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At least 235 records · Page 13Linked to original sources
PubMed2003

Exudative retinal detachment due to small noncalcified retinal astrocytic hamartoma.

PURPOSE: To report a case of exudative retinal detachment due to small noncalcified retinal astrocytic hamartoma and review pertinent literature. DESIGN: Case report and review of literature. METHODS: Clinical examination, fluorescein angiography, optical coherence tomography, and laser treatment were performed. RESULTS: Exudative macular detachment caused by a small noncalcified retinal astrocytic hamartoma confirmed by optical coherence tomography regressed completely after laser therapy. Visual acuity improved only slightly because lamellar macular thinning developed after subretinal fluid and macular exudates resolved. CONCLUSIONS: Small noncalcified, parafoveal retinal astrocytic hamartomas may cause macular retinal detachment. Optical coherence tomography may aid in the diagnosis of the tumor. Argon laser photocoagulation may induce tumor regression and resolution of exudative detachment. Final visual acuity may be limited in some cases.

Adult↗
PubMed1998

Prophylactic argon laser coagulation for rhegmatogenous retinal detachment in AIDS patients with cytomegalovirus retinitis.

BACKGROUND: The incidence of cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS) reaches 20-45%. Despite aggressive medical treatment, rhegmatogenous retinal detachments develop in up to 30% of the affected eyes. Surgical repair is often difficult due to multiple large and hardly visible retinal holes with vitreal traction. Pars plana vitrectomy with instillation of silicone oil is the procedure of choice, giving limited functional results with anatomical reattachment. METHODS: We performed prophylactic laser coagulation in AIDS patients with medically treated CMV retinitis to prevent a progressive retinal detachment. Twenty-two quiescent CMV lesions in 22 eyes of 20 patients were treated with argon green laser coagulation. Each CMV lesion was completely surrounded with a double or triple row of laser spots (500-600 mumols; 0.2 s; gray-white lesions). RESULTS: The duration of follow-up was 2-24 months. Histopathologic evaluation was possible in two eyes of one patient. Reactivated or smoldering CMV retinitis crossed the laser scars in 11 eyes, making additional laser coagulation necessary. In four eyes retinal holes in the CMV scar tissue led to retinal detachment, which stopped at the laser scar. In three eyes the detachment is still controlled by the laser scar. In one eye, the detachment stopped at the laser scar for 6.5 months and then slowly progressed across it. There were no complications associated with our laser treatment. CONCLUSION: Prophylactic argon laser coagulation in quiescent CMV retinitis seems to reduce the rate of progressive retinal detachment with no need for vitrectomy and silicone oil tamponade.

AIDS-Related Opportunistic Infections↗
PubMed1981

[Posterior vitreous detachment with collapse, and peripheral retinal degeneration in the aetiology of idiopathic retinal detachment. A synapsis of clinical observations and anatomical studies (author's transl)].

The crucial aetiological factors of idiopathic retinal detachment are posterior vitreous detachment with collapse, and degenerative lesions in the fundus periphery. Posterior vitreous detachment does not imply diagnostic problems to the expert in this field. On the other hand, the peripheral retinal degenerations include wide range of lesions the clinical and pathoanatomical study of which has so far not resulted in a complete picture. The author of the present paper attempts to get closer to a clearly arranged classification and terminology of those peripheral retinal degenerations, which are of importance to the aetiology, prophylaxis and treatment of idiopathic retinal detachment.

Aged↗
PubMed2000

Optical coherence tomography of the neurosensory retina in rhegmatogenous retinal detachment.

