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Lee DH, Ziari M, Shah RD, Mojica G, Movahedan A. Dynamic angle closure following pars plana vitrectomy with perfluoropropane gas. Am J Ophthalmol Case Rep 2024; 34:101954. [PMID: 38577387 PMCID: PMC10992708 DOI: 10.1016/j.ajoc.2023.101954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 04/06/2024] Open
Abstract
Purpose To report the clinical course of an aphakic patient who developed positional secondary angle closure glaucoma following pars plana vitrectomy (PPV) with perfluoropropane (C3F8) gas tamponade. Observations A 23-year-old male presented due to a two-year history of vision loss in the left eye. Best-corrected visual acuity (BCVA) was 20/200 and intraocular pressure (IOP) was 12 mm Hg OS. Exam revealed iridodonesis and aphakia of both eyes, and a total RRD in the left eye. The patient underwent scleral buckle plus PPV with 15 % C3F8 gas and was instructed to maintain face-down positioning for 5 days. On post-operative day 1, IOP was 32 mm Hg and exam revealed significant diffuse corneal edema, a large epithelial defect, and 85 % C3F8 fill of the vitreous cavity. Patient was started on IOP-lowering drops but continued to have elevated IOP and corneal epithelial sloughing over the next 3 weeks. He was taken for a superficial keratectomy, but when placed supine under the microscope, a large new gas bubble was visualized overlying the pupil in a now shallow anterior chamber (AC) and IOP was 52 mm Hg. The patient was positioned back upright and the gas bubble migrated posteriorly out of the AC with return of IOP to 25 mm Hg. The dynamic nature of his IOP raised concerns for intermittent angle closure by C3F8 induced by supine positioning. Thus, a pars plana aspiration of the C3F8 gas was performed and resulted in normalization of the IOP. Conclusions and importance Dynamic, positional secondary angle closure glaucoma can occur after vitrectomy with C3F8 in the setting of aphakia. This is the first report to capture C3F8 gas migration causing intermittent acute angle closure in real-time. Due to its intermittent nature however, the diagnosis may not be initially apparent at the slit lamp. Thus, we suggest this potential complication should be carefully monitored for and discussed when advising post-vitrectomy positioning in aphakic patients.
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Affiliation(s)
- Debora H. Lee
- Ruiz Department of Ophthalmology and Visual Science, University of Texas Health Science Center, Houston, TX, USA
| | - Melody Ziari
- UT Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Ruchi D. Shah
- Ruiz Department of Ophthalmology and Visual Science, University of Texas Health Science Center, Houston, TX, USA
| | - Gioconda Mojica
- Ruiz Department of Ophthalmology and Visual Science, University of Texas Health Science Center, Houston, TX, USA
| | - Asadolah Movahedan
- Ruiz Department of Ophthalmology and Visual Science, University of Texas Health Science Center, Houston, TX, USA
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Shah S, Santos da Cruz NF, Staropoli P, Lopez-Font F, Peter Chang TC, Berrocal A. Non-nasal, atypical retinochoroidal coloboma in pediatric patients: Case series and review. Am J Ophthalmol Case Rep 2024; 34:102015. [PMID: 38384735 PMCID: PMC10876588 DOI: 10.1016/j.ajoc.2024.102015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/16/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Purpose To report 2 cases of atypically located, non-nasal colobomas in the pediatric population. Observations A 3-week-old female neonate with no known past ocular or medical history was diagnosed with temporal iris and chorioretinal coloboma with tractional membranes upon examination under anesthesia and imaging. A 9-year-old female with a history of bilateral sensorineural hearing loss and left mild hydronephrosis presented with a temporal chorioretinal coloboma associated with retinal detachment. Conclusions and importance Very few cases of atypically located, non-nasal pediatric colobomas have been reported, and they lack a clear cause or mechanism of formation. Continued documentation of their occurrence and research into their formation at a molecular and embryological level are warranted to better understand their pathogenesis.
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Affiliation(s)
- Serena Shah
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Natasha Ferreira Santos da Cruz
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Patrick Staropoli
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Francisco Lopez-Font
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Ta Chen Peter Chang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
| | - Audina Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. 900 NW 17 Street, Miami, FL 33136, USA
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Kanai M, Sakimoto S, Nishida K. Spontaneous separation of secondary epiretinal membrane after vitrectomy for retinal detachment. Am J Ophthalmol Case Rep 2024; 34:102017. [PMID: 38404483 PMCID: PMC10883812 DOI: 10.1016/j.ajoc.2024.102017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/14/2023] [Accepted: 01/15/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose While secondary epiretinal membranes (ERMs) are well-documented postoperative complications following rhegmatogenous retinal detachment (RRD) surgery, literature addressing the mechanisms of spontaneous resolution, particularly in cases involving vitrectomy, remain limited. In this case report, we describe the spontaneous resolution of secondary ERM in an amateur boxer following traumatic RRD surgery. Observations Pars plana vitrectomy was performed for traumatic RRD in a 20-year-old man. Secondary ERM formation was observed one month after RRD surgery, resulting in retinal distortion. The ERM began to peel spontaneously and disappeared one year after surgery. His visual function did not deteriorate in the meantime. Conclusions and Importance Spontaneous ERM separation is possible even after vitrectomy. This is the first published observation of the formation and spontaneous disappearance of secondary ERM after vitrectomy without intervention.
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Affiliation(s)
- Masanori Kanai
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Susumu Sakimoto
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Ocular Immunology and Regenerative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan
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Rapizzi E, Barosco G, Zemella N, Samassa F, Rassu N, Frattolillo A, Buratto L. Routine use of filtered air as endotamponade in the management of primary rhegmatogenous retinal detachment. Eur J Ophthalmol 2024; 34:816-824. [PMID: 37849334 DOI: 10.1177/11206721231206842] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 10/19/2023]
Abstract
PURPOSE To evaluate the safety and efficacy of filtered air as endotamponade in the management of primary rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV) and complete drainage of subretinal fluid. METHODS For this retrospective study, we reviewed the medical charts of 273 patients (275 eyes) who consecutively underwent PPV, subretinal fluid drainage and filtered air tamponade to treat primary RRD between 2018 and 2022. As primary outcome we evaluated the anatomical success considered as retinal reattachment after single surgery. As secondary outcomes: final mean best corrected distance visual acuity (BCDVA), complications, and mean intraocular pressure (IOP) trends. RESULTS The anatomical success was reached by 262 (95.6%) of cases. Mean BCDVA improved from 0.73 LogMAR at baseline, to 0.21 LogMAR at the end of follow-up. As complications we recorded: 5 cases of clinically relevant macular pucker, 1 full thickness macular hole, and 1 PFO bubble under the retina. The mean IOP remained on normal values during the overall follow-up period.
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Affiliation(s)
- Emilio Rapizzi
- Eye Clinic, Ospedale dell'Angelo - ULSS 3 Serenissima, Venezia, Italy
| | - Guido Barosco
- Eye Clinic, Ospedale dell'Angelo - ULSS 3 Serenissima, Venezia, Italy
| | - Nicola Zemella
- Eye Clinic, Ospedale di Conegliano - ULSS 2 Marca Trevigiana, Treviso, Italy
| | - Francesco Samassa
- Eye Clinic, Ospedale dell'Angelo - ULSS 3 Serenissima, Venezia, Italy
| | - Nicolò Rassu
- Eye Clinic, Ospedale dell'Angelo - ULSS 3 Serenissima, Venezia, Italy
| | | | - Lenni Buratto
- Eye Clinic, Ospedale dell'Angelo - ULSS 3 Serenissima, Venezia, Italy
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Kim E, Choi Y, Byon I, Lee JE, Park SW. Selective internal limiting membrane peeling for prevention of secondary epiretinal membrane after vitrectomy for rhegmatogenous retinal detachment. Jpn J Ophthalmol 2024; 68:216-224. [PMID: 38598145 DOI: 10.1007/s10384-024-01056-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 09/10/2023] [Accepted: 01/31/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE We introduce selective internal limiting membrane (ILM) peeling, a guideline procedure to determine whether to remove the ILM during vitrectomy for rhegmatogenous retinal detachment (RRD). STUDY DESIGN Retrospective case series METHODS: Patients who underwent pars plana vitrectomy for RRD and were followed up for 12 months or longer were included. When vitreous cortex remnants (VCRs) were detected with triamcinolone acetonide, the ILM was removed; otherwise, the ILM was preserved ("selective ILM peeling"). The factors associated with the presence of VCRs and incidence of secondary epiretinal membrane (ERM) were analyzed. RESULTS VCRs were detected in 87 of 133 eyes (65.4%) in which the ILM was removed. Younger age, better preoperative visual acuity, and vitreous hemorrhage were negatively correlated with the presence of VCRs. No ERM occurred in the eyes after ILM peeling. Among the eyes with ILM preservation, subclinical ERM was noticed in 4 eyes (8.7%), and 1 eye (2.1%) required additional surgery owing to ERM. ERM occurred more commonly in eyes with the ILM preserved (P = .004). However, no differences in the rate of additional surgeries were found between the 2 groups. CONCLUSION Selective ILM peeling offers an alternative option to reduce the burden of ILM peeling or additional surgery.
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Affiliation(s)
- EunAh Kim
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, Inje University School of Medicine, Busan, South Korea
| | | | - Iksoo Byon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Pusan National University, 927 Building B, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea
- Pusan National University School of Medicine, Yangsan, South Korea
| | - Ji Eun Lee
- Pusan National University School of Medicine, Yangsan, South Korea
- Lee Eye Clinic, Busan, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Pusan National University, 927 Building B, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea.
- Pusan National University School of Medicine, Yangsan, South Korea.
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Ge JY, Teo ZL, Chee ML, Tham YC, Rim TH, Cheng CY, Wong TY, Wong EYM, Lee SY, Cheung N. International incidence and temporal trends for rhegmatogenous retinal detachment: A systematic review and meta-analysis. Surv Ophthalmol 2024; 69:330-336. [PMID: 38000699 DOI: 10.1016/j.survophthal.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/06/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
We set out to estimate the international incidence of rhegmatogenous retinal detachment (RRD) and to evaluate its temporal trend over time. There is a lack of robust estimates on the worldwide incidence and trend for RRD, a major cause of acute vision loss. We conducted a systematic review of RRD incidence. The electronic databases PubMed, Scopus, and Thomson Reuters' Web of Science were searched from inception through 2nd June 2022. Random-effects meta-analysis model with logit transformation was performed to obtain pooled annual incidence estimates of RRD. Pooled analysis was performed to evaluate the temporal trend of RRD incidence of the 20,958 records identified from the database searches; 33 studies from 21 countries were included for analysis (274,836 cases of RRD in 273,977 persons). Three of the 6 global regions as defined by WHO had studies that met the inclusion and exclusion criteria of the study. The annual international incidence of RRD was estimated to be 12.17 (95% confidence interval [CI] 10.51-14.09) per 100,000 population; with an increasing temporal trend of RRD at 5.4 per 100,000 per decade (p 0.001) from 1997 to 2019. Amongst world regions, the RRD incidence was highest in Europe (14.52 [95% CI 11.79 - 17.88] per 100,000 population), followed by Western Pacific (10.55 [95% CI 8.71-12.75] per 100,000 population) and Regions of Americas (8.95 [95% CI 6.73-11.92] per 100,000 population). About one in 10,000 persons develop RRD each year. There is evidence of increasing trend for RRD incidence over time, with possibly doubling of the current incidence rate within the next 2 decades.
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Affiliation(s)
- Jasmine Yaowei Ge
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Zhen Ling Teo
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Miao Li Chee
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Yih-Chung Tham
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore; Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | | | - Ching-Yu Cheng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore; Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore; Tsinghua Medicine, Tsinghua University, Beijing, China
| | | | - Shu Yen Lee
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore
| | - Ning Cheung
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore.
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Li S, Li M, Wu J, Li Y, Han J, Song Y, Cao W, Zhou X. Developing and validating a clinlabomics-based machine-learning model for early detection of retinal detachment in patients with high myopia. J Transl Med 2024; 22:405. [PMID: 38689321 PMCID: PMC11061938 DOI: 10.1186/s12967-024-05131-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/23/2023] [Accepted: 03/26/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Retinal detachment (RD) is a vision-threatening disorder of significant severity. Individuals with high myopia (HM) face a 2 to 6 times higher risk of developing RD compared to non-myopes. The timely identification of high myopia-related retinal detachment (HMRD) is crucial for effective treatment and prevention of additional vision impairment. Consequently, our objective was to streamline and validate a machine-learning model based on clinical laboratory omics (clinlabomics) for the early detection of RD in HM patients. METHODS We extracted clinlabomics data from the electronic health records for 24,440 HM and 5607 HMRD between 2015 and 2022. Lasso regression analysis assessed fifty-nine variables, excluding collinear variables (variance inflation factor > 10). Four models based on random forest, gradient boosting machine (GBM), generalized linear model, and Deep Learning Model were trained for HMRD diagnosis and employed for internal validation. An external test of the models was done. Three random data sets were further processed to validate the performance of the diagnostic model. The primary outcomes were the area under the receiver operating characteristic curve (AUC) and the area under the precision-recall curve (AUCPR) to diagnose HMRD. RESULTS Nine variables were selected by all models. Given the AUC and AUCPR values across the different sets, the GBM model was chosen as the final diagnostic model. The GBM model had an AUC of 0.8550 (95%CI = 0.8322-0.8967) and an AUCPR of 0.5584 (95%CI = 0.5250-0.5879) in the training set. The AUC and AUCPR in the internal validation were 0.8405 (95%CI = 0.8060-0.8966) and 0.5355 (95%CI = 0.4988-0.5732). During the external test evaluation, it reached an AUC of 0.7579 (95%CI = 0.7340-0.7840) and an AUCPR of 0.5587 (95%CI = 0.5345-0.5880). A similar discriminative capacity was observed in the three random data sets. The GBM model was well-calibrated across all the sets. The GBM-RD model was implemented into a web application that provides risk prediction for HM individuals. CONCLUSION GBM algorithms based on nine features successfully predicted the diagnosis of RD in patients with HM, which will help ophthalmologists to establish a preliminary diagnosis and to improve diagnostic accuracy in the clinic.
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Affiliation(s)
- Shengjie Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Meiyan Li
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jianing Wu
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yingzhu Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jianping Han
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yunxiao Song
- Department of Clinical Laboratory, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, China.
