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PubMed1983

Phakic retinal detachment associated with atrophic hole of lattice degeneration of the retina.

Forty patients with phakic nontraumatic retinal detachment caused by atrophic retinal hole of lattice degeneration were reviewed. The condition was characterized by insidious, slowly developing shallow detachment, with frequent formation of demarcation lines. Often, the patients did not recognize their visual problems until the detachment had extended to the macular region. Young patients under 40 years of age were more common than older patients. Myopic refractive errors were frequently associated. The results of surgical repair were favorable. The risk of retinal detachment in lattice degeneration with atrophic holes was estimated to be about 1 in 90 patients, and prophylactic treatment for this common anomaly is not readily recommended.

Adolescent↗
PubMed2002

Submacular exudates with serous retinal detachment caused by cat scratch disease.

PURPOSE: To present submacular exudates as a manifestation of cat scratch disease. METHODS: Report of two cases. RESULTS: The first patient, a 34-year-old man, developed submacular exudates with serous retinal detachment ten days after having axillary lymphadenopathy and fever. The second patient, a 30-year-old woman, developed submacular exudates with serous retinal detachment mimicking central serous chorioretinopathy. Fluorescein angiography revealed late staining of the subretinal lesions in both cases. The lesion resolved spontaneously in the first patient, while sulfamethoxazole and trimethoprim was required for the second patient. Both patients had a positive IgG titer for Bartonella henselae. CONCLUSIONS: Submacular exudates with serous retinal detachment can occur in cat scratch disease. Cat scratch disease should be included in the differential diagnosis of submacular exudates with central serous chorioretinopathy.

Adult↗
PubMed1981

Intraocular lenses, axial length, and retinal detachment.

A large series of patients with intraocular lens implants had an overall 0.98% incidence of retinal detachment (eight detachments in 819 eyes). Within this group, patients with axial lengths of more than 25 mm had a statistically significantly higher incidence of retinal detachment (P = .054).

Aged↗
PubMedDate not supplied

Results of surgical treatment of retinal detachments complicated with proliferative vitreoretinopathies with the use of perfluropropane (C3F8) gas.

The aim of the current study is the efficiency assessment of C3F8 gas usage in posterior vitrectomies in patients having retinal detachment of different etiologies with presence of proliferative vitreoretinopathies and retinal tears. 34 patients have undergone posterior vitrectomy with the usage of perfluoropropane C3F8 gas for providing internal tamponade. Total attachment of retina has been attached in all 34 cases and C3F8 gas has been injected in each eye. The most frequent complications that have been revealed after the usage of C3F8 gas and their management are reflected in the article. Thus, we came to a conclusion that vitrectomy in combination with episcleral buckling, transvitreal drainage of subretinal liquid, diode endolaser coagulation of retina and internal tamponade with C3F8 gas is effective and pathogenetikally proved method for treatment of rhegmatogenous retinal detachments complicated with severe vitreoretinopathies. The achievement of perfect anatomical results depends on manifestation degree of proliferative vitreoretinopathy. This study was supported by grant of the Ministry of Health of Armenia.

Adolescent↗
PubMed2001

Indocyanine green facilitates removal of epiretinal and internal limiting membranes in myopic eyes with retinal detachment.

PURPOSE: To describe the use of intravitreal indocyanine green as an aid to identifying epiretinal membranes and internal-limiting membranes during surgery for a retinal detachment resulting from a macular hole. METHODS: A 62-year-old man who had a retinal detachment resulting from a macular hole underwent vitrectomy. During the surgery, intravitreal indocyanine green was injected intravitreally. RESULTS: The internal-limiting membrane was stained green, but the epiretinal membrane was unstained. Because the epiretinal membrane and internal-limiting membrane were clearly identified, they could be completely removed. The clinical observations of the epiretinal membrane and internal-limiting membrane excised were confirmed by electron microscopy. Successful reattachment was obtained without damage to the retina. CONCLUSION: Removal of epiretinal membrane and internal-limiting membrane can be facilitated by using intravitreal indocyanine green during vitrectomy. We recommend further studies to confirm the benefit of this technique.

Basement Membrane↗
PubMed1999

Elevated intraocular pressure and hypotony following silicone oil retinal tamponade for complex retinal detachment: incidence and risk factors.

