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At least 73 records · Page 4Linked to original sources
PubMed2005

Vitrectomy and silicone oil tamponade as an initial surgery for retinal detachment after acute retinal necrosis syndrome.

PURPOSE: To show the feasibility of vitrectomy and silicone oil tamponade as an initial surgical procedure for retinal detachments with multiple tears that develop after the fulminant type of acute retinal necrosis syndrome. METHODS: In a prospective noncomparative interventional case series, vitrectomy, silicone oil tamponade, and encircling scleral buckling with a solid silicone, combined with phacoemulsification and intraocular lens implantation (except for one pseudophakic patient [Case 2]), were performed in three consecutive patients during the four-year period from 1999 to 2002. These patients had developed retinal detachment with multiple retinal tears after the resolution of acute retinal necrosis syndrome. As an initial standard treatment for acute retinal necrosis syndrome, all patients received maximum-dose intravenous acyclovir (1500 mg daily) for two weeks combined with intravenous prednisolone tapered from 200 mg daily. RESULTS: Case 1 was a 65-year-old woman who developed retinal detachment 44 days after the onset of acute retinal necrosis syndrome; Case 2, a 79-year-old man, developed retinal detachment 51 days after the onset; and Case 3, a 59-year-old man, developed retinal detachment 70 days after the onset. Before surgery, all patients showed multiple tears scattered on the detached atrophic retina extending over the entire midperipheral fundus with vitreoretinal adhesions and vitreous opacity. The retina was reattached during the initial surgery. The patients showed no recurrence of retinal detachment and maintained a visual acuity of 20/200 or 20/100 during the one- to three-year follow-up period. CONCLUSIONS: Vitrectomy and silicone oil tamponade could be a treatment option as the initial surgical procedure for retinal detachments that develop after the fulminant type of acute retinal necrosis syndrome.

Aged↗
PubMed2006

[Treatment of retinal detachments with giant retinal tear. Retrospective study of 23 cases].

PURPOSE: Report of anatomic and functional results of retinal detachment with giant retinal tear. PATIENTS AND METHODS: Retrospective study of 23 cases of retinal detachment resulting from retinal tear of 90 degrees or more: five had a history of ocular trauma, 14 had myopia, and six had no risk for giant retinal tear. Episcleral surgery was performed on cases of giant retinal tear less than 180 degrees , with no advanced proliferative vitreoretinopathy and no inversion of the retinal flap. A vitrectomy was performed on other cases. Scleral buckle was associated with vitrectomy in cases of advanced vitreoretinopathy. RESULTS: The degree of success in the primary surgery was 50% in vitreoretinal surgery, 75% in vitreoretinal surgery with an encircling scleral buckle, and 86.4% in episcleral surgery. Of the seven failed cases, six patients underwent second-intention surgery: vitrectomy in four cases (primary surgery: the first case, episcleral surgery; the next two cases, vitrectomy; and in the fourth, vitrectomy with an encircling scleral buckle). In the last two cases, vitrectomy with scleral buckle was used (the primary surgery in both cases was vitreoretinal surgery). The final success rate was 78.2%, and the average follow-up was 32 months. Through the last test, postsurgery acute vision improved in 16 cases. CONCLUSION: Vitrectomy is often recommended to repair retinal detachment with giant retinal tear. However, episcleral surgery can be used if the giant tear is less than 180 degrees , the proliferative vitreoretinopathy is not advanced, and the retina flap is not inverted. The scleral buckle must be associated with the vitrectomy in cases of inferior giant retinal tear even if the proliferative vitreoretinopathy is not advanced.

Adolescent↗
PubMedDate not supplied

[Idiopathic macular edema, macular hole, retinal detachment and retinal fibrosis as complications of the involutional vitreoretinal syndrome].

The author suggests calling the involution vitreoretinal syndrome a characteristic symptom complex of vitreoretinal changes occurring in advanced age. He distinguishes three stages in the course of this syndrome an early one, whose signs are, among other things, destruction of the anterior segment of the vitreous body, presence of glial plaques of the retina (coin-shaped and flap reflexes of the fundus oculi), and changes of the posterior lenticular capsule in the lentivitreoretinal form of the syndrome. The mature stage is characterized by total destruction of the vitreous body or its detachment, transformation of a part of glial plaques into individual foci of fibrosis, phacosclerosis of lenticular nucleus. The present communication sums up complications of the syndrome occurring in the third stage of the disease. In 44 of the 109 patients the following complications were observed: macular edema in 6, macular opening in 9, reticular fibrosis in 9, retinal detachment in 8, nuclear cataract in 12. The author explains so high an incidence of complications by the fact that involutional vitreoretinal syndrome cannot be diagnosed at the early stages and that patients come to consult a doctor only when complications are developing as a rule. Physicians' awareness of the early signs of the syndrome may become an essential factor in the prevention of quite a number of intraocular conditions developing in advanced age.