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China.
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Lin YC, Wang CT, Chen KJ, Chou HD. Traumatic terson syndrome with a peculiar mass lesion and tractional retinal detachment: a case report. BMC Ophthalmol 2024; 24:153. [PMID: 38589883 PMCID: PMC11003055 DOI: 10.1186/s12886-024-03407-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/12/2023] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND To report a case with bilateral Terson syndrome presented with a unique mushroom-like mass lesion on the optic disc along with proliferative vitreoretinopathy and tractional retinal detachment. CASE PRESENTATION A 33-year-old man was injured during a traffic accident and had diffuse brain swelling and intraocular hemorrhage. Poor vision in both eyes was noted after the patient regained consciousness. B-scan ultrasonography showed extensive vitreous opacity with a posterior vitreous detachment and without obvious retinal detachment. Vitrectomy was performed in both eyes five months after the accident. After clearing up the vitreous opacity, a peculiar pigmented mushroom-like mass lesion was noted in the posterior pole and had severe adhesion to the underneath optic disc. Extensive multilayered peripapillary epiretinal membrane was found covering the posterior pole and led to tractional retinal detachment around the macula. The mass was presumed to be an organized vitreous hemorrhage originated from the optic disc. The extensive and adherent epiretinal membrane together with the mass lesion were removed as much as possible and silicon oil was injected for tamponade. However, in the right eye, the retina redetached under silicon oil, whereas in the left eye, his vision improved to 20/100. CONCLUSIONS Terson syndrome usually has a favorable prognosis but may be complicated by proliferative vitreoretinopathy and tractional retinal detachment. Careful monitoring is warranted and early vitrectomy should be considered in cases suspecting additional pathologies.
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Affiliation(s)
- Yung-Chen Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Ting Wang
- Department of Ophthalmology, Linkou Branch, Chang Gung Memorial Hospital, 5 Fuxing Street, Guishan District, 333423, Taoyuan, Taiwan
| | - Kuan-Jen Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Linkou Branch, Chang Gung Memorial Hospital, 5 Fuxing Street, Guishan District, 333423, Taoyuan, Taiwan
| | - Hung-Da Chou
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Ophthalmology, Linkou Branch, Chang Gung Memorial Hospital, 5 Fuxing Street, Guishan District, 333423, Taoyuan, Taiwan.
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Hsia Y, Yang CM. Bilateral vitrectomy in patients with proliferative diabetic retinopathy-characteristics and surgical outcomes. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06462-5. [PMID: 38578330 DOI: 10.1007/s00417-024-06462-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/11/2024] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE Comparing characteristics and outcomes of patients with bilateral proliferative diabetic retinopathy (PDR) undergoing concurrent and sequential vitrectomy. METHODS Patients having bilateral vitrectomy were classified into concurrent (requiring bilateral surgery simultaneously) and sequential (indicating vitrectomy in one eye later) groups. Clinical characteristics and outcomes were compared, and correlation between the first and second-operated eyes was analyzed. RESULTS One hundred eight and 126 eyes were in the concurrent and sequential groups, respectively. The sequential group was older (50 vs. 45 years, P = 0.017), had less retinal detachment (54 vs. 77%, P < 0.001), and better visual outcomes (0.79 vs. 1.30, P = 0.021), especially the second-operated eyes. The concurrent group had weaker correlations of disease severity (phi coefficient: 0.36 vs. 0.61) and post-operative visual acuity (r: 0.12 vs. 0.34) between the first- and second-operated eyes than the sequential group. Prior intravitreal injection of anti-vascular endothelial growth factor (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.15-0.86, P = 0.025) predicted better outcomes, while post-operative neovascular glaucoma predicted worse outcomes (OR 6.5, 95% CI 1.7-27.9, P = 0.008). CONCLUSIONS PDR patients requiring surgery concurrently were younger and had more severe diseases and worse outcomes. However, poor outcomes in the first eye did not predict similar outcomes in the second eye.
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Affiliation(s)
- Yun Hsia
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd., Taipei, 100, Taiwan.
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10
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Sinha AK, Durrani AF, Li KX, Zhou Y, Musch DC, Zacks DN, Huvard MJ. Retinal Detachments after Open-Globe Injury: Risk Factors and Outcomes. Ophthalmol Retina 2024; 8:340-349. [PMID: 37844658 DOI: 10.1016/j.oret.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/31/2023] [Revised: 09/21/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To identify risk factors for retinal detachment (RD) after open-globe injury (OGI) and evaluate outcomes of RD repair after OGI. DESIGN Case-control study. PARTICIPANTS Overall, 769 patients presented with 786 OGIs, which were surgically managed with ≥ 30 days of follow-up. Of the 786 eyes, 223 developed RD, the other 551 served as controls, and RD status of 12 eyes was unknown. METHODS A retrospective chart review was performed of all OGIs presented to the University of Michigan between 2000 and 2022. Multivariable regression identified risk factors for RD after OGI and predictors of poor vision after RD repair. Kaplan-Meier analysis estimated time from OGI to RD. MAIN OUTCOME MEASURE Predictors of visual outcome after RD repair after OGI. RESULTS After OGI, 223 (28.4%) of 786 eyes were diagnosed with RD, with > 73% diagnosed within a month. Predictors of RD include posterior injury (zone II vs. I odds ratio [OR], 1.60 [95% confidence interval {CI}, 1.04-2.46]; P = 0.0331; zone III vs. I OR, 2.29 [1.53-3.41]; P < 0.0001), vitreous hemorrhage (OR, 2.29 [1.54-3.1]; P < 0.0001), and presenting acuity worse than count fingers (CFs) (OR, 2.65 [1.69 - 4.16]; P < 0.0001). Retinal detachment repair took place in 142 of 223 eyes. The mean logarithm of minimal angle of resolution visual acuity (VA) improved from 2.3 ± 0.8 to 1.7 ± 0.9 after RD repair at 6-month follow-up, with 51.2% of eyes achieving CF or better vision. Single surgery anatomic success rate was 69.7% and final anatomic success was 88%. Predictors of vision worse than CF include history of ocular surgery (OR, 0.32 [0.11-0.94]; P = 0.039), proliferative vitreoretinopathy (PVR; OR, 0.39 [0.16 - 0.92]; P = 0.032), aphakia (OR, 0.25 [0.08 - 0.77]; P = 0.016), and redetachment (OR, 0.26 [0.1 - 0.63]; P = 0.003). CONCLUSIONS Most RD occur within the first month after OGI. Patients with posterior injuries, vitreous hemorrhage, or poor presenting VA were more likely to develop RD after OGI. Anatomic success was achieved in the majority, as was final VA of CF vision or better. History of ocular surgery, PVR at time of repair, aphakia, and redetachment were risk factors for a poor outcome. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Alina K Sinha
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri; Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan
| | - Asad F Durrani
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia
| | - Katie X Li
- Department of Ophthalmology and Visual Sciences, Yale Eye Center, Yale School of Medicine, New Haven, Connecticut (5)Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Yunshu Zhou
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan
| | - David N Zacks
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan
| | - Michael J Huvard
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan.
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Koh K, Tuuminen R, Jeon S. Ultra-Widefield-Guided Swept-Source OCT Findings of Peripheral Vitreoretinal Abnormality in Young Myopes. Ophthalmology 2024; 131:434-444. [PMID: 37972896 DOI: 10.1016/j.ophtha.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/29/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE To evaluate the ultra-widefield fundus photography (UWF-FP)-guided swept-source OCT (SS-OCT) images of peripheral vitreoretinal abnormality (PVRA) in young asymptomatic myopes. DESIGN Cross-sectional, single-center study. PARTICIPANTS A total of 1966 eyes of 983 consecutive patients aged 18 to 42 years with refractive error in the spherical equivalent of < 0 diopters (D) who visited KEYE Eye Center, Seoul, Republic of Korea, for refractive surgery. METHODS The prevalence of PVRA and their characteristics, including shape, location, presence of pigmentation, membrane, retinal breaks, and detachment, were evaluated. A logistic regression analysis was done to evaluate the risk factors of PVRA and the risk of retinal breaks or detachment among eyes with PVRA. RESULTS Among 1966 eyes, 317 (16.1%) had PVRA, and 182 (57.4%) and 135 (42.6%) had focal and linear lesions, respectively. The risk of PVRA was increased with axial length of the eyes (odds ratio [OR], 1.238, 95% confidence interval [CI], 1.112-1.379, P < 0.001), corneal astigmatism (OR, 1.320, 95% CI, 1.148-1.519, P < 0.001), presence of discrete margins of different retinal reflectivity (DMDRR; indicating outer retinal disruption from abnormal vitreoretinal traction) (OR, 1.751, 95% CI, 1.334-2.300, P < 0.001), and posterior vitreous detachment (PVD) at the posterior pole of the retina (OR, 1.833, 95% CI, 1.352-2.485, P < 0.001). Among eyes with PVRA, patient age (OR, 1.063, 95% CI, 1.008-1.121, P = 0.025), linear lesions (OR, 15.234, 95% CI, 7.891-29.407, P < 0.001), and multiple lesions (OR, 3.432, 95% CI, 1.780-6.620, P < 0.001) were independently associated with the presence of retinal breaks or detachment. CONCLUSIONS The follow-up for PVRA among young myopes should be personalized on the basis of their ocular characteristics, including asymmetric ocular expansion (axial length and astigmatism) and vitreoretinal interface status. The treatment plan for PVRA eyes should emphasize the greater risk of retinal breaks and detachment with increasing age and the presence of linear and multiple lesions. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Kyungmin Koh
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea
| | - Raimo Tuuminen
- Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland; Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sohee Jeon
- Keye Eye Center, Seoul, Republic of Korea.
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12
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Naik K, du Toit LC, Ally N, Choonara YE. In vivo evaluation of a Nano-enabled therapeutic vitreous substitute for the precise delivery of triamcinolone to the posterior segment of the eye. Drug Deliv Transl Res 2024:10.1007/s13346-024-01566-1. [PMID: 38519828 DOI: 10.1007/s13346-024-01566-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 03/25/2024]
Abstract
This study focused on the design of a thermoresponsive, nano-enabled vitreous substitute for the treatment of retinal diseases. Synthesis of a hydrogel composed of hyaluronic acid and a poloxamer blend was undertaken. Poly(D,L-lactide-co-glycolide) acid nanoparticles encapsulating triamcinolone acetonide (TA) were synthesised with a spherical morphology and mean diameter of ~ 153 nm. Hydrogel fabrication and nanoparticle loading within the hydrogel was confirmed via physicochemical analysis. Gelation studies indicated that hydrogels formed in nine minutes and 10 min for the unloaded and nanoparticle-loaded hydrogels, respectively. The hydrogels displayed in situ gel formation properties, and rheometric viscoelastic studies indicated the unloaded and loaded hydrogels to have modulus values similar to those of the natural vitreous at 37 °C. Administration of the hydrogels was possible via 26G needles allowing for clinical application and drug release of triamcinolone acetonide from the nanoparticle-loaded hydrogel, which provided sustained in vitro drug release over nine weeks. The hydrogels displayed minimal swelling, reaching equilibrium swelling within 12 h for the unloaded hydrogel, and eight hours for the nanoparticle-loaded hydrogel. Biodegradation in simulated vitreous humour with lysozyme showed < 20% degradation within nine weeks. Biocompatibility of both unloaded and loaded hydrogels was shown with mouse fibroblast and human retinal pigment epithelium cell lines. Lastly, a pilot in vivo study in a New Zealand White rabbit model displayed minimal toxicity with precise, localised drug release behaviour, and ocular TA levels maintained within the therapeutic window for the 28-day investigation period, which supports the potential applicability of the unloaded and nanoparticle-loaded hydrogels as vitreous substitutes that function as drug delivery systems following vitrectomy surgery.
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Affiliation(s)
- Kruti Naik
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, Parktown, 2193, South Africa
| | - Lisa Claire du Toit
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, Parktown, 2193, South Africa
| | - Naseer Ally
- Division of Ophthalmology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, Parktown, 2193, South Africa
| | - Yahya Essop Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, Parktown, 2193, South Africa.
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13
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Dermine R, Poncelet PA, Verschaeve V. A Rare Case of Non-Small Cell Lung Cancer Presenting as Exudative Retinal Detachment. J Belg Soc Radiol 2024; 108:29. [PMID: 38523724 PMCID: PMC10959139 DOI: 10.5334/jbsr.3533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024] Open
Abstract
Teaching Point: Retinal detachment is a rare initial clinical manifestation of lung cancer with intraorbital metastases, early diagnosis on magnetic resonance imaging is important for therapeutic implications.
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Affiliation(s)
- Raphaëlle Dermine
- Physician Assistant, Cliniques Universitaires Saint-Luc UCLouvain, Bruxelles
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14
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Aljindan M, Albalawi N, Alzaher F, Hariri J, Bin Helayel H, Alsubaie MF, Khan O, Aloqab A, Alarfaj G, Sulaimani NM. Retinal complications post posterior chamber phakic intraocular lens implantation at a tertiary eye hospital in the Eastern Province of Saudi Arabia. Int Ophthalmol 2024; 44:141. [PMID: 38492122 DOI: 10.1007/s10792-024-03076-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 09/24/2023] [Accepted: 02/16/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Phakic intraocular lenses treat higher degrees of myopia not possible previously with conventional refractive surgery. The aim of this study is to report the incidence and risk factors of retinal complications after posterior chamber PIOL implantation and assess the differences in biometric parameters between patients who developed such complications versus those who did not. METHODS This retrospective study recruited 514 patients who underwent ICL implantation to correct myopia at a tertiary eye hospital center in the Eastern province of Saudi Arabia. Follow up period was at least one year. Medical records of the patients were reviewed to obtain the required data. Associations between respondents' characteristics and retinal complications were evaluated using the Chi-squared test. RESULTS The mean (SD) age was 27.7 (± 6.5) years ranging from 18 to 47. Laser treatment was performed in 14 cases (2.7%). Retinal complications occurred in six cases (1.2%). The risk of retinal complication was significantly higher among patients with high axial length (OR = 1.3, 95% CI 1.2, 1.4) and patients with high pre-spherical equivalent before ICL (OR = 1.09, 95% CI 1.03, 1.4). CONCLUSION Patients with higher axial length and higher pre-spherical equivalent before ICL implantation are at high risk of retinal complications.
