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At least 739 records · Page 41Linked to original sources

PubMed2001

Experimental retinal detachment causes widespread and multilayered degeneration in rabbit retina.

Retinal detachment remains one of the most frequent causes of visual impairment in humans, even after ophthalmoscopically successful retinal reattachment. This study was aimed at monitoring (ultra-) structural alterations of retinae of rabbits after experimental detachment. A surgical procedure was used to produce local retinal detachments in rabbit eyes similar to the typical lesions in human patients. At various periods after detachment, the detached retinal area as well as neighbouring attached regions were studied by light and electron microscopy. In addition to the well-known degeneration of photoreceptor cells in the detached retina, the following progressive alterations were observed, (i) in both the detached and the attached regions, an incomplete but severe loss of ganglion cell axons occurs; (ii) there is considerable ganglion cell death, particularly in the detached area; (iii) even in the attached retina distant from the detachment, small adherent groups of photoreceptor cells degenerate; (iv) these photoreceptor cells degenerate in an atypical sequence, with severely destructed somata and inner segments but well-maintained outer segments; and (v) the severe loss of retinal neurons is not accompanied by any significant loss of Müller (glial) cells. It is noteworthy that the described progressive (and probably irreparable) retinal destructions occur also in the attached retina, and may account for visual impairment in strikingly large areas of the visual field, even after retinal reattachment.

Animals↗

PubMed1995

Apoptotic photoreceptor cell death after traumatic retinal detachment in humans.

OBJECTIVE: To determine the mechanism of photoreceptor cell death after traumatic retinal detachment in humans. DESIGN: Clinical records from 1975 to 1993 of 75 patients, whose eyes were enucleated after traumatic retinal detachment, were reviewed for age, sex, previous ocular or systemic medical history, interval from initial trauma to enucleation, visual acuity, and types of trauma. The patients were divided into five groups of 15 cases each, based on the interval from initial trauma to enucleation. The retinal tissue was examined for two markers of apoptosis: (1) nicked nuclear DNA in situ by the terminal deoxynucleotidyl transferase-mediated biotinylated deoxyuridine triphosphate nick end labeling (TUNEL) technique and (2) apoptotic bodies by light and electron microscopy. RESULTS: Of the 75 cases of ruptured globe and traumatic retinal detachment that were evaluated, 19 eyes (25.3%) showed TUNEL-positive labeling of photoreceptor cells. Nicked nuclear DNA was detected in photoreceptor cells of detached retinas as early as 8 hours after trauma. The detached retinas in seven of 15 eyes enucleated within 2 days after ocular trauma showed TUNEL-positive photoreceptor nuclei. The number of cases showing TUNEL-positive photoreceptor nuclei decreased as the interval between initial trauma and enucleation increased. The TUNEL-positive photoreceptor cells could still be seen in the detached retinas of two eyes enucleated 22 days after trauma. Light microscopy disclosed condensation and fragmentation of photoreceptor nuclei in the detached retinas. Electron microscopy showed structures resembling apoptotic bodies phagocytosed by neighboring cells in the TUNEL-positive retinas. CONCLUSIONS: Apoptosis is an important mechanism of photoreceptor cell degeneration in the early stage after traumatic retinal detachment in humans.

Adolescent↗

PubMed1987

[Prevention of bilateralization of idiopathic retinal detachment by treatment with argon laser].

The incidence of bilateral retinal detachment ranges from 12 to 15%. A retrospective study including of 141 patients with a systematical prophylactic treatment of the fellow eye is reported. After the prophylactic photocoagulation no bilateral retinal detachment occurred, no complication arose. The average follow-up was about 18 months. The authors describe the technique of the prophylactic argon laser treatment. This photocoagulation associates a focal treatment excluding suspicious lesions, and a 360 degree equatorial treatment, completed by several anterior radial rows and by a scattered but tight photocoagulation from the equator to the ora. The authors conclude that prophylactic and systematical treatment is safe and effective, avoiding the focal retinal detachments, anterior giant tears and probably many breaks. The follow-up is still too short to know the longterm percentage of bilateral detachments with such a treatment of the fellow eyes.

Adult↗

PubMed1997

Retinal detachment associated with type III retinoblastoma regression after cryotherapy and external-beam radiotherapy.

