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At least 415 records · Page 23Linked to original sources
PubMed1996

Retinal detachments by squash ball accidents.

PURPOSE: To evaluate the characteristics of retinal detachments caused by squash ball accidents. METHODS: Twenty-six patients had a retinal detachment after a squash ball hit their eyes. RESULTS: Characteristics of the 26 eyes with retinal detachment were large retinal tears parallel to the corneoscleral limbus located close to the ora serrata usually in the temporal superior fundus quadrant (in 14 [54%] of the 26 eyes) and in the temporal inferior quadrant (in seven eyes [27%]); primarily intact vitreous with a traumatic avulsion of the vitreous base in approximately one half the patients; relatively slow progression of the retinal detachment; and additional damage to the choroid and retinal pigment epithelium in the posterior fundus. The patients were young and did not have severe myopia. Reattachment of the retina was achieved in 22 (85%) of the 26 patients. In 11 patients (42%), visual acuity outcome was 20/40 or better with best correction. CONCLUSIONS: Retinal detachments after squash ball accidents show different characteristics with worse prognosis than do ordinary rhegmatogenous detachments. Protective eyewear should be worn when playing squash.

Adolescent↗
PubMed1978

Rhegmatogenous retinal detachments in blacks.

Primary rhegmatogenous retinal detachment is probably much less common in blacks than whites. We reviewed 100 consecutive black patients with retinal detachment who were seen over a 3 year period, and compared them to a randomly selected group of 100 whites seen during the same period. Trauma was the most common cause of detachment in blacks (52%), but was a relatively uncommon cause in whites (12%). Posterior vitreous detachment was the most frequent etiology of detachment in whites (47%), but was rare in blacks (15%). Aphakia was the second most common etiology in whites (30%), while it was relatively uncommon in blacks (13%). Myopia and/or lattice was a more frequent associated finding in blacks with detachment (19%), than in whites (9%). These findings are discussed and the literature reviewed.

Adolescent↗
PubMed2000

Bilateral choroidal ischaemia and serous retinal detachment in pre-eclampsia.

Serious retinal detachment secondary to choroidal ischaemia is an unusual but well-documented cause of visual loss in preeclampsia. Very few cases have been reported in the literature. We report a case of a 26-year-old multigravida with pre-eclampsia who developed bilateral choroidal ischaemia with serious retinal detachments. There was spontaneous resolution of the serous detachment and the choroidal changes in the post-partum period, with residual pigment epithelial changes. Serous retinal detachments in pre-eclampsia are secondary to choroidal ischaemia and disturbances in the choroidal vascular supply.

Adult↗
PubMed1992

Presumed exudative retinal detachment after cryotherapy in retinopathy of prematurity.

Cryotherapy of the peripheral avascular retina in selected cases of retinopathy of prematurity has been shown to reduce the incidence of posterior retinal detachment, retinal fold involving the macula, and retrolental tissue. Although exudative retinal detachments have been described after cryotherapy during scleral buckling procedures, to our knowledge, this observation has not been reported after cryotherapy in retinopathy of prematurity. We describe such a case.

Cryosurgery↗
PubMed1984

Experimental retinal detachment. VII. Intravenous horseradish peroxidase diffusion across the blood-retinal barrier.

Intravenous horseradish peroxidase (HRP) was administered to cynomolgus monkeys to study chorioretinal diffusion in eyes with retinal detachment. In control eyes, HRP was contained within the choriocapillaris and did not penetrate beyond Bruch's membrane. In addition, HRP was confined within blood vessels of the sensory retina. In detached eyes, HRP diffused out of the choriocapillaris and through the intercellular spaces of the retinal pigment epithelium (RPE), where it was blocked by zonulae occludentes. Occasionally HRP was found within pinocytotic vesicles of the RPE. It was also confined within retinal blood vessels by their endothelial cells. It is concluded that the blood-retinal barrier remains intact to HRP following long-term rhegmatogenous retinal detachment. However, a slight alteration exists at the choriocapillaris in detached eyes.

