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Results for “Retinal Detachment”

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At least 451 records · Page 25Linked to original sources

PubMed2000

Rhegmatogenous retinal detachment in retinoblastoma patients undergoing chemoreduction and cryotherapy.

PURPOSE: To report the development of rhegmatogenous retinal detachment, with the retinal break adjacent to a cryotherapy scar, in three patients undergoing systemic chemotherapy for intraocular retinoblastoma. METHOD: Case series. RESULTS: Three patients with intraocular retinoblastoma were referred after poor response to systemic chemotherapy and local cryotherapy; three eyes of these three patients were noted to have rhegmatogenous retinal detachment and active retinoblastoma, with retinal breaks adjacent to cryotherapy scars. CONCLUSION: Rhegmatogenous retinal detachment may result from retinal necrosis associated with cryotherapy in the setting of intraocular retinoblastoma treated with systemic chemotherapy and local cryotherapy.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1997

[Tyndallometry and cell count in the anterior chamber in retinal detachment].

BACKGROUND: Aim of this study was the investigation of changes of aqueous flare and cells in eyes with retinal detachment. PATIENTS AND METHODS: We examined 62 eyes of 61 patients with retinal detachment (56 eyes with rhegmatogenous retinal detachment, 6 eyes with traction retinal detachment; 51 eyes without and 11 eyes with clinical signs of proliferative vitreoretinopathy (PVR) stage C) with the laser flare-cell meter (LFCM) and compared the results with clinical findings and with the results of a control group. RESULTS: The flare values as well as the cell count of all eyes with retinal detachment were significantly elevated (p < 0.0001) in comparison to those of the control group. In eyes with PVR a significant elevation of flare values in comparison to eyes without PVR appeared (p = 0.0052). A slight correlation was found between the extension of the detachment and the flare values and the cell count, respectively. In cases with rhegmatogenous retinal detachment a significant elevation of the cell count was found if the largest break was localized in the upper hemisphere (p = 0.03) or if the macula was affected (p = 0.02). In rhegmatogenous retinal detachment, the cell count correlated slightly with the age of the patients (r = 0.3, p = 0.02), and flare values correlated with the height of the detachment (r = 0.28, p = 0.04). CONCLUSIONS: Our results demonstrate a breakdown of the blood-ocular barriers in eyes with retinal detachment and an elevation of corpuscular elements in aqueous as manifestations of pseudouveitis. In eyes with PVR the alteration of blood-ocular barriers seems to be more extensive than in eyes without PVR indicating a possible role of the LFCM for early detection of PVR.

Adolescent↗

PubMed1992

[The risk factors of proliferative vitreoretinopathy after operation of retinal detachment].

160 failure cases (160 eyes) following retinal reattachment surgery were reviewed. 62 cases with proliferative vitreoretinopathy were divided into proliferative vitreoretinopathy (PVR) group, the other cases (98 cases) without PVR changes were divided into NO PVR group. The clinical characteristics of two groups were compared in order to determine the risk factors in the development of server PVR after surgical repair of retinal detachment. The study shows that retinal detachment with uveitis and low tension, preoperative and post-operative vitreous hemorrhage, multiple operations were the highly significant risk factors. Once these factors existed simultaneously, the incidence of PVR increased. The way how to prevent and decrease the occurrence of PVR were suggested in the series.

Eye Diseases↗

PubMed1998

Retinal detachment after posterior segment intraocular foreign body injuries.

