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PubMed1986

Copper and zinc metabolism in high myopic patients with retinal detachment evaluation of the Cu/Zn ratio.

In a previous work abnormalities in the copper and zinc metabolism in high myopic patients were found. Primary Retinal Detachment is a common complication of High Myopia. In order to establish further their relationship, a study of the metabolism of these metals was performed in myopic patients with Retinal Detachment. A significant high copper and zinc concentration in the urine of these patients was found. An inverse ratio of copper and zinc between their concentration in the subretinal fluid and their concentration in serum was present as well. The significance of these findings and their connection to the Retinal Pigment Epithelium is discussed.

Adult↗
PubMed1993

[Marfan's syndrome with retinal detachment].

14 patients (16 eyes) of Marfan's syndrome are reviewed with regard to retinal detachment. The patients aged a mean 25.1 years; 9 cases were of high myopia, and lens dislocation was found in all. Multiple atrophic retinal holes were detected in 11 eyes (68.8%), and the retina was totally detached in 12 eyes (75.0%). Scleral encircling with external compression performed in 15 eyes achieved retinal reattachment in 14 eyes. The predisposing factors for retinal detachment, the selection of the mode of surgery, the management of the pupil, and the prognosis are discussed.

Adolescent↗
PubMed1998

Retinal detachment following intracapsular cataract extraction. A 10-year follow-up study.

PURPOSE: To examine the incidence of and risk factors for retinal detachment during a 10-year follow-up on intracapsular cataract extraction (ICCE). METHODS: Retrospective analysis of medical records of 1041 eyes operated on with ICCE in the years 1984-86. A complete follow-up was achieved, and actuarial methods were used in the risk assessment. The risk time averaged 82 months. RESULTS: Twenty-two (2.1%) eyes developed retinal detachment; half of the cases occurred during the first postoperative year, but new cases emerged throughout the period. The cumulative incidence of RD amounted to 2.8%; 95% confidence interval: 1.5-4.2%. Multivariate Cox regression analysis identified younger age at surgery (relative risk for each 10-year increase in age=0.6; 95% confidence interval: 0.39-0.95) and male gender (relative risk=2.5; 95% confidence interval 1.04-6.04) as significant risk factors for RD. Eleven eyes, 50% of eyes with RD and 1% of the total number of eyes, lost useful vision in spite of retinal surgery. CONCLUSION: Even though the risk for both RD and an unfavourable result following retinal surgery may be smaller using contemporary surgical techniques, the present study indicates a substantial morbidity following cataract surgery, when a sufficiently long observation period is considered.

Age Distribution↗
PubMed1987

Rhegmatogenous retinal detachment after YAG laser posterior capsulotomy.

Twenty-five eyes in 24 patients with rhegmatogenous retinal detachment (RD) after YAG laser posterior capsulotomy were treated during 1984 and 1985. The average time from extracapsular cataract surgery to YAG capsulotomy was 15 months. The average interval from capsulotomy to RD was 6 months (median time, 3 1/2 months). In 8 of the 25 eyes, a risk factor for RD (i.e., high myopia, lattice degeneration, or a history of RD in the fellow eye) was present. All but one of the detachments was successfully repaired.

Adult↗
PubMedDate not supplied

Evaluation of S-cone sensitivity in reattached macula following macula-off retinal detachment surgery.

PURPOSE: To investigate the recovery of short-wavelength sensitivity in patients who had undergone successful reattachment of a rhegmatogenous retinal detachment with macular involvement. METHODS: Postoperative assessment of the visual acuity and the visual fields by standard achromatic automated perimetry (SAP), and short-wavelength automated perimetry (SWAP, Humphrey visual field analyzer; macula test pattern) was performed on 12 patients after the macula was reattached. The follow-up period was up to 12 months. RESULTS: The visual acuity and SAP sensitivity recovered rapidly after reattachment, with further moderate improvements up to 6 months after reattachment. The improvements stabilized by 9 to 12 months. The SWAP sensitivities improved more slowly than the visual acuity or SAP sensitivities, but they continued to improve even when visual acuity or SAP sensitivities had stabilized. CONCLUSION: We conclude that measurement of the sensitivities of the short-wavelength-sensitive cones (S-cones) with SWAP may be a sensitive method to evaluate the visual recovery of the reattached macula following macula-off retinal detachment.

Adult↗
PubMedDate not supplied

Experimental retinal detachment in the cone-dominant ground squirrel retina: morphology and basic immunocytochemistry.

