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PubMed2006

Natural course of macular retinoschisis in highly myopic eyes without macular hole or retinal detachment.

PURPOSE: To investigate the natural course of macular retinoschisis in highly myopic patients. DESIGN: A prospective, observational case series. METHODS: Seven consecutive patients (eight eyes) with macular retinoschisis without macular hole or retinal detachment determined by optical coherence tomography (OCT) were followed at least two years without surgical intervention. The changes in the OCT findings and best-corrected visual acuity (BCVA) were analyzed. RESULTS: During follow-up, two eyes that had vitreoretinal adhesions developed a macular hole, one with and one without retinal detachment (RD), and two eyes without detectable vitreoretinal adhesion developed RD without a macular hole. BCVA in these four eyes was significantly reduced. The remaining four eyes did not develop complications, although the thickness of the macula increased significantly. CONCLUSIONS: These findings suggest that macular retinoschisis might be a progressive condition, and that complications appeared to be related to the presence of vitreoretinal tractions.

Aged↗
PubMedDate not supplied

[Treatment of retinal detachment with macular hole].

The methods and results of surgery in 6 cases of retinal detachment with macular hole are presented. In all 6 cases pars plana vitrectomy was performed, in 4 with subsequent SF6 and in 2 with silicone oil tamponade. Retinal attachment was achieved in 4 eyes. Visual acuity 1/50-2/50 was found after surgery in 5 cases. The follow-up ranged from 6 to 9 months.

Aged↗
PubMed1989

Visual acuity after the repair of pseudophakic retinal detachments involving the macula.

Postoperative visual acuities were retrospectively evaluated in a series of 100 pseudophakic eyes in which rhegmatogenous retinal detachments involved the macula and in which reattachment surgery was anatomically successful. Preoperative visual acuity and duration of macular detachment were related to visual outcome. Eyes in which extracapsular surgery had been followed by posterior chamber lens implantation had significantly better postoperative visual acuities than cases in which older iris-fixation intraocular lenses (IOLS) were placed after intracapsular procedures. Retinal detachments associated with posterior chamber IOLs have a relatively favorable anatomical and visual prognosis.

Adult↗
PubMedDate not supplied

Repair of retinal detachment associated with congenital excavated defects of the optic disc.

Excavated defects of the optic disc have been associated with retinal detachment in the macula and beyond. Included among these defects are congenital pits of the optic disc, optic nerve colobomas, and the morning glory syndrome. We report eight consecutive patients with congenital, excavated defects of the optic disc and associated retinal detachment managed with pars plana vitrectomy, laser photocoagulation, and intravitreal gas injection.

Adolescent↗
PubMedDate not supplied

Primary vitrectomy in complicated rhegmatogenous retinal detachment--a survey of 205 eyes.

INTRODUCTION: In a few types of rhegmatogenous retinal detachment (RRD), scleral buckling (SB) has a lower success, and, here, pars plana vitrectomy (PPV) is a good alternative option. This survey reviews the indications and the surgical outcome of primary PPV with internal tamponade. PATIENTS AND METHODS: We reviewed 205 eyes operated by primary PPV for RRD at the Department of Ophthalmology of the Philipps University Marburg between the years 1990 and 1997. The indications of PPV were: holes greater than 90 degrees; holes posterior to the equator; proliferative vitreoretinopathy grade C; pseudophakic status. RESULTS: A complete reattachment of the retina after absorption of the gas or after silicone oil removal was achieved by 1 operation in 146 eyes (71.2%) and in 195 eyes (95.2%) by a second intervention. CONCLUSION: Although SB is the standard procedure for the treatment of RRD, complicated cases can be treated successfully with primary PPV.

Adolescent↗
PubMed1991

Blood-aqueous barrier breakdown associated with rhegmatogenous retinal detachment.

We compared the integrity of the blood-aqueous barrier (BAB) between normal eyes and those with first-time rhegmatogenous retinal detachment (RRD) using the technique of anterior segment fluorophotometry. We found significantly greater anterior segment fluorescence in eyes with retinal detachment (p = less than .001) thereby demonstrating quantitatively for the first time that there is significant damage to the BAB associated with RRD. We have also shown that the BAB permeability returns to normal within two months of successful reattachment of the retina. The origin of this transient increase in BAB permeability is unknown but its severity and duration may well be of significance in the pathogenesis of complications associated with RRD such as uveitis, rubeosis and proliferative vitreoretinopathy.

Adult↗
PubMed1984

[Retinal detachments caused by giant tear].

