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Results for “Retinal Perforations”

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At least 595 records · Page 33Linked to original sources

PubMed2005

Photoreceptor layer features in eyes with closed macular holes: optical coherence tomography findings and correlation with visual outcomes.

PURPOSE: Study correlation between optical coherence tomography (OCT) findings and visual acuity (VA) outcomes after successful macular hole surgery (MHS). DESIGN: Retrospective cross-sectional study. METHODS: Postoperative OCT scans were analyzed in 34 eyes of 30 patients. Raw files of horizontal and vertical OCT scans were exported to Adobe Photoshop 7.0. Measured parameters included central foveal thickness, photoreceptor thickness, photoreceptor reflectivity, and relative reflectivity of photoreceptor to retinal pigment epithelium in the foveal area. Foveal configuration was subjectively graded. RESULTS: OCT scans were obtained at a median of 2 years (1 month to 10 years) postoperatively. The median visual acuity was 20/80 (20/50 to 8/200) preoperatively and 20/50 (20/20 to 5/200) postoperatively. The median foveal thickness was 198.5 micro (148 to 283). The mean (SD) photoreceptor layer thickness was 16.5 (8) micro in the 500 micro area and 17.5 (8) micro in the 1000 micro area. Mean (SD) of relative reflectivity of the photoreceptor layer was 0.60 (0.10) in both 500 micro and 1000 micro area. Postoperative VA did not correlate with foveal thickness or foveal configuration. Central (500 micro and 1000 micro) photoreceptor thickness was significantly correlated with final VA (r = .38, P = .026, each). Relative reflectivity of photoreceptors to retinal pigment epithelium in the 500 micro area was correlated with postoperative VA at a borderline significance (r = .32, P = .07). Relative reflectivity of photoreceptors to retinal pigment epithelium in the 1000 micro area was not significantly correlated with postoperative VA (r = .27, P = .12). CONCLUSION: Specific retinal features can be assessed from OCT images. Morphology and thickness of the foveal photoreceptor layer correlate well with macular function after successful MHS. Outer retinal features appear to be more important to determine postoperative visual function. Inner retinal features may be more relevant for the ophthalmoscopic appearance of anatomic closure.

Adult↗

PubMed2005

Stage 3 macular hole: role of optical coherence tomography and of B-scan ultrasonography.

PURPOSE: To analyze the various aspects of Stage 3 macular hole with optical coherence tomography (OCT) and B-scan ultrasonography. DESIGN: Observational case series. METHODS: Patients referred for full-thickness macular hole were prospectively screened with OCT and B-scan ultrasonography. OCT examination analyzed the diameter of the hole, the posterior hyaloid, the surrounding retina, and the inconstant presence of a pseudo-operculum. B-scan ultrasonography permitted the distinction between stage 3 and stage 4 holes, based on the detachment of the posterior hyaloid. RESULTS: The study included 62 eyes with stage 3 holes. On OCT, the typical aspect with a hyaloid detached from the macular area was observed in 37% of the eyes (group 3C). In 42% of the eyes (group 3B), a focal adherence was visible at the margin of the hole, as in stage 2 macular hole, but the hole was long-standing, large, and noneccentric. In 21% of the eyes, the hyaloid was not visible anterior to the retina but was still adherent to it (group 3A). In the absence of B-scan ultrasonography, these OCT features could be confused with a stage 4 macular hole. No difference in the size of the hole was observed between subgroups. CONCLUSION: OCT can show various aspects of stage 3 macular holes. B-scan ultrasonography was useful for assessing the location of the posterior hyaloid and to distinguish stage 3 from stage 4 macular holes. These features may provide additional information on the pathogenesis of macular hole and may have therapeutic implications.

Aged↗

PubMed2005

Macular hole in cat scratch disease.

