[Bilateral meningioma of the optic nerve].
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Biomedical subjects
Publications and source records attributed to F Camuzet.
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A vitrectomy was performed in a diabetic patient because of unilateral vitreous hemorrhage, which persisted for six months. There was only background retinopathy in the other eye. In the operated eye, no proliferative retinopathy was found. During surgery a partial posterior vitreous detachment was noted with persistent vitreoretinal attachment to the superotemporal vascular arcade. Postoperative fundus examination and fluorescein angiography showed background retinopathy and the presence of a venous loop involving the superotemporal vein. Histologic description of venous loops with vitreoretinal adhesion was recently reported and it was suggested that this could lead to vitreous hemorrhage even in absence of severe proliferative retinopathy. To our knowledge, there is no previous report of diabetic vitreous hemorrhage probably due to a venous loop with vitreoretinal attachment.
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15 cases of superior bullous hemi-retinal detachment were repaired during a 16-month period, with a post-operative follow-up of 3-19 months. Intravitreal injection of 0,75-1,5 cc of pure sulfur hexafluoride (SF 6) was performed in 9 cases. The indications for injection at the end of the procedure were: 1) absence of chorioretinal contact in spite of an indentation in the correct position; 2) fishmouth configuration of the retinal break; 3) presence of radial folds over an indentation parallel to the limbus. Only two out of patients required a second operation, due to the development of proliferative vitreoretinopathy. One case was unsuccessful because of a redetachment secondary to massive periretinal proliferation. No complication was observed with the injection of SF 6. In particular, ocular hypertension was avoided by controlling the amount of gas used, always inferior to 2 cc, and postoperative treatment with acetazolamide and topical timolol. The intraocular injection of SF 6 appears to be useful contribution to the surgical treatment of superior bullous hemi-retinal detachment, allowing effective and durable internal tamponade, while avoiding prolonged bedrest.
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