PURPOSE: To report a child with rhegmatogenous retinal detachment originating from a focus of type III retinoblastoma regression after cryotherapy and external-beam radiation therapy. METHOD: Retinal detachment and multiple retinal holes, which were closely associated with the calcified mass of the regressed retinoblastoma, were treated with cryotherapy and scleral buckle. RESULTS: Positioning the regressed tumor and the retinal holes on the scleral buckle closed the holes. Subretinal fluid gradually reabsorbed after surgery, and complete retinal reattachment resulted. CONCLUSION: Rhegmatogenous retinal detachment is rare in patients with retinoblastoma, and scleral buckle can successfully manage such cases. In our patient, the detachment probably resulted from retinal necrosis secondary to cryotherapy and external-beam radiation therapy.

Calcinosis↗

PubMed1986

A simplified method of treating retinal detachment with macular hole. Long-term follow-up.

Eighteen patients with macular hole retinal detachment and no visible posterior vitreoretinal connections were treated by one of two methods. In ten patients with extensive retinal detachment, the subretinal fluid was released in the temporal scleral side, and 1.0 mL or more of air or gas was injected into the vitreous cavity through the pars plana. In eight patients with localized retinal detachment in the posterior pole, 0.7 mL or more of gas was injected into the vitreous cavity after 0.3 to 0.5 mL of aqueous humor was released. Macular buckling, macular diathermy, or vitrectomy was not used. After the operation, the patients were placed in a prone position for at least six hours a day until the air or gas disappeared from the vitreous cavity. In 15 of 18 patients, the retina remained attached during follow-up periods that ranged from four to 32 months (average, 14 months). This operation is easy and safe and requires no sophisticated instruments. In addition, the macula is not damaged, as it can be by diathermy and buckling. This procedure should be the treatment of choice in patients with retinal detachments with macular holes but without other breaks or visible vitreous adhesion.

Aged↗

PubMed2006

Outcome of eyes developing retinal detachment during the Early Treatment for Retinopathy of Prematurity Study (ETROP).

OBJECTIVE: To report the structural and visual outcomes of eyes in which retinal detachment developed from retinopathy of prematurity (ROP) in the Early Treatment of Retinopathy of Prematurity (ETROP) Study. Method Infants in the ETROP Study with bilateral high-risk prethreshold ROP had 1 eye randomized to early treatment, with the fellow eye managed conventionally. In infants with asymmetric disease, the eye with high-risk prethreshold ROP was randomized to early treatment or conventional management. When a retinal detachment was detected, observation or vitreoretinal surgery (ie, scleral buckling and/or vitrectomy) was provided at the discretion of the individual investigator. At 9 months corrected age, retinal examinations were performed and visual acuities were assessed by masked testers using grating acuity. RESULTS: The ETROP Study enrolled 401 patients with high-risk prethreshold ROP. Retinal detachments occurred in 89 eyes of 63 patients. Follow-up was available for 78 eyes of 56 patients. The detachments were bilateral in 21 patients (38%) and were classified as stage 4A in 30 eyes, stage 4B in 14 eyes, and stage 5 in 16 eyes. Detachments were not classified in 18 eyes. Twelve eyes of 11 patients were observed and 66 eyes of 52 patients underwent vitreoretinal surgery. Attachment of the macula at 9 months persisted or was achieved in 17 (30%) of 56 eyes after vitrectomy with or without scleral buckle, in 6 (60%) of 10 eyes after scleral buckle only, and in 2 (17%) of 12 eyes followed up without surgery. Favorable visual acuity (> or =1.85 cycles/degree) was found in 13 (17%) of the 78 eyes. All 6 eyes that maintained normal visual acuity (> or =3.70 cycles/degree) had a stage 4A detachment (1 of 6 managed by observation, 3 of 6 by scleral buckle, and 2 of 18 by vitrectomy). Eleven eyes with stage 5 detachment underwent vitreoretinal surgery, resulting in 6 with no light perception, 3 with light perception only, and 2 with detection of only the low vision card. CONCLUSIONS: In the ETROP Study, the outcome of retinal detachment owing to ROP was generally poor. Vitreoretinal surgery for retinal detachment was associated with macular attachment in 16 of 48 eyes. Normal acuity was maintained after surgical repair of stage 4A retinal detachment in 5 (21%) of 24 eyes. Vitreoretinal surgery for stage 5 disease was associated with some structural successes but poor functional outcomes.