PURPOSE: To report the development of a macular hole as a complication of cat scratch disease. DESIGN: Case report. METHODS: A 10-year-old girl was seen with unilateral neuroretinitis from serologically confirmed cat scratch disease. Twelve days later, she developed a macular hole in the involved eye. Fundus photography and optical coherence tomography (OCT) were obtained at presentation and after the development of a macular hole. RESULTS: Fundus photography and OCT on presentation revealed a nasal neurosensory detachment and multiple inflammatory foci throughout the macula, including a subfoveal lesion. Fundus photography and OCT 12 days later revealed the development of a partial posterior vitreous detachment and a full thickness macular hole. CONCLUSIONS: Macular hole should be included among posterior segment complications of cat scratch disease. In this case, the macular hole was associated with partial vitreous detachment and a preexisting subfoveal lesion, likely representing an inflammatory focus.

Antibodies, Bacterial↗

PubMed2005

Spontaneous rip of the retinal pigment epithelium with a macular hole in neovascular age-related macular degeneration.

PURPOSE: To report a case of retinal pigment epithelial tear associated with a macular hole in a patient with neovascular age-related macular degeneration (AMD). DESIGN: Observational case report. METHODS: An 87-year-old woman with AMD-related fibrovascular pigment epithelial detachment associated with vision loss was followed with sequential fundus photography, fluorescein angiography, and optical coherence tomography for 8 months. RESULTS: The detachment developed into a retinal pigment epithelium tear with macular hole formation. The temporal evolution of the lesion and optical coherence tomography findings suggested that the retinal pigment epithelium tear led to stretching forces along the posterior surface of the neurosensory retina with secondary foveal dehiscence. CONCLUSION: Macular hole formation is one mechanism by which retinal pigment epithelium tears may cause vision loss in AMD.

Aged↗

PubMed2005

Surgical management of traumatic macular hole-related retinal detachment.

PURPOSE: To investigate the clinical characteristics and surgical outcome of traumatic macular hole-related retinal detachment. DESIGN: Retrospective, interventional case series. METHODS: Eight eyes of eight patients with traumatic macular hole-related retinal detachment underwent vitrectomy combined with gas tamponade, either initially or subsequently. Anatomic re-attachment of the retina, closure of traumatic macular hole, and visual outcome were measured. RESULTS: Successful retinal re-attachment was achieved in seven eyes (87.5%), and the macular hole was successfully closed in all eyes (100%). Improved vision after the surgery was noted in five eyes (62.5%), whereas three eyes (37.5%) displayed no change. CONCLUSIONS: Vitrectomy combined with gas tamponade appears to give an effective anatomic re-attachment rate for traumatic macular hole-related retinal detachment. The presence of peripheral retinal breaks, vitreous hemorrhage, or the extent of retinal detachment has no discernible significant influence on closure rate of macular hole and retinal re-attachment rate.

Adult↗

PubMed2005

Late reopening and spontaneous closure of previously repaired macular holes.

PURPOSE: The features of late reopening with spontaneous closure in previously repaired macular holes are illustrated with optical coherence tomography (OCT). DESIGN: Observational case reports. METHODS: Case study of two patients with reopened macular holes that developed 7 years after successful macular hole surgery and then spontaneously closed while patients were awaiting surgery. RESULTS: OCT imaging demonstrated reduction in the cystic spaces within the leaves of the macular hole followed by bridging of the hole in one patient. The second patient had abrupt closure of the hole with resolution of the cystic spaces. Subsequent normalization of the foveal contour was observed in both patients. CONCLUSION: OCT imaging accurately demonstrated the features of spontaneous closure of late reopened macular holes. Possible mechanisms for this rare event are discussed and compared with the characteristics of spontaneously closed primary and traumatic macular holes.

Aged↗

PubMed2005

Macular hole development in fellow eyes of patients with unilateral macular hole.

PURPOSE: To determine the incidence of developing an idiopathic full-thickness macular hole in fellow eyes that have vitreofoveal attachments and perifoveal vitreous detachment in patients with unilateral idiopathic macular hole. DESIGN: Retrospective cross-sectional observational study. METHODS: The fellow eyes of 201 patients with full-thickness macular holes were examined by optical coherence tomography (OCT). A subset of 58 fellow eyes with vitreofoveal attachments and perifoveal vitreous detachment was observed during follow-up, and the changes in the vitreofoveal attachment within 24 months from the initial OCT examination were investigated. RESULTS: In the 58 eyes, the vitreofoveal relationship changed in 27 eyes. Among the 27 eyes, three eyes developed a full-thickness macular hole, and the other 24 eyes developed a posterior vitreous detachment only over the fovea or a complete posterior vitreous detachment without macular hole formation. The vitreofoveal relationship did not change in 31 eyes during the 24-month period. CONCLUSION: From an analysis of the changes in the vitreoretinal relationship identified by OCT, three (11%) of 27 fellow eyes in patients with unilateral idiopathic macular hole developed a full-thickness macular hole.