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Affiliation(s)
- Mohanna Aljindan
- Ophthalmology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
| | - Nada Albalawi
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
- Ophthalmology Department, King Salman Armed Forces Hospital, Tabuk, Saudi Arabia
| | - Fatimah Alzaher
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
| | - Jumana Hariri
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
| | - Halah Bin Helayel
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
- Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Majed Fehaid Alsubaie
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
| | - Omar Khan
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
- Ophthalmology Department, Ohud Hospital, Ministry of Health, Madinah, Saudi Arabia
| | - Aysha Aloqab
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia.
- Ophthalmology Department, Bahrain Defence Force Hospital, Riffa, Bahrain.
| | - Ghufran Alarfaj
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
| | - Naif M Sulaimani
- Ophthalmology Department, Dhahran-Eye-Specialist-Hospital, Al Jamiah, Dhahran, Saudi Arabia
- Dr. Sulaiman Al Habib Hospital, Khobar, Saudi Arabia
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15
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Alfaar AS, Wiedemann P, Rehak M, Wolf A. The rising tide of rhegmatogenous retinal detachment in Germany: a nationwide analysis of the incidence, from 2005 to 2021. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06392-2. [PMID: 38466396 DOI: 10.1007/s00417-024-06392-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/17/2024] [Accepted: 01/30/2024] [Indexed: 03/13/2024] Open
Abstract
PURPOSE This nationwide study aims to delineate the incidence and trends of rhegmatogenous retinal detachment (rRD) in Germany across 17 years (2005-2021). METHODS We conducted a retrospective cohort study using data from the German Federal Statistics Office and the Institute for the Hospital Remuneration System (InEK). The dataset includes approximately 19 million annual inpatient admissions annually. Retinal detachment was identified through ICD-10 code H33.0. Adjusted incidence rates were estimated after excluding reoperation cases. We used R Statistical Software to calculate estimates to 2021, and Tableau for visualisation. RESULTS From 2005 to 2021, Germany reported 332,650 rRD cases, with males consistently more affected. Adjusted incidence rose from 15.6 per 100,000 in 2005 to 24.8 in 2021. Variable annual percentage changes in incidence were noted, averaging 4.0% for males and 2.6% for females. The annual mean age of affected individuals ranged from 60.2 to 62 years, with a median age between 62 and 63, suggesting increasing diagnoses at younger ages. Hospital stays declined from 6 to 3.3 days, and higher management rates were observed in Saarland and Rhineland-Palatine. CONCLUSION The study confirms an increasing incidence of rRD in Germany from 2005 to 2021, particularly among males. These findings call for further research to investigate the underlying causes. Collaboration among healthcare professionals, researchers, and policymakers is essential for effective management and improved visual outcomes.
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Affiliation(s)
- Ahmad Samir Alfaar
- Ophthalmology Department, Ulm University Hospital, Ulm, Germany.
- Medical Neuroscience Program, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- St. Paul Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
| | - Peter Wiedemann
- Ophthalmology Department, Leipzig University Hospital, Leipzig, Germany
| | - Matus Rehak
- Ophthalmology Department, Giessen University Hospital, Giessen, Germany
- Ophthalmology Department, Medical University of Innsbruck, Innsbruck, Austria
| | - Armin Wolf
- Ophthalmology Department, Ulm University Hospital, Ulm, Germany
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16
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Katoch D, Handa S, Singh SR, Tekchandani U, Singh R, Pandav SS, Kaushik S. Use of the Aurolab Aqueous Drainage Implant as a buckling element in pediatric retinal detachment with a preexisting glaucoma drainage device. Am J Ophthalmol Case Rep 2024; 33:101962. [PMID: 38192606 PMCID: PMC10772371 DOI: 10.1016/j.ajoc.2023.101962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/05/2023] [Accepted: 11/19/2023] [Indexed: 01/10/2024] Open
Abstract
Purpose To describe a novel technique for repair of rhegmatogenous retinal detachment in an eye with a previous non-valved glaucoma drainage device, the Aurolab Aqueous Drainage Implant (AADI). Observations A 5-year-old child with bilateral primary congenital glaucoma presented with an inferior retinal detachment (RD) in the left eye. The left eye had a history of multiple surgical interventions including combined trabeculotomy and trabeculectomy done twice, AADI implantation and subsequently phacoaspiration with IOL implantation, 18 months prior to presentation. The left eye retinal detachment was managed by scleral buckling technique using the plate of the AADI as a buckling element without its explantation. Conclusions AND IMPORTANCE: Management of retinal detachment in eyes with a pre-existing glaucoma drainage device (GDD) is uniquely challenging. Explantation of the GDD would likely result in intractable glaucoma post-operatively, requiring another surgery. Use of the trimmed plate of the GDD itself as the buckling element helped in settling the RD and preserving intraocular pressure control.
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Affiliation(s)
- Deeksha Katoch
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sabia Handa
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Simar Rajan Singh
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Uday Tekchandani
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ramandeep Singh
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Surinder Singh Pandav
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sushmita Kaushik
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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17
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Choi G, An SH, Choi JW, Rho MS, Park WC, Jeong WJ, Cha HJ. Injectable alginate-based in situ self-healable transparent hydrogel as a vitreous substitute with a tamponading function. Biomaterials 2024; 305:122459. [PMID: 38199216 DOI: 10.1016/j.biomaterials.2023.122459] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/24/2023] [Revised: 12/24/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024]
Abstract
Retinal detachment and other vision-threatening disorders often necessitate vitreous body removal and tamponade injection for retina stabilization. Current clinical tamponades such as silicone oil and expansile gases have drawbacks, including patient discomfort and the need for secondary surgery. We introduce a transparent alginate-phenylboronic acid/polyvinyl alcohol composite hydrogel (TALPPH) as a novel vitreous substitute with tamponading capabilities. In vitro physicochemical, rheological, and optical characterization of in situ self-healable TALPPH was performed, and long-term biocompatibility was assessed in a rabbit model of vitrectomy retinal detachment. In vivo evaluations confirmed TALPPH's ability to inhibit retinal detachment recurrence and preserve rabbit vision without adverse effects. TALPPH's close resemblance to the natural vitreous body suggests potential as a vitreous tamponade substitute for future ophthalmological applications.
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Affiliation(s)
- Geunho Choi
- Department of Chemical Engineering, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Seoung Hyun An
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Jae-Won Choi
- Department of Ophthalmology, Sungmo Eye Hospital, Busan 48064, Republic of Korea
| | - Mee Sook Rho
- Department of Pathology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Woo Chan Park
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Woo Jin Jeong
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea.
| | - Hyung Joon Cha
- Department of Chemical Engineering, Pohang University of Science and Technology, Pohang 37673, Republic of Korea; Medical Science and Engineering, School of Convergence Science and Technology, Pohang University of Science and Technology, Pohang 37673, Republic of Korea.
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Zajner C, Leung B, Sheidow T, Malvankar-Mehta MS. Quality of Life after Pars Plana Vitrectomy, Scleral Buckle, or Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment: A Meta-Analysis. Curr Eye Res 2024; 49:295-302. [PMID: 37937863 DOI: 10.1080/02713683.2023.2280440] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/17/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE Comparisons of the surgical and anatomic results of rhegmatogenous retinal detachment surgery have been investigated previously. A systematic evaluation of the available evidence comparing quality of life outcomes of either pars plana vitrectomy, scleral buckling, or pneumatic retinopexy has not been evaluated to date. This article analyzes whether pars plana vitrectomy, scleral buckling, or pneumatic retinopexy for the treatment of rhegmatogenous retinal detachment results in differing quality of life outcomes. METHODS In February of 2022, a comprehensive search of MEDLINE, EMBASE, CINHAL, and Cochrane Library was conducted for studies on patients treated surgically for rhegmatogenous retinal detachment and included follow-up measurements of quality of life outcomes. Meta-analysis was completed using STATA v. 14.0. The main outcomes of interest were the mean vision-related quality of life score (VRQOL) and SD of VRQOL of each type of surgical procedure. RESULTS In this systematic review of 13 distinct trials including follow-up of patient quality of life after rhegmatogenous retinal detachment surgery (n = 1063), a better correlation was found between higher quality of life outcomes with scleral buckling than with pars plana vitrectomy (SMD = 0.62, CI: [0.31, 0.93]). There was also no signficant difference in quality of life outcomes between pneumatic retinopexy and pars plana vitrectomy (SMD = 0.08, CI: [-0.07, 0.22]). CONCLUSIONS Scleral buckling results in better quality of life outcomes for patients when compared to pars plana vitrectomy. Pneumatic retinopexy did not show a difference in quality of life outcomes compared to pars plana vitrectomy.
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Affiliation(s)
- Chris Zajner
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada
| | - Bernice Leung
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada
| | - Tom Sheidow
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
| | - Monali S Malvankar-Mehta
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
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Iovino C, Rosolia A, Marano E, Della Corte M, Testa F, Simonelli F. Navigated yellow subthreshold micropulse laser for refractory cystoid macular edema following rhegmatogenous retinal detachment surgery. Am J Ophthalmol Case Rep 2024; 33:101981. [PMID: 38274400 PMCID: PMC10809002 DOI: 10.1016/j.ajoc.2023.101981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 11/03/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024] Open
Abstract
Purpose To report the efficacy and safety of navigated 577nm yellow subthreshold micropulse laser (YSML) treatment in a case of refractory cystoid macular edema (CME) following combined phaco-vitrectomy for rhegmatogenous retinal detachment (RRD). Observations A 69-year-old male patient complained a slow and progressive visual loss in the right eye (RE) since two months. A complete ophthalmological evaluation was performed. Best corrected visual acuity (BCVA) was hand motion and slit lamp examination revealed a nuclear cataract and a total macula-off RRD in the RE. Patient underwent a combined phaco +25 gauge pars plana vitrectomy (PPV) with 5000 cSt silicon oil (SO) tamponade. At the 3-month follow up BCVA was 20/250, retina was completely flat but a macular proliferative vitreoretinopathy (PVR) was detected with swept source optical coherence tomography (SS-OCT) and a second 23 G PPV with PVR peeling and SO removal was performed. At 1 month visit from the second surgery retina was flat and BCVA was 20/200 due to a persistent CME. Oral carbonic anhydrase inhibitors and topical steroids were administered for 2 months without any improvements. At this point, YSML was applied with a macular grid pattern and at three months follow up visit SS-OCT showed a complete resolution of CME, BCVA was 20/100 and these anatomical and functional outcomes were maintained at 6 months follow-up. Conclusions and importance YSML treatment may be considered a safe and effective treatment strategy for the management of refractory CME following complex RRD surgery cases.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Andrea Rosolia
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ernesto Marano
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Michele Della Corte
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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20
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Amaral DC, Lane M, Aguiar EHC, Marques GN, Cavassani LV, Rodrigues MPM, Alves MR, Manso JEF, Monteiro MLR, Louzada RN. Surgical management of retinal detachment and macular holes secondary to ocular toxoplasmosis: a systematic review and meta-analysis. Int J Retina Vitreous 2024; 10:23. [PMID: 38424638 PMCID: PMC10903043 DOI: 10.1186/s40942-024-00540-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/03/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Toxoplasma gondii causes ocular toxoplasmosis (OT), involving inflammation, scarring, and retinal complications. The OT complications were retinal detachment (RD), and retinal breakage (RB). Surgical interventions like scleral buckling (SB) and vitrectomy are common. Limited understanding exists of the safety and efficacy of surgical management of RD/RB secondary to OT. Another complication is toxoplasmosis-related macular holes (tMH), with sparse evidence on surgical outcomes. This meta-analysis aims to clarify clinical characteristics, and surgical results, and enhance understanding of RD, RB, and MH secondary to OT. METHODS PubMed, Cochrane, Embase and Web of Science database were queried for retrospective studies, case series and case reports that provided information on RD, RB and MH associated with OT and reported the outcomes of: (1) Retinal reattachment of RD/RB and tMH closure; (2) Best-corrected visual acuity (BCVA) improvement; and (3) Complications. Heterogeneity was examined with I2 statistics. A random-effects model was used for outcomes with high heterogeneity. Statistical analysis was performed using the software R (version 4.2.3, R Foundation for Statistical Computing, Vienna, Austria). RESULTS Fourteen final studies, comprising a total of 96 patients were analyzed, 81 with RD or RB and 15 with tMH. Overall, surgical management was associated with several advantages: a high rate of retinal reattachment of RD/RB of 97% (95% Confidence Interval [CI] 92-100%; I2 = 0%), retinal reattachment of just RD of 96% (95% CI 89-100%; I2 = 30%) and tMH closure 97% (95% CI 87-100; I2 = 12%). There were significant differences in BCVA after surgeries in studies of RD/RB (MD 0.60; 95% CI 0.35-0.65; I2 = 20%) and MH (MD 0.67; 95% CI 0.50-0.84; I2 = 0%). The overall complication rate associated with surgical procedures in RD/RB secondary to OT was confirmed to be 25%. CONCLUSIONS The systematic review and meta-analysis showed that the treatment approaches currently in use are effective, with a remarkable rate of retinal reattachment of RD/RB, tMH closure, and substantial improvements in visual acuity. More randomized, long-term studies on disease and surgical factors can provide valuable insights into their impact on anatomical and visual outcomes.
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Affiliation(s)
- Dillan Cunha Amaral
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | | | | | - Ricardo Noguera Louzada
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
- Instituto de Olhos São Sebastião, Largo Do Machado 54, 1208, Rio de Janeiro, 22221-020, Brazil.
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El Baha S, Ghandour M, Ahmed ISH. Evaluation of the (Baha) technique of scleral indentation using a self-retained scleral indenter during vitrectomy surgery: a randomized trial. Int Ophthalmol 2024; 44:92. [PMID: 38367129 PMCID: PMC10874340 DOI: 10.1007/s10792-024-03028-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/11/2024] [Indexed: 02/19/2024]
Abstract
AIMS The current study compared a novel technique of scleral indentation using the self-retaining Leyla retractor to the conventional scleral self-indentation with the chandelier light. METHODS Patients with rhegmatogenous retinal detachment were randomized on a 1:1 basis to either have the (Baha) indentation using a tip of a thimble scleral indenter welded to the support for the Leyla retractor system or to have the conventional scleral indentation while using a 25-gauge chandelier light. A video was recorded for the surgery of all the cases and reviewed by another consultant masked to the type of indentation. The indentation duration (i.e., the time in seconds between the first appearance of a hump due to scleral indentation in the recorded video until its final disappearance) was measured for every case. RESULTS The current study included 60 eyes of 60 adults with a mean age of 59.6 ± 9.8 years. Thirty-nine of the eyes were phakic and 21 were pseudophakic. The mean indentation time was 618 ± 87 and 696 ± 72 s in (Baha) indentation and conventional indentation groups, respectively. The difference was not statistically significant (p = 38). There was a positive correlation between the vertical palpebral fissure height and the indentation duration for both (Baha) indentation (r = 0.58) and conventional indentation groups (r = 0.42). Readjustment of the chandelier endo-illumination was required in 19 cases (63.3%) in the conventional indentation group. Iatrogenic breaks or accidental crystalline lens touch did not occur in any case. CONCLUSION The (Baha) technique is effective and safe, especially in patients with a larger palpebral fissure.