Cryosurgery↗

PubMed1980

Effect of preoperative posture and binocular occlusion on retinal detachment.

In an unselected series of retinal detachments a 24-hour period of binocular occlusion and posture with a retinal hole dependent produces some resolution of subretinal fluid in 13% of cases. If only patients with acute, freely mobile detachments and retinal holes above the horizontal meridian were selected the proportion of detachments showing some resolution rose to 30%. In 8% of cases a paradoxical response occurred, the detachment increasing in depth or extending to involve an additional area of retina.

Eye Movements↗

PubMed1979

Retinal detachment and pseudophakia.

A consecutive series of pseudophakic retinal detachments was statistically compared with a matched group of aphakic retinal detachments. Distribution of breaks, anatomic results, and final visual acuities were tabulated. Success in reattachment was equal in the two groups, but final visual acuities were better in the aphakic group. Emphasis was placed on the intraoperative ophthalmoscopic examination of pseudophakic eyes with compromised peripheral fundus visibility.

Aphakia, Postcataract↗

PubMed1994

[Application of silicone oil in management of complicated retinal detachment surgery].

60 eyes of 60 cases with complicated retinal detachment were treated by vitrectomy combined with silicone oil tamponade, including grade D of proliferative vitreoretinopathy (PVR) in 27, giant retinal tears with posterior flaps folded up in 15, posterior polar or macular holes in 13 and traumatic PVR in 5 eyes. After 3-24 months of follow-up, it is shown that 48 eyes obtained anatomic reattachment, the success rate being 80%, and the post-operative visual acuities improved in 43 eyes of which 32 eyes achieved > 0.05. The authors consider that vitrectomy and membrane peeling create a situation for silicone oil tamponade to play its role fully, vitrectomy is perfected by the combination of silicone oil tamponade and the rate of success of the retinal detachment operation is increased. The theory, indications, advantages and disadvantages of silicone oil tamponade were briefly discussed.

Adolescent↗

PubMed2002

The effect of duration of macular detachment on results after the scleral buckle repair of primary, macula-off retinal detachments.

PURPOSE: To present a current series that determined the effect of duration of macular detachment (DMD) and patient age on postscleral buckle (SB) visual acuity (VA) and anatomic results. DESIGN: Retrospective, noncomparative, observational case series. PARTICIPANTS: Ninety-four consecutive patients (94 eyes) with primary, uncomplicated, macula-off retinal detachments, a preoperative VA of 20/200 or worse, and a precise history of when macular function was lost. INTERVENTION: Standard explant scleral buckle technique performed by multiple surgeons. MAIN OUTCOME MEASURES: Visual acuity, anatomic reattachment, and proliferative vitreoretinopathy. RESULTS: Visual acuity after SB of 20/40 or better was seen in 71% of eyes with a DMD of 10 days or fewer, 27% of eyes with a DMD of 11 days to 6 weeks, and 14% of eyes with a DMD of more than 6 weeks. Eyes achieved a mean VA after SB of 20/41 after a DMD of 10 days or fewer, 20/121 after a DMD of 11 days to 6 weeks, and 20/178 after a DMD of more than 6 weeks. No decrease in VA was seen within the 1- to 10-day period or the 11 days to 6 week period of DMD. Patients 60 years of age or less achieved a mean VA after SB of 20/47 compared with 20/81 for patients between 61 to 75 years of age and 20 of 96 in patients more than 76 years of age. Duration of macular detachment and patient age had no statistically significant effect on final anatomic reattachment after SB, reoperation rate, or proliferative vitreoretinopathy. CONCLUSIONS: Eyes with primary, uncomplicated, macula-off retinal detachment repaired with SB achieve excellent postoperative VA if repaired within the first 10 days of macular detachment. These results are better than the VA in eyes repaired after 11 days to 6 weeks and more than 6 weeks of macular detachment. Patients 60 years of age and younger obtained better postoperative VA than older patients. Duration of macular detachment and patient age did not significantly effect anatomic outcomes.