PURPOSE: To clarify the pathologic changes of the detached neurosensory retina in rhegmatogenous retinal detachment. METHODS: Retinal images were prospectively examined by optical coherence tomography in 25 eyes of 25 consecutive patients with rhegmatogenous retinal detachment. We excluded the patients whose retinal detachment did not involve the central fovea or patients with poor fixation during optical coherence tomography (OCT) examination. Optical coherence tomography was scanned through the center of the fovea. The patients ranged in age from 15 to 77 years (mean, 45 years; SD, 20 years). The period from onset of subjective symptoms of retinal detachment to OCT ranged from 2 to 60 days (mean, 16 days; SD, 18 days). Optical coherence tomography findings, best-corrected visual acuity, and the height of the retinal detachment at the central fovea were statistically analyzed using ANCOVA (analysis of covariance) and the Mann-Whitney U test. RESULTS: In 25 eyes of 25 patients, OCT of the detached neurosensory retina at and adjacent to the center of the fovea demonstrated normal retinal structure (10 eyes, 40%), intraretinal separation (7 eyes, 28%), and an undulated separated outer retina (8 eyes, 32%). Three statistically significant factors affected best-corrected visual acuity: intraretinal separation (P = .001), intraretinal separation with undulated outer retina (P = .001), and height of retinal detachment at the central fovea (P<.001). Best-corrected visual acuity was significantly worse in the 15 eyes with intraretinal separation with or without an undulated outer retina than in the 10 eyes with retinal thickening but no intraretinal separation (P = .036). The eight eyes with undulated separated outer retina showed significantly higher retinal detachment at the central fovea than the seven eyes with intraretinal separation but no undulated outer retina (P = .009) and the 10 eyes without intraretinal separation (P = .016). The duration from onset of subjective symptoms to OCT was not related to the occurrence of intraretinal separation of the detached retina. CONCLUSIONS: Intraretinal separation of the detached retina occurred frequently and shortly after retinal detachment in rhegmatogenous retinal detachment and was one of the factors associated with poor vision in rhegmatogenous retinal detachment. Best-corrected visual acuity significantly decreased in the highly detached retina.

Adolescent↗
PubMed1985

Rhegmatogenous retinal detachment in Labrador retrievers. I. Development of retinal tears and detachment.

We used clinical and pathologic methods to examine ten Labrador retrievers with ocular and skeletal abnormalities. The major ocular findings were axial myopia; cataract; vitreous abnormalities, including liquefaction, detachment, and vitreoretinal traction; retinal tears; rhegmatogenous retinal detachment; and proliferative vitreoretinopathy. The appendicular skeleton showed retarded bone growth, bone dysplasia, and degenerative arthropathy. Vitreoretinal traction appeared to be the cause of the retinal tears because (1) formed vitreous was always attached near the anterior edge of the tear, and (2) vitreous traction caused a retinal ridge adjacent to a retinal tear in a dog that had not yet developed retinal detachment. The pathogenetic sequence of spontaneous vitreous abnormalities, retinal tears, and retinal detachment observed in these dogs has not previously been described in animals, to the best of our knowledge, and mimicked human rhegmatogenous retinal detachment, particularly those associated with giant retinal tears.

Animals↗
PubMed1991

Rhegmatogenous retinal detachments in patients with AIDS and necrotizing retinal infections.

Rhegmatogenous retinal detachments can occur in patients with acquired immune deficiency syndrome (AIDS) and necrotizing retinal infections. Of 68 patients with AIDS and necrotizing retinal infections seen between 1983 and 1987, rhegmatogenous retinal detachments developed in 16 patients (27 eyes). In this group, cytomegalovirus retinopathy was present in 75% (12 of 16) of patients, 18.8% (3 of 16) had probable herpes simplex virus retinopathy, and 6.2% (1 of 16) had toxoplasmic retinochoroiditis. Retinal detachment was bilateral in 68.8% (11 of 16) of patients. The retina was reattached successfully in 91% (10 of 11) of operated eyes. Proliferative vitreoretinopathy was present preoperatively in 95% of these eyes. Seven of 11 operated eyes had initial improvement in visual acuity. However, 5 of 11 continued to lose vision despite successful reattachment. Techniques included pneumatic reattachment, scleral buckle, vitrectomy, and silicone oil injection. Complicated retinal detachments in AIDS patients with rhegmatogenous retinal detachments and necrotizing retinal infections are common and can be repaired, but the prognosis is guarded in many patients.

Acquired Immunodeficiency Syndrome↗
PubMed1978

Rhegmatogenous retinal detachment complicating diabetic retinopathy.

Retinal detachment complicating proliferative diabetic retinopathy is being recognized with increasing frequency. Although one type of detachment is tractional and requires vitrectomy for hopeful repair, the other variety of detachment is rhegmatogenous. The rhegmatogenous form of retinal detachment does not generally require the radical surgical approach of vitrectomy. However, because of the unusual nature of the retinal detachment , a standard encircling scleral buckling procedure does not suffice to correct the problem. The unusual characteristics of this form of retinal detachment are discussed, and the criteria for types of surgical repair are considered. A modification of scleral buckling procedure which has been successful in anatomically reattaching most rhegmatogenous retinal detachments is described. The complications resulting from surgery are reviewed along with methods to avoid complications.