OBJECTIVE: To evaluate the incidence of and risk factors for persistently elevated intraocular pressure (IOP) and hypotony in patients who have undergone pars plana vitrectomy with silicone oil injection for the management of complex retinal detachment. SUBJECTS AND METHODS: The medical records of 532 patients who underwent silicone oil injection for the management of complex retinal detachments between January 1, 1991, and December 31, 1996, at the Bascom Palmer Eye Institute, Miami, Fla, were reviewed. Elevated IOP was defined as elevated IOP requiring an operation at any time postoperatively or a persistently elevated IOP of greater than 25 mm Hg at or after the 6-month visit. Hypotony was defined as a persistent IOP of 5 mm Hg or less at or after the 6-month visit. Patients with transient perioperative IOP fluctuations were not counted. RESULTS: Survival analysis for patients without cytomegalovirus retinitis (n = 383) revealed that 12.9% had an elevated IOP and 14.1% had hypotony by 6 months, 21% had an elevated IOP and 20.3% had hypotony by 1 year, and 29.5% had an elevated IOP and 27.3% had hypotony by 2 years. Among patients with cytomegalovirus retinitis (n = 149), none had a persistently elevated IOP, 10% had hypotony by 6 months, and 5.9% had persistently elevated IOP and 10% developed chronic hypotony by 1 year. A history of glaucoma before silicone oil retinal tamponade (P = .03), diabetes mellitus (P = .02), and a high IOP on the first postoperative day (P = .006) were risk factors for elevated postoperative IOP in patients without cytomegalovirus retinitis. Risk factors for postoperative hypotony in patients without cytomegalovirus retinitis included preoperative hypotony (P<.001) and aphakia (P = .03). CONCLUSIONS: An elevated or low IOP often develops postoperatively in patients without cytomegalovirus retinitis who undergo silicone oil injection for the management of complex retinal detachment. Risk factors for an elevated postoperative IOP include a history of glaucoma, diabetes mellitus, and a high IOP on the first postoperative day. Risk factors for hypotony include preoperative hypotony and aphakia.

Adolescent↗
PubMed1995

Surgical risk factors for severe postoperative proliferative vitreoretinopathy (PVR) in retinal detachment with grade B PVR.

BACKGROUND: Previous studies have shown that grade B proliferate vitreoretinopathy (PVR) is a considerable risk factor for the development of severe postoperative PVR. We conducted a prospective study to elucidate which surgical procedures used in retinal detachment management may stimulate the PVR process in such eyes. MATERIALS AND METHODS: The study included 156 eyes of 152 consecutive patients with rhegmatogenous retinal detachment complicated by grade B PVR referred before any failed surgery and operated on between 1983 and 1993. The parameters evaluated by multivariate statistical analysis included the cumulative circumferential extent of the retinal tears, the extent of the scleral buckle, gas injection, vitrectomy, the method used for retinopexy, and the time of surgical management during the period of the study. RESULTS: The incidence of severe postoperative PVR was 25.8% in eyes managed with cryotreatment versus 2.2% in eyes managed with argon laser photocoagulation (P = 0.001). The rate of severe postoperative PVR was not influenced by the other surgical variables. CONCLUSION: We conclude that cryotherapy may be a risk factor for the development of severe postoperative PVR in retinal detachments associated with grade B PVR.

Adolescent↗
PubMedDate not supplied

Exudative retinal detachment in retrolental fibroplasia.

Four cases of exudative retinal detachment associated with retrolental fibroplasia are presented. The exudation appears to be secondary to leakage from neovascularization as well as vitreous traction on normal retinal vessels. The range in age of onset was between 13 and 17 years, with three of the four cases occurring in patients 23 years of age or younger. Treatment is directed at eliminating the abnormal vasculature which, in our experience, has been accomplished best by an encircling scleral-buckling procedure. One patient, however, required vitrectomy because of the severe vitreous membranes and traction which were present.

Adolescent↗
PubMed1995

[Prediction of postoperative visual acuity in retinal detachment with macular involvement].

We used laser interferometry (LI) and a potential acuity meter (PAM) to predict visual acuity after surgery for patients with rhegmatogenous retinal detachment with macular involvement. Thirty one eyes of 31 patients with retinal detachment were treated with scleral buckling procedures. Postoperative visual acuity was correlated with preoperative measurements of the LI and PAM, preoperative visual acuity by Landort's ring, and the estimated duration of macular detachment. The correlation between the duration of macular detachment and the postoperative visual acuity was not good (r = 0.55, p < 0.01). Although the preoperative visual acuity showed a relatively good correlation with postoperative visual acuity (r = 0.62, p < 0.01), the results of the LI and PAM provided a better correlation (LI; r = 0.73, PAM; r = 0.71). Our results suggest that the LI and PAM are useful to predict the visual acuity after retinal reattachment in patients with preoperative macular detachment.