Aged↗

PubMed2005

Changes in retinal pigment epithelium after indocyanine green-assisted internal limiting lamina peeling during macular hole surgery.

PURPOSE: To determine the changes in the retinal pigment epithelium (retinal pigment epithelium) and secondary changes in the choroid and fovea after indocyanine green (ICG) staining of the internal limiting lamina during surgery for an idiopathic macular hole (MH). DESIGN: Observational case series. METHODS: The medical charts of 31 patients who underwent MH surgical procedures with internal limiting lamina staining and peeling were reviewed. The eyes were examined by optical coherence tomography, scanning laser ophthalmoscopy, fluorescein, and ICG angiography. RESULTS: In three cases that experienced retinal pigment epithelium changes, there was foveal thinning and choriocapillary atrophy in the area of the previous MH. The visual acuity was markedly worse, and the retina was markedly thinner in these three cases than in the other cases without retinal pigment epithelium changes (P = .003, P = .009, respectively). CONCLUSION: The use of ICG dye with illumination may increase the risk of retinal pigment epithelium damage and secondary choroidal and foveal morphologic changes.

Basement Membrane↗

PubMed2005

Immunohistochemical analysis of the internal limiting membrane peeled with infracyanine green.

PURPOSE: To investigate whether the peeled internal limiting membrane (ILM) contains cellular retinal cell fragments, and to learn more about their possible origin. DESIGN: Experimental study. METHODS: ILM peeled from ten eyes during vitrectomy by infracyanine green (ICG) was studied immunohistochemically using the markers: GFAP, S-100, and vimentin. Five ILM specimens were from eyes with diabetic macular edema (DME), two from eyes with a macular hole, and three from eyes with persisting macular edema after retinal detachment surgery. RESULTS: In eight of the ten ILM specimens, we found GFAP-positive staining, indicating the presence of remnants of footplates from Müller cells or glial cells. Two ILM specimens were positive for S-100, indicating the presence of neural cells or ganglion cells. CONCLUSIONS: ILM peeled from the retina during vitrectomy using ICG may contain remnants of Müller cell footplates, neural cells, and ganglion cells.

Aged↗

PubMed2005

Pars plana vitrectomy with gas tamponade for lamellar macular holes.

PURPOSE: To report anatomic and visual improvement after pars plana vitrectomy with gas tamponade for a lamellar macular hole with poor central visual acuity. DESIGN: Two interventional case reports. METHODS: Two patients with a lamellar macular hole underwent vitrectomy, internal limiting membrane peeling, and long-acting gas injection. Main outcome measures included best-corrected visual acuity, biomicroscopic appearance, and optical coherence tomography findings. RESULTS: Vitrectomy with gas tamponade resulted in biomicroscopic, functional, and tomographic improvement in both patients for follow-up periods of 12 months. CONCLUSIONS: Vitrectomy with gas tamponade may be an effective method for a lamellar macular hole with poor visual acuity.

Aged↗

PubMed2006

Spontaneous resolution of macular microhole.

PURPOSE: To report a case of spontaneous resolution of macular microhole. DESIGN: Observational case report. METHODS: Clinical examination and optical coherence tomography (OCT) evaluation of a patient who experienced spontaneous resolution of a macular microhole. RESULTS: A 62-year-old woman with decreased vision was found to have a full-thickness macular microhole with posterior vitreous detachment and an operculum on fundus biomicroscopy and OCT. Spontaneous resolution of the microhole was documented on clinical examination and OCT 3 weeks after the examination when the patient returned with improved vision and a small central floater. CONCLUSIONS: Macular microholes can be associated with posterior vitreous detachment. Spontaneous closure of macular microholes can occur.