The cellular responses of the cone-dominant ground squirrel retina to retinal detachment were examined and compared to those in rod-dominant species. Retinal detachments were made in California ground squirrels. The retinas were prepared for light, electron, and confocal microscopy. Tissue sections were labeled with antibodies to cone opsins, rod opsin, glial fibrillary acidic protein (GFAP), vimentin, synaptophysin, cytochrome oxidase, and calbindin D 28K. Wax sections were probed with the MIB-1 antibody to detect proliferating cells. By 10 h postdetachment many photoreceptor cells in the ground squirrel already show structural signs of apoptosis. At 1 day many photoreceptors have collapsed inner segments (IS), yet others still have short stacks of outer segment discs. At 3 days there is a marked increase in the number of dying photoreceptors. Rod and medium-/long-wavelength opsins are redistributed in the cell membrane to their synaptic terminals. At 7 days photoreceptor cell death has slowed. Some regions of the outer nuclear layer (ONL) have few photoreceptor somata. IS remnants are rare on surviving photoreceptors. At 28 days these trends are even more dramatic. Retinal pigmented epithelium (RPE) cells do not expand into the subretinal space. The outer limiting membrane (OLM) appears flat and uninterrupted. Müller cells remain remarkably unreactive; they show essentially no proliferation, only negligible hypertrophy, and there is no increase in their expression of GFAP or vimentin. Horizontal cells show no dendritic sprouting in response to detachment. The speed and extent of photoreceptor degeneration in response to detachment is greater in ground squirrel than in cat retina-only a small number of rods and cones survive at 28 days of detachment. Moreover, the almost total lack of Müller cell and RPE reactivity in the ground squirrel retina is a significant difference from results in other species.

Animals↗
PubMed2002

Postoperative laser coagulation as retinopexy in patients with rhegmatogenous retinal detachment treated with scleral buckling surgery: a prospective clinical study.

PURPOSE: To evaluate postoperative laser photocoagulation as retinopexy mode in patients with rhegmatogenous retinal detachment treated with scleral buckling surgery. METHODS: The authors conducted a prospective feasibility study of consecutive patients with rhegmatogenous retinal detachment treated with scleral buckling surgery and postoperative laser during an 18-month period with a minimal follow-up of 6 months. Outcome measures were total retinal reattachment and the occurrence of proliferative vitreoretinopathy (PVR). RESULTS: A total of 123 patients (124 eyes) were included in this study. Seventy-six percent were phakic and 24% were pseudophakic. Fifty percent presented with one horseshoe tear, 15% with multiple tears, 30% with round breaks, and 5% with no identifiable break. Ten percent presented with a vitreous hemorrhage and 25% with three or four quadrants of detached retina. Six patients had PVR C1. Twelve patients required a postoperative gas injection, five patients received an additional buckle, and five patients underwent a vitrectomy, in four because of PVR. In all patients the retina was fully reattached at the end of follow-up. Planned postoperative laser coagulation took place 1 day to 10 weeks (median 3(1/2) weeks) after buckling surgery. Buckling material was removed in three patients without redetachment. CONCLUSION: Postoperative laser coagulation is a feasible alternative retinopexy mode in scleral buckling surgery, with encouraging anatomical results and a low incidence of PVR.

Cryosurgery↗
PubMed1989

[C3F8 in the treatment of retinal detachment associated with vitreoretinal proliferation].

The perfluoropropane gas was used as an adjunct to vitreoretinal microsurgery in 60 eyes of 60 patients with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy. 0.3 ml to 1.8 ml (average 0.9 ml) of pure perfluoropropane gas was used. The surgical procedure included vitrectomy and scleral buckling in all patients. The follow-up after complete gas absorption ranged from 6 months to 3 years in the successful eyes. Total retinal reattachment was achieved in 41 eyes (68.3%). The anatomical success rate was 88% (22/25 eyes) in grade C1-C2 PVR cases, 68.7% (11/15 eyes) in grade C3-D1 PVR cases, and 42% (8/19 eyes) in grade D2-D3 PVR cases. Visual acuity of 0.1 or better was achieved in 80% of eyes with grade C PVR and 61% of eyes with grade D PVR. Visual acuity of 0.4 or better was achieved in 26.9% of eyes with grade C PVR. Macular changes were revealed by fluorescein angiography in 53% of successful eyes. We recommend the use of C3F8 rather than SF6 in the management of rhegmatogenous retinal detachment complicated by PVR. In our experience the anatomical success rate achieved with C3F8 is approximately the same as that achieved with SF6. However permanent retinal reattachment was achieved with a single operation in 87.8% of successful eyes of the present series of patients managed with C3F8 as compared to only 12% of successful eyes of a previous series of patients managed with SF6. The anatomical results achieved with a single operation in the C3F8 series are probably related to the greater longevity of C3F8 as compared to that of SF6.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Diagnostic methods in retinal detachment].

