1
|
Jindachomthong KK, Cabral H, Subramanian ML, Ness S, Siegel NH, Chhablani J, Hsu SX, Chen X. Incidence and Risk Factors for Delayed Retinal Tears after an Acute, Symptomatic Posterior Vitreous Detachment. Ophthalmol Retina 2023; 7:318-324. [PMID: 36307014 DOI: 10.1016/j.oret.2022.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 04/24/2023]
Abstract
PURPOSE To determine the long-term incidence of and risk factors for delayed retinal tears after acute, symptomatic posterior vitreous detachment (PVD) without concurrent retinal tears. DESIGN Retrospective, observational case series. SUBJECTS Patients diagnosed with an acute, symptomatic PVD without concurrent retinal tears at a tertiary eye center between 2013 and 2018. METHODS This is a retrospective, consecutive, and observational case series. Acute and symptomatic PVD was defined as experiencing flashes or floaters for 1 month or less at the time of diagnosis. Patients with a retinal tear or detachment at or before the time of diagnosis were not included. The occurrence and timing of subsequent retinal tears after initial PVD diagnosis were recorded. The age, sex, race, refractive error, lens status, lattice degeneration status, and type of physician (retina specialist vs. nonretina specialist) who saw the patient were also recorded. MAIN OUTCOME MEASURES Time to the development of a delayed retinal tear. RESULTS A total of 389 eyes from 389 patients had acute and symptomatic PVDs without concurrent retinal tears or detachments at diagnosis. Kaplan-Meier analysis showed that 7.39% of eyes developed delayed retinal tears by 6.24 years after initial PVD diagnosis. Of these tears, 50% occurred within 4.63 months of PVD diagnosis, and 63.46% occurred within 1 year of PVD diagnosis. Cox-Mantel log-rank analysis showed that those who were younger (age < 60 years), myopic, or had lattice degeneration were more likely to develop tears. A multivariate Cox proportional-hazards models controlling for other significant risk factors supported lattice degeneration as a likely risk factor for delayed retinal tear. CONCLUSIONS This study demonstrates that 7.39% of patients with acute, symptomatic PVD without concurrent retinal tears develop delayed retinal tears by 6.24 years after PVD diagnosis, with many developing tears well after a typical 6-week follow-up time for PVD. Lattice degeneration is a significant risk factor for delayed tears. These findings can guide clinicians in establishing optimal follow-up protocols for patients with acute, symptomatic PVD. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Manju L Subramanian
- Boston University School of Medicine, Boston, Massachusetts; Department of Ophthalmology, Boston Medical Center, Boston, Massachusetts
| | - Steven Ness
- Boston University School of Medicine, Boston, Massachusetts; Department of Ophthalmology, Boston Medical Center, Boston, Massachusetts
| | - Nicole H Siegel
- Boston University School of Medicine, Boston, Massachusetts; Department of Ophthalmology, Boston Medical Center, Boston, Massachusetts
| | - Jay Chhablani
- Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Samuel X Hsu
- Boston University School of Medicine, Boston, Massachusetts
| | - Xuejing Chen
- Boston University School of Medicine, Boston, Massachusetts; Department of Ophthalmology, Boston Medical Center, Boston, Massachusetts.
| |
Collapse
|
2
|
Uhr JH, Obeid A, Wibbelsman TD, Wu CM, Levin HJ, Garrigan H, Spirn MJ, Chiang A, Sivalingam A, Hsu J. Delayed Retinal Breaks and Detachments after Acute Posterior Vitreous Detachment. Ophthalmology 2020; 127:516-22. [DOI: 10.1016/j.ophtha.2019.10.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 11/17/2022] Open
|
3
|
Huang X, Li D, Li HJ, Zhong YL, Freeberg S, Bao J, Zeng XJ, Shao Y. Abnormal regional spontaneous neural activity in visual pathway in retinal detachment patients: a resting-state functional MRI study. Neuropsychiatr Dis Treat 2017; 13:2849-2854. [PMID: 29200859 PMCID: PMC5703148 DOI: 10.2147/ndt.s147645] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The aim of the study was to investigate changes of brain neural homogeneity in retinal detachment (RD) patients using the regional homogeneity (ReHo) method to understand their relationships with clinical features. MATERIALS AND METHODS A total of 30 patients with RD (16 men and 14 women), and 30 healthy controls (HCs) (16 men and 14 women) closely matched in age and sex were recruited. Resting-state functional magnetic resonance imaging scans were performed for all subjects. The ReHo method was used to investigate the brain regional neural homogeneity. Patients with RD were distinguished from HCs by receiver operating characteristic curve. The relationships between the mean ReHo signal values in many brain regions and clinical features in RD patients were calculated by Pearson correlation analysis. RESULTS Compared with HCs, RD patients had significantly decreased ReHo values in the right occipital lobe, right superior temporal gyrus, bilateral cuneus and left middle frontal gyrus. Moreover, we found that the mean ReHo signal of the bilateral cuneus showed positive relationships with the duration of the RD (r=0.392, P=0.032). CONCLUSION The RD patients showed brain neural homogeneity dysfunction in the visual pathway, which may underline the pathological mechanism of RD patients with acute vision loss. Besides, the ReHo values can reflect the progress of the RD disease.