Female↗

PubMed2006

Intraocular rake for removal of epiretinal membranes.

PURPOSE: To examine the feasibility of the use of a flexible intraocular rake to remove epiretinal membranes (ERM). DESIGN: Interventional case series. METHODS: A multi-tine flexible intraocular rake was designed. Ten consecutive patients with idiopathic epiretinal membranes underwent vitrectomy and removal of the ERM with the intraocular rake. Outcome measures included intraoperative complications, Early Treatment Diabetic Retinopathy Study visual acuity, rate of recurrent ERM, and rate of persistent cystoid macular edema. RESULTS: The rake was used successfully to remove the ERM in all cases. Two patients had intraoperative retinal tears. At a mean postoperative follow-up examination of 24 weeks, the visual acuity was improved significantly (20/90 before the operation vs 20/50 after the operation; P<.05). One patient had a recurrent epiretinal membrane. CONCLUSION: The flexible intraocular rake appears to be capable of the removal of idiopathic ERM. The increased tolerance for retinal contact that results from the flexible tines may make the rake of value to many vitreoretinal surgeons.

Epiretinal Membrane↗

PubMed2006

Retinal pigment epithelium tears following verteporfin therapy combined with intravitreal triamcinolone.

PURPOSE: To detect patients with neovascular age-related macular degeneration (AMD) who experience retinal pigment epithelium tears after initial verteporfin therapy combined with intravitreal triamcinolone during early follow-up. DESIGN: Prospective interventional case series. METHODS: Forty-five consecutive patients with choroidal neovascularization (CNV) in AMD were treated with verteporfin therapy combined with 4 mg of intravitreal triamcinolone. Optical coherence tomography (OCT), visual acuity, and fluorescein angiography were performed. RESULTS: Two eyes with a predominantly classic CNV developed a retinal pigment epithelium tear. An early onset tear could be differentiated from a delayed onset tear. OCT showed an increased depth signal in areas of missing retinal pigment epithelium and a wavy, contracted, and elevated retinal pigment epithelium band. CONCLUSIONS: Retinal pigment epithelium tears can occur despite adding intravitreal triamcinolone to verteporfin therapy. OCT shows characteristic changes in the evolution of retinal pigment epithelium tears after combination therapy.

Choroidal Neovascularization↗

PubMed2006

Correlation between angiotensin-converting enzyme, vascular endothelial growth factor, and matrix metalloproteinase-9 in the vitreous of eyes with diabetic retinopathy.

PURPOSE: To investigate the involvement of angiotensin-converting enzyme (ACE) with angiogenic factors, vascular endothelial growth factor (VEGF), and matrix metalloproteinase (MMP)-9 in the vitreous of eyes with proliferative diabetic retinopathy (PDR). DESIGN: Observational case series. METHODS: Angiotensin-converting enzyme activity in the vitreous was measured by using a synthetic substrate for ACE. VEGF and MMP-9 concentrations were determined by enzyme-linked immunosorbent assay. RESULTS: Vitreous ACE activity was significantly higher in eyes with PDR (1.4 +/- 1.3 mU/ml) than in eyes with macular holes (0.22 +/- 0.11 mU/ml). Vitreous VEGF concentration in the eyes with PDR (1067 +/- 1076 pg/ml) was significantly higher than in eyes with macular holes (34 +/- 5.5 pg/ml). Vitreous MMP-9 concentration was also significantly higher in eyes with PDR (7.5 +/- 3.8 ng/ml) than in eyes with macular holes (4.2 +/- 1.4 ng/ml). Significant correlations between ACE and VEGF (P < .01) and between ACE and MMP-9 (P < .01) were observed in the vitreous of eyes with PDR. CONCLUSIONS: Angiotensin-converting enzyme was significantly correlated with angiogenic factors, VEGF and MMP-9, in the vitreous of eyes with PDR.

Aged↗

PubMed2006

Prevalence of full-thickness macular holes in urban and rural adult Chinese: the Beijing Eye Study.