PURPOSE: To identify the risk factors for retinal detachment after posterior segment intraocular foreign body (IOFB) injuries and to study the association between the development of retinal detachment and visual outcome. METHODS: Ninety-six consecutive patients with posterior segment IOFB injuries were retrospectively reviewed. Vitrectomy techniques were used in primary and secondary treatment. Two eyes were eviscerated after primary repair because of Clostridium perfringens endophthalmitis. Factors analyzed included (1) entrance wound location, (2) presence of uveal prolapse, (3) presence of vitreous prolapse, (4) presence of traumatized iris, (5) presence of endophthalmitis, (6) location of IOFB, (7) size of IOFB, (8) use of scleral buckling and/or an encircling band, (9) use of gas tamponade, (10) use of lensectomy. Data were analyzed using univariate and multivariate logistic regression analysis. RESULTS: Retinal detachment was present in 6 eyes at presentation and occurred in another 19 eyes after vitrectomy. After a mean follow-up of 8.6 months, 63 (65.6%) eyes achieved visual acuities of 20/200 or better, and total retinal detachment complicated by inoperable proliferative vitreoretinopathy was present in 9 (9.4%) eyes. Multivariate analysis identified retinal detachment as a factor significantly associated with a poor visual outcome (odds ratio = 4.54, 95% confidence interval [CI] = 1.05-19.6). Foreign body size of more than 4 mm (odds ratio = 5.8, 95% CI = 1.66-2.03) and presence of endophthalmitis (odds ratio = 11.7, 95% CI = 2.57-52.9) were identified as the only predictive factors for the development of retinal detachment after vitrectomy. Use of prophylactic scleral buckling and/or an encircling band reduced the risk of developing postoperative retinal detachment. CONCLUSIONS: Retinal detachment after posterior segment IOFB injuries is associated with a poor visual outcome. Large IOFB and presence of endophthalmitis are the strongest predictive factors for the development of retinal detachment.

Adolescent↗

PubMed1981

The onset of pigment epithelial proliferation after retinal detachment.

The adult mammalian retinal pigment epithelium (RPE) is mitotically inactive, yet retains the capacity to proliferate under certain conditions. To determine the onset of RPE proliferation after retinal detachment, we examined experimentally detached cat retinas of 12, 24, 48, and 72 hr duration. An additional animal served as a nondetached, sham-operated control. 3H-thymidine was injected into the vitreous chamber and the eyes were processed for light microscopic autoradiography. Autoradiograms from both the control and the 12 hr detachment showed no evidence of labeled RPE nuclei; however, labeled nuclei were present at both 24 and 48 hr after detachment. Labeled nuclei per millimeter of RPE at 24 hr were 55% of the 48 hr rate. Mitotic figures were noted only at 48 and 72 hr after detachment. No labeled RPE nuclei appeared in autoradiograms that bordered the detachment zone. Electron micrographs showed that proliferating RPE cells assume several configurations, some of which have been reported in other species. The proliferative response of the RPE occurs much sooner than had previously been thought. It appears to be a local effect that does not involve retinal regions beyond the detachment boundaries, and it may have potentially adverse effects when the retina and RPE are reapposed after retinal reattachment surgery.

Animals↗

PubMedDate not supplied

Retinal detachment in myopic eyes after laser in situ keratomileusis.

PURPOSE: To report the characteristics and surgical outcomes of rhegmatogenous retinal detachments in myopic eyes after laser in situ keratomileusis (LASIK). METHODS: Clinical charts of patients that developed rhegmatogenous retinal detachment after LASIK were reviewed. Surgery to repair rhegmatogenous retinal detachment was performed in 31 eyes (mean follow-up of 14 months after vitreoretinal surgery). RESULTS: A total of 38,823 eyes underwent surgical correction of myopia from -0.75 to -29.00 D (mean -6.00 D). Thirty-three eyes (27 patients; frequency .08%) developed rhegmatogenous retinal detachment after LASIK; detachments occurred between 12 days and 60 months (mean 16.3 mo) after LASIK. Eyes that developed a rhegmatogenous retinal detachment had a mean -8.75 D before LASIK. Most rhegmatogenous retinal detachment and retinal breaks occurred in the temporal quadrants (71.1%). Final best spectacle-corrected visual acuity (BSCVA) of 20/40 or better was obtained in 38.7% of the 31 eyes (two patients refused surgery). Poor final visual acuity (20/200 or worse) occurred in 22.6% of eyes. Information regarding visual acuity after LASIK and before the development of rhegmatogenous retinal detachment was available in 24 eyes; 45.8% (11/24 eyes) lost two or more lines of visual acuity after vitreo-retinal surgery. Reasons for poor visual acuity included the development of proliferative vitreo-retinopathy (n=5), epiretinal membrane (n=1), chronicity of rhegmatogenous retinal detachment (n=1), new breaks (n=1), displaced corneal flap (n=1), and cataract. CONCLUSIONS: Rhegmatogenous retinal detachment after LASIK for myopia is a serious complication. Final visual acuity may be limited by myopic degeneration, amblyopia, or delayed surgical repair.