Animals↗
PubMed2005

Structural organization of choroidal colobomas of young and adult patients and mechanism of retinal detachment.

PURPOSE: In colobomatous eyes, the risk of retinal detachment increases with age. This study elucidates the anatomic conditions and pathologic process of retinal detachment associated with colobomas. METHODS: The records, including histologic slides, of 14 children (1 day to 17 months old) and 7 adults (17 to 78 years old) with colobomas were examined. RESULTS: In children, colobomas were associated with lethal malformations. The extracolobomatous inner retinal layers extended centrally, forming the intercalary membrane. Duplication of the outer retinal layers and a horizontal shift of Müllerian glia created a triangle and a locus minoris resistentiae adjacent to the laterally displaced pigment epithelium. Part of the locus was an incomplete layer of photoreceptors excluding Müllerian glia. In adults, atrophy of the intercalary membrane, manifested as central schisis, thinning of the neuroepithelium, and hole formation, was related to a paucity of blood vessels within and underneath the intercalary membrane and the size of colobomas. The margins featured blood vessels, pigment epithelial hypertrophy, and choroidal and scleral thickening in a compact, intertwined arrangement. CONCLUSIONS: Glial atrophy, schisis, and hole formation in the intercalary membrane and separation of the locus minoris resistentiae from the pigment epithelium can disrupt barriers to fluid flow and set the stage for rhegmatogenous retinal detachment. That process is exacerbated by scleral ectasia, increasing vitreous traction at the margin, and retinovascular ischemia within the intercalary membrane. A vascularized, compact margin resembling a laser barrier, found predominantly in adults, may protect against retinal detachment.

Adolescent↗
PubMedDate not supplied

Risk of retinal detachment in patients with lattice degeneration.

To determine the risk of retinal detachment in patients with lattice degeneration of the retina, we statistically analyzed the incidence of retinal detachment in these patients. The data of hospital patients with retinal detachment associated with lattice degeneration in Kumamoto Prefecture, Japan, in 1990 were collected. The prevalence of lattice degeneration in Kumamoto was reported to be 9.5% in 1980. Based on population data from the 1990 census, the cumulative incidence of retinal detachment associated with lattice degeneration was calculated in this study. Among 1,840,000 residents in Kumamoto, there were 110 patients with retinal detachment associated with lattice degeneration; 72 with detachment resulting from tractional tears (tears), and 38 with detachment from atrophic holes. The cumulative incidence of retinal detachment from atrophic holes was 1.5% at the age of 40 years; from tears it was 3.6% at the age of 80 years. The cumulative incidence of detachment from both atrophic holes and tears was 5.3% at the age of 80 years. The results of this study are useful for clarifying the natural course of lattice degeneration.

Adolescent↗
PubMed2003

Optical coherence tomographic findings of macular holes and retinal detachment after vitrectomy in highly myopic eyes.

PURPOSE: Macular holes cause retinal detachments in highly myopic eyes. Because degenerative macular changes often coexist, biomicroscopic evaluation of macular hole status after retinal reattachment is sometimes difficult. We studied macular holes with retinal detachment after vitrectomy using optical coherence tomography and evaluated the anatomic status of the hole and factors associated with anatomic success. DESIGN: Retrospective, nonrandomized, comparative study. PATIENTS: Sixteen eyes that underwent vitrectomy for retinal detachment associated with a macular hole were included. Internal limiting membrane peeling with indocyanine green was performed in 14 eyes; the epiretinal membrane was peeled with a diamond-dusted membrane scraper alone in two eyes. All retinas reattached postoperatively. The follow-up period at the optical coherence tomography examination was at least 6 months. METHODS: Optical coherence tomography was performed vertically and horizontally, and the presence of a persistent macular hole was determined. Other information was obtained from patient records. RESULTS: The macular holes closed in seven of 16 eyes (44%). Age, sex, axial length, preoperative best-corrected visual acuity, duration of symptoms, preoperative refractive error, and the preoperative area of the retinal detachment were not significantly correlated with hole closure. Improved postoperative best-corrected visual acuity (P <.05) was significantly associated with macular hole closure, and more frequent visual improvement (P =.06) was of borderline significance. CONCLUSIONS: The success rate was lower than those obtained in eyes without myopia or in myopic macular holes without retinal detachments. Macular hole closure may predict improved visual outcome for patients with retinal detachment and macular holes. Optical coherence tomography detects persistent macular holes in highly myopic eyes with retinal detachment.