PURPOSE: To determine the prevalence of full-thickness macular holes in the elderly Chinese population. DESIGN: Population-based, cross-sectional cohort study. METHODS: The Beijing Eye Study included 4439 subjects out of 5324 subjects invited to participate (response rate 83.4%) aged 40 years or older. The present investigation consisted of 8653 (97.9%) eyes of 4346 subjects for whom readable fundus photographs were available. RESULTS: Full-thickness macular holes were found in eight (0.092%) eyes of seven (0.16%) patients (six women). Prevalence was 0.09 +/- 3.04% [95% confidence interval (CI): 0.03, 0.16%]. CONCLUSIONS: Full-thickness macular holes may be present in approximately 1.6 out of 1000 elderly Chinese in Northern China. Calculated for the entire population in China, the figure would be approximately 750,000 patients with unilateral full-thickness macular holes [n = 650,000 (95% CI: 217,000 to 1,156,000)] or bilateral full-thickness macular holes [n = 100,000 (95% CI: 33,000 to 178,000)].

Adult↗

PubMed2006

Retinal pigment epithelial tear following intravitreal pegaptanib sodium.

PURPOSE: To report two cases of a retinal pigment epithelial tear after intravitreal injection of pegaptanib sodium. To our knowledge, this is the first report of this finding after intraocular antivascular endothelial growth factor therapy. DESIGN: Observational case reports. METHODS: Two patients presented with occult choroidal neovascularization and associated serous pigment epithelial detachment that was a result of age-related macular degeneration. Both patients were treated with an intravitreal injection of pegaptanib sodium. RESULTS: One patient developed a retinal pigment epithelium tear one week after the intravitreal injection. The second patient developed a retinal pigment epithelium tear eight weeks after treatment. CONCLUSIONS: Although these cases may represent natural history, there should be a high index of suspicion for retinal pigment epithelium tears in patients who report significant visual deterioration after intravitreal injection of pegaptanib sodium. Further studies are needed to determine whether angiographic subtypes of choroidal neovascular membranes are more susceptible to developing retinal pigment epithelium tears after treatment with antivascular endothelial growth factor agents.

Aged↗

PubMed2006

Ocular trauma score in deadly weapon-related open-globe injuries.

PURPOSE: To assess prognostic value of the ocular trauma score (OTS) in deadly weapon-related open-globe injuries. DESIGN: Retrospective, interventional case series. METHODS: In 82 patients (88 eyes) with deadly weapon-related open-globe injuries, certain numerical values rendered to the OTS variables (visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, afferent pupillary defect) at presentation were summated and converted into OTS categories. The likelihood of the final visual acuities in the OTS categories were calculated and compared with those in the OTS study. RESULTS: The likelihood of the final visual acuities (no light perception NLP, light perception LP/hand motion HM, 1/200 to 19/200, 20/200 to 20/50, and > or = 20/40) in the OTS categories (1 through 5) in this group were similar to those in the OTS study group except for LP/HM in the category-2 (53% vs 26%, P < .001). No study eye was in the category-5 (the best prognosis). CONCLUSIONS: OTS calculated at initial examination may provide prognostic information in deadly weapon-related open-globe injuries.

Adolescent↗

PubMed2006

Nonprogressive extrafoveal retinal hole after foveal epiretinal membrane removal.

PURPOSE: To report an extrafoveal posterior retinal hole after surgical removal of foveal epiretinal membrane. DESIGN: Observational case reports. METHODS: We describe two patients who underwent vitrectomy surgery with an epiretinal membrane removal. Five months after vision improving surgery, a small retinal hole outside the macular area developed. RESULTS: Fundus photography and optical coherence tomography showed a full-thickness retinal hole with a surrounding cuff of subretinal fluid smaller than described in stage III or IV macular holes. The hole has been stable in shape and dimension, has not progressed to retinal detachment, and is not associated with an epiretinal membrane; the fluid is not impinging on the macular area. CONCLUSIONS: Asymptomatic full-thickness extrafoveal retinal holes, which do not progress to neurosensory detachment, can develop after epiretinal membrane peeling. These appear stable and have substantially smaller cuffs of subretinal fluid than typical macular holes.

Aged↗