Important diagnosis methods are anamnesis, visual acuity determination, visual field determination, anterior segment biomicroscopy, tonometry, gonioscopy. Great attention must be paid to the ophthalmoscopy with scleral indentation. The paper compare the advantages and disadvantages of direct ophthalmoscopy using Goldmann contact lens. A great importance has the graphical representation of the eye fundus pathology, and also applying Lincoff rules in the localisation of the retinal breaks in retinal detachment. As special methods in examination are revealed the diaphanoscopy, the angiofluorography, the computerized tomography, the tomography in magnetic resonance field, and also the utilization of the electrophysiological and echographic exams in retinal detachment diagnosis.

Acute Disease↗
PubMed1999

Transscleral diathermy: an additional tool in the management of retinal detachment due to posterior breaks in highly myopic eyes.

PURPOSE: To investigate the usefulness of transscleral diathermy for the treatment of retinal detachment due to breaks located at the posterior pole in areas of advanced chorioretinal atrophy or staphyloma in highly myopic eyes. METHODS: We reviewed the charts of seven consecutive patients who were operated on between 1984 and 1994 and for whom transscleral diathermy was used during intraocular retinal reattachment surgery to reduce posterior staphyloma. Mean refraction of the seven eyes was -24 diopters (range -16 to -35 diopters). RESULTS: After surgery, which included diathermy, the retina was reattached in six eyes (86%) that also had undergone vitrectomy and silicone oil tamponade, but remained detached in one eye (14%) that had undergone pneumopexy and diathermy; in this eye, the retina was subsequently reattached after vitrectomy and silicone oil injection. Silicone oil was removed from all seven eyes after a mean duration of 2.5 months. During a mean follow-up of 3 years, a recurrent retinal detachment developed in one eye 8 months after silicone oil removal. This retina was reattached after reinjection of silicone oil. CONCLUSIONS: In the treatment of retinal detachment in highly myopic eyes, closure of posterior holes in areas of advanced chorioretinal atrophy or staphyloma can be achieved by transscleral diathermy in conjunction with vitrectomy and temporary silicone oil tamponade. The main benefit of transscleral diathermy results from its posterior pole scleral buckling effect due to shrinkage of the sclera.

Adult↗
PubMed1999

Rapidly resorptive exudative retinal detachment in a patient with renogenic hypertension: case report.

We present an 18-year-old woman who developed rapidly resorptive exudative retinal detachment (ERD) due to chronic renal failure and renogenic hypertension. In July 1998, the patient came to our clinic because of a 2-month-history of progressively deteriorating visual acuity. Initially examination of the fundi revealed typical hypertensive retinopathy. Two weeks later, the patient was admitted due to hypertension and consulted our ophthalmic department again. In addition to hypertensive retinopathy, the fundi showed high bullous ERD, involving the temporal retinas in both eyes. Intensive medical therapy was begun, including blood pressure control and maintenance of body fluid and electrolyte balance, resulting in almost complete regression of retinal detachment within two days. The visual acuity improved during the following 2 weeks. The clinical features and treatment response in this rare case indicate that multiple factors, including fluids overload, hypertension, and possibly renal failure, contributed to the development of ERD. Blood pressure control and the balance of fluids are important in patients with renal failure, and may help to prevent the occurrence of ERD.

Adolescent↗
PubMed2006

Lens clarity after 3-port lens-sparing vitrectomy in stage 4A and 4B retinal detachments secondary to retinopathy of prematurity.

OBJECTIVE: To assess lens clarity after 3-port lens-sparing vitrectomy for stages 4A and 4B tractional retinal detachment secondary to retinopathy of prematurity. METHODS: In a retrospective, interventional, consecutive clinical case series, 108 eyes of 102 patients who underwent lens-sparing vitrectomy for stages 4A and 4B tractional retinal detachment from February 1, 1998, through January 31, 2004, were reviewed. All procedures and follow-up examinations were performed by a single surgeon. Lens clarity was assessed at the final follow-up examination. RESULTS: Of the 108 eyes reviewed, 102 (94.4%) maintained clear lenses at the final follow-up examination, which ranged from 6 to 48 months (mean, 32 months) after the procedure. Thirty-two eyes had stage 4A detachments and 76 eyes had stage 4B. CONCLUSIONS: Three-port lens-sparing vitrectomy may be performed with relatively low risk of cataract formation during the early postoperative period. Maintenance of a clear crystalline lens during the critical period of visual development may lead to better functional outcomes.

Female↗
PubMed1975

[Contribution to the problem of central serous retinal detachment (author's transl)].

We described extensive and multifocal serous detachment of the neuroretina in cases of Harada's disease, optic head pitting, coloboma of choroid and optic nerve-head and bullous retinal detachment (Gass). Peripapillary serous detachment occurred in an additional case after branch occlusion of central retinal artery. Systemic steroids were useful in Harada's disease. The other cases required photocoagulation or argon laser treatment. Bullous retinal detachment did not heal until a buckling procedure was performed. The serous detachment of the neuroretina is considered as an uniform tissue-reaction of choroid, pigmentepithelium and neuroretina. The pathogenesis for this is unknown.

