the risk of complications.

Choroid↗
PubMed1984

Corneal endothelial overgrowth of angle and iris. Evidence of myoblastic differentiation in three cases.

Corneal endothelialization of the anterior chamber angle was observed in three cases of iris neovascularization and one case of post-contusion deformity. Scanning electron microscopy in two cases revealed a sheet composed of confluent fusiform cells forming a regular mosaic, growing in a tissue culture-like fashion, and extending over the anterior iris surface. Electron microscopy revealed an endothelial lining continuous with the corneal endothelium extending over the fibrovascular membrane which covered the anterior iris surface in the cases of iris neovascularization and partially extended over the trabecular meshwork in an eye with post-contusion deformity. These endothelial cells possess junctional complexes, apical villi, and prominent basement membrane. In addition, myoblastic differentiation with intracytoplasmic microfilaments, measuring 5 to 6 nm in diameter and often marginally located with fusiform densities, were observed. The presence of myoblastic features may play a role in the ability of corneal endothelial cells to migrate and participate in production of peripheral anterior synechia and ectropion of the iris.

Adolescent↗
PubMed1986

Long-term natural history study of senile retinoschisis with implications for management.

This is a long-term natural history study of 123 consecutive, nonselected patients (218 eyes) with senile retinoschisis examined periodically, while deliberately withholding all forms of treatment, for from 1 to 21 years (average, 9.1 years) so that the natural behavior and prognosis of this disease could be learned and reasonable recommendations for management could be formulated. The quadrant of maximal involvement was the inferior temporal and 74% of the lesions had posterior borders which were postequatorial. Senile retinoschisis was found to be primarily asymptomatic and nonprogressive. Current indications for treatment, treatment modalities, and complication rates published in recent literature are analysed. No case of symptomatic progressive retinal detachment occurred, but there were 14 cases of localized, nonprogressive and asymptomatic "schisis-detachment". Current indications for treatment of senile retinoschisis should be seriously reevaluated and reduced to one primary indication for treatment, namely symptomatic progressive retinal detachment.

Adult↗
PubMed1986

Macular alterations secondary to intraocular inflammatory disease.

It is often the sequelae of intraocular inflammation that is most damaging to the patient's vision. Macular alterations are frequently seen and include neovascularization, both subretinal and retinal; pre-retinal membranes, particularly in young patients with recurrent vitreal hemorrhages; macular holes; and cystoid macular edema, by far the most common alteration. The goal in assessing the maculae of these patients is to determine if and what type of therapy might be applicable. In addition to fluorescein angiography, we have found that laser interferometry is a useful tool in predicting the visual outcome of patients with uveitis. Therapeutic modalities center around corticosteroids, while cyclosporine also has been found to be effective in treating cystoid edema. Vitrectomy has been suggested as a therapeutic approach to both the uveitis and cystoid edema, but this approach still needs to be more scientifically evaluated. A well-defined therapeutic approach to uveitis-induced macular changes is lacking, with well-designed clinical trials sorely needed.

Fluorescein Angiography↗
PubMed1987

Occlusion of bridging or avulsed retinal vessels by repeated photocoagulation.

A technique is described for occlusion of bridging vessels associated with retinal breaks, and recurring vitreous hemorrhage. Argon laser photocoagulation, applied around and to the vessel in repeated sessions, produces scarring and progressive thinning of the retina until laser energy absorbed in the deep pigmented layers can reach the vessel and occlude it. Seventeen patients presenting with vitreous hemorrhage from bridging vessels were treated. Vitreous hemorrhage recurred in only two patients, one of whom had not returned for completion of treatment. The authors conclude that repeated argon laser photocoagulation is a safe, simple, and effective method for preventing recurrent vitreous hemorrhage from bridging vessels.

Aged↗
PubMed1994

Vitreomacular observations. I. Vitreomacular adhesion and hole in the premacular hyaloid.

PURPOSE: Variations in vitreomacular adhesions and the significance of a hole in the premacular hyaloid membrane were studied clinically to better understand vitreomacular pathology. METHODS: With an El-Bayadi-Kajiura aspheric preset lens, the authors used a vitreous examination technique on 96 eyes, which were divided into three groups. Findings were recorded photographically. RESULTS: Group 1 (25 eyes, 26%) included eyes with a partial posterior vitreous detachment and a residual vitreomacular attachment, but no hole in the premacular hyaloid. All eyes in this group, except one, showed another complication. Diabetic retinopathy and retinal vein occlusion were the most frequent problems noted. Premacular fibrosis, often present in these eyes, may have been precipitated by a vascular complication in the retina. In groups 2 and 3 (71 eyes, 74%), a hole was seen in the premacular hyaloid. Group 2 (46 eyes, 48%) comprised eyes showing a partial posterior vitreous detachment with a strand of vitreous that extruded through the hole in the posterior hyaloid and adhered to the macula. In group 3 (25 eyes, 26%), the hole in the premacular hyaloid was accompanied by a total posterior vitrous detachment. The most common complication noted in eyes in groups 2 and 3 was premacular fibrosis (34 of 71 eyes, 47.9%). The persistence of a residual vitreous attachment to the macula was accompanied by a significantly greater frequency of visual acuity equal to or worse than 20/200. CONCLUSIONS: Variations in vitreomacular pathology seem to result from differences in the strength of the vitreomacular adhesion and in the process of vitreous liquefaction and shrinkage. In patients with a hole in the premacular hyaloid membrane, the vitreomacular attachment is stronger than the vitreous attachment to other parts of the retina. The latter feature may cause visual acuity deterioration. When there is a hole in the premacular hyaloid membrane, the presence or absence of a vitreomacular adhesion may affect the prognosis for macular function.