Humans↗
PubMed1987

Treatment of retinal detachment after penetrating injury: heavy cryotreatment of the fibrous ingrowth as an adjunct to vitreoretinal microsurgery.

Heavy cryotreatment of the fibrous ingrowth remnants at the inner surface of the scleral wound was performed, as an adjunct to vitreo retinal microsurgery, in a series of 32 eyes affected with retinal detachment after penetrating scleral wound. Surgical success, with a follow-up of 6-42 months after gas disappearance, was achieved in 25 eyes (71%). However, permanent retinal reattachment was achieved with a single operation in only 64% of the eyes successfully operated on (16/25). Thirty-six per cent (9/25 eyes) of the retinal detachments that were eventually successfully operated on showed clinical evidence of gradual contraction of the vitreous base in the postoperative course, and required 2 or more operations. Experimental studies on standardized models are required to determine whether destruction of the fibrous ingrowth remnants with heavy cryo is of any value in the management of retinal detachment after penetrating scleral wound.

Adolescent↗
PubMed2000

Reduced rate of retinal detachment following silicone oil removal.

PURPOSE: To investigate the rate of retinal redetachment and other complications after silicone oil removal over a 4-year period. METHODS: Retrospective analysis of charts of patients who underwent vitrectomy and silicone oil injection between January 1994 and June 1998 followed by oil removal. RESULTS: Sixty-eight eyes of 67 patients were included. The average follow-up time after oil removal was 15 months. Significant retinal redetachment developed in 6 eyes (8.8%). The redetachment rate was slightly higher in the 32 eyes with proliferative vitreoretinopathy (9.3%) than in the 36 eyes with other pathologies (8.3%). The average time to redetachment was 4.2 months. These eyes were reoperated and reattached, and at the end of the follow-up, three retained silicone oil. Two other eyes without redetachment were hypotonus after oil removal. Cataract extraction and intraocular lens implantation were performed at the time of oil removal in 18 eyes; 2 (11%) developed redetachment. Visual acuity improved significantly after oil removal (P < 0.001). CONCLUSION: The rate of retinal redetachment after removal of silicone oil in recent years is low compared with previous series. The authors attribute this reduction to the improved surgical management of complicated retinal detachments; particularly, the introduction of perfluorocarbon liquids and wide-field viewing systems and the widespread use of endolaser.

Adolescent↗
PubMed1984

Retinal telangiectasia, retinoschisis and retinal detachment.

A 32-year-old woman had progressive bilateral peripheral and central retinal telangiectasis with secondary exudative, nonrhegmatogenous, retinal detachment, and secondary retinoschisis. This is unique constellation of clinical findings, retinal telangiectasis itself being an uncommon disease, and usually occurring in young males, unilaterally. Theories for the etiology of this disease process are presented. The disease was successfully treated bilaterally with retinal cryopexy extensively applied to the retinal telangiectasis, both peripheral and paracentral, with both scleral buckling and drainage of copious amounts of thick subretinal exudation.

Adult↗
PubMed2000

Retinal detachment in myopic eyes after photorefractive keratectomy.

PURPOSE: To analyze the incidence and characteristics of retinal detachment (RD) in myopic patients who had photorefractive keratectomy (PRK). SETTING: Universidad Miguel Hernández, Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: The incidence of RD in 5936 consecutive eyes that had PRK to correct myopia was studied. Mean follow-up was 38.5 months +/- 17.4 (SD). RESULTS: Retinal detachment occurred in 5 eyes (0.08%); 2 in women and 3 in men. The mean interval between PRK and RD was 21. 00 +/- 15.89 months (range 9 to 48 months). The mean best corrected visual acuity (BCVA) after PRK and before RD development was 20/81 (range 20/200 to 20/25). After RD repair, the mean BCVA was 20/460 (range 20/2000 to 20/29). In 4 of the 5 eyes, BCVA after RD was within 1 line of the preoperative value; in 1 eye, it decreased from 20/40 to 20/2000. The mean spherical equivalent (SE) before RD treatment was -1.35 +/- 1.08 diopters (D) (range 0 to -3.00 D) and after RD treatment, -2.95 +/- 0.83 D (range -2.00 to -4.00 D). Differences between SE before and after RD treatment were statistically significant (P =.01, paired Student t test). CONCLUSIONS: The incidence of RD after PRK to correct myopia was 0.08%. In 4 of 5 eyes, there was little or no visual loss; but in the group as a whole, there was a significant increase in myopic SE.