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Affiliation(s)
- Samir El Baha
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Moutaz Ghandour
- Anaesthesia and Surgical Intensive Care Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Islam S H Ahmed
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
- Faculty of Medicine, Alexandria University, Khartoum Square, Azarita, Alexandria, Egypt.
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Corcóstegui I, Subirás J, Corcóstegui B. Outcomes of rhegmatogenous retinal detachment surgery in patients with Stickler syndrome. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06406-z. [PMID: 38358525 DOI: 10.1007/s00417-024-06406-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
PURPOSE Despite recent developments in vitrectomy technology and instrumentation, rhegmatogenous retinal detachment in Stickler syndrome (RDS) remains a challenge for surgeons. RDSs are associated with a higher rate of complications and surgical failures than those not associated with Stickler syndrome. This study is a report about anatomic and visual outcomes of RDS surgery and describes the surgical techniques associated with the treatment of this specific condition. METHODS This is a retrospective, interventional, consecutive case series of patients with RDS undergoing retinal reattachment surgery from 1990 to 2020 at the Institute of Ocular Microsurgery (IMO) in Barcelona, Spain. RESULTS Twenty-four eyes of 18 patients with genetically confirmed Stickler syndrome were included in the study. Ten eyes (41.6%) presented a giant retinal tear. Retinal reattachment was achieved in all cases after an average of 1.21 (range 1-6) surgical interventions. Nineteen eyes (79%) required only one operation to achieve complete retinal reattachment. The most common first surgical procedure was a 4-mm scleral buckle with posterior pars plana vitrectomy and silicone oil endotamponade, performed on 16 (66.6%) of the eyes. The mean follow-up period was 10.2 years. Mean preoperative visual acuity LogMar was 1.10 (Snellen equivalent 20/252), which improved to 0.50 (Snellen equivalent 20/63) at final follow-up (p < 0.05). CONCLUSION In most RDS cases, anatomic success and visual acuity improvement can be achieved with the first surgical procedure, using a combination of silicone oil tamponade and a 4-mm scleral encircling band. In some early cases of RDS, other less invasive surgical techniques can be used.
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Affiliation(s)
| | - Javier Subirás
- Vitreo-Retinal Department, Institute of Ocular Microsurgery, Barcelona, Spain
| | - Borja Corcóstegui
- Vitreo-Retinal Department, Institute of Ocular Microsurgery, Barcelona, Spain
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de Saint Sauveur G, Sayadi S, Lejoyeux R, Salviat F, Tadayoni R, Bruneau S, Bonnin S, Le Mer Y. Incidence of macular displacement after rhegmatogenous retinal detachment surgery using ultra-widefield fundus autofluorescence. Int Ophthalmol 2024; 44:66. [PMID: 38347237 DOI: 10.1007/s10792-024-03018-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/24/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024]
Abstract
PURPOSE The incidence of retinal displacement after rhegmatogenous retinal detachment (RRD) surgery is variable and its clinical consequences are unclear. The aim of this study was to assess the incidence and clinical features of retinal displacement after RRD surgery by using ultra-widefield (UWF) imaging. METHODS Retrospective observational study including all consecutive patients who underwent RRD surgery at the Rothschild Foundation Hospital. Postoperative data included the visual acuity and symptoms of visual impairment. Macular retinal displacement occurrence and its features were assessed and measured by using the autofluorescence images. RESULTS A total of 123 eyes were included. UWF fundus autofluorescence revealed the presence of macular retinal displacement in 14 (11%) eyes. All displacements were inferior, with a mean angle of 3.8°. Patients with and without macular displacement did not differ in postoperative visual acuity. The retinal detachment extent and preoperative macular involvement were not significantly associated with the occurrence of retinal displacement. CONCLUSION In this representative cohort of eyes that underwent RRD surgery with systematic screening for postoperative retinal displacement by UWF fundus autofluorescence, 11% of eyes experienced an inferior retinal shift. As in other cohorts, the presence of metamorphopsia was not associated with the occurrence of retinal shift.
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Affiliation(s)
- Guy de Saint Sauveur
- Ophthalmology Department, Rothschild Foundation Hospital, 29 rue Manin, 75940, Paris-Cedex 19, France
| | - Sana Sayadi
- Ophthalmology Department, Rothschild Foundation Hospital, 29 rue Manin, 75940, Paris-Cedex 19, France
| | - Raphaël Lejoyeux
- Ophthalmology Department, Rothschild Foundation Hospital, 29 rue Manin, 75940, Paris-Cedex 19, France
| | - Flore Salviat
- Ophthalmology Department, Rothschild Foundation Hospital, 29 rue Manin, 75940, Paris-Cedex 19, France
| | - Ramin Tadayoni
- Ophthalmology Department, Rothschild Foundation Hospital, 29 rue Manin, 75940, Paris-Cedex 19, France
| | - Sébastien Bruneau
- Ophthalmology Department, Rothschild Foundation Hospital, 29 rue Manin, 75940, Paris-Cedex 19, France
| | - Sophie Bonnin
- Ophthalmology Department, Rothschild Foundation Hospital, 29 rue Manin, 75940, Paris-Cedex 19, France.
| | - Yannick Le Mer
- Ophthalmology Department, Rothschild Foundation Hospital, 29 rue Manin, 75940, Paris-Cedex 19, France
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Schöneberger V, Li JQ, Menghesha L, Holz FG, Schaub F, Krohne TU. Outcomes of short- versus long-acting gas tamponades in vitrectomy for rhegmatogenous retinal detachment. Int J Retina Vitreous 2024; 10:16. [PMID: 38317211 PMCID: PMC10840190 DOI: 10.1186/s40942-024-00530-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/13/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND In vitrectomy for rhegmatogenous retinal detachment, long-acting gas tamponades (LGT) such as C3F8 or C2F6 may improve surgical success rate due to their prolonged effect compared to a short-acting gas tamponade (SGT) with SF6. On the other hand, SGT allow a significantly faster visual rehabilitation after surgery and may reduce the risk of gas-related complications. As comparative data in retinal detachment surgery is limited, we assessed the outcomes of vitrectomies using either LGT or SGT. METHODS We retrospectively analyzed 533 eyes of 524 consecutive patients diagnosed with primary rhegmatogenous retinal detachment not complicated by proliferative vitreoretinopathy (PVR) and treated by vitrectomy at two clinical sites. Depending on the site the patients presented at, they received either preferentially LGT (study site 1) or SGT (study site 2). Retinal re-detachment rates during a period of 6 months following surgery were analyzed. RESULTS At study site 1, 254 of 278 eyes (91.4%) were treated by LGT (C3F8 72.3%; C2F6 19.1%), whereas at study site 2, 246 of 255 eyes (96.5%) received SGT (SF6). Rates of retinal re-detachment in the LGT- and SGT-treated groups were similar with 23 of 254 eyes (9.1%) and 24 of 246 eyes (9.8%), respectively (p = 0.9). Median time to re-detachment was 5.7 weeks in the LGT-treated group and 4.4 weeks in the SGT-treated group (p = 0.4). CONCLUSION In rhegmatogenous retinal detachment repair by vitrectomy, the use of SGT results in comparable rates of successful retinal re-attachment as LGT. Given the faster visual rehabilitation with SGT, these results suggest SGT as a sensible alternative to LGT in surgery of retinal detachment without PVR.
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Affiliation(s)
- Verena Schöneberger
- Department of Ophthalmology, University Medical Center Rostock, University of Rostock, Doberaner Str. 140, 18057, Rostock, Germany.
| | - Jeany Q Li
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Leonie Menghesha
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Friederike Schaub
- Department of Ophthalmology, University Medical Center Rostock, University of Rostock, Doberaner Str. 140, 18057, Rostock, Germany
| | - Tim U Krohne
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Rohowetz LJ, Panneerselvam S, Williams BK, Smiddy WE, Berrocal AM, Townsend JH, Gayer S, Palte HD, Flynn HW. Proliferative Sickle Cell Retinopathy: Outcomes of Vitreoretinal Surgery. Ophthalmol Retina 2024:S2468-6530(24)00049-6. [PMID: 38302055 DOI: 10.1016/j.oret.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/17/2023] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE To report the clinical presentation and outcomes in patients who underwent surgery for proliferative sickle cell retinopathy (PSCR). DESIGN Retrospective, consecutive case series. SUBJECTS All patients who underwent vitreoretinal surgery for complications secondary to PSCR between January 1, 2014, and December 31, 2021, at a university referral center. METHODS Retrospective consecutive case series. MAIN OUTCOME MEASURES Best-corrected visual acuity (BCVA), single operation anatomic success rate. RESULTS The study included 65 eyes of 61 patients. Disease distribution included 24 (44.4%) eyes with hemoglobin SC disease, 14 (25.9%) with hemoglobin SS disease, 13 (24.1%) with sickle cell trait, and 3 (5.6%) with sickle cell-β thalassemia. Preoperative transfusion was not performed in any study patients. Regional anesthesia with monitored anesthesia care (RA-MAC) was utilized in 58 (89.2%) eyes and general anesthesia in 7 (10.8%). In eyes that underwent surgery for retinal detachment (RD; N = 52) the rate of single operation anatomic success was 72.4% with combined scleral buckling/pars plana vitrectomy (SB/PPV; N = 29) compared with 47.8% with PPV alone (N = 23; P = 0.07). Mean BCVA at the last follow-up examination was 1.27 (20/372) in the SB/PPV group and 1.05 (20/226) in the PPV group (P = 0.48). In all SB cases, an encircling band was utilized and there were no known cases of anterior segment ischemia. All eyes that had surgery for vitreous hemorrhage (N = 13) underwent PPV with endolaser and mean BCVA improved from 1.67 (20/944) preoperatively to 0.45 (20/56) at last follow-up examination (P < 0.001). Mean preoperative BCVA, indication for surgery, single operation success rate, and mean BCVA at last follow-up examination did not differ based on sickle cell disease type (P > 0.05). CONCLUSIONS In patients with RD, SB/PPV achieved slightly higher rates of single operation anatomic success compared with PPV alone. Visual acuity outcomes were similar in the 2 groups. The majority of patients received RA-MAC anesthesia and preoperative transfusions were not performed. There were no cases of postoperative anterior segment ischemia. Hemoglobin SC disease was the most common disease type in the current study and surgical outcomes did not differ between sickle cell disease types. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Landon J Rohowetz
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Sugi Panneerselvam
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Basil K Williams
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - William E Smiddy
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Audina M Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Justin H Townsend
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Steven Gayer
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Howard D Palte
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Harry W Flynn
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida.
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Bomdica PR, MacCumber MW, Abdel-Hadi S, Parker M, Minaker S. Surgical Outcomes of Rhegmatogenous Retinal Detachment and Fellow Eye Involvement in Adolescent and Young Adult Patients. Ophthalmol Retina 2024; 8:148-154. [PMID: 37716430 DOI: 10.1016/j.oret.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 06/05/2023] [Revised: 08/30/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE To investigate the associations, fellow eye retinal tear or detachment, and surgical outcomes of rhegmatogenous retinal detachments (RRDs) in young adults. DESIGN Retrospective consecutive case series. SUBJECTS Patients aged ≤ 30 years who underwent surgical repair for RRD between 2014 and 2021 at a single practice. The mean age was 23.85 years (range, 12-30 years). METHODS Data collected included demographics, preoperative clinical features of the RRD, visual acuity (VA), type of surgery performed, anatomic outcomes, OCT findings, fellow eye retinal tear or detachment, and postoperative complications. MAIN OUTCOME MEASURES Postoperative VA and single-surgery anatomic success rate. RESULTS One hundred one patients (109 eyes) were included. Sixty-seven patients (74 eyes) and 17 patients (19 eyes) were followed for ≥ 1 year and 5 years, respectively. The most common associations were myopia (66 eyes, 60.6%), trauma (8 eyes, 7.3%), and prior ocular surgery (7 eyes, 6.4%). Median preoperative Snellen VA was 20/70. The macula was attached in 31 eyes. Scleral buckle (SB) alone was performed in 75 eyes, pars plana vitrectomy (PPV) + SB was performed in 27 eyes, PPV alone was performed in 6 eyes, and cryotherapy with pneumatic retinopexy was performed in 1 patient. Single-surgery anatomical success was 88.7% for SB, 89.7% for PPV + SB, and 75% for PPV. The median final postoperative Snellen VA was 20/50. Twelve patients presented with bilateral RRDs, and sequential surgery was performed in 8 patients, followed by 4 patients who underwent surgery with fellow eye laser barricade. Fourteen patients (13.9%) developed a retinal tear or detachment in the fellow eye, with a mean interval of 8 months from presentation. Of the 17 patients who were followed for ≥ 5 years, 3 patients (17.6%) developed a fellow eye retinal tear or detachment. After initial anatomical success, 6 eyes (5.5%) developed proliferative vitreoretinopathy. CONCLUSIONS The most common association of RRD in this study was myopia. Scleral buckle alone was the most common surgical intervention. However, outcomes were generally favorable with SB-only and PPV + SB. Surgeons and patients should be aware of the risk of bilateral retinal detachment and the risk of fellow eye retinal tear and detachment. These patients require long-term surveillance in both eyes. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Prithvi R Bomdica
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois
| | - Mathew W MacCumber
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois; Illinois Retina Associates, Chicago, Illinois
| | - Sarah Abdel-Hadi
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois
| | - Makena Parker
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois
| | - Samuel Minaker
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois; Illinois Retina Associates, Chicago, Illinois.