Diabetic Retinopathy↗
PubMed1982

The sequelae of serous retinal detachment in preeclampsia.

Retinal detachment is a rare complication of preeclampsia. In 24,920 consecutive deliveries from 1970 at the Vancouver General Hospital, preeclampsia was diagnosed in 1435 patients (5.76%), and in 2 cases serous retinal detachment occurred. Despite spontaneous retinal reattachment, focal pigmentary macular disturbances with visual impairment may persist. Serial examination of the optic fundi, visual acuity, and central visual field assessment by Amsler grid are simple, indispensable tests that will help identify the visually threatened patient with severe preeclampsia. Timely obstetric intervention in severe cases is suggested.

Adult↗
PubMed2001

[Characteristics of retinal detachment in children].

INTRODUCTION: Pediatric retinal detachments differ from adult retinal detachments in their etiologies, prognosis and treatment. The aims of this study were the analysis and long-term follow-up of a group of pediatric retinal detachment patients. PATIENTS AND METHODS: All the cases of juvenile retinal detachments treated in our department between 1987 and 1999 were retrospectively studied. The age at the time of diagnosis, etiology, initial topography of the detachment, treatments undertaken, follow-up, and final results were recorded. RESULTS: The study investigated 64 eyes of 53 children. The follow-up was longer than 6 months for 31 eyes, with a mean follow-up of 39.5 months. The main etiologies were traumatism, high myopia, and affections leading to an exudative retinal detachment such as retinoblastoma and Coats disease. Circular scleral buckling was often used because of the vitreous cohesiveness in children. A vitrectomy was frequently associated to treat severe proliferative vitreoretinopathy. The final visual acuity was higher than 0.05 in 32% of the cases. DISCUSSION: The etiological features, late diagnosis and frequency of proliferative vitreoretinopathy are responsible for the greater severity of retinal detachments in children. These factors associated with amblyopia lead to poor visual prognosis. CONCLUSION: Retinal detachment in children remains a severe pathology. However the prognosis seems to be improving with progress in examination techniques and surgery methods.

Adolescent↗
PubMed1989

[Three dimensional analysis (XY plane and time) of averaged electroretinograms for the evaluation of rhegmatogenous retinal detachment and related pathological conditions].

Retinal functional imaging in patients with rhegmatogenous retinal detachment and related pathological conditions was investigated by three dimensional analysis of ERG topography. The three dimensional analysis revealed that the area of maximal amplitude deviated to the skin area closest to the location of the retinal detachment (paradoxical localization). In temporal retinal detachment, for example, the maximal amplitude of the a- and b-waves deviated toward the temporal side on the surface topography. The depth of the retinal detachment was clearly indicated by differential ERG topography. Flicker ERG with a stimulus frequency of 30Hz was especially successful in showing the existence and location of macular detachment within the area surrounding the temporal vascular arcades. ERG topography also indicated the meridional extent of retinal detachment. When there was detachment in two quadrants (e.g., two inferior quadrants), deviation in the surface topography of a- and b-waves appeared in the same quadrants. When detachment expanded into three quadrants, deviation of the amplitude of a- and b-waves closely resembled the extent of the detachment. In addition, however, there was inverse a- and b-wave surface topography on the opposite skin area. When there were two quadrants of retinal detachment, there were two quadrants of inverse a-and b-waves. When there were three quadrants of retinal detachment, there was only one quadrant of inverse a- and b-waves. No inverse a- and b-waves were detected when there was only one quadrant of retinal detachment. In such cases, however, deviation in the surface topography covered three quadrants. These abnormalities were detected in 90.6% of all cases with the retinal detachment disappeared after the retina was reattached. While the buckling procedure and argon laser retinopexy had little effect on the topographical distribution, it was markedly distorted by cryoretinopexy. No remarkable changes in the topographical distribution of a- and b-waves were detected in pathological conditions related to rhegmatogenous retinal detachment. This new method for functional imaging of the retina should be valuable for objective clinical evaluation of retinal detachment.

Adult↗
PubMed1981

Inherited retinal detachment.