Aged↗
PubMed1998

Surgical repair of rhegmatogenous retinal detachment after treatment for retinoblastoma.

OBJECTIVE: This study aimed to evaluate the causes of rhegmatogenous retinal detachment in children with retinoblastoma and to assess the surgical approach and results of retinal reattachment surgery. DESIGN: The study design was a retrospective review of all children in whom a rhegmatogenous retinal detachment developed after treatment for retinoblastoma over a 20-year period. PARTICIPANTS: Nine children, 5 to 33 months of age, participated. MAIN OUTCOME MEASURES: Assessment of the treatment methods for retinoblastoma, apparent cause of the rhegmatogenous retinal detachment, interval from the most recent retinoblastoma treatment until repair of the rhegmatogenous retinal detachment, method of surgical repair, and long-term anatomic and visual results were measured. RESULTS: Rhegmatogenous retinal detachment was diagnosed in nine eyes of nine children with treated retinoblastoma. Prior treatment of retinoblastoma included cryotherapy (n = 5), laser photocoagulation (n = 1), external beam radiation therapy (n = 7), and systemic chemotherapy (n = 4). An atrophic retinal hole was present at the most recent site of cryotherapy in three eyes and of laser photocoagulation in one eye. Extreme retinal thinning with a possible retinal break was noted in two eyes at a cryotherapy site. A dialysis was noted in one eye, and a retinal break could not be detected in two eyes. Treatment of retinoblastoma tumors was performed between 1 week and 15 years before retinal reattachment surgery. The retinal detachment was repaired externally with a scleral buckling procedure in seven eyes, with subretinal fluid drainage in five eyes, and without drainage in two eyes. Cytologic evaluation of subretinal fluid was performed in three eyes and showed no tumor cells. The retinal detachment was repaired by pars plana vitrectomy in one eye, and the vitrectomy specimen showed no tumor cells. In one child, the retinal detachment was not repaired. The retina remained attached after surgery in five eyes with follow-up ranging from 5 to 115 months. In three eyes, retinal redetachment associated with recurrent viable intraocular retinoblastoma was noted after surgery, necessitating enucleation. In no case was orbital or metastatic retinoblastoma detected at follow-up. CONCLUSIONS: Rhegmatogenous retinal detachment in children with treated retinoblastoma generally originates from an atrophic retinal hole at the site of prior cryotherapy or laser photocoagulation. If there appears to be complete regression of the intraocular tumor after treatment, surgical repair of the rhegmatogenous retinal detachment may be approached cautiously.

Antineoplastic Agents↗
PubMed1994

Natural history of posterior vitreous detachment with early management as the premier line of defense against retinal detachment.