Adult↗
PubMed1983

Predicting age of onset for individuals at risk for phakic retinal detachment.

Three hundred sixty-five cases of nontraumatic phakic retinal detachment were examined by analysis of covariance to determine the degree of association among type of detachment, refractive error, and age of onset. The combination of type of detachment and refractive error explained 57% of the variation in age of onset. Discrimination among types of detachment by variation in mean age was limited. Discrimination among types of detachment by variation in mean refractive error could not be established. Detachments due to vitreoretinal adhesion, lattice degeneration, and retinal dialysis differed significantly in mean age of onset and regression of age on refractive error. A regression model was created to predict from refractive error the age of onset with 95% confidence limits for individuals who appear to be at risk for these types of detachment.

Adolescent↗
PubMed1976

Exudative retinal detachment and scleritis in polyarteritis.

A 64-year-old white man, treated with systemic corticosteroids for five years, developed polyarteritis. He then developed a severe scleritis with an exudative retinal detachment in the right eye, which became blind and painful and was enucleated 23 months after onset of the scleritis. Histopathologic examination of the enucleated eye revealed granulomatous scleritis, chronic nongranulomatous uveitis, exudative retinal detachment, and perivasculitis of intrascleral, iris, ciliary body, and retinal blood vessels. Systemic findings were minimal and limited to elevated sedimentation rate, weight loss, mild anemia, and microscopic hematuria. Respiratory disease, severe kidney disease, hypertension, and arthritis were notably absent. A muscle biopsy established the diagnosis.

Adrenal Cortex Hormones↗
PubMed1976

Fluorescein angiography of degenerative lesions of the peripheral fundus and rhegmatogenous retinal detachment.

Since the number of cases for each of the conditions in our study was small, only preliminary conclusions can be made; in order to establish the fluorescein pattern of each of these peripheral retinal lesions, additional studies will be required. The following summarizes our preliminary observations. 1. Areas of retinal white-with-pressure or without and peripheral retinal cystoid degeneration did not reveal remarkable fluorescein angiographic findings. One exception was in an area of pigment epithelial disturbance characterized by atrophy and proliferation, which showed a "window and masking" effect of choroidal fluorescence. 2. Fluorescein angiography of areas of the fundus with lattice retinal degeneration showed little or no findings in early or mild cases. In severe or advanced cases, the affected retina revealed poor or absent perfusion caused by vascular occlusion. The retinal and choroidal circulation was devoid of fluorescein leakage. Advanced lesions displayed choroidal hypofluorescence in areas of pigment proliferation and hyperfluorescence in areas of pigment atrophy. 3. In advanced cases, occlusive vascular changes over areas of acquired retinoschisis were observed. There was intraretinal leakage of the dye from deep capillaries and pooling of the dye in cystic cavities near the margin of the retinoschisis. 4. There was no perfusion of the choroid and retina in the area of the hole and in the retina surrounding it. This finding suggests choroidal and retinal ischemia in the pathogenesis of a retinal hole. 5. Fluorescein angiography of retinal tears revealed fluorescein leakage along the edge of the tear and absent perfusion of the retinal flap. The retinal and choroidal circulation-around the tear was otherwise unremarkable. The choroidal fluorescein underlying the retinal flap was not visible, perhaps because it was masked by the retinal flap. 6. Our fluorescein angiographic findings in cases of rhegmatogenous retinal detachment confirmed those of others [7, 8, 10]. Transit of fluorescein through the retinal circulation was sluggish. The retinal capillaries were dilated. 7. In cases of rhegmatogenous retinal detachment which had become reattached surgically, areas treated with diathermy or cryoapplications showed absent or diminished choroidal and retinal perfusion. Leakage of the fluorescein from capillaries in the optic disc and retina in the posterior pole was sometimes persistent several months postoperatively.

Fluorescein Angiography↗
PubMedDate not supplied

[Vitreal and retinal changes in the fellow eye in children and adolescents with retinal detachment].

The authors examined 78 fellow eyes in patients aged 2.5-20 years treated for retinal detachment. The examinations were carried out in the course of the hospital treatment and 2-10 years after the discharge from the Ophthalmological Department. In the period of observation the progression of the vitreous changes was seen in 9 eyes and it took the form of appearance or increase of the fibrillar degeneration of the vitreous, the condensation of its basis and of vitreoretinal adhesions; it coexisted with the appearance of new pathological processes in the retina. During the hospital treatment the retinal pathological changes were seen in 30.8 p.c. of cases and in the late examinations in 41 p.c. The most frequently discovered degeneration was the lattice degeneration. The frequency of the fellow eye syndrome in the late examinations increased from 10.2 p.c. to 17.7 p.c. of the examined patients.

Adolescent↗