52 eyes in 50 patients have been treated for a retinal detachment with a giant tear extending over at least 70 degrees. 27 eyes had an inverted posterior retinal flap covering the posterior pole. Conventional extraocular surgery was performed on 20 eyes. There was no success in 6 folded cases and a 42,85% success rate in 14 non-folded retinas. Endocular surgery by vitrectomy plus internal tamponade using air or silicone oil was done on 32 eyes with an 87,50% success rate at the end of surgery. Post-operative retinal retraction reduced the success rates to 45,45% for non-folded cases and 52,38% with folded retinas. There is no question in our mind about the value of endocular surgery for folded retinas. We think that endocular surgery is also the best choice for non folded retinas because of the excellent initial results. Secondary retraction phenomena are caused by endocular cellular proliferation and membrane formation and contraction. We presently try to minimize these by avoiding excess cryopexy, performing a vitrectomy as complete as possible and treating the reattached retina as soon as possible by argon laser photocoagulation. An efficient and safe antiproliferative drug is definitely needed.

Adolescent↗
PubMedDate not supplied

Macular hole diameter after vitrectomy for macular hole and retinal detachment.

PURPOSE: We measured postoperative macular hole (MH) size after vitrectomy for MH and retinal detachment (MHRD) in high myopia and investigated potentially associated factors. METHODS: Eleven patients (11 eyes) with high myopia (axial length, 25.6-30.8 mm; mean patient age +/- SD, 64.0 +/- 4.31 years) who had retinal attachment without MH closure after vitrectomy for MHRD were included in the study. Postoperative MHs were measured using optical coherence tomography. A horizontal 5.65-mm-long scan of the retina was obtained, and the MH size was measured as the length between the edges of the MH using the retinal thickness mode of the optical coherence tomography system. RESULTS: The mean postoperative MH size +/- SD was 1,220 +/- 450 microm. Only axial length was significantly associated with postoperative MH size (P < 0.05). There was a tendency for smaller MH sizes to be associated with better postoperative best-corrected visual acuity (P = 0.06). CONCLUSIONS: Persistent MHs after vitrectomy were enlarged according to axial length elongation in highly myopic eyes. Even if MH closure was not successful, the maximum effort to shorten postoperative MH size led to a better postoperative outcome.

Aged↗
PubMed1990

Aqueous protein concentration in rhegmatogenous retinal detachment.

Changes in aqueous protein concentration (APC) in rhegmatogenous retinal detachment (RD) were investigated. A 6-month prospective study was carried out in 40 unilateral RD patients who underwent scleral buckling procedures with cryotherapy, and a retrospective examination was performed in another 40 patients who had undergone successful retinal reattachment at least 2 years previously. Before the surgery, the APC in the RD eyes was more than twice as high as that in the contralateral control eyes. The surgery caused a further increase in APC, and the peak was observed at the 2nd postoperative week. The APC values decreased to a stable level 3 months postoperatively, but remained significantly higher than those of the control eyes. A statistical analysis revealed the following clinical factors to have a significant correlation with the increase in APC: 1) before surgery, age, extent of RD, balloon-shaped RD, presence of retinal tear rather than hole, and decreased preoperative intraocular pressure; 2) in the early postoperative period, age, size of retinal breaks, and number of cryoapplications; and 3) in the late postoperative period, age, extent of RD, and performance of scleral encircling procedure. These findings would suggest that different mechanisms are responsible for the increase in APC in each period, including 1) a reduction in the aqueous bulk flow; 2) disruption of the blood-retinal barrier caused by cryotherapy, or dispersion of subretinal protein into the vitreous cavity during the surgery; and 3) a decrease in aqueous flow rate following buckling procedures, and alteration of the blood-aqueous barrier function induced by changes in anterior uveal blood circulation.

Adult↗
PubMed1977

[Ultrasonics in the diagnosis of retinal detachment].

With the help of ultrasonography, 360 cases of opaque anterior segment of the eye have been examined. In these, 99 cases (27%) of retinal detachment have been found. Also in 200 cases of opaque media of the posterior segment, 61 cases (30%) of retinal detachment were present.

Choroid Neoplasms↗
PubMed1988

Macular hole following rhegmatogenous retinal detachment repair.

In each of three phakic eyes, a full-thickness macular hole developed after scleral buckling surgery for repair of a rhegmatogenous retinal detachment. Presumed predisposing factors included retinal ischemia in the central fovea due to separation of the retina from the choroidal vascular supply and vitreomacular traction.

Aged↗
PubMed1986

[Retinal detachment caused by late-stage retinopathy of prematurity].