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Mammo DA, Wai K, Rahimy E, Pan CK, Srivastava SK, Mruthyunjaya P. Association of Cutaneous Keloids, Hypertrophic Scarring, and Fibrosis with Risk of Postoperative Proliferative Vitreoretinopathy. Ophthalmology 2024:S0161-6420(24)00093-9. [PMID: 38296203 DOI: 10.1016/j.ophtha.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/23/2024] [Indexed: 03/21/2024] Open
Abstract
PURPOSE To assess an association between cutaneous keloids, hypertrophic scarring, and fibrosis (KHF) and risk of postoperative proliferative vitreoretinopathy (PVR) after rhegmatogenous retinal detachment (RRD) repair. DESIGN Retrospective, population-based cohort study. PARTICIPANTS Patients aged ≥ 18 years who underwent initial retinal detachment (RD) repair with pars plana vitrectomy with or without scleral buckle (SB) (Current Procedural Terminology [CPT] 67108), pneumatic retinopexy (67110), and primary SB (67107) from January 1, 2003, to March 1, 2023. METHODS A de-identified electronic health record database through TriNetX, a global health research network, was used to analyze patients. Patients were queried for International Classification of Diseases, 10th Revision (ICD-10) codes L91.0 (hypertrophic scar) and L90.5 (scar conditions and fibrosis of skin). Frequency of subsequent diagnosis of PVR (H35.2) and CPT codes for secondary surgery including complex RD repair (67113) were determined. Patients with proliferative diabetic retinopathy (PDR) (ICD-10 H10.35/H11.35) were excluded. Descriptive statistics (Z-test) and propensity score matching (PSM) were used to match for age, sex, and race. MAIN OUTCOME MEASURES Prevalence of H35.2 and CPT 67113 within 180 days after RRD repair in the KHF cohort versus the non-KHF cohort. RESULTS Among patients with CPT 67108, 1061 in each cohort (KHF and non-KHF) were analyzed after PSM. The mean (standard deviation) age was 60.7 (15.2) years. Within 180 days, 10.1% of patients in the KHF cohort and 3.4% in the non-KHF cohort had a diagnosis of PVR (H35.2) (P < 0.001, odds ratio [OR], 3.2; 95% confidence interval [CI], 2.13-4.71). A total of 8.3% of patients in the KHF cohort and 5.4% of patients in the non-KHF cohort underwent complex RD repair (CPT 67113) (P = 0.008; OR, 3.2; 95% CI, 1.13-2.25). When including all RD repair types (CPT 67108, 67110, 67107), the rate of PVR diagnosis was still significantly greater in the KHF cohort than in the non-KHF cohort (9.0% vs 4.2%, P < 0.01; OR, 2.28; 95% CI, 1.64-3.16). CONCLUSIONS A dermatologic history of KHF may be a risk factor for PVR after RD repair. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Danny A Mammo
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Karen Wai
- Byers Eye Institute, Stanford Health Care, Palo Alto, California
| | - Ehsan Rahimy
- Byers Eye Institute, Stanford Health Care, Palo Alto, California
| | - Carolyn K Pan
- Byers Eye Institute, Stanford Health Care, Palo Alto, California
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Alberti M, Ilsby C, Christensen UC, Kiilgaard JF, la Cour M. Preoperative Positioning and Progression of Fovea-on Retinal Detachments. Ophthalmol Retina 2024; 8:137-147. [PMID: 37659721 DOI: 10.1016/j.oret.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 04/24/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/04/2023]
Abstract
PURPOSE To study the relationship between positioning and rhegmatogenous retinal detachment (RRD) progression before surgery in patients with a fovea-on RRD. DESIGN Prospective, single-cohort study. SUBJECTS Patients with fovea-on RRD admitted to hospital for bedrest before surgical treatment were recruited. METHODS Primary outcome was the shortest distance from the foveal center to the retinal detachment border on OCT. Secondary outcomes were measured with a head-mounted positioning sensor and included measures of head movement (linear acceleration and angular velocity) as well as measures of positioning regimen compliance. MAIN OUTCOME MEASURES Distance from the fovea to the retinal detachment border. RESULTS Overall, 50 patients with fovea-on positioned before RRD repair. One patient (1/50, 2%) progressed from fovea-on to fovea-off. Of the positioning measures, angular velocity demonstrated the strongest correlation with RRD border movement, whereas measures of positioning compliance showed nonsignificant correlation. After defining 3 movement groups: stable, intermediate, and mobile RRDs, we found that a doubling of head movement (angular velocity) correlated with a median RRD border progression of -6 μm/h, -75 μm/h, and -219 μm/h in the 3 groups, respectively. CONCLUSIONS Rhegmatogenous retinal detachment border movement is correlated to angular velocity of the head, whereas compliance with our current positioning regimen does not have a significant impact on RRD border movement. Not all RRDs progress rapidly toward the fovea, but those that do seem to be highly influenced by head movement. For limiting RRD progression, a reduced movement positioning regimen may be superior to our current gravity-based approach. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Mark Alberti
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
| | - Christian Ilsby
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
| | | | | | - Morten la Cour
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
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Matoba R, Kanzaki Y, Morita T, Kimura S, Hosokawa MM, Shiode Y, Morizane Y. Evaluation of epiretinal membrane formation after scleral buckling for treating rhegmatogenous retinal detachment: En face optical coherence tomography image-based study. Graefes Arch Clin Exp Ophthalmol 2024; 262:469-476. [PMID: 37864637 DOI: 10.1007/s00417-023-06285-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/31/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
PURPOSE To assess epiretinal membrane (ERM) formation, severity, and the associated risk factors after scleral buckling using en face optical coherence tomography (OCT) images. METHODS Medical records of 61 consecutive patients (66 eyes) with rhegmatogenous retinal detachment who underwent scleral buckling were retrospectively reviewed. Posterior vitreous detachment (PVD) was determined based on B-scan OCT images. En face OCT images were used to visualize the ERM and retinal folds. ERM formation was identified by comparing en face images pre- and post-surgery. The maximum depth of the retinal folds (MDRF) was measured using en face imaging to objectively assess traction strength. RESULTS ERM formation occurred in 15 (22.7%) eyes at the final visit; the foveal pit was preserved in all cases. Parafoveal retinal folds were present in 5 (7.6%) eyes, with a mean MDRF of 21.8 ± 12.6 µm. No significant difference was observed in best-corrected visual acuity (logarithm of the minimal angle of resolution) between the ERM formation (-0.019 ± 0.128) and non-ERM formation (-0.001 ± 0.213) groups at the final visit (P = 0.593; Mann-Whitney U test). Multivariate logistic regression analysis revealed that older age and the presence of PVD were significant risk factors for ERM formation (odds ratio 1.07, 95% confidence interval 1.01-1.14, P = 0.032; odds ratio 5.26, 95% confidence interval 1.06-26.10, P = 0.042; respectively). CONCLUSION ERM occurred in 22.7% of cases but was mild and did not affect visual acuity. Older age and the presence of PVD are risk factors for ERM formation.
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Affiliation(s)
- Ryo Matoba
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho Kita-Ku, Okayama City, Okayama, 700-8558, Japan.
| | - Yuki Kanzaki
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho Kita-Ku, Okayama City, Okayama, 700-8558, Japan
| | - Tetsuro Morita
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho Kita-Ku, Okayama City, Okayama, 700-8558, Japan
| | - Shuhei Kimura
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho Kita-Ku, Okayama City, Okayama, 700-8558, Japan
| | - Mio Morizane Hosokawa
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho Kita-Ku, Okayama City, Okayama, 700-8558, Japan
| | - Yusuke Shiode
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho Kita-Ku, Okayama City, Okayama, 700-8558, Japan
| | - Yuki Morizane
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho Kita-Ku, Okayama City, Okayama, 700-8558, Japan
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Alshamrani AA, Magliyah M, Alkuraya FS, Alabdi L, Alfaadhel TA, Alsulaiman SM. Early-Onset Myopia and Retinal Detachment without Typical Microcoria or Severe Proteinuria due to a Novel LAMB2 Variant. Ophthalmol Retina 2024; 8:155-162. [PMID: 37678612 DOI: 10.1016/j.oret.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 06/10/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE To describe the ocular and renal features, as well as outcomes of retinal detachment repair, in patients with a novel, homozygous laminin β-2 (LAMB2) pathogenic variant. DESIGN Single-center retrospective chart review of patients with a homozygous variant, c.619T>C p.(Ser207Pro), in the LAMB2 gene. SUBJECTS Eleven patients (22 eyes) from 4 families. METHODS Demographic data and ocular findings were recorded. Patients were recalled for a detailed renal evaluation. MAIN OUTCOME MEASURES Ocular features, renal features, and outcomes of retinal detachment repair. RESULTS The mean age at presentation was 6.0 (range, 1-26) years. None of the study eyes had microcoria, and none of the patients had nephrotic-range proteinuria. The mean refraction and axial length were -7.9 diopters (range, -4.0 to -12.0 diopters) and 25.3 (range, 22.7-27.7) mm, respectively. Eleven eyes (50%) had cataract at presentation. Fifteen eyes had a clear view to the fundus and all showed tessellated myopic fundus, avascular peripheral retina evident clinically or on fluorescein angiography, and rudimentary fovea. Optic disc pallor was observed in 10 eyes (66.7%). Straightened retinal vessels, abnormal vascular emanation (situs inversus) from the optic disc, supernumerary vascular branching at the optic disc, and vascular tortuosity were observed in 10 (66.7%), 2 (13.4%), 2 (13.4%), and 2 (13.4%) eyes, respectively. Discrete areas of punched-out chorioretinal atrophy were observed in 4 (26.7%) eyes. Spectral-domain OCT showed retinal and choroidal thinning in 13 eyes (86.7%), retinoschisis temporal to the fovea in 2 eyes (13.4%), and rudimentary fovea in 15 eyes (100%). Among the 22 eyes, 14 eyes (63.6%) developed rhegmatogenous retinal detachment (RRD), mostly during childhood, of which 5 patients had bilateral RRD. Eight eyes were operated on and 6 (75%) achieved retinal reattachment at the last follow-up. The mean preoperative visual acuity was 20/300 and the mean postoperative visual acuity at the last follow-up was 20/400. CONCLUSIONS This study describes a distinct phenotype of LAMB2-related disease with a novel, homozygous LAMB2 variant, and further expands the spectrum of ophthalmic and renal features, and the molecular genetic basis, of LAMB2-related disease. Because the typical microcoria and nephrotic-range proteinuria might be absent, the retinal features can guide the diagnosis. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
| | - Moustafa Magliyah
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Department of Ophthalmology, Prince Mohammed Medical City, Aljouf, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Translational Genomics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Lama Alabdi
- Department of Translational Genomics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Talal A Alfaadhel
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Hassan A, Abdel-Radi M, Aly MOM, Alattar S. Correlation between multifocal electroretinogram and optical coherence tomography findings with visual acuity after vitrectomy surgery for retinal detachment: an observational study. Int J Retina Vitreous 2024; 10:10. [PMID: 38263142 PMCID: PMC10804544 DOI: 10.1186/s40942-024-00527-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Despite the marked increase in the anatomical success rates of macula-off rhegmatogenous retinal detachment (RRD) surgery, patients may still complain about unsatisfactory visual outcome. This study aims to correlate the postoperative corrected distance visual acuity (CDVA) with the mf-ERG (multifocal electroretinogram) and OCT (optical coherence tomography) findings following vitrectomy surgery for RRD. PATIENTS AND METHODS This retrospective observational study included 40 eyes of 40 patients who underwent successful vitrectomy surgery for macula-off RRD. CDVA, mf-ERG amplitudes, mf-ERG latencies, the central macular thickness (CMT) and the integrity of the inner segment/outer segment (IS/OS) junction assessed by OCT, were evaluated 6 months postoperatively. The correlations between CDVA with mf-ERG amplitudes, mf-ERG latencies, central macular thickness, and IS/OS junction integrity were analyzed. RESULTS There was a statistically significant moderate positive correlation between CDVA of the studied eyes with mf-ERG amplitudes of N1, P1 and N2 in ring 1 (P = 0.008; P < 0.001 and P = 0.004, respectively), CMT (P < 0.001), and the integrity of IS/OS junction (P < 0.001). There was no significant correlation between CDVA and mf-ERG latencies in ring 1 (P > 0.05). Linear regression analysis revealed that CDVA was significantly associated with mf-ERG amplitudes and the IS/OS junction integrity. In addition, there was a strong positive correlation between mf-ERG amplitudes in ring 1 and the IS/OS junction integrity. CONCLUSIONS The integrated interpretation of postoperative CDVA, multifocal ERG parameters, and OCT findings provides useful information about functional visual recovery and retinal microstructural changes following vitrectomy for macula-off RRD surgery. The positive correlation between the IS/OS junction integrity and the mf-ERG amplitudes was stronger than the correlation between the IS/OS junction integrity and CDVA suggesting that mf-ERG may be superior to CDVA in reflecting the extent of microstructural damage in the photoreceptor layer. TRIAL REGISTRATION Clinicaltrials.gov, NCT05993208. Registered 15 August 2023 - Retrospectively registered, https://classic. CLINICALTRIALS gov/ct2/show/NCT05993208 .
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Affiliation(s)
- Asmaa Hassan
- Department of Ophthalmology, New Valley University, New Valley, Egypt
| | | | | | - Sara Alattar
- Department of Ophthalmology, Assiut University, Assiut, Egypt
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Riboni N, Ribezzi E, Marraffa E, Mora P, Bellucci C, Bianchi F, Careri M. An ex vivo headspace gas chromatography-mass spectrometry method for the determination of short-chain siloxanes in silicon oil tamponades used in ophthalmic surgery. J Pharm Biomed Anal 2024; 238:115871. [PMID: 38006704 DOI: 10.1016/j.jpba.2023.115871] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
Being able to facilitate retinal reattachment by preventing water migration into the subretinal space, silicone oils are widely used as long-term intraocular tamponade to treat cases of retinal detachment. Various commercial tamponades constituted by linear polydimethylsiloxane polymers with different molecular weights and cyclic impurities are available. In this study, for the first time, an untargeted headspace-gas-chromatography-mass spectrometry (HS-GC-MS) method was developed to identify low-molecular weight contaminants in three different types of silicone oil tamponades, namely Siluron 2000, RS-OIL ECS5000 and Densiron Xtra. Both commercial and post-operative tamponades were analysed to screen for the different classes of compounds present in the samples. The most abundant classes were short-chain siloxanes, fluorinated compounds, and hydrocarbons. To quantify the siloxanes present in the samples, a targeted HS-GS-MS was optimized using a central composite design and validated according to guidelines for bioanalytical methods. Lower limits of quantification in the low μg/L range, good precision with RSD% < 12% and accuracy with recovery rates in the 81 ( ± 7) - 96 ( ± 4) % range were achieved. Short-chain siloxanes were quantified in both commercial and post-operative tamponades, being the RS-OIL ECS5000 characterized by the highest concentration levels of the investigated analytes. By contrast, Densiron Xtra tamponades showed the lowest amount of short-chain siloxanes, observing a general decrease in their concentration levels according to the residence time in the eyes.