Adolescent↗
PubMed1977

[Retinal adhesion after retinal detachment surgery (author's transl)].

The effect of cryotherapy was studied in experimentally detached retinas under conditions similar to those in retinal detachment surgery. When cryotherapy was applied to the pigment epithelium and to the retina and the retina was reattached, a strong adhesion developed, characterized by the occurrence of true cell junctions between pigment epithelium and retinal cells. When only the pigment epithelium was treated, the adhesion after reattachment appeared weak due to the absence of microvillous interdigitations normally present between pigment epithelium and retina.

Animals↗
PubMed1994

[Failures in primary surgery of retinal detachment with cerclage].

In a retrospective study we analysed 30 unsuccessful circumferential buckling operations being performed in the years 1990 and 1991 as primary interventions on simple retinal detachments without PVR, directing our attention to the cause of the failure. 13 eyes (43%) showed simple retinal detachments with holes located anterior (20%) or posterior (23%) to the circumferential buckle. In 12 of these eyes (40%) the retina could be reattached permanently by a re-operation with a second scleral buckling procedure. Another 15 eyes (50%) showed retinal holes not being sealed by the circumferential buckle. In addition, however, the retina in these eyes was kept from reattachment by a PVR grade C or D at the time of the re-operation. In 9 eyes (30%) of this group reattachment could be achieved after vitrectomy with endotamponade, in 6 eyes (20%) the retina could not be reattached. Only 2 eyes (7% of all patients) showed a PVR detachment without detectable retinal breaks. Thus, failures of primary circumferential buckling operations in numerous cases are caused by either inadequate surgical procedures or by a poor surgical technique.

Adolescent↗
PubMed1989

Evaluation of the functional results after different techniques for treatment of retinal detachment due to macular holes.

A total of 50 eyes with retinal detachment due to macular holes were treated in the period from July 1986 to December 1987. In all, 10 eyes underwent pneumatic retinopexy using plain room air. A total of 30 eyes were treated by pars plana vitrectomy, followed by fluid/air exchange, with no treatment of the macular break; in 9 of these the detachment recurred, reflattening of the retina by air tamponade followed by laser photo-coagulation. The other 10 eyes underwent pars plana vitrectomy followed by silicone oil tamponading because of proliferative vitreoretinopathy (PVR). This paper compares the functional results for each group. The parameters used included visual acuity, color vision and visual fields.

Adult↗
PubMed1991

Treatment of retinal detachments in patients with the acquired immune deficiency syndrome.

Thirty-nine eyes from 31 patients with retinal detachment due to cytomegalovirus (CMV) retinitis were treated by either laser photocoagulation (22 eyes), scleral buckle (9 eyes), pars plana vitrectomy (5 eyes), or no therapy (3 eyes). The success rates for photocoagulation (77.2%), scleral buckle (77.7%), and vitrectomy (with gas or oil, 80%) were similar. The median survival time was 95 days (range, of 7 to 280 days). The extent of detachment, the presence of active disease in either the periphery or the posterior pole, and overall health served to determine what type of therapy was best suited for each patient. Although silicone oil appears to be best for patients with a total retinal detachment and active disease, this small series suggests that conservative modes of therapy such as laser photocoagulation and scleral buckles can be used successfully to treat these patients if there is an absence of active retinitis.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Electroretinographic studies in rhegmatogenous retinal detachment before and after reattachment surgery.

Changes in the scotopic electroretinogram (ERG) and oscillatory potentials (Ops) were examined in patients who had rhegmatogenous retinal detachment within 3 days before and also at regular intervals after a successful reattachment operation. Electroretinograms were recorded in 38 patients (age 10 to 62 years) for the recent 5 year period. The amplitudes of the scotopic a-wave and b-wave in the detached eye were significantly decreased compared to the fellow normal eye preoperatively. Statistically significant differences were found between the preoperative and the postoperative recordings of the diseased eye. However, postoperative interocular differences in the amplitude of the a-wave between the reattached and normal fellow eye were not statistically significant. The amplitudes of the a-wave and b-wave were inversely related to the extent of the retinal detachment area, the duration of the detachment, and the extent of the buckles that were applied. Significant interocular differences in the b/a wave amplitude ratio and the Ops amplitude were observed. These results strongly suggest that the retinal function, even after successful reattachment surgery, might be compromised mainly by an inner retinal malfunction rather than from a photoreceptor dysfunction.

Adolescent↗