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At least 343 records · Page 19Linked to original sources

[Choroidal vascular lesions in serous retinal detachment viewed with indocyanine green angiography].

In serous retinal detachment due to damaged retinal pigment epithelium (RPE), fluorescein angiography shows dye leakage into the subretinal space from the choroid. We performed indocyanine green (ICG) angiography in 110 eyes with serous retinal detachment comprising 71 eyes with central serous chorioretinopathy (CSC), 19 with bullous retinal detachment, 18 with Harada's disease, and 2 with toxemia of pregnancy. Choroidal tissue staining was present around the site of subretinal leakage in late-phase ICG angiograms from 63 eyes with CSC and 18 with bullous retinal detachment. ICG angiography also showed leakage from choroidal vessels in 16 eyes with Harada's disease and 2 with toxemia of pregnancy. As a common feature, ICG angiography showed choroidal vascular hyperpermeability in various types of serous retinal detachment. Choroidal circulation was delayed in Harada's disease and toxemia of pregnancy. Choroidal hypoperfusion and hyperpermeability of choroidal vessels probably contribute to the damage of RPE, and choroidal vascular hyperpermeability probably provides fluid pressure to move fluid into the subretinal space from the choroid.

Adult↗

The multifocal electroretinogram in retinal detachment.

We evaluated the retinal electrophysiologic function in both the detached and attached areas of eyes with retinal detachment, and assessed the functional recovery of these areas after surgery by quantifying the results obtained from multifocal electroretinograms. Multifocal electroretinographic recordings and central 0 degrees to 30 degrees visual field tests were performed preoperatively and 2 weeks 1, 3 and 6 months postoperatively in 12 patients with unilateral retinal detachment. Each patient's response to the multifocal electroretinogram and the visual field test was classified into two groups: group A, the response from the attached area; and group B, that from the detached retinal area. Individual mean deviation and percentage mean deviation were calculated for each group. All retinal detachments were successfully reattached by the conventional scleral buckling method. The retinal sensitivity in the visual field test of all the patients in group B greatly improved. However, the percentage mean deviation in the response density of the multifocal electroretinogram in group B was -81% preoperatively and -63% at 6 months postoperatively. Thus, the improvement was confined within narrow limits. The response density of the multifocal electroretinogram in group A was very low, and never improved beyond -50% of percentage mean deviation. In the eyes with retinal detachment, clectroretinogram response in both the attached and detached areas was more disturbed than predicted by means of the visual field test during the course of this study.

Adolescent↗

[Pseudophakic retinal detachment from personal material].

PURPOSE: To analyse retinal detachment in pseudophakic eyes. MATERIAL AND METHODS: Analysis of 23 pseudophakic patients with retinal detachment operated at the Department of Ophthalmology in Bydgoszcz in the period from 1996 to 1998. The following factors were evaluated: time interval to retinal detachment surgery from the date of cataract surgery, intraoperative complications during the cataract extraction, state of posterior capsule, type and location of retinal tears, extension of retinal detachment, anatomical and functional results and state of fellow eye. RESULTS: Retinal detachment occurred in 65.2% pseudophakic eyes in the period shorter than 3 years after cataract extraction and IOL implantation and in 34.8% more than 5 years after this operation. In 17.4% pseudophakic eyes posterior capsula was ruptured intraoperatively, in 17.4% YAG capsulotomy and in 4.3% surgical capsulotomy were performed. In 56.5% eyes posterior capsula was intact. CONCLUSIONS: Our results suggest possibility of the occurrence of delayed retinal detachment in pseudophakic eyes. The rupture of posterior capsule is not the only risk factor for this disease.

Adult↗

[Risk of retinal detachment in pseudophakia and axial myopia].

The incidence of retinal detachment on axial myopic pseudophakic eyes after Nd:Yag laser capsulotomy or intraoperative complications varies in the literature. In this study we analysed the incidence of retinal detachment in 136 pseudophakic myopic eyes (axial length > or = 26.0 mm) with and without capsulotomy and after intraopertive complications. These results were compared with those published in the literature and those obtained in a control group of 136 pseudophakic eyes with an axial length of less than 26.0 mm. Both groups were followed up for 2 years following operations in 1989 and 1990. The incidence of retinal detachment in eyes with axial myopia > or = 26.0 mm was 3.6% (5/136), without capsulotomy 3.3% (3/90) and with capsulotomy 2.5% (1/40). Intraoperative defects of the posterior capsule occurred in 6 cases, and in 1 case retinal detachment (1/6) developed. No retinal detachment occurred in the control group. The risk of retinal detachment does not seem to be significantly higher after uncomplicated extracapsular cataract extraction in eyes with axial myopia than in myopic eyes in which cataract extraction has not been performed. The combination of capsulotomy and axial myopia does not seem to increase the risk of retinal detachment. However, intraoperative complications do increase the risk of retinal detachment. Retinal detachment is three times as likely to develop in pseudophakic myopic eyes as in eyes with normal axial length.

Adult↗

[Results of systematic preventive treatment with argon laser after idiopathic retinal detachment].