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Affiliation(s)
- Nicolò Riboni
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy.
| | - Erika Ribezzi
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
| | - Enrico Marraffa
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
| | - Paolo Mora
- Ophthalmology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Carlo Bellucci
- Ophthalmology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Federica Bianchi
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy.
| | - Maria Careri
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
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Pérez SMP, Arias VC, Ramírez DJ, Martínez CE, Tamayo Martínez N. Efficacy of the use of perfluorocarbon as a temporary tamponade agent in severe ocular trauma and/or complex retinopexy: a scoping review. Int J Retina Vitreous 2024; 10:6. [PMID: 38238791 PMCID: PMC10797930 DOI: 10.1186/s40942-023-00504-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 10/22/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Perfluorocarbon (PFC)possesses unique chemical properties that favor the pigment epithelium's adhesion and allows the drainage of subretinal fluid through retinal holes present in retinal detachment cases. However, PFC as a temporary tamponade agent has been limited due to its high potential for toxicity. MAIN BODY We conducted a scoping review regarding the use of PFC in vitreoretinal surgery as a temporary tamponade in subjects with severe ocular trauma or severe retinal detachment who received a therapeutic intervention (vitrectomy via posterior approach with the use of PFC as a temporary tamponade), compared to vitrectomy without the use of PFC as a temporary tamponade. Outcomes of interest were retinal reattachment, visual acuity (VA), postoperative complications and retinal toxicity. The search was performed in Medline, Medline In-Process & Other Non-Indexed Citations, Medline Daily Update, Embase databases. Reference lists from relevant review articles were also included. Two hundred thirty-eight studies were found, with no duplicate entries. In the first selection, 230 articles were eliminated; in the second selection, 6 additional articles were discarded. In total, 8 articles were obtained in this review. Two selected articles corresponded to animal studies and 6 to studies in humans. Regarding study design, 5 were case series, and 1 was a cohort study. CONCLUSION PFC as a short-term tamponade had high rates of reapplication, improved VA, and the most frequent adverse effects were reversible after PFC withdrawal. Nonetheless, the quality of the studies was poor. Studies with more rigorous methodologies are needed to determine visual and structural outcomes and potential risks of PFC use as a temporary tamponade in vitreoretinal surgery.
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Affiliation(s)
- Sara Margarita Pérez Pérez
- Unidad de Oftalmología. Hospital Universitario San Ignacio. Bogotá, Bogotá, Colombia.
- Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá, Bogotá, Colombia.
- Ophthalmology Unit, Pontifical Xavierian University, Street 7 # 40-62, Bogotá, Colombia.
| | - Valentina Cárdenas Arias
- Unidad de Oftalmología. Hospital Universitario San Ignacio. Bogotá, Bogotá, Colombia
- Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá, Bogotá, Colombia
- Ophthalmology Unit, Pontifical Xavierian University, Street 7 # 40-62, Bogotá, Colombia
| | - Daniela Jaramillo Ramírez
- Unidad de Oftalmología. Hospital Universitario San Ignacio. Bogotá, Bogotá, Colombia
- Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá, Bogotá, Colombia
| | - Camilo Eduardo Martínez
- Unidad de Oftalmología. Hospital Universitario San Ignacio. Bogotá, Bogotá, Colombia
- Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá, Bogotá, Colombia
| | - Nathalie Tamayo Martínez
- Departamento de Epidemiología Clínica, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
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Chehaibou I, Abdelmassih Y, Metge F, Chapron T, Dureau P, Caputo G. Outcomes of Modified Limbal Lensectomy-Vitrectomy in Stages 4B and 5 Retinopathy of Prematurity with Extended Retrolental Fibroplasia. Ophthalmol Retina 2024:S2468-6530(24)00009-5. [PMID: 38199456 DOI: 10.1016/j.oret.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
PURPOSE To report on the anatomical and functional outcomes of a modified limbal lensectomy-vitrectomy (LV) approach for stages 4B and 5 retinopathy of prematurity (ROP) as defined in the International Classification of Retinopathy of Prematurity, 3rd Edition (ICROP 3). DESIGN Retrospective, monocentric, consecutive case series. PATIENTS Infants with ROP that underwent limbal LV for diffuse retrolental fibroplasia. METHODS Clinical charts and Retcam photographs were reviewed. Surgical approach consisted of a limbal LV through peripheral iridectomies with centripetal dissection of the preretinal fibrosis. MAIN OUTCOME MEASURES Anatomical success and visual function at last follow-up were evaluated. Multivariate logistic regression was used to explore potential prognostic factors affecting the anatomical outcome. RESULTS A total of 128 eyes of 81 patients with a mean gestational age of 28.7 ± 3.0 weeks and a mean birthweight of 1244 ± 429 g were included. Eighteen eyes (14.1%) had a stage 4B, 24 (18.8%) a stage 5B, and 86 a stage 5C (67.2%) ROP. Mean age at surgery was 57.4 ± 36.3 weeks and mean postoperative follow-up was 22.7 ± 20.4 months. Only 5 eyes (3.9%) had prior peripheral retinal ablation. Macular reattachment was achieved in 74 eyes (57.8%). Controlling for other baseline factors, a stage 5C (versus stage 4B, odds ratio [OR] = 6.9 [1.5-32.1], P = 0.01 and versus stage 5B, OR = 7.4 [1.5-37.1], P = 0.02), the presence of vascular activity (OR = 6.4 [2.3-18.1], P < 0.001), and the presence of Schlieren sign (OR = 13.0 [2.1-82.2], P = 0.006) were associated with a failure of macular reattachment. Visual acuity was assessed in 92 eyes (71.9%), among which 59 eyes (64.1%) had light perception or better. CONCLUSIONS Modified limbal LV resulted in macular reattachment in more than half of eyes with ROP-related retinal detachment and diffuse retrolental fibrosis. A stage 5C based on ICROP 3, the presence of vascular activity, and a Schlieren sign were significantly associated with a failure of macular reattachment. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Ismael Chehaibou
- Department of Pediatric Ophthalmology and Retina, Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Youssef Abdelmassih
- Department of Pediatric Ophthalmology and Retina, Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Florence Metge
- Department of Pediatric Ophthalmology and Retina, Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Thibaut Chapron
- Department of Pediatric Ophthalmology and Retina, Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Pascal Dureau
- Department of Pediatric Ophthalmology and Retina, Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Georges Caputo
- Department of Pediatric Ophthalmology and Retina, Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
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Iatropoulos I, Christou EE, Karmiris E, Chranioti IG, Kounas K, Kozobolis V, Stavrakas P. Multiple Types Late-Onset Postoperative Retinal Folds following Vitrectomy for Retinal Detachment Repair with Silicone Oil: Morphologic Variability and Optical Coherence Tomography Angiography Features - A Case Report. Case Rep Ophthalmol 2024; 15:358-368. [PMID: 38628308 PMCID: PMC11021041 DOI: 10.1159/000538501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Retinal folds (RFs) may develop following rhegmatogenous retinal detachment (RRD) repair, though it consists an uncommon complication. Case Presentation Herein, we present a case of late-onset postoperative outer RFs with aggravating characteristics following vitrectomy with silicone oil (SO) tamponade for RRD repair; early clinical findings, complications, anatomical and functional status during a 12-month follow-up period are described. Retinal imaging by acquiring optical coherence tomography scans and angiograms indicates detailed morphological and angiographic characteristics of the evolution of RFs over time. Our case provides insight into a combination of various types of RFs along with retinal disorganization with appearance in the late postoperative period after RRD repair with SO tamponade. Conclusion Our aim was to raise awareness of the pathological processes that may be associated with the development and evolution of RFs after successful RRD repair, indicating that it is critical to accurately diagnose the type of RFs and closely monitor their progression in an attempt to provide prognostication for future visual outcomes.
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Affiliation(s)
| | | | - Efthymios Karmiris
- Ophthalmology Department, Hellenic Air Force General Hospital, Athens, Greece
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Berco E, Elsliger S, Weinberg T, Ghannam W, Shoham-Hazon N. Triple Trouble with Triple Solutions: A Unique Case Report of a Severe Exudative Retinal Detachment Accompanied by Retinal Traction and Two Retinal Holes in Coats Disease. Case Rep Ophthalmol 2024; 15:84-91. [PMID: 38288027 PMCID: PMC10824515 DOI: 10.1159/000535821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/12/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction Coats disease is a rare vasculature pathology that usually presents as retinal telangiectasia with possible progression to exudative retinal detachment (RD). Intravitreal anti-VEGF injections, cryotherapy, laser photocoagulation, and surgery are commonly used to control the disease and prevent its progression. Although iatrogenic tractional RDs secondary to anti-VEGF injections have been reported in patients with Coats disease, RDs in Coats disease are exudative, secondary to retinal exudation and vascular abnormalities. In this article, we present the first reported case of a severe exudative RD accompanied by retinal traction and two retinal holes in a patient with Coats disease. Case Presentation A 32-year-old male initially presented with Coats disease stage 2A, which then progressed to 3A1 within a month of close follow-ups, finally leading to exudative RD. Following cryotherapy and bevacizumab injections, the exudative RD progressed, with the emergence of retinal traction and two retinal holes. This complex case was successfully treated with a scleral buckle vitrectomy accompanied by radial elements to support the RD, pars plana vitrectomy, silicon oil tamponade, and post-surgical bevacizumab injections. Six months following the surgical intervention, the patient's vision is restored at 20/30, and retinal imaging shows a totally flattened retina. Conclusion We present the first reported case of a severe exudative RD accompanied by retinal traction and two retinal holes in a patient with Coats disease. The combination of surgical treatment and bevacizumab injections is thought to have collectively contributed to our patient's favorable outcome.
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Affiliation(s)
- Efraim Berco
- Department of Ophthalmology, Hadassah University, Rehovot, Israel
| | - Simon Elsliger
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tamir Weinberg
- Department of Ophthalmology, Hadassah University, Rehovot, Israel
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Sherbrooke, Moncton, NB, Canada
| | - Waleed Ghannam
- Department of Ophthalmology, Hadassah University, Rehovot, Israel
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Sherbrooke, Moncton, NB, Canada
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Melo IM, Zhou TE, Nagel F, Patil NS, Faleel FA, Popovic M, Muni RH. Histological changes in retinal detachment: A systematic review for the clinician. Surv Ophthalmol 2024; 69:85-92. [PMID: 37652188 DOI: 10.1016/j.survophthal.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 04/30/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
Although there have been numerous innovations in the management of retinal detachment (RD) over the past decades, there is still limited understanding of the pathophysiological processes that take place before and after repair. Summarizing key concepts using animal studies may allow for a better assessment of common pre- and postoperative microstructural abnormalities in RD. We performed a systematic literature review on Ovid MEDLINE, EMBASE, and Cochrane Controlled Register of Trials from January 1968 to January 2022, searching animal or human studies reporting retinal histologic changes following primary or induced RD. Thirty-two studies were included. Main cellular events were summarized: photoceptor apoptosis occurs as early as 12 hours after RD and, although most cells survive, there is extensive remodeling. Outer segments progressively degenerate, while inner segments are reorganized. Rod and cone opsins are redistributed, and rod axons retract while cones undergo changes in shape. Second- and third-order neurons rearrange their dendritic processes, and Müller cells become hypertrophic, growing into the subretinal space. Finally, retinal pigment epithelium cells undergo a change in their morphology. Acknowledging critical morphologic changes following RD is crucial in understanding why anatomical and functional outcomes can vary. Insights from histological studies, together with high-resolution imaging, may be key in identifying novel biomarkers in RD.
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Affiliation(s)
- Isabela Martins Melo
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Tianwei Ellen Zhou
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Flavia Nagel
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Nikhil S Patil
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Marko Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Kensington Vision and Research Institute, Toronto, Ontario, Canada.
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Yagura T, Nishida K, Hirokazu S, Nishida K. A Case of Closure of Recurrent Full-Thickness Macular Hole by Spontaneous Retinal Detachment around the Macular Hole and Gas Tamponade. Case Rep Ophthalmol 2024; 15:150-156. [PMID: 38357213 PMCID: PMC10866610 DOI: 10.1159/000536338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Here, we present a case of full-thickness macular hole (FTMH) recurrence following two vitrectomies, accompanied by additional internal limiting membrane (ILM) peeling and gas tamponade. Ultimately, FTMH closure was accomplished by spontaneous retinal detachment around the macular hole and gas tamponade alone. Case Presentation The patient, a 54-year-old woman with a lamellar macular hole, had a visual acuity of 20/100 in her left eye. The treatment regimen included cataract surgery, a 25-gauge pars plana vitrectomy involving ILM peeling, application of the lamellar hole epiretinal proliferation embedding technique, and subsequent gas tamponade. Closure of the lamellar macular hole was observed a month post-surgery, improving visual acuity to 20/40. However, FTMH developed 3 months after the initial surgery, resulting in visual acuity decline to 20/100. A 25-gauge pars plana vitrectomy was performed with extensive ILM peeling and 20% sulfur hexafluoride gas tamponade. FTMH closure was noted within 19 days after reoperation, enhancing visual acuity to 20/66. Approximately 1.5 months after reoperation, a pinhole-shaped macular hole was identified, and the patient opted for follow-up observation due to her refusal to undergo additional surgery. As the macular hole gradually enlarged resembling retinal detachment, outpatient fluid-gas exchange with 14% perfluoropropane was performed 3.5 months after reoperation. The FTMH closed within a week post-gas injection and remained closed for more than 1 year. Consequently, visual acuity in the left eye was sustained at 20/50. Conclusion We encountered a case that might highlight the significance of releasing subretinal adhesions surrounding a FTMH for successful closure.