Retinal detachment occurring in late stages of retinopathy of prematurity may appear spontaneous when a short oxygen therapy in low birthweight infant has been failed to recognized. As it is initially a tractional detachment the understanding of underlying pathogenic mechanisms is still important to choose adequate treatment which will determine the success of the surgery. Six patients with R.D. were recognised as having late complication of R.P. on the aspect of pathological posterior retinal vasculature and typical history of prematurity and oxygen therapy. All cases were treated successfully by different procedures varying with the severity of the disease. Use of vitrectomy can be advised in some cases but, is still a dangerous procedure, especially in this peculiar condition.

Adolescent↗
PubMed2006

Longterm incidence of rhegmatogenous retinal detachment and survival in a defined population undergoing standardized phacoemulsification surgery.

PURPOSE: To determine the longterm risk of pseudophakic retinal detachment (PRD) in a defined population undergoing standardized phacoemulsification surgery at a single centre. DESIGN: We carried out a register-based, retrospective, consecutive, uncontrolled study. All 6352 eyes that underwent cataract surgery at our institution during the years 1996-1998 were included in the study. The main outcome measure was the incidence of surgery for PRD. METHODS: Cataract-operated eyes were identified by a search in the local hospital registry. Eyes that subsequently underwent surgery for PRD were identified by a search in the Danish Patients Registry (LPR). Follow-up ended by 31 December 2003. Eyes in patients who died before that date were censored. RESULTS: The 8-year cumulated incidence of PRD after phacoemulsification was 0.93 per eye (95% CI 0.65-1.33). This is 8.77 (95% CI 7.12-10.72) times higher than expected in eyes that do not undergo cataract surgery. The incidence rate for retinal detachment was significantly higher in pseudophakic eyes than in the background population for at least 6 years after surgery. Patient mortality was slightly increased for men, but no different for women from that of the background population. CONCLUSION: For eyes undergoing phacoemulsification surgery, the cumulated incidence of PRD continues to increase for at least 8 years after surgery. Comparison of the cumulated incidence of PRD between different studies requires equal lengths of follow-up.

Adolescent↗
PubMed1982

[Retinal detachment recurrences. 2. Mechanisms and treatment (author's transl)].

Retinal detachment recurrences are almost always caused by vitreous tractions or vitreo-retinal retractions. Classical methods of prevention: as atraumatic surgery as possible, no superfluous subretinal fluid drainage, prevention of intraocular bleeding during drainage were employed in the series reported but with a 10.5 per cent recurrence rate. Prevention is based on two methods: encircling laser photocoagulation in the postoperative period when possible and if it is not dangerous for the vitreous, and preventive vitrectomy which has the following indications: bullous detachment, important pre or peroperative intraocular bleeding, or presence of clear signs of impending vitreo-retinal retraction. Using the classical therapeutic methods of indentation, the treatment a 50 per cent success rate for of recurrence was obtained. Treatment can be improved by vitrectomy in every case of recurrence, with combined internal retinal contention, preferably by silicone injection, recurrences due to massive vitreo-retinal retraction.

Female↗
PubMed2000

Macular buckling for retinal detachment due to macular hole in highly myopic eyes with posterior staphyloma.

PURPOSE: To evaluate the efficacy of macular buckling surgery using a special exoplant. METHODS: The authors reviewed 33 cases of patients with retinal detachment due to macular hole with posterior staphyloma who underwent a macular bucking procedure and 11 cases of patients with the same condition due to macular hole without posterior staphyloma or due to a hole along the edge of the posterior staphyloma who underwent gas injection or vitrectomy. The reattachment rate, visual acuity (VA), and area size (V-4, I-4 isopter) by Goldmann perimetry were calculated. RESULTS: Reattachment rate for the macular buckling procedure was 94% (initial) and 100% (final), and that for the gas injection or vitrectomy was 100% (both initial and final). Twenty of the 33 eyes (60.6%) had VA of 20/400 or better, and none of these 33 eyes had a VA at the level of finger counting or poorer following macular buckling. Nine of the 11 eyes (81.8%) had VA of 20/400 or better, and none of these 11 eyes had a VA at the level of finger counting or poorer following the gas injection or vitrectomy. The area size of V-4 isopter in the macular buckling group was significantly larger than that in the gas injection or vitrectomy group (P = 0.017). CONCLUSION: The macular buckling procedure is effective when considered both from an anatomic and a functional perspective for retinal detachment due to macular hole with posterior staphyloma.

Aged↗