Adult↗
PubMed1997

Retinal detachment after branch retinal vein occlusion: influence of the type of break on the outcome of vitreous surgery.

BACKGROUND: Branch retinal vein occlusion (BRVO) is occasionally complicated by two types of retinal breaks (retinal holes without vitreous traction or retinal traction tears) that may lead to a rhegmatogenous retinal detachment (RRD). The authors describe surgical results of vitrectomy for RRD after BRVO and investigate whether there is any difference between clinical features or surgical results from eyes with the two types of retinal breaks. PATIENTS AND METHODS: The authors retrospectively studied 25 patients (25 eyes) who underwent vitrectomy for RRD after BRVO. Twelve of 25 eyes (48%) had a detachment secondary to one or more retinal holes (group I), and 13 of the eyes (52%) had one or more retinal tears (group II). RESULTS: Seventeen of the eyes (68%) achieved total retinal reattachment after the initial surgery; 22 (88%) did so by the time of final examination. Patients with retinal holes achieved more favorable final vision than those with retinal tears (P = 0.0391). A higher rate of preoperative macular detachment (P = 0.0112) and a higher rate of recurrent retinal detachment after initial vitrectomy (P = 0.0302) were the factors associated with the reduced final visual acuity in patients with retinal tears. The increased rate of recurrent retinal detachment in patients with retinal tears was associated with a higher rate of existing preretinal neovascular membranes (P = 0.0112) and a trend toward an increased incidence of intraoperative iatrogenic retinal breaks. CONCLUSION: Among patients who undergo vitrectomy for RRD after BRVO, better surgical results are expected in eyes with retinal holes without vitreous traction than in those with retinal traction tears. This difference is thought to be due to the difference in vitreoretinal anatomy between eyes with the two types of retinal breaks.

Aged↗
PubMed1998

Funduscopic lesions associated with mortality in shaken baby syndrome.

PURPOSE: The shaken baby syndrome (SBS) has been defined as a syndrome of intraocular and intracranial hemorrhage in young children, thought to be caused by violent shaking inflicted by an adult. In many cases SBS is fatal as a result of intracranial injury. Intraocular findings include hemorrhage, which may be accompanied by characteristic retinal folds or retinoschisis lesions. This study was performed to determine whether acute ophthalmologic findings might predict a fatal outcome. METHODS: A consecutive series of 10 patients meeting a strict definition of SBS was reviewed for ophthalmic findings at presentation and outcome. RESULTS: Seven patients survived, and three died. Of the six funduscopic characteristics identified in these patients, two were significantly associated with a fatal outcome: circular perimacular retinal folds found in four patients (p = 0.048) and peripheral retinoschisis lesions seen in three patients (p = 0.012). Lack of visual response at initial examination was also significantly associated with a fatal outcome (p = 0.033). CONCLUSIONS: Ophthalmic examination of children with suspected SBS is important for prognostic as well as diagnostic purposes. Circular perimacular retinal folds, peripheral retinoschisis lesions, and lack of visual response correlated with fatal neurologic trauma and may be useful in predicting severity of central nervous system injury in shaken baby syndrome.

Battered Child Syndrome↗
PubMed1996

Giant retinal tear and retinal detachment with underlying retinitis pigmentosa and hearing loss.

Few retinal detachments have been described in patients with retinitis pigmentosa and allied retinal disorders, with only two cases (both with hearing loss) reported in association with giant retinal tears. To further characterise clinical characteristics of giant retinal tear associated with retinitis pigmentosa, we reviewed the course of four eyes of three patients. Unexpectedly, all three individuals also suffered from congenital sensorineural hearing loss. One suffered from associated myopathy. Despite aggressive surgical management, three of the four eyes became blind. The diagnosis of retinal detachment preceded the diagnosis of photoreceptor dystrophy in two of the three patients. To date, giant retinal tears occurring with underlying retinitis pigmentosa have been described in five young individuals, all of whom had associated congenital sensorineural hearing loss.

Adolescent↗
PubMed2005

Initial clinical experience using a diode red laser (670 nm) in the treatment of retinal disease.

AIM: To investigate the clinical use of a 670-nm diode red laser in the treatment of a number of retinal conditions. METHODS: In all, 17 eyes of 17 patients were treated for conditions such as proliferative diabetic retinopathy, retinal neovascularization in central retinal vein occlusion, rhegmatogenous retinal lesions and retinal breaks, and prophylactic peripheral retinopexy prior to silicone oil removal after three port pars plana vitrectomy. RESULTS: Regression of neovascularization was observed in all the eyes treated for vascular proliferation at the 3-month follow-up visit. Adhesive pigmented scars were observed in the remaining eyes 1 month after treatment. No major complications were recorded. CONCLUSIONS: In this pilot study, the 670-nm diode laser appears to be a promising modality for laser photocoagulation of the retina.

Diabetic Retinopathy↗