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Affiliation(s)
- Tatsuya Yagura
- Department of Ophthalmology, Kinan Hospital, Wakayama, Japan
| | - Kentaro Nishida
- Department of Advanced Device Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Sakaguchi Hirokazu
- Department of Advanced Device Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Ophthalmology, Gifu University School of Medicine, Gifu, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Osaka, Japan
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Ng E, Masalkhi M, Steel DH, Pavičić-Astaloš J, Nolan C, Mernagh S, Ankamah E. Twenty-seven-gauge vitrectomy: a consecutive, single-centre case series with exclusive use over a 4-year period. BMC Ophthalmol 2023; 23:518. [PMID: 38129776 PMCID: PMC10734045 DOI: 10.1186/s12886-023-03265-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/11/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND To assess the safety and effectiveness of the exclusive use of 27-gauge instruments for all vitreoretinal diseases requiring vitrectomy. METHODS In this retrospective study, 1020 consecutive surgeries were performed on 958 eyes of 848 patients using 27-gauge instruments from March 2017 to June 2021. Patients with a minimum follow-up of 3 months were included. Surgical case-mix, best-corrected visual acuity (BCVA), intraocular pressure (IOP), intra- and post-operative complications, and surgery times were recorded. RESULTS The study patients were followed up for averagely 11 months. Of the 1020 vitrectomies, 958 were primary procedures. Of the 148 retinal detachment (RD) cases, 138 (93%) required a single vitrectomy. Primary macular hole closure was achieved in 143 of 145 (99%) cases. The average surgical times were 55 and 38 min for RD surgeries and for all other indications, respectively. BCVA improved significantly at the final visit (20/49) compared with the pre-operative visit (20/78) (p < 0.01). IOP was similar at the pre-operative (14.8mmHg) and final (14.3mmHg) visits. Complications recorded include transient hypotony in 39 eyes, iatrogenic retinal breaks in 2 eyes, and a vitreous bleed in 1 other eye. CONCLUSION This study revealed that 27-gauge vitrectomy instruments can be used for a wide range of indications, with exclusive use in certain settings. The outcomes were similar to other gauges, including for rhegmatogenous retinal detachment, with minimal complications.
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Affiliation(s)
- Eugene Ng
- Institute of Eye Surgery, UPMC Whitfield Hospital, Butlerstown North, Cork Road, X91 DH9W, Waterford, Ireland.
- Institute of Eye Surgery, UPMC Kildare Hospital, Clane, Ireland.
| | - Mouayad Masalkhi
- Institute of Eye Surgery, UPMC Whitfield Hospital, Butlerstown North, Cork Road, X91 DH9W, Waterford, Ireland
- Institute of Eye Surgery, UPMC Kildare Hospital, Clane, Ireland
- UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - David H Steel
- Bioscience Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Jasna Pavičić-Astaloš
- Institute of Eye Surgery, UPMC Whitfield Hospital, Butlerstown North, Cork Road, X91 DH9W, Waterford, Ireland
- Institute of Eye Surgery, UPMC Kildare Hospital, Clane, Ireland
| | - Claire Nolan
- Institute of Eye Surgery, UPMC Whitfield Hospital, Butlerstown North, Cork Road, X91 DH9W, Waterford, Ireland
- Institute of Eye Surgery, UPMC Kildare Hospital, Clane, Ireland
| | - Sarah Mernagh
- Institute of Eye Surgery, UPMC Whitfield Hospital, Butlerstown North, Cork Road, X91 DH9W, Waterford, Ireland
- Institute of Eye Surgery, UPMC Kildare Hospital, Clane, Ireland
| | - Emmanuel Ankamah
- Institute of Eye Surgery, UPMC Whitfield Hospital, Butlerstown North, Cork Road, X91 DH9W, Waterford, Ireland
- Institute of Eye Surgery, UPMC Kildare Hospital, Clane, Ireland
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Tzoumas N, Yorston D, Laidlaw DAH, Williamson TH, Steel DH. Improved Outcomes with Heavy Silicone Oil in Complex Primary Retinal Detachment: A Large Multicenter Matched Cohort Study. Ophthalmology 2023:S0161-6420(23)00899-0. [PMID: 38104666 DOI: 10.1016/j.ophtha.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To establish whether Densiron 68, a heavier-than-water endotamponade agent, is an effective alternative to conventional light silicone oil in primary rhegmatogenous retinal detachment (RD) surgery for eyes with inferior breaks in the detached retina and severe proliferative vitreoretinopathy (PVR). DESIGN Cohort study of routinely collected data from the European Society of Retina Specialists and British and Eire Association of Vitreoretinal Surgeons vitreoretinal database between 2015 and 2022. PARTICIPANTS All consecutive eyes that underwent primary rhegmatogenous RD surgery using Densiron 68 or light silicone oil as an internal tamponade agent. METHODS To minimize confounding bias, we undertook 2:1 nearest-neighbor matching on inferior breaks, large inferior rhegmatogenous RDs, PVR, and, for visual analyses, baseline visual acuity (VA) between treatment groups. We fit regression models including prognostically relevant covariates, treatment-covariate interactions, and matching weights. We used g-computation with cluster-robust methods to estimate marginal effects. For nonlinear models, we calculated confidence intervals (CIs) using bias-corrected cluster bootstrapping with 9999 replications. MAIN OUTCOME MEASURES Presence of a fully attached retina and VA at least 2 months after oil removal. RESULTS Of 1061 eyes enrolled, 426 and 239 were included in our matched samples for anatomic and visual outcome analyses, respectively. The primary success rate was higher in the Densiron 68 group (113 of 142; 80%) compared with the light silicone oil group (180 of 284; 63%), with an adjusted odds ratio of 1.90 (95% CI, 1.63-2.23, P < 0.001). We also observed a significant improvement favoring Densiron 68 of -0.26 logarithm of the minimum angle of resolution (logMAR) in postoperative VA between the 2 groups (95% CI, -0.43 to -0.10, P = 0.002). The anatomic benefit of using Densiron 68 in eyes with inferior retinal breaks and large detachments was more pronounced among eyes with PVR grade C. We found no evidence of visual effect moderation by anatomic outcome or foveal attachment. CONCLUSIONS Densiron achieved higher anatomic success rates and improved visual outcomes compared with conventional light silicone oil in eyes with inferior retinal pathology and severe PVR. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Nikolaos Tzoumas
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Sunderland Eye Infirmary, Sunderland, United Kingdom
| | | | | | - Tom H Williamson
- Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - David H Steel
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Sunderland Eye Infirmary, Sunderland, United Kingdom.
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Machairoudia G, Kazantzis D, Chatziralli I, Theodossiadis G, Georgalas I, Theodossiadis P. Microvascular changes after pars plana vitrectomy for rhegmatogenous retinal detachment repair: A comparative study based on gas tamponade agent. Eur J Ophthalmol 2023:11206721231218656. [PMID: 38043935 DOI: 10.1177/11206721231218656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/05/2023]
Abstract
PURPOSE The purpose of this study was to investigate the effect of gas tamponade on microvascular changes in patients with rhegmatogenous retinal detachment (RRD), who underwent pars plana vitrectomy (PPV), using optical coherence tomography angiography (OCTA). METHODS Participants in this study were 48 patients with RRD, who were treated with PPV and gas tamponade without internal limiting membrane peeling. All participants underwent slit-lamp examination, fundoscopy, spectral domain-optical coherence tomography and optical coherence tomography angiography at month 6 postoperatively. The fellow untreated eyes were also examined and served as the control data. RESULTS A statistically significant enlargement in the foveal avascular zone (FAZ) in both the superficial (p = 0.002) and the deep capillary plexus (p = 0.01) was noticed 6 months postoperatively in patients with RRD treated with PPV compared to the fellow eyes. The foveal avascular zone perimeter was increased in the operated eyes in the deep capillary plexus (p = 0.0003) and the foveal avascular zone circularity was decreased in both the superficial (p = 0.045) and the deep capillary plexus (p < 0.001) compared to the fellow eyes. The vessel density was not significantly different between the operated and the fellow eyes in the superficial and the deep capillary plexus. The vessel density and the foveal avascular zone parameters were comparable between the C3F8 and SF6 groups. CONCLUSION Specific microvascular indices as measured by OCTA were statistically different between the operated and the fellow eyes in the superficial and deep capillary plexus. C3F8 and SF6 as gas tamponades did not seem to differ in their impact on the microvascular parameters.
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Affiliation(s)
- Genovefa Machairoudia
- Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kazantzis
- Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Irini Chatziralli
- Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - George Theodossiadis
- Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ilias Georgalas
- Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
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Chen SN, Chen SJ, Wu TT, Wu WC, Yang CH, Yang CM. Refining vitrectomy for proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 2023; 261:3659-3670. [PMID: 37314522 PMCID: PMC10667443 DOI: 10.1007/s00417-023-06134-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
Pars plana vitrectomy (PPV) is the main treatment modality for patients with severe diabetic retinopathy. With the development of systems for microincision, wide-angle viewing, digitally assisted visualization, and intraoperative optical coherence tomography, contemporary PPV for diabetic retinopathy has been performed on a wider range of indications than previously considered. In this article, we reviewed, in conjunction with our collective experiences with Asian patients, the applications of new technologies for PPV in eyes with diabetic retinopathy and highlighted several important procedures and entities not generally reiterated in the literature, in order for vitreoretinal surgeons to optimize their approaches when facing the challenges imposed by the complications in diabetic eyes.
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Affiliation(s)
- San-Ni Chen
- Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
- Department of Medicine, School of Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Jen Chen
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tsung-Tien Wu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
- School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
- School of Medicine, National Taiwan University, Taipei, Taiwan.
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Dentel A, Brazhnikova E, Norberg N, Jaillard C, Grieve K, Paques M, Sahel JA, Bertin S, Forster V, Picaud S. Adaptive Optics Flood Illumination Ophthalmoscopy in Nonhuman Primates: Findings in Normal and Short-term Induced Detached Retinae. Ophthalmol Sci 2023; 3:100316. [PMID: 37274010 PMCID: PMC10238594 DOI: 10.1016/j.xops.2023.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/18/2023] [Accepted: 04/13/2023] [Indexed: 06/06/2023]
Abstract
Objective To describe adaptive optics flood illumination ophthalmoscopy (AO-FIO) of the photoreceptor layer in normal nonhuman primates (NHPs) and in the case of a short-term induced retinal detachment (RD). Design Longitudinal fundamental research study. Subjects Four NHPs were used to image normal retinae with AO-FIO (in comparison with 4 healthy humans); 2 NHPs were used to assess the effects of RD. Intervention The photoreceptor layer (cone mosaic metrics, including cone density, cone spacing, and cone regularity) was followed with AO-FIO imaging (rtx1, Imagine Eyes) during a surgically induced RD in 2 NHPs using a vehicle solution containing dimethyl sulfoxide, classically used as a chemical solvent. We also performed functional testing of the retina (full-field and multifocal electroretinogram [ERG]). Main Outcome Measures Correlation of cone mosaic metrics (cone density, spacing, and regularity) between normal retinae of NHPs and humans, and cone metrics, power spectrum, and ERG wave amplitudes after RD. Results Imaging features were very similar in terms of cone reflectivity, cell density, regularity, and spacing values, showing strong positive correlations between NHPs and humans. After RD, AO-FIO revealed several alterations of the cone mosaic slowly recovering during the 3 months after the reattachment, which were not detected functionally by ERG. Conclusions These results demonstrate by in vivo AO-FIO imaging the transient structural changes of photoreceptors after an RD in the primate retina. They also provide an interesting illustration of the AO-FIO potential for investigating photoreceptor toxicity during preclinical studies in NHPs with a high translatability to human studies. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Alexandre Dentel
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Elena Brazhnikova
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | | | - Céline Jaillard
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Kate Grieve
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
| | - Michel Paques
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
| | - José A. Sahel
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
- Department of Ophthalmology, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, Pennsylvania
| | | | - Valérie Forster
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Serge Picaud
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
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Zhu K, Li X, Zhou E, Zhang W, Zhang R, Gu Y. Evaluation of anterior chamber morphology following scleral buckling with Pentacam. Photodiagnosis Photodyn Ther 2023; 44:103881. [PMID: 37935344 DOI: 10.1016/j.pdpdt.2023.103881] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/29/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To evaluate anterior segment parameter changes following scleral buckling (SB) surgery for rhegmatogenous retinal detachment (RRD) using the Pentacam Scheimpflug system. METHODS Twenty-eight phakic eyes of 28 patients who underwent SB surgery for RDD were included. The anterior chamber volume (ACV), central anterior chamber depth (CACD), mean anterior chamber angle (ACA) and ACA in a specific position (buckle quadrant), and central corneal thickness (CCT) were evaluated preoperatively and at 1 day, 1 week, and 1 and 3 months postoperatively by an anterior Pentacam Scheimpflug method. RESULTS The ACV parameters were significantly decreased compared with preoperative levels at 1 day after SB surgery (P = 0.0004), but had no significant differences at 1 week, and 1 and 3 months (P > 0.05). The mean intraocular pressure (IOP) at 1 day was significantly higher than the preoperative level, but no subsequent significant difference was noted between the preoperative IOP and that at 1 week and 1 and 3 months postoperatively (P > 0.05). The CCT at 1 day after surgery increased significantly (P = 0.0122) and subsequently returned to the normal level postoperatively at 1 week and remained stable until 3 months (P > 0.05). The degree of postoperative ACA displayed different changes in the different quadrants and there was a significant increase in the ACA of the buckle quadrants at 1 day (P < 0.0001), 1 week (P = 0.02), and 1 month (P = 0.0266) after surgery, returning to the normal level at 3 months. CONCLUSIONS The changes of anterior chamber parameters after SB can be demonstrated by Pentacam both objectively and quantitatively. The ACV and CCT changes were mild and resumed their preoperative parameters after 1 week, while the increase of the ACA at the buckle quadrant returned to normal after 3 months. SB surgeries without encircling or conducted with radial buckling might decrease anterior chamber change.
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Affiliation(s)
- Kai Zhu
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province 230001, China
| | - Xiaojun Li
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province 230001, China
| | - Enliang Zhou
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province 230001, China
| | - Wei Zhang
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province 230001, China
| | - Rui Zhang
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province 230001, China
| | - Yonghao Gu
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province 230001, China.