Adolescent↗

PubMed2004

Management of primary rhegmatogenous retinal detachment with inferior breaks.

BACKGROUND: Rhegmatogenous retinal detachments (RRD) with inferior breaks are usually treated by scleral buckling (SB) or pars plana vitrectomy (PPV) or a combination of both methods. However, applying a SB during PPV may produce a risk of choroidal haemorrhage. Following a recent pilot study showing that such cases can be safely treated by PPV without SB the authors re-examined their management of RRD in which inferior breaks were present. METHODS: All patients had a detached vitreous and a complex configuration of retinal breaks. A case-control study was performed to analyse the surgical methods and results of PPV on 48 consecutive patients with RRD associated with inferior breaks and 48 age/sex matched controls who underwent PPV for RRD without inferior breaks. Exclusion criteria were giant retinal tears, retinal dialysis, trauma, proliferative vitreoretinopathy (PVR) grade B or higher, schisis detachments, and eyes that had been operated previously for RRD. A simple algorithm was followed to manage patients with inferior breaks. All patients underwent a standard three port PPV with intraocular gas tamponade without supplementary SB. Patients were asked to posture face up or right or left side down for 1 week. RESULTS: 39 of the 48 patients (81.3%) with inferior breaks were treated successfully with one operation. 41 of 48 patients (85.4%) control patients achieved primary success. The final success rate was 95.8% in both groups. There was no statistical difference between the two groups. When all the cases of RRD were analysed (including external plomb/non-drain procedures) the primary success rate was 89% and final success rate 97.5%. CONCLUSIONS: This study has shown that acceptable success rates can be achieved using PPV alone to treat RRD with inferior breaks. Complications are minimised and patients in this high risk group have an 81% chance of primary success. Pars plana vitrectomy and gas will successfully reattach the retina and a supplementary SB, to support the inferior retina, is unnecessary as the intraocular gas, and face up or, right or left side down positioning will tamponade breaks satisfactorily.

Case-Control Studies↗

PubMed2002

Laser photocoagulation repair of recurrent macula-sparing retinal detachments.

Laser photocoagulation was performed around a detached retina in 4 patients who developed localized retinal detachment after successful scleral buckling. The range of retinal redetachment in all 4 patients was no larger than that of the initial retinal detachment and did not go over the vascular arcade. No evidence of vitreous traction or proliferative vitreoretinopathy was observed in these cases. Laser photocoagulation was performed in 3 lines of gray-white burn around the detached retina. Retinal attachment occurred between 4 and 14 days of laser treatment in all cases. No procedure related complications were seen. Laser photocoagulation may be an alternative procedure for the treatment of redetached retina with little and shallow detachment, before considering resurgery.

Adult↗

PubMed1982

Epidemiology of retinal detachment.

A survey of rhegmatogenous retinal detachment during 1976 was conducted on the population of Iowa. The annual incidences (per 100,000 populations) of four types of detachment were determined: nontraumatic phakic (6.1), traumatic phakic (1.0), nontraumatic aphakic (4.9), and traumatic aphakic (0.4). The incidences of nontraumatic phakic detachment for men and women were similar, although there was a preponderance of women that reflected their greater representation in the general population. The proportions of men were significantly higher in traumatic detachments compared with nontraumatic detachments. Men tended to be younger than women for all types of detachment; however, only in nontraumatic aphakic detachment was there a significant difference between mean ages. There was an insignificant preponderance of right eye involvement in all four detachment groups.

Adolescent↗

PubMed1978

Retinal detachment due to ocular penetration. I. Clinical characteristics and surgical results.

The records of 74 patients--young and almost exclusively males--with retinal detachment due to ocular penetration were reviewed to study the characteristics and surgical results of this type of traumatic retinal detachment. There was a high incidence of industrial and domestic accidents. The incidence and degree of myopia were significantly lower than in nontraumatic cases of retinal detachment. The time interval between the injury and the detection of the retinal detachment was variable. Many of the eyes with longer latent intervals had classic signs of traumatic retinal detachment. The most common type of retinal break was a dialysis in the oral zone at the posterior vitreous base border. The most common cause of these retinal breaks was severe traction from contracting vitreous bands and membranes that followed the loss of vitreous gel from the eye. Surgical results were relatively poor; recurrence was common because of progressive vitreous pathology. Postoperative traction on the vitreous base by the continued shrinkage of vitreous membranes was noted in 50% of the eyes that contained such membranes preoperatively.