Aged↗
PubMed1988

[Rhegmatogenous retinal detachment and retinal tear with intravitreous hemorrhage].

A retrospective study was conducted on a series of 28 eyes with primary retinal tears associated with vitreous hemorrhage. At initial presentation, the retina was detached in 17 eyes and attached in 11. In the series of eyes with an attached retina, the vitreous hemorrhage was massive in 5 eyes (45%), the average number of retinal tears was 1.36. All eyes showed a retinal tear located in the upper quadrants. Three patients (27%) experienced recurrent vitreous hemorrhage after sealing of the retinal tears. In the series of eyes with a detached retina, the vitreous hemorrhage was massive in 5 eyes (29%) and the average number of retinal tears was 1.9. The retinal detachment was located in the upper quadrants in 16 eyes (94%). Clinical evidence of proliferative vitreoretinopathy was noted, at initial presentation, in 6 eyes (35%). Permanent retinal reattachment was achieved in only 12 eyes (70%). All surgical failures were related to proliferative vitreoretinopathy. In the present series the prognosis of primary retinal tears with significant vitreous hemorrhage was guarded because of recurrent vitreous hemorrhages. The prognosis of primary rhegmatogenous retinal detachments with significant vitreous hemorrhage at initial presentation was guarded because of the high incidence of proliferative vitreoretinopathy.

Adult↗
PubMed2003

Comparison of scleral buckling with combined scleral buckling and pars plana vitrectomy in the management of rhegmatogenous retinal detachment with unseen retinal breaks.

BACKGROUND: The purpose of the present paper was to compare the techniques of conventional scleral buckling and combined pars plana vitrectomy and scleral buckling procedures in rhegmatogenous retinal detachments with unseen retinal breaks. METHODS: Forty-four consecutive eyes with uncomplicated, primary rhegmatogenous retinal detachments with a clear media and unseen retinal breaks were randomized to two groups. The scleral buckling group underwent 360 degrees scleral buckling, cryopexy and external subretinal fluid drainage. In the combined surgery group, 360 degrees scleral buckling, pars plana vitrectomy, air-fluid exchange, endolaser and injection of 14% perfluoropropane gas was done. RESULTS: At 3 months follow up the primary reattachment rate was 80% (16/20 cases) in the combined surgery group, and 70% (14/20 cases) in the scleral buckling group (P = 0.716). The visual acuity improved significantly from a preoperative median of hand movement (HM; range: HM to 6/60; similar in both the groups), to a median of 6/60 (range: perception of light to 6/18) in the combined surgery group and a median of 6/36 (range: HM to 6/18) in the scleral buckling group, the difference between the two groups not being statistically significant (P = 0.4). The number of intraoperative and postoperative complications was more in the combined surgery group. (four cases were lost to follow up and were doing well when last examined.) CONCLUSION: Conventional scleral buckling was found to be a safe and effective technique in the primary management of uncomplicated, rhegmatogenous retinal detachments with unseen retinal breaks when the media is clear.

Adolescent↗
PubMed1975

Rhegmatogenous retinal detachment after tributary retinal vein occlusion.

Two patients had rhegmatogenous retinal detachment after tributary retinal vein occlusion. Neovascularization adherent to the posterior hyaloid was avulsed, along with a plug of retinal tissue, as the vitreous body collapsed. Localized retinal detachments resulted. Photocoagulation successfully obliterated the retinal holes and prevented extension of the retinal detachments in both cases.

Female↗
PubMed1992

[Retinal detachment with retinal dialysis].

A group of 165 eyes operated on account of detachment of the retina comprised 16 eyes with oral dialysis (i.e. 9.7%). Only in 6 eyes of the group there was a positive traumatic case-history. The anatomical results of the operations were favourable (81% amotions cured), the functional results depended on the state of the macula before operation.

Adolescent↗
PubMed1995

[Prognosis of retinal detachment in cytomegalovirus retinitis].

