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PubMed1979

Acute severe uveitis with retinal vasculitis and retinal detachment.

5 adult patients (7 eyes) with acute severe uveitis with retinal vasculitis and retinal detachment of unknown etiology were studied. Yellowish exudations which appeared in the peripheral fundus rapidly extended posteriorly, and there was a patchy perivasculitis, white sheathing and obliteration of the retinal vessels. The absorption of these yellowish exudations was followed by atrophy of the retina and the choroid. Secondary detachment of the retina then developed, and the visual acuity remained poor in most cases.

Acute Disease↗
PubMed1985

IgM paraprotein in the subretinal fluid of a patient with recurrent retinal detachment and Waldenström's macroglobulinaemia.

IgM paraprotein was detected by immunoelectrophoresis and polyacrylamide-gel electrophoresis in the subretinal fluid (SRF) of a patient suffering from recurrent retinal detachment and Waldenström's macroglobulinaemia. Paraproteins in large quantities may inhibit fibrin formation which in turn may be an important agent in retinal reattachment and the starting point of scar formation in the subretinal space. By this case report the authors wanted to support the assumption that changes in the protein composition of SRF might explain the unsuccessful outcome in certain cases of retinal detachment when reattachment could not be achieved though the diagnosis was correct and the surgery performed correctly.

Electrophoresis↗
PubMed2003

Outcome of temporary silicone oil tamponade in complex rhegmatogenous retinal detachment.

PURPOSE: To evaluate the anatomic and visual outcomes and complications of temporary silicone oil (SO) retinal tamponade in patients with complex rhegmatogenous retinal detachments (RD). METHODS: The retrospective study included 100 eyes of 93 consecutive patients. Indications for the use of SO were proliferative vitreoretinopathy (PVR) (30 eyes), difficult RD (30 eyes), giant retinal tears (17 eyes), RD after penetrating trauma (14 eyes), and macular holes in highly myopic eyes (9 eyes). Vitrectomy surgery was performed with 5000-centistoke SO as the retinal tamponade. All eyes underwent prophylactic 360 degree retinopexy at the time of the retinal reattachment operation. The mean duration of SO tamponade was 26.4 weeks, with a mean follow-up of 67.5 weeks after removal of SO. RESULTS: . In 6 of 100 eyes (6%), the retina redetached after removal of SO. Including the successfully reoperated eyes, the final anatomic success rate was 96%. Other complications were cataract (61%), increased intraocular pressure (13%), hypotony (4%), keratopathy (4%), intravitreal hemorrhage (1%), and suprachoroidal hemorrhage (1%). Correspondence analysis demonstrated that redetachment and hypotony were associated with PVR and trauma. Overall, good visual outcome (20/200 or better) was achieved in 51% of the whole study group, and in 70.6% of eyes with giant tears, 62.1% of eyes with difficult RD, 44.8% of eyes with PVR, 33.3% of eyes with macular holes, and 28.6% of eyes with trauma (p=0.0382). Logistic regression analysis identified initial visual acuity of 20/200 or better as a factor associated with good visual outcome and occurrence of retinal redetachment/hypotony and old age ( > or = 50 years) as factors negatively associated with good visual outcome. CONCLUSIONS: The low redetachment rate might be due to prophylactic 360 degree retinopexy. Giant tears had the best visual outcome. Redetachment/hypotony had a negative impact on achievement of good visual outcome and were associated with PVR and trauma.

Adolescent↗
PubMed1995

Retinal detachments in patients with AIDS and CMV retinopathy: a role for laser photocoagulation.

A retrospective review of all patients with a cytomegalovirus (CMV) related retinal detachment and HIV infection managed at the ocular immunology clinic at St Vincent's Hospital between January 1985 and June 1992 was performed. Over this period 142 patients with CMV retinopathy were managed and 17 eyes from 14 of these patients developed a retinal detachment related to CMV retinopathy. Fourteen eyes from 11 of these patients were treated surgically with combinations of laser photocoagulation, cryopexy, scleral buckling, vitrectomy, and silicone oil tamponade. The use of laser photocoagulation alone in five patients resulted in an excellent visual outcome. The majority of patients (90.9%) benefited from surgery in that vision was either stabilised or improved.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Pseudophakic retinal detachment. Surgical success rate with various types of IOLs.

The overall anatomic success rate of surgical treatment of 122 consecutive cases of pseudophakic retinal detachment was 82%. In 78 eyes with iris-supported intraocular lenses (IOLs), the success rate was 83%, and it did not differ between the 47 eyes with intracapsular and the 31 eyes with extracapsular extraction. Reattachment rate was highest in 14 eyes with posterior chamber IOLs (100%) and lowest (70%) in 30 eyes with anterior chamber IOLs. Low success rate was associated with the preoperative findings of vitreous gel in the anterior chamber in front of the IOL, vitreous reaction, and vitreous hemorrhage, all of which were found most frequently with retinal detachment in eyes with anterior chamber IOLs. Of the 30 eyes with anterior chamber IOLs, 43% required repeat operations, 43% had perioperative complications, and only 14% of the 21 successful cases achieved 20/40 or better postoperative vision.

Adult↗
PubMed1975

Management of traumatic retinal detachment with pars plana vitrectomy, scleral buckling, and gas injection.

Vitreous involvement as a result of penetrating trauma complicates and worsens the prognosis in retinal detachment repair. Seven patients in whom poor visualization of the fundus seemed to preclude success by routine procedures underwent combined vitrectomy, scleral buckling, release of subretinal fluid, and intravitreal gas injection. The retina was successfully reattached in five of the seven patients, although postoperative visual acuity was limited - possible on account of the duration of retinal detachment prior to repair or because of the degree of macular involvement.

Adolescent↗
PubMed1979

Retinal detachment from hyperosmotic intravitreal injection.

Hyperosmotic solutions were injected into the rabbit vitreous to study their effects upon the retina. Injection of 0.05 ml of a 1000 mOsm solution caused rapid whitening of the posterior retina followed by the development of a large detachment and permanent retinal degeneration. The weakest solutions which produced ophthalmoscopically visible changes in the retina (after an injection of 0.05 ml) were near 500 mOsm. Sodium chloride, sodium aspartate, EDTA, mannitol, sucrose, and penicillin were effective at similar osmolarities. An osmotic load in the vitreous caused immediate loss of the c-wave of the electroretinogram (ERG), and a slower decline of the a- and b-waves. The reported intravitreal toxicity of some drugs may relate to osmotic rather than pharmacologic effects. Osmolarity should be accounted for in planning the amount and location of any vitreous injection.

Animals↗