PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Retinal Perforations”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources
PubMed2003

Long-term results following pars plana vitrectomy with platelet concentrate in pediatric patients with traumatic macular hole.

PURPOSE: To describe the long-term clinical course in children with a traumatic macular hole after vitrectomy with platelet concentrate. DESIGN: Interventional case series. METHODS: Four pediatric patients with a mean age of 13.2 years (range, 10-15 years) underwent pars plana vitrectomy with platelet concentrate, internal limiting membrane peeling, and SF6 gas tamponade for stage 3 traumatic macular hole repair. RESULTS: Primary closure was achieved by a single intervention in all patients with a marked visual improvement of three to seven lines after surgery. The surgically achieved visual improvement remained stable and no vision-threatening complications occurred during the mean follow up of 35.2 months (range, 27-51 months). CONCLUSION: We regard pars plana vitrectomy with platelet concentrate and SF6 gas instillation as safe and effective and, therefore, as the therapy of choice for traumatic macular holes particularly in children after a period of observation no longer than 3 to 4 months.

Adolescent↗
PubMed2003

Persistent subretinal indocyanine green induces retinal pigment epithelium atrophy.

PURPOSE: To describe a case of a patient with macular hole with subretinal indocyanine green (ICG) during vitrectomy. DESIGN: Interventional case report. METHODS: A 66-year-old woman with macular hole underwent a vitrectomy with ICG. RESULTS: After application of ICG into the vitreous, ICG was introduced in the subretinal space. Indocyanine green was found to be present for more than 6 months. Retinal pigment epithelium atrophy appeared at the site of the lesion. CONCLUSIONS: Although ICG may be a useful tool for distinguishing the internal limiting membrane and other tissues careful application is required to prevent side effects.

Aged↗
PubMed2003

Optical coherence tomography and focal macular electroretinogram in eyes with epiretinal membrane and macular pseudohole.

PURPOSE: To determine the morphology of macular pseudoholes (MPHs) and the relationship of morphology to macular function. DESIGN: Observational case series. METHODS: Optical coherence tomography (OCT) was performed on 42 eyes of 42 consecutive patients with an epiretinal membrane (ERM) and an MPH. The diameters of the MPH, and the thickness of the foveal and parafoveal retina were measured. Of these 42 eyes, focal macular electroretinograms (FMERGs) were recorded from 22 eyes of 22 patients with a 15 degree stimulus; FMERGs were also recorded with a 5 degree stimulus from 9 eyes of these 22 eyes. RESULTS: In 42 eyes, the mean +/- Standard deviation (SD) diameter (437.7 +/- 172.8 microm) and geometrical shape of the MPHs were not significantly correlated with the visual acuity. The MPHs were divided into 2 types from the OCT images at the base of MPHs; group A had normal thickness (100-199 microm; n = 29), and group B (n = 13) had thicknesses of >or= 200 microm, or thickness < 100 microm, or irregular base. The visual acuity in group A (logarithm of the minimum angle of resolution [log MAR] mean +/- SD:.083 +/-.144) was significantly better than group B (log MAR,.407 +/-.212, P <.0001). There was a significant reduction in the amplitude of all components of FMERGs elicited by the 15 degree stimulus in the affected eyes (mean +/- SE, A-wave: 1.26 +/-.12 microv, B-wave: 3.07 +/-.27 microv, oscillatory potentials: 1.23 +/-.25 microv) compared with the normal fellow eyes (A-wave: 1.58 +/-.13 microv, B-wave: 4.14 +/-.27 microv, oscillatory potentials: 2.35 +/-.29 microv). A significant correlation was found between the relative amplitudes of the B-wave elicited by the 5 degree stimulus and the visual acuity (r =.918, P =.0005). CONCLUSIONS: In eyes with an ERM and an MPH, the visual acuity is generally correlated with the OCT images. Macular function of eyes with an MPH resembles eyes with an ERM without an MPH. The effect of the ERM appears to be different on the base and parafovea of the MPHs.