Patients with retinal detachment and their relatives with the same disease (Group F) are compared to a group of unselected cases of retinal detachment from the Swedish population (Group C). The prevalence of bilaterality is greater in Group F. The age-distribution shows younger patients. Myopic refraction is common. More cases with aphakia, lattice degeneration and large tears are found. All these differences are highly significant. Multiple retinal holes are also significantly more common in Group F. After operation, healing is achieved in 78.8% which is not significantly different in comparison with the cure rate in Group C. (83.4%).

Adolescent↗
PubMed2000

[Multifactorial analysis of therapeutic outcome of pseudophakic retinal detachment surgery].

BACKGROUND: Pseudophakic retinal detachment is one of the most severe complications after cataract surgery and is a common cause of permanently reduced visual acuity. We evaluated parameters predicting reduced functional outcome by a model of stepwise regression analysis. PATIENTS AND METHODS: A series of 102 consecutive patients with pseudophakic retinal detachment were analyzed for various parameters regarding cataract surgery, retinal surgery, and retinal detachment features. First, univariate analysis determined the correlations with reduced functional outcome. Secondly, a stepwise regression model analyzed statistically significant variables for their predictive value of a reduced visual outcome. RESULTS: The overall reattachment rate was 99%. In 69% of the patients there was an improvement of more than two lines at the end of the follow-up period. The most predictive factors for reduced functional outcome were the need for a silicone oil tamponade and the visual acuity prior to retinal detachment surgery. When silicone oil tamponade was not needed, the requirement of more than two retinal surgeries was the most predictive factor for reduced visual outcome. CONCLUSION: In our series the strongest predictive factors for a reduced functional outcome were the necessity of silicone oil, reduced visual acuity at the time of retinal detachment, and the requirement of more than two retinal surgeries. These findings suggest that first-line procedures should not be necessarily minimally invasive measurements but rather procedures that result in a stably attached retina in the first instance without permanent silicone oil tamponade, even if this first operation consists of an extended pars plana vitrectomy.

Adult↗
PubMed1982

Central serous choroidopathy with exudative retinal detachment.

An exudative retinal detachment that may be a severe type of central serous choroidopathy (CSC) developed in ten patients. These patients were all middle-aged, all but one were men, and all had a tendency of bilateral involvement. The retinal detachment was associated with doughnut-shaped exudative flecks, and the shifting of subretinal fluid with head position was observed in some cases. Fluorescein angiography revealed wide-ranged retinal pigment epithelial disturbances and effusive dye leakages, especially descending leakage. Treatment with steroids and antibiotics was ineffective, and photocoagulation resolved these conditions rapidly, otherwise spontaneous improvement occurred. The final visual outcomes were variable, and in some cases permanent visual loss occurred.

Adult↗
PubMed1977

Intravitreal gas- an asset or debit in retinal detachment surgery?

38 retinal detachment cases in which intravitreal gas was injected were compared to 156 cases without intravitreal gas injection to determine if intraocular gas had deleterious effects upon the visual and surgical results. No differences were found in either group. Intraocular gas enhances the technical aspects in retinal detachment surgery.

Air↗
PubMed1997

Repair of retinal detachments due to herpes varicella-zoster virus retinitis in patients with acquired immune deficiency syndrome.

PURPOSE: The authors characterize surgical techniques and report results for repair of retinal detachments due to varicella-zoster retinitis in patients with acquired immune deficiency syndrome (AIDS). BACKGROUND: Varicella-zoster virus (VZV) retinitis is a distinctly aggressive infection in patients with AIDS. Retinal detachments occur in the majority of such patients, and contribute to their poor visual prognosis. METHODS: A case series of five eyes in four patients with AIDS and retinal detachments due to VZV retinitis is presented, highlighting surgical technique and results. Pars plana vitrectomy, silicone oil tamponade, and endolaser photocoagulation were used in all cases. RESULTS: Apparent contraction of the necrotic retina was observed, requiring large relaxing retinectomies to achieve retinal attachment in three of the five eyes. Follow up after surgery was 4, 6, 15, 29, and 30 months. Four eyes maintained ambulatory vision and the retinas remained attached. CONCLUSION: Vitrectomy with silicone oil tamponade may be used to preserve ambulatory vision in carefully selected patients with AIDS and retinal detachments due to VZV retinitis. Relaxing retinectomy is a useful technique to achieve and maintain retinal attachment.

AIDS-Related Opportunistic Infections↗