PURPOSE: To evaluate the incidence and the prognosis of retinal detachment in CMV retinitis in AIDS. To test intravitreal injections of ganciclovir into the vitreal cavity filled with silicone. METHODS: Among 136 eyes with CMV retinitis, 15 (11%) had retinal detachment. Ten eyes underwent intraocular surgery with injection of silicone oil, one extraocular surgery and four eyes were not operated. Later, four eyes filled with silicone received intravitreal injections of ganciclovir. RESULTS: At 2 months, the retina was flat in all the operated eyes, with a visual acuity improved or stabilized in 8 cases (73%). Conversely, visual acuity was lost in all the unoperated eyes. The 14 intravitreal injections of ganciclovir performed in four eyes (which received 2, 3, 3 or 6 injections, respectively) were well tolerated. CONCLUSION: Surgery of retinal detachment in CMV retinitis usually allows the conservation of ambulatory visual acuity. Its indications must be discussed together with the patient, the ophthalmologist and the physician. Intravitreal injections of ganciclovir in vitreal cavity filled with silicone oil are possible.

AIDS-Related Opportunistic Infections↗
PubMed2003

Retinal detachment in cytomegalovirus retinitis: intravenous versus intravitreal therapy.

PURPOSE: To compare the rate of retinal detachment in a group of patients treated with intravitreal ganciclovir to the rate of retinal detachment in a group of patients treated with systemic ganciclovir. METHODS: A retrospective non-randomized comparative case series was conducted. The participants were 186 consecutive patients with cytomegalovirus (CMV) retinitis treated at two centres over the period from June 1990 to May 1997. Of the 186, 133 patients had systemic therapy of whom 113 had intravenous ganciclovir or foscarnet and 20 had oral ganciclovir, and 53 patients had intravitreal induction and maintenance therapy. The main outcome measure was the rate of retinal detachment, which was calculated using person-months-at-risk denominators. The effect measure used in the main comparative analysis was the hazard ratio obtained from multiple regression using the Cox proportional hazards model. RESULTS: Retinal detachment occurred in three of 53 patients in the intravitreal therapy group, one of 20 patients receiving oral maintenance therapy and 21 of 113 patients receiving intravenous maintenance therapy. The risk of retinal detachment with systemic therapy was 14-fold higher than with intravitreal therapy (P < 0.001)and up to fourfold higher with oral maintenance therapy. CONCLUSIONS: Intravitreal therapy offers a significant advantage over systemic therapy in the treatment of CMV retinitis by substantially reducing the risk of CMV-related retinal detachment.

AIDS-Related Opportunistic Infections↗
PubMed2000

Rapid glutamatergic alterations in the neural retina induced by retinal detachment.

PURPOSE: Retinal detachment induces neurochemical changes in the neural retina over a span of days to weeks. However, little information is available on the acute response in the retina to detachment. METHODS: Distribution of the neurotransmitters glutamate, glycine, and gamma-aminobutyric acid (GABA) and the metabolic amino acids aspartate and glutamine was examined immunocytochemically from 5 to 30 minutes and at 3 hours after retinal detachment in a salamander eyecup preparation. RESULTS: Glutamate showed a rapid depletion from neuronal cell bodies in detached retina, whereas Müller cells, which normally sequester and metabolize glutamate, showed increased immunolabeling for glutamine. Changes occurred exclusively in detached retinal regions of the eyecup. Aspartate, a precursor for glutamate synthesis, also showed decreased labeling in neuronal cell bodies in detached retinal regions, although these changes were not as striking as those observed for glutamate. In contrast, the distributions of the inhibitory amino acid neurotransmitters glycine and GABA were not affected appreciably by acute retinal detachment. CONCLUSIONS: These results indicate that retinal detachment induces rapid, localized alterations in the glutamatergic system of the neural retina that are consistent with a massive efflux of neuronal glutamate and concomitant alterations in glutamate metabolism. An acute efflux of neuronal glutamate in detached retina could contribute to excitotoxicity and to the initiation of structural alterations and changes in gene expression; it is also consistent with reported neurochemical changes associated with longer term retinal detachment.

Ambystoma↗
PubMed1995

Concurrent acute angle-closure glaucoma, choroidal detachment and exudative retinal detachment in a patient with spontaneous carotid cavernous fistula.

A 61-year-old woman had proptosis, pulsation of the globe, orbital bruit and epibulbar congestion in the left eye. The cavernous sinus appeared enlarged by computed tomography. No trauma was noted. Despite the lack of carotid angiographic findings, the patient was diagnosed as having spontaneous carotid cavernous fistula. No surgery was performed. At the age of 67 years, the patient complained of pain in the left eye. Acute angle-closure glaucoma, choroidal detachment and exudative retinal detachment were concurrently found in the left eye. An ocular pulse on the tonography reading in the left eye was larger than in the right eye. Concurrent acute angle-closure glaucoma, choroidal detachment and exudative retinal detachment with carotid cavernous fistula, as found in our patient, may be rare.

Acetazolamide↗