Incidence of spontaneous second retinal detachment ranged from 10 to 19%. We reported a retrospective study of 527 rhegmatogenous retinal detachments. At the end of this study 302 second eyes with an average follow up of 46 months have been analysed. 205 second eyes were treated systematically by 360 degrees equatorial Argon Laser Photocoagulation (ALP) completed by four anterior radial rows independently of evidence or lack of peripheral retinal degenerations or retinal breaks. The incidence of bilateral retinal detachment decreased from 11 to 2.4% when systematical prophylactic treatment has been applied. After prophylactic treatment, no complications could be certainly attribute to ALP. This study contributed to ascertain safety and effectiveness of systematical prophylactic treatment by ALP.

Adult↗

[Prematurity and retinal detachment (author's transl)].

Cases of retinal detachment due to retinopathy of prematurity are presented. 1. There are cases of total retinal detachment without a complete retrolental fibroplasia. 2. Very typical are cases with a dragged disc and mascular ectopy due to preretinal strands in the temporal periphery, the symptoms of an earlier retinopathy of prematurity. By traction these temporal alterations can cause a retinal detachment, the distortion of the retinal vessels can heavily increase after surgical reattachment of the retina. 3. There are cases of juvenile myopes without further signs of a retinopathy of prematurity. A retinal detachment may occur, due to round holes.

Humans↗

Branch retinal vein occlusion and exudative retinal detachment: pathogenetical aspects.

Exudative retinal detachment (ERD) is an uncommon complication of branch retinal vein occlusion (BRVO). The ERD pathogenesis has been mainly related to the haemodynamic overload and to an impairment in the function of the retinal pigment epithelium. Data relative to 98 cases of BRVO without ERD were compared with the correspondent data of 10 cases of BRVO with ERD. Venous leakage showed a substantial equivalency between the two groups, while evaluation of retinal venous collaterals demonstrated a lower amount in the BRVO cases with ERD, with a statistically significant difference. Moreover, considering the various ERD localizations, we suggest that the ERD pathogenesis is mainly ascribable to the scant development of retinal venous collaterals but that an important role may also be played by the retinal pigment epithelium impairment consequent to the retinal ischaemia.

Adult↗

Guidelines for the management of rhegmatogenous retinal detachment.

Current techniques of rhegmatogenous retinal detachment repair allow most detachments to be repaired successfully. The success of repair depends on a careful pre-operative examination and choice of an appropriate procedure. The surgery is usually tailored to individual needs. Improvements in surgical techniques coupled with a better understanding of the pathophysiology of rhegmatogenous retinal detachment continue to improve the anatomic and functional success of retinal detachment repair.

Humans↗

Basic aspects and practical considerations in retinal detachment surgery.

Factors responsible for retinal attachment include structural factors such as the integrity of the retina and the interdigitation of receptor cells with the retinal pigment epithelium combined with dynamic factors which include the movement of water from the vitreous to the choroid under the influence of colloid osmotic pressure in the presence of an intact posterior blood-ocular barrier. In successful retinal detachment surgery an intact cortical vitreous is important. Retinal detachments can be subdivided into simple or complex according to the degree of vitreous abnormality present. Complex detachments demand vitreous surgery and the use of vitreous substitutes. Silicone oil may have a dual role in the eye, tamponade of retinal breaks and waterproofing of the retina with which it is in contact, so reducing transretinal water movement and lightening the load on the mechanisms responsible for retinal reattachment.

Evaluation Studies as Topic↗

Combined scleral buckle and pars plana vitrectomy as a primary procedure for pseudophakic retinal detachments.

BACKGROUND AND OBJECTIVE: Pseudophakic and aphakic retinal detachments are associated with a lower percentage of successful primary repair with standard scleral buckling surgery, than phakic retinal detachments. The objective of this study was to determine whether a combined scleral buckle and vitrectomy, as a primary procedure, offers any advantage over conventional scleral buckling in primary pseudophakic and aphakic retinal detachments, without proliferative vitreoretinopathy. MATERIALS AND METHODS: This was a prospective, non-randomized clinical study. Ninety-four consecutive pseudophakic and aphakic retinal detachments were included in the study. All patients were operated upon by the same surgeon. Each patient underwent a combined scleral buckle and pars plana vitrectomy with perfluorocarbon injection and air-fluid exchange. Each patient was followed by the operating surgeon for a minimum of 6 months. Patients were followed with respect to anatomic reattachment, visual acuity improvement, and surgical complications. RESULTS: All eyes were anatomically reattached after a single operation. All demonstrated an increase in their visual acuity, and there were no complications attributable to the vitrectomy procedure. CONCLUSIONS: We conclude that such a combined approach to primary pseudophakic and aphakic retinal detachments offers significant benefits to scleral buckling alone. We believe that the improved success rate is a function of vitrectomy contributing to both an improved peripheral visibility, resulting in fewer missed peripheral breaks, and a lower likelihood of proliferative vitreoretinopathy. We recommend this combined surgical approach for all primary pseudophakic and aphakic retinal detachments.

Adult↗