PURPOSE: This study was designed to elucidate various aspects of the natural history of posterior vitreous detachment (PVD), in particular the relation between symptomatology and prognosis as it relates to management of patients with the earliest symptoms of PVD. METHODS: A prospective study of 350 consecutive patients with PVD was performed, excluding all patients referred from an ophthalmologist, those with symptoms of more than 3 months in duration, and those with a history of ocular trauma, except for cataract surgery. Aphakia was present in 21 eyes, and 50 patients were bilaterally involved. RESULTS: Of 163 patients who had one to two floaters as their presenting symptom, with or without light flashes, a retinal tear developed in 12 (7.3%). Of 31 phakic eyes with secondary retinal tears on initial examination, 9 (29%) had one to two floaters and light flashes as the only symptoms. Of eight phakic eyes that initially, or eventually, had a retinal detachment, three (37%) had an interval of 2 1/2 to 3 weeks before visual field loss, during which they noticed only one to three visual floaters plus light flashes as their only symptoms. This early stage in which symptoms are detectable is crucial in terms of providing an opportunity for early treatment that might prevent retinal detachments. CONCLUSIONS: The prompt and conscientious vitreoretinal examination of each patient older than 45 years of age who experiences vitreous floaters, even though limited to one or two, should be undertaken without delay. This practice, combined with expeditious treatment of any secondary retinal tears, provides the most effective known means of preventing rhegmatogenous retinal detachment, and currently it appears to be neglected. A national public educational effort should be pursued to publicize the importance of these symptoms.

Adult↗
PubMed2006

Paediatric vs adult retinal detachment.

OBJECTIVE: To evaluate the causes, incidences, characteristics, and treatment outcomes of paediatric vs adult retinal detachment. PATIENTS AND METHODS: One hundred and sixty (136 patients) out of 2408 consecutive retinal detachments (6.6%) at our facility occurred in children under the age of 18 years. Of them, 144 eyes (90%) of 127 (93%) children were treated and compared with a sample of 56 consecutive retinal detachments in 50 adults (over the age of 18 years). The parameters for comparison included cause, type of retinal detachment, its extent, macular involvement, number of tears, number and types of surgery, and the anatomic and functional surgical outcome. RESULTS: Statistically significant differences were found in the type of retinal detachment. Rhegmatogenous RD was less common (P=0.004), and exudative RD was more common (P=0.021) in the paediatric group. Ocular trauma and ocular syndromes were more common in the paediatric group (P<0.001), while myopia, posterior vitreous detachment, and retinal detachment following cataract surgery were less common in this group compared with adults (P<0.001, <0.001, and 0.001, respectively). Ocular pathologies associated with retinal detachment were more common in the paediatric group (P<0.001). Initial and last visual acuity of >20/400, last visual acuity of >20/40, and retinal complete reattachment were higher in adults (P<0.001). CONCLUSIONS: The type of retinal detachment, causes and outcomes were statistically different between paediatric and adult cases. The less successful functional and anatomical outcomes of retinal detachment surgery in children may reflect the different aetiologies and indicate the need for aetiology-specific treatment strategies according to each aetiology.

Adolescent↗
PubMed1978

Vitreous findings in fellow eyes of aphakic retinal detachment.

One hundred patients had bilateral aphakia, primary rhegmatogenous retinal detachment, and adequate visualization of the retinal and vitreous in the fellow eye. Of 43 patients with posterior vitreous separation and no retinal tear in the fellow eye, only one (2%) subsequently developed retinal detachment. Of 40 patients without posterior vitreous separation in the fellow eye, eight (20%) later developed retinal detachment following posterior vitreous separation. The remaining 17 patients had posterior vitreous separation and retinal tear or detachment at the time of initial examination. Thus, if posterior vitreous separation occurs without forming retinal tear, the risk of developing retinal detachment is significantly lowered.

Adult↗
PubMed1977

Retinal mobility and retinal detachment surgery.

A series of 200 consecutive retinal detachments was examined prospectively to consider the physical sign of mobility of the detached retina. Retinal mobility was found to be absent in 28 cases, and this immobility is caused by periretinal membrane formation. The importance of retinal mobility when considering the case for non-drainage retinal surgery has been examined with particular emphasis on the tear/buckle relationship at the end of the operation. It was found that there was an excellent prognosis (92% success rate) for cases in which the retina was found to be mobile in the vicinity of the retinal tear, and a high proportion of these cases (71%) can be successfully treated with a non-drainage operation.

Drainage↗
PubMed2004

Retinal detachment from inadvertent intraocular injection of botulinum toxin A.