Adolescent↗

PubMedDate not supplied

Subretinal fluid in primary rhegmatogenous retinal detachment: physiopathology and composition.

During retinal detachment, subretinal fluid is present, whose composition and physiopathology are still little known. Under normal conditions, osmotic and oncotic pressures help keep the retina in place, but the main retinal attachment force is provided by active transport in the pigment epithelium. Subretinal fluid composition varies according to detachment duration; total protein concentration in subretinal fluid increases with time. In addition, all proteins are qualitatively modified. The detached retina loses its oxygen supply, and it then uses the anaerobic pathway to degrade glucose. Thus, long-duration retinal detachments feature increased lactic acid and dextrose concentrations. Phospholipids are also increased in subretinal fluid, reflecting retinal degradation. This review presents data on the physiopathology and composition of the subretinal fluid in retinal detachments.

Adhesiveness↗

PubMed1998

Silicone oil tamponade in eyes with posterior staphyloma and retinal detachment caused by macular hole.

PURPOSE: A retinal detachment caused by a macular hole in an eye with a posterior staphyloma presents a therapeutical challenge. Vitrectomy and silicone oil tamponade might be a therapeutic strategy in such eyes. METHODS: We report on three eyes of three patients with retinal detachment caused by a macular hole in the presence of a posterior staphyloma, where a vitrectomy and a silicone oil filling was performed. RESULTS: In all three eyes the retina could be reattached. After oil removal, the retina remained attached in all three eyes until the end of the follow-up period (mean 18.7 months). In all three eyes, visual acuity improved, no major complications were noted. CONCLUSION: The use of silicone oil in eyes with retinal detachment caused by a macular hole in the presence of a posterior staphyloma presents a therapeutic option and we discuss this strategy as a primary treatment for these eyes.

Aged↗

PubMed2004

Tomographic image and visual recovery of acute macula-off rhegmatogenous retinal detachment.

PURPOSE: To observe the macula of acute rhegmatogenous retinal detachment involving the macula with optical coherence tomography (OCT) after scleral buckling and to study the relation between pre- and postoperative visual acuity and the OCT image. METHODS: Prospective study of 15 eyes of 15 patients with macula-off rhegmatogenous retinal detachment. We selected cases with preoperative visual acuity worse than 0.5 to analyze the improvement in postoperative visual acuity. The time period between macula-off retinal detachment and surgery was less than 1 week. RESULTS: Indirect ophthalmoscopy indicated that all retinal detachments were reattached at 2 weeks postoperatively. Accumulation of subretinal fluid at the fovea was observed in nine (60%) cases with OCT. In four of these nine eyes, the accumulation of subretinal fluid persisted up to 6 months after the operation. The presence of residual subretinal fluid did not influence visual recovery during the 6 months' postsurgical follow-up. CONCLUSIONS: OCT revealed postoperative residual subretinal fluid at the macula in some acute macula-off retinal detachment cases. Residual subretinal fluid did not influence the recovery of visual acuity for at least 6 months after surgery.

Acute Disease↗

PubMed1999

Retinal detachment in phakic eyes with anterior chamber intraocular lenses to correct severe myopia.

PURPOSE: To analyze the incidence and characteristics of retinal detachment in patients with severe myopia corrected by implantation of phakic anterior chamber intraocular lenses. METHODS: We studied retinal detachments in 166 consecutive eyes (98 patients) that underwent implantation of angle-supported phakic anterior chamber intraocular lenses (models ZB5M and ZB5MF; Domilens; Lyon, France) for the correction of severe myopia (follow-up +/- SD, 45.26 +/- 14.65 months; range, 20 to 84 months). RESULTS: Retinal detachment occurred in eight eyes (4.8%); four eyes belonged to men and four to women. The time between implanting surgery and retinal detachment was 17.43 +/- 16.4 months (range, 1 to 44 months). In all cases, retinal detachment was spontaneous. In seven eyes, the retina was reattached successfully during the first retinal detachment surgery. Mean best-corrected visual acuity after phakic anterior chamber intraocular lens implantation and before retinal detachment development was 20/50 (range, 20/100 to 20/25). After retinal detachment repair, best-corrected visual acuity was 20/73 (range, 20/2000 to 20/33). In these seven eyes, differences between best-corrected visual acuity before and after reattachment were not statistically significant (P = .898, paired Student t test). In one eye, a proliferative vitreoretinopathy was observed, which required additional treatment by vitrectomy and explantation of the phakic anterior chamber intraocular lens. A refractive change was observed after retinal detachment repair, from -1.1 +/- 0.7 diopters (range, 0.00 to -2.50 diopters) before retinal detachment and -2.8 +/- 1.1 diopters (range, -1.00 to -4.50 diopters) after retinal detachment surgery (P = .03, paired Student t test). CONCLUSIONS: The implantation of a phakic anterior chamber intraocular lens as a correcting procedure for severe myopia was followed by a 4.8% incidence of retinal detachment. Conventional scleral surgery was successful in most cases, without causing significant changes in the final best-corrected visual acuity. A significant increase in the myopic spherical equivalent was observed after retinal detachment repair in these patients.