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Sayanagi K, Hara C, Fukushima Y, Sato S, Kawasaki R, Nishida K. Three cases of macular retinal detachment exacerbated during follow-up with myopic foveoschisis around myopic choroidal neovascularization. Am J Ophthalmol Case Rep 2023; 32:101899. [PMID: 37564973 PMCID: PMC10410127 DOI: 10.1016/j.ajoc.2023.101899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/07/2023] [Accepted: 07/19/2023] [Indexed: 08/12/2023] Open
Abstract
Purpose Myopic choroidal neovascularization (CNV) and myopic traction maculopathy are major complications of pathologic myopia, and myopic foveoschisis (MF) is one of several symptoms that can be included under the general term "myopic traction maculopathy"; however, only a few cases will have MF around the myopic CNV. We report three cases with MF around myopic CNV that followed different clinical courses observed using swept-source optical coherence tomography. Observations Case 1 was a 69-year-old woman with an axial length of 29.71 mm, myopic CNV, and MF in the left eye. One month after intravitreal injection of ranibizumab (IVR), a macular retinal detachment (RD) expanded. Vitrectomy and gas tamponade were performed during month 2; the macular RD and MF resolved gradually thereafter. Case 2 was a 54-year-old man with an axial length of 30.59 mm, myopic CNV, and MF in the right eye; after IVR, a macular RD developed and gradually expanded until month 4; the RD and MF resolved spontaneously and resolved during month 8. Case 3 was a 66-year-old woman with an axial length of 28.63 mm, myopic CNV, and MF in the left eye. A macular RD expanded 1 month after a previous vitrectomy for MF; after intravitreal injection of aflibercept, the macular RD and MF resolved gradually in month 12. In all cases, the CNV was accompanied by subretinal fluid, and two of the three cases had outer lamellar holes. Conclusion and Importance The MF around the myopic CNV may lead to exacerbated MF and RD during follow-up, and the subretinal fluid caused by the CNV might facilitate MF progression. Since this condition is rare, further investigation of this entity is needed to determine appropriate management.
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Affiliation(s)
- Kaori Sayanagi
- Department of Ophthalmology, Osaka University Medical School, Osaka, Japan
| | - Chikako Hara
- Department of Ophthalmology, Osaka University Medical School, Osaka, Japan
| | - Yoko Fukushima
- Department of Ophthalmology, Osaka University Medical School, Osaka, Japan
| | - Shigeru Sato
- Department of Ophthalmology, Osaka University Medical School, Osaka, Japan
| | - Ryo Kawasaki
- Department of Ophthalmology, Osaka University Medical School, Osaka, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Medical School, Osaka, Japan
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Fan J, da Cruz NFS, Fan KC, Negron CI, Amescua G, Grajewski AL, Chang TC, Berrocal AM. A patient with concurrent Axenfeld-Rieger and Stickler syndromes verified by molecular genetics. Am J Ophthalmol Case Rep 2023; 32:101931. [PMID: 37822332 PMCID: PMC10562680 DOI: 10.1016/j.ajoc.2023.101931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/25/2023] [Accepted: 09/09/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose To report a case of Axenfeld-Rieger and Stickler Syndrome in a pediatric patient. Observations A 3-month-old male was referred to the glaucoma clinic after he was noted to have elevated intraocular pressures in both eyes. His family history was notable for infantile glaucoma on his maternal side and retinal detachment on his paternal side. He was found to have anterior segment dysgenesis with iris strands, iridocorneal adhesions, and corectopia, as well as veil-like vitreous in both eyes. He required trabeculotomy, goniotomy, and multiple Baerveldt glaucoma implants in both eyes to achieve intraocular pressure control. Furthermore, the patient later developed macula-involving retinal detachments in both eyes, requiring pars plana vitrectomy with silicone oil tamponade. Genetic analysis confirmed heterozygous pathogenic variants in both the FOXC1 and COL2A1 genes, leading to the concurrent diagnoses of Axenfeld-Rieger and Stickler syndromes. Conclusions and importance This is a rare case of a patient with concurrent Axenfeld-Rieger and Stickler syndromes. The severity of pathology in both the anterior and posterior segments required a collaborative multidisciplinary approach. In the diagnostic evaluation of congenital eye diseases, if there is strong family history of atypical findings for a given diagnosis, concurrent syndromes should be considered and ruled out. A comprehensive eye genetics panel may be a useful tool in these cases.
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Affiliation(s)
- Jason Fan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | | | - Kenneth C. Fan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Catherin I. Negron
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Alana L. Grajewski
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Ta C. Chang
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Audina M. Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
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Ahmad KT, Chauhan MZ, Soliman MK, Elhusseiny AM, Yang YC, Sallam AB. Impact of axial length on visual outcomes and complications in phacoemulsification surgery: a multicenter database study. Graefes Arch Clin Exp Ophthalmol 2023; 261:3511-3520. [PMID: 37347245 DOI: 10.1007/s00417-023-06120-2] [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: 11/22/2022] [Revised: 04/07/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
PURPOSE To analyze the impact of axial length (AL) on the visual outcome and rate of perioperative complications in phacoemulsification surgery. DESIGN Retrospective clinical database study. METHODS Cataract surgery data of 217,556 eyes was extracted from the electronic medical records of 8 ophthalmic centers in the United Kingdom from July 2003 to March 2015. A total of 88,774 eyes without ocular co-pathologies were grouped eyes according to AL (mm): short AL (< 22), average AL (22-26; reference group), and long AL (> 26). MAIN OUTCOMES AND MEASURES We analyzed visual acuity (VA) outcomes at 4 weeks, 4-12 weeks, and 12-24 weeks postoperatively, as well as the incidence of posterior capsular rupture (PCR), torn iris (TI), cystoid macular edema (CME), and retinal detachment (RD). RESULTS Mean pre-operative VA (logMAR) was the worst in eyes with long AL compared to average and short AL eyes (VA 0.59 vs. 0.58 and 0.56; p < 0.001). However, post-operative VA at 4-12 weeks was slightly better in the long AL group (0.14 in short and average AL; 0.12 in long AL, p < 0.001). We observed an increased odds of TI in the short AL group (OR 2.09, 95% CI 1.60-2.75). There was increased risk of RD in long AL eyes (p < 0.001). However, PCR and CME rates were not different. CONCLUSION In the absence of any coexisting ocular pathology, AL alone did not have an impact on VA improvement or the risk of encountering PCR or CME. The risk of TI was greater in the short AL group, and the risk of RD was higher in the long AL group.
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Affiliation(s)
- Kinza T Ahmad
- Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72207, USA
| | - Muhammad Z Chauhan
- Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72207, USA
| | - Mohamed K Soliman
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdelrahman M Elhusseiny
- Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72207, USA
| | - Yit C Yang
- Wolverhampton Eye Infirmary, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72207, USA.
- Department of Ophthalmology, Gloucestershire Hospitals NHS Trust, Cheltenham, United Kingdom.
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Govetto A, Radice P, Lucchini S, Bacherini D, Rizzo S, Savastano A. Recovery of bacillary layer detachment associated with macula-off rhegmatogenous retinal detachment: Evidence of foveation mechanisms? Am J Ophthalmol Case Rep 2023; 32:101923. [PMID: 37693691 PMCID: PMC10482997 DOI: 10.1016/j.ajoc.2023.101923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/20/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose To describe the mechanisms of postoperative foveal restoration in three patients with bacillary layer detachment (BALAD) associated with macula-off rhegmatogenous retinal detachment. Observations BALAD associated with macula-off rhegmatogenous retinal detachment presented with two different morphologies: with an intact foveal roof (case 1) and lamellar, with an open foveal roof (cases 2 and 3). In case 1 visual acuity significantly improved and foveal morphology completely restored at postoperative month 6, with a marked increase in foveal thickness. Case 2 presented with a lamellar BALAD in a long-standing retinal detachment, and it was treated with scleral buckling with an unfavourable evolution into a full-thickness hole in the early postoperative period. It was then addressed with internal limiting membrane peeling and inverted flap, which resulted in the resolution of the lesion, but with limited postoperative visual and anatomical recovery. Case 3 lamellar BALAD was directly addressed with pars plana vitrectomy, ILM peeling and inverted flap, with a remarkable foveal anatomical restoration and visual acuity improvement over the follow-up period. Conclusions and importance The process of foveation may play a key role in the healing process of BALAD associated with rhegmatogenous retinal detachment. Lamellar BALAD should be considered and treated as a FTMH associated with retinal detachment. The two BALAD subtypes may represent different clinical stages of the BALAD spectrum.
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Affiliation(s)
- Andrea Govetto
- Ophthalmology Department, Vitreoretinal Division, Circolo Hospital and Macchi Foundation, Varese, Italy
| | - Paolo Radice
- Ophthalmology Department, Vitreoretinal Division, Circolo Hospital and Macchi Foundation, Varese, Italy
| | - Sara Lucchini
- Ophthalmology Department, Vitreoretinal Division, Circolo Hospital and Macchi Foundation, Varese, Italy
| | - Daniela Bacherini
- Ophthalmology Department, Careggi Hospital, University of Florence, Florence, Italy
| | - Stanislao Rizzo
- Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
- Consiglio Nazionale della Ricerca (CNR), Istituto di Neuroscienze, Pisa, Italy
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Wang J, Lu L, Zou G, Ye Z, Jin F, Wang L, Ke G, Dong K, Tao L. Transcriptomic Analysis of Retinal Gene in Experimental Retinal Detachment Rats and Exploration of S100A9 and TLR4 in Human Vitreous. Curr Eye Res 2023; 48:1170-1178. [PMID: 37846082 DOI: 10.1080/02713683.2023.2254016] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 04/20/2023] [Accepted: 08/28/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To screen for the differentially expressed genes in experimental retinal detachment rats, and to explore the expression of S100 calcium-binding protein A9 and Toll-like receptor 4 in the vitreous of rhegmatogenous retinal detachment patients. METHODS Three rats of experimental retinal detachment and three normal rats were enrolled in the study. Transcriptomics (RNAseq) sequencing technology was used to screen differentially expressed genes in the retinas of the experimental retinal detachment group and the normal group. The selected differentially expressed genes for gene ontology and Kyoto Encyclopedia of Genes and Genomes functional enrichment analysis were performed. In addition, the vitreous of 15 patients with rhegmatogenous retinal detachment and six patients with the control group were collected. The expressions of S100 calcium-binding protein A9 and Toll-like receptor 4 were detected by Elisa, and the differences in expression levels were analyzed statistically. RESULTS A total of 198 differentially expressed genes were screened by RNAseq sequencing, including 118 upregulated genes and 80 downregulated genes. Kyoto Encyclopedia of Genes and Genomes analysis confirmed that the most enriched pathway was the mitogen-activated protein kinase signaling pathway. Compared to the normal group, the expressions of suppressor of cytokine signaling-3, Storkhead box-2, S100 calcium-binding protein A9, Spi-1 proto-oncogene, phosphodiesterase 1B, and kinesin-light chain 1 mRNA in the retinas of the experimental retinal detachment rats were up-regulated, and the expressions of Max interacting protein 1 and the voltage-gated sodium 1 were down-regulated. Compared to the control group, the expressions of S100 calcium-binding protein A9 and Toll-like receptor 4 were upregulated by Elisa in the vitreous humor of rhegmatogenous retinal detachment patients with a statistically significant difference (p all <.05). CONCLUSION The differentially expressed genes of experimental retinal detachment rats were suppressor of cytokine signaling-3, Storkhead box-2, S100 calcium-binding protein A9, Spi-1 proto-oncogene, phosphodiesterase 1B, kinesin-light chain 1, Max interacting protein 1, voltage-gated sodium 1, etc. The differences of S100 calcium-binding protein A9 and Toll-like receptor 4 expressions between the rhegmatogenous retinal detachment patients and the control group were statistically significant, indicating that they may play a potential role in the inflammatory process of rhegmatogenous retinal detachment.
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Affiliation(s)
- Jing Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Ophthalmology, Division of Life Sciences and Medicine, Eye Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Li Lu
- Department of Ophthalmology, Division of Life Sciences and Medicine, Eye Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Gaocheng Zou
- Department of Ophthalmology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Ziyang Ye
- Department of Ophthalmology, Division of Life Sciences and Medicine, Eye Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Feiyu Jin
- Department of Ophthalmology, Division of Life Sciences and Medicine, Eye Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Lin Wang
- Department of Ophthalmology, Division of Life Sciences and Medicine, Eye Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Genjie Ke
- Department of Ophthalmology, Division of Life Sciences and Medicine, Eye Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Kai Dong
- Department of Ophthalmology, Division of Life Sciences and Medicine, Eye Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Liming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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O'Riordan MM, McCabe GA, Kennelly KP. Early vitrectomy is indicated for both diffuse and dense vitreous haemorrhages of unknown aetiology. Ir J Med Sci 2023:10.1007/s11845-023-03573-6. [PMID: 37975994 DOI: 10.1007/s11845-023-03573-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Early vitrectomy for complete fundus-obscuring vitreous haemorrhage (VH) allows for prompt diagnosis and treatment of the cause. AIMS To analyse the causes of VH of unknown aetiology, whether partially fundus-obscuring or dense, and to determine the outcomes of early vitrectomy. METHODS A retrospective review of patients who underwent early vitrectomy within 10 days of symptom-onset for partially fundus-obscuring or dense VH of unknown origin. Patients with evidence of proliferative diabetic retinopathy in either eye or any other preoperatively diagnosed aetiology of VH were excluded. RESULTS 19 patients were included. Intraoperative diagnoses were: retinal tears without rhegmatogenous retinal detachment (RRD) (53%); peripheral localised RRD (32%); neovascularisation secondary to retinal vein occlusion (11%) and posterior vitreous detachment without a retinal break (5%). Patients with diffuse VH were as likely to have a retinal tear diagnosed as those with dense VH (88% vs 82%, respectively; p = 0.7). Mean VA improved from 1.26 LogMAR to 0.23 LogMAR postoperatively (p = 0.001). 1 patient (5%) developed a RRD one-year postoperatively. CONCLUSIONS In cases of diffuse or dense VH of unknown aetiology, an occult retinal tear should be suspected. Early vitrectomy should be strongly considered regardless of whether the fundal view is partially or completely obscured, to prevent progression to visually significant RRDs.
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Affiliation(s)
- Matthew M O'Riordan
- Department of Ophthalmology, University Hospital Limerick, Limerick, Ireland.
| | - Grace A McCabe
- Department of Ophthalmology, University Hospital Limerick, Limerick, Ireland
| | - Kevin P Kennelly
- Department of Ophthalmology, University Hospital Limerick, Limerick, Ireland
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