Adult↗
PubMed2003

Surgical management of retinal detachment associated with myopic macular hole: anatomic and functional status of the macula.

PURPOSE: To evaluate the postoperative status of the macula after vitreous surgery with internal limiting membrane removal for macular hole related retinal detachment in patients with severe myopia. DESIGN: Interventional case series. METHODS: We prospectively examined 10 eyes with retinal detachment associated with a myopic macular hole from 10 consecutive patients, and performed pars plana vitrectomy with internal limiting membrane peeling. Macular buckling was performed in one eye during the initial treatment and in three eyes during subsequent operations. The main outcome measures were the anatomic reattachment rate and the postoperative status of the macular hole. We examined the macular area pre- and postoperatively with slit-lamp biomicroscopy and with a scanning laser ophthalmoscope. Cross-sectional imaging of the macular area was conducted with optical coherence tomography. RESULTS: Successful retinal reattachment was achieved in seven eyes (70%) after the initial surgery and in three eyes (30%) after additional procedures. Visual acuity remained unchanged in two eyes (20%), and improved by two or more logarithmic units of minimum angle of resolution (logMAR) measurement in eight eyes (80%). The macular hole was anatomically closed in only one eye (10%). Postoperative enlargement of the macular hole was observed in seven eyes. CONCLUSIONS: In highly myopic eyes with macular hole related retinal detachment, closure of the macular hole is difficult to attain despite the complete relief of tangential traction by internal limiting membrane peeling. Results indicate the presence of a possible imbalance between the retina and the choroid-sclera complex associated with axial elongation and posterior staphyloma in highly myopic eyes.

Adult↗
PubMed2003

Indocyanine green for successful repair of a long-standing macular hole.

PURPOSE: To report on the successful closure of a persistent chronic macular hole using indocyanine green (ICG) during the second surgical approach. DESIGN: Interventional case report. METHODS: A patient with a long standing macular hole (18 years) underwent pars plana vitrectomy with peeling of the internal limiting membrane (ILM). While no dye was used during the first operation, ICG (0.05%, Pulsion) was applied during the second procedure. The light source was turned off immediately after the ICG application until the dye was washed out after a period of 15 seconds. Tissue harvested during the second surgical approach was prepared for electron microscopy. RESULTS: After the failure of the first operation, areas of incomplete ILM peeling could be stained using ICG and a thorough ILM removal was achieved. Postoperatively, the macular hole was closed, as confirmed by optical coherence tomography. Visual acuity increased from 20/200 to 20/50. No visual field defects were seen postoperatively. There were only few cellular elements adherent to the retinal surface of the ILM as seen during electron microscopy. CONCLUSION: In cases where tractional forces due to incomplete ILM removal are considered responsible for the persistence of a macular hole, ICG is useful to identify areas of unpeeled ILM. Under certain safety precautions no adverse effect on functional outcome was seen.

Aged↗
PubMed2003

Vitrectomy with internal limiting membrane peeling for macular retinoschisis and retinal detachment without macular hole in highly myopic eyes.

PURPOSE: To report anatomic and visual improvement following vitrectomy with internal limiting membrane (ILM) peeling for two highly myopic patients with retinoschisis and/or retinal detachment without a macular hole. DESIGN: Two interventional case reports. METHODS: Two highly myopic patients who had retinoschisis and/or retinal detachment without a full-thickness 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 coherent tomography finding. RESULTS: Vitrectomy with ILM peeling results in biomicroscopic, functional, and tomographic improvement in both patients, for follow-up periods of 12 months and 8 months, respectively. CONCLUSIONS: Vitrectomy with ILM peeling and gas tamponade is an effective method for retinoschisis and/or retinal detachment without a macular hole in highly myopic patients.

Aged↗
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↗
PubMed2003

Early macular holes with retinoschisis in highly myopic eyes.

PURPOSE: We present two cases with early macular holes (MH) complicated by retinoschisis and foveal detachment (RSFD). DESIGN