Adult↗

PubMed1975

[Argon laser in the prevention of retinal detachment].

The prevention of retinal detachment by the argon laser photocoagulation of the peripheral degenerations of the retina was unsuccessful in 6 p. 100 of the cases. The proportion of failures is about the same as that of xenon photocoagulation. It is much more important than that of cryocoagulation. In the contrary the results are better in the management of macular holes without detachment.

Cryosurgery↗

PubMed2001

[A case of choroidal hemangioma with bullous exudative retinal detachment treated successfully by transpupillary thermotherapy].

BACKGROUND: Choroidal hemangioma associated with bullous retinal detachment may be difficult to treat, due to varying results with conventional laser photocoagulation, radiotherapy, or surgical drainage. Here we report on a case of extensive bullous retinal detachment secondary to circumscribed choroidal hemangioma that was resolved after combined treatment with vitrectomy, silicone oil tamponade, and transpupillary thermotherapy. CASE: A 29-year-old woman presented with a large choroidal hemangioma in her right eye associated with serous retinal detachment. The tumor measured 8 disc diameters in size and was located in the inferotemporal macula, abutting the fovea. RESULTS: Laser photocoagulation of the tumor was unsuccessful in inducing absorption of subretinal fluid. Because of progressive bullous retinal detachment, surgery was performed consisting of external drainage of subretinal fluid, vitrectomy, endolaser photocoagulation of the tumor, and silicone oil tamponade. The silicone oil was removed four weeks postoperatively at which time almost complete resolution of the retinal detachment was observed. However, retinal detachment recurred eight weeks later, and transpupillary thermotherapy was then applied to the tumor. By four weeks after transpupillary thermotherapy, total reabsorption of subretinal fluid, visual acuity improvement, and decreased height of the choroidal hemangioma were noted. CONCLUSION: Transpupillary thermotherapy is an effective treatment for serous retinal detachment associated with choroidal hemangioma.

Adult↗

PubMed1982

Treatment of retinal detachment due to macular holes without chorio-retinal lesions. A seven-year follow-up study.

For the treatment of retinal detachment arising from macular holes we do not apply cryotherapy, light-coagulation, or diathermy in the area of the macula. Our method involves merely the fixation of a silastic sponge of 14-17 mm length and 7.5 mm diameter at the posterior part of the eyeball corresponding to macula and along the meridian of 12-6 o'clock axis. The sponge is stretched and then fixed at both ends to the sclera away from the posterior pole. The stretching and fixation of the sponge creates the proper indentation which closes the macular hole. By avoiding energy application we obtain better visual acuity. The present paper describes the results we have had in the last 7 years exclusively using this technique.

Follow-Up Studies↗

PubMed1978

The electro-oculogram in human retinal detachment.

Thirteen patients with retinal detachment and surgical reattachment were studied with preoperative and multiple postoperative electro-oculograms. The light rise was reduced to a mean of 1.17 with detachment but recovered in 77% to a 1.87 ratio, the equivalent of the control eye. This recovery was complete within 66 days in 80% of patients who eventually did return to normal. This rapid recovery parallels the rapid return of anatomical, biochemical, and electrophysiological function demonstrated in experimental detachment.

Adolescent↗

PubMed1995

Asymptomatic rhegmatogenous retinal detachments.