Adolescent↗

PubMed2006

Refractile superficial retinal crystals and chronic retinal detachment: case report.

BACKGROUND: Few previous reports have described the presence of retinal refractile opacities at the macular area in patients presenting with longstanding peripheral retinal detachment. The exact nature of these opacities is unknown. CASE PRESENTATION: Two patients were referred with an abnormal appearance of refractile opacities in the macular area noted during routine examination. Both were found to have longstanding peripheral retinal detachments. Subretinal fluid analysis of one patient revealed the presence of multiple birefringent crystals. We hypothesise that these crystals are the origin of the refractile macular opacities noted. CONCLUSION: This report describes the rare presentation of asymptomatic peripheral retinal detachment by the detection of refractile macular opacities on routine examination. It highlights the importance of meticulous peripheral retinal examination in these cases. The article also describes the findings of the subretinal fluid analysis and discusses the possible hypothesis behind their appearance.

Adult↗

PubMed1996

[The fellow eye in patients with retinal detachment associated with atopic dermatitis].

The fellow eyes of 13 cases of retinal detachment associated with atopic dermatitis were examined by binocular ophthalmoscope combined with scleral indentation. Breaks in the retina or pars plana were detected in 8 cases (62%); 2 of these eyes had asymptomatic retinal detachment. The most common location of these breaks was at the vitreous base symmetrical to the affected, symptomatic eye. Meticulous ophthalmoscopic examination is recommended for both eyes in patients with retinal detachment associated with atopic dermatitis.

Adolescent↗

PubMedDate not supplied

Primary vitrectomy for combined rhegmatogenous retinal detachment and choroidal detachment with or without oral corticosteroids: a pilot study.

PURPOSE: The occurrence of choroidal detachment (CD) in eyes with primary rhegmatogenous retinal detachment (RRD) is relatively uncommon (2%-4.5%). Recent reports suggest that primary vitrectomy yields better anatomic success than scleral buckling. However, for these inflamed eyes with low intraocular pressure, the influence of preoperative oral steroids on reattachment rates has not been elucidated yet. METHODS: Twenty eyes with combined RRD and CD that underwent primary vitrectomy were randomized to receive oral steroids (for 1 week) or no oral steroids before surgery. RESULTS: Preoperative clinical data such as mean age, lens status, Snellen visual acuity, duration of macular detachment, CD (size and extent), and retinal detachment characteristics (e.g., extent, number of retinal breaks, atrophic or tractional retinal break, size of retinal break, and location of retinal break) were similarly distributed in both groups. Single-operation anatomic success was 81.8% (9/11) among those patients who received preoperative oral steroids and was 66.7% (6/9) among those who did not receive preoperative oral steroids. After reoperation, anatomic success was 100% in both groups. The mean follow-up was 20.1 months. CONCLUSION: The results suggest that administration of oral steroids before primary vitrectomy in eyes with combined RRD and CD improves reattachment rates.

Administration, Oral↗

PubMed1986

Rhegmatogenous retinal detachment after neodymium-YAG laser capsulotomy in phakic and pseudophakic eyes.

A retrospective study of 18 eyes in 17 patients with rhegmatogenous retinal detachments after neodymium-YAG laser posterior capsulotomy was performed to determine operative settings and to describe anatomic changes after the procedure in an effort to assess their relationship to subsequent retinal detachment. The laser energy required to create a capsulotomy did not appear to be excessive and the capsulotomy openings were not unusually large. The time between YAG capsulotomy and diagnosis of retinal detachment ranged from four to 82 weeks (mean, 28 weeks). The characteristics of the retinal detachments were similar to those after routine cataract extraction. Retinal reattachment surgery was ultimately successful in all 18 eyes. Both YAG laser and knife-needle posterior capsulotomies may increase the risk of subsequent rhegmatogenous retinal detachment as a result of opening the capsule.

Adult↗