Collapse
Affiliation(s)
- Xin Huang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, People's Republic of China.,Department of Ophthalmology, Eye Center, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Dan Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Hai-Jun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Yu-Lin Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, People's Republic of China
| | - Shelby Freeberg
- Department of Ophthalmology, University of Florida, Gainesville, FL, USA
| | - Jing Bao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, People's Republic of China
| | - Xian-Jun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, People's Republic of China
| |
Collapse
|
4
|
Abstract
Prophylactic treatment of retinal breaks has been examined in several studies and reviews, but so far, no studies have successfully applied a systematic approach. In the present systematic review, we examined the need of follow-up after posterior vitreous detachment (PVD) - diagnosed by slit-lamp biomicroscopy or Goldmann 3-mirror examination - with regard to retinal breaks as well as the indication of prophylactic treatment in asymptomatic and symptomatic breaks. A total of 2941 publications were identified with PubMed and Medline searches. Two manual search strategies were used for papers in English published before 2012. Four levels of screening identified 13 studies suitable for inclusion in this systematic review. No meta-analysis was conducted as no data suitable for statistical analysis were identified. In total, the initial examination after symptomatic PVD identified 85-95% of subsequent retinal breaks. Additional retinal breaks were only revealed at follow-up in patients where a full retinal examination was compromised at presentation by, for example, vitreous haemorrhage. Asymptomatic and symptomatic retinal breaks progressed to rhegmatogenous retinal detachment (RRD) in 0-13.8% and 35-47% of cases, respectively. The cumulated incidence of RRD despite prophylactic treatment was 2.1-8.8%. The findings in this review suggest that follow-up after symptomatic PVD is only necessary in cases of incomplete retinal examination at presentation. Prophylactic treatment of symptomatic retinal breaks must be considered, whereas no unequivocal conclusion could be reached with regard to prophylactic treatment of asymptomatic retinal breaks.
Collapse
Affiliation(s)
- Søren Blindbaek
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
| | - Jakob Grauslund
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
| |
Collapse
|
5
|
Tabibian D, Hoogewoud F, Mavrakanas N, Schutz JS. Misdirected aqueous flow in rhegmatogenous retinal detachment: A pathophysiology update. Surv Ophthalmol 2015; 60:51-9. [DOI: 10.1016/j.survophthal.2014.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 07/20/2014] [Accepted: 07/23/2014] [Indexed: 11/28/2022]
|
6
|
Zhang Q, Filas BA, Roth R, Heuser J, Ma N, Sharma S, Panitch A, Beebe DC, Shui YB. Preservation of the structure of enzymatically-degraded bovine vitreous using synthetic proteoglycan mimics. Invest Ophthalmol Vis Sci 2014; 55:8153-62. [PMID: 25342623 DOI: 10.1167/iovs.14-14366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Vitreous liquefaction and subsequent posterior vitreous detachment can lead to several sight-threatening diseases, including retinal detachment, macular hole and macular traction syndrome, nuclear cataracts, and possibly, open-angle glaucoma. In this study, we tested the ability of three novel synthetic chondroitin sulfate proteoglycan mimics to preserve the structure and physical properties of enzymatically-degraded bovine vitreous. METHODS Chondroitin sulfate proteoglycan mimics, designed to bind to type II collagen, hyaluronic acid, or both, were applied to trypsin- or collagenase-treated bovine vitreous in situ and in vitro. Rheology and liquefaction tests were performed to determine the physical properties of the vitreous, while Western blots were used to detect the presence and degradation of soluble collagen II (α1). Deep-etch electron microscopy (DEEM) identified the ultrastructure of mimic-treated and untreated enzyme-degraded bovine vitreous. RESULTS Proteoglycan mimics preserved the physical properties of trypsin-degraded bovine vitreous and protected against vitreous liquefaction. Although the collagen-binding mimic maintained the physical properties of collagenase-treated vitreous, liquefaction still occurred. Western blots indicated that the mimic provided only marginal protective ability against soluble collagen degradation. Deep-etch electron microscopy, however, showed increased density and isotropy of microstructural components in mimic-treated vitreous, supporting the initial result that vitreous structure was preserved. CONCLUSIONS Proteoglycan mimics preserved bovine vitreous physical properties after enzymatic degradation. These compounds may be useful in delaying or preventing the pathological effects of age-related, or enzymatically-induced, degradation of the vitreous body.
Collapse
Affiliation(s)
- Qianru Zhang
- Eye Center, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Benjamen A Filas
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Robyn Roth
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, United States
| | - John Heuser
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Nan Ma
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States Department of Ophthalmology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Shaili Sharma
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, United States
| | - Alyssa Panitch
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, United States
| | - David C Beebe
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Ying-Bo Shui
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
| |
Collapse
|
7
|
Framme C, Wolf S. Retinal complications after damaging the vitreolenticular barrier. ACTA ACUST UNITED AC 2011; 227:20-33. [PMID: 21952101 DOI: 10.1159/000330421] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 06/30/2011] [Indexed: 11/19/2022]
Abstract
This article gives an overview of the vitreal anatomy and its changes in ageing, which have a significant impact on the two main retinal complications after damage of the vitreolenticular barrier, namely retinal detachment and cystoid macular edema. The possible reasons and pathomechanisms for this entity of retinal diseases in the context of anterior segment interaction are highlighted, and a summary of references is provided showing the epidemiology and consequences of such interventions.
Collapse
|