PURPOSE: To report a case of inadvertent intraocular injection of botulinum toxin A (Botox, BTA) resulting in a retinal tear and bullous retinal detachment. The retinal detachment resolved spontaneously, and the tear was treated with laser demarcation with good visual outcome. DESIGN: Interventional case report. METHODS: A 36-year-old woman underwent Botox injections for paralytic esotropia and developed ocular perforation. Dilated fundus examination showed a slit-like retinal tear infranasally with a bullous retinal detachment nasally. RESULTS: The retinal detachment spontaneously resolved, and the patient was treated with laser demarcation on the following day. After 2 more days, her vision returned to baseline. CONCLUSIONS: Botox did not appear toxic to human intraocular tissues. Close observation may be indicated in the event of an inadvertent intraocular Botox injection.

Adult↗
PubMed1986

Retinal detachment following penetrating keratoplasty.

The time-related risk of retinal detachment during the follow-up of 1146 penetrating keratoplasty procedures was evaluated, using survival analysis techniques. Twenty-eight retinal detachments were observed during follow-up. The Kaplan-Meier estimate of the risk of developing retinal detachment increased from 1.5% at three months to 2.1% at one year after surgery. Further follow-up showed a gradual increase in the cumulative proportion developing retinal detachment to 4.7% at 3.5 years after surgery. Of the preoperative and intraoperative factors available for study, performing an anterior vitrectomy during penetrating keratoplasty was associated with a greater risk of postoperative retinal detachment. The outcome of visual acuity following retinal detachment in these patients' eyes was poor; five patients could not perceive light with the affected eye, and 82% (23/28) had visual acuity of 20/200 or less.

Corneal Transplantation↗
PubMed2004

Structural features of attached retina in rhegmatogenous retinal detachments.

PURPOSE: To examine the thickness and structural features of the ophthalmoscopically normal-appearing, attached retina in rhegmatogenous retinal detachments by optical coherence tomography (OCT) and compare them with those of the fellow eye. METHODS: Seventy eyes of 35 patients with rhegmatogenous retinal detachments were included in this study. The retinal detachments were not total. None of the patients had pathologic myopia or a history of ocular surgery. The fellow eyes were ophthalmoscopically normal and used as controls. Attached retinal sites of the eyes with a retinal detachment and the corresponding retinal sites of the fellow eyes were examined by OCT. Three OCT sections were taken from each eye, and thicknesses of three reflective zones corresponding to the inner part of the neurosensory retina (partial neurosensory retina), photoreceptor-photoreceptor outer segment, and total retinal thickness on each OCT section were measured and compared with those of the fellow eye. These three measurements were taken as the main outcome measures and performed on five different sites of each OCT section taken from each eye. RESULTS: The mean partial neurosensory retinal thickness of the attached retina in the eyes with a retinal detachment and the corresponding retinal sites in the fellow eyes was 172.74 +/- 14.23 microm and 170.60 +/- 16.51 microm, respectively. There was no statistically significant difference between these two values. The mean photoreceptor outer segment thickness of the attached retina in the eyes with a retinal detachment and the corresponding retinal sites in the fellow eyes was 62.74 +/- 12.02 microm and 58.23 +/- 15.14 microm, respectively. There was a statistically significant difference between these two values. The mean total retinal thickness of the still-attached retina in the eyes with a retinal detachment and the corresponding retinal sites in the fellow eyes were 293.23 +/- 27.87 microm and 277.06 +/- 19.12 microm, respectively. There was a statistically significant difference between these two values. CONCLUSIONS: The main difference between the two groups of eyes was at the level of the thickness of the black hyporeflective zone, corresponding anatomically to the photoreceptor and photoreceptor outer segment that enlarges in the retinal detachments. Therefore, there may be a subclinical retinal detachment or a global retinal relaxation even in the ophthalmoscopically normal-appearing, still-attached retina. This may be the underlying cause of preoperative and postoperative signs and symptoms. Additional studies are required to confirm these findings.

Adolescent↗