OBJECTIVE: To describe the clinical characteristics and risk of progression of asymptomatic rhegmatogenous retinal detachments. METHODS: We retrospectively reviewed the clinical records of 28 patients (31 eyes) with asymptomatic rhegmatogenous retinal detachments followed up without surgery for 0.5 to 12.1 years (mean, 3.4 years). Tractional tears were present in six eyes and atrophic holes in 25 eyes. In five patients, the asymptomatic retinal detachment was noted when the patient presented with a symptomatic retinal detachment in the fellow eye. RESULTS: Twenty-nine of the 31 eyes remained asymptomatic without progression of the retinal detachment. Two eyes progressed to a symptomatic retinal detachment 2.25 and 3.3 years after the initial examination, underwent a successful scleral buckling procedure, and maintained 20/20 visual acuity. CONCLUSIONS: Observation can be considered a reasonable option in the treatment of patients with asymptomatic retinal detachments. Chart documentation of the risks and benefits of observation and instruction of the patient on self-monitoring of the peripheral visual field are necessary in such patients.

Adolescent↗

PubMed1996

[Rhegmatogenous retinal detachment].

Among all the types of retinal detachments, the most common are rhegmatogenous detachments, as defined by the presence of a break in the retina. This is the predominant factor in their mechanism. For this reason, treatment is exclusively surgical and consists of sealing the retinal holes by adhesion. The main cause is modification of the vitreous fluid due to age. Presently, surgery obtains good functional results if undertaken rapidly: retinal detachment is an emergency. An essential factor in prophylaxy is information of patients and physicians.

Humans↗

PubMed1984

Experimental retinal detachment. VI. The permeability of the blood-retinal barrier.

Fluorophotometry was used to study the permeability of the blood-retinal barrier in six monkeys with stable rhegmatogenous retinal detachments. Fluorescein transport was inhibited by probenecid. The rate of fluorescein disappearance (KvVv) was determined following intravitreal injection. In a separate experiment the equilibrium vitreous-plasma concentration ratio (Cv/Cp) was determined following intraperitoneal administration. Expressed in equivalent volumes of vitreous, the rate of fluorescein diffusion across the blood-retinal barrier (K'vVvCv/Cp) was 0.29 microL/min in control eyes and 0.73 microL/min in detached eyes. The rate of fluid movement across the blood-retinal barrier (K'vVv) [1 - (Cv/Cp)] was 2.89 microL/min in control eyes and 6.38 microL/min in detached eyes. Posterior movement of fluid contributes to retinal apposition under normal conditions and accounts for the rapid resolution of retinal detachment following closure of the retinal hole.

Animals↗

PubMed2004

Traumatic pediatric retinal detachment: a comparison between open and closed globe injuries.

PURPOSE: To compare retinal detachment as a result of open and closed globe trauma in a pediatric age group. DESIGN: Retrospective, comparative, consecutive, interventional case series study. SETTING: Tertiary referral medical center. PATIENTS AND METHODS: One-hundred thirty-eight (5.7%) of 2,408 retinal detachments that were treated at our facility between 1980 and 2000 occurred in children aged 18 years or younger. Of these, 37 eyes (26%, n = 36) had retinal detachment following open globe injury and 23 eyes (14%, n = 20) had retinal detachment following closed globe injury. Those were compared with regard to the retinal detachment characteristics, number, types and timing of surgeries, and the anatomic and functional surgical outcome. RESULTS: Similar incidence was found in the type of retinal detachment, number of tears, extent, macular attachment type, and timing of surgery. Anatomic surgical success was achieved in 16 eyes (46%) with open globe injury and in 13 eyes (65%) with closed globe injury. The improvement in visual acuity was limited and comparable in both groups (23% to 25%), and lower than the expected according to the Ocular Trauma Score (OTS). The only predictor for favorable visual outcome of > or =20/200 was preoperative macular attachment (P =.003, Fisher exact test). CONCLUSION: The type, extent, and severity of the retinal detachment were similar in both open and closed globe injuries, suggesting that the detachment is caused by secondary indirect impact of globe deformation. The anatomic and functional surgical outcome was guarded and similar, suggesting that further surgical innovation is required to improve the visual outcome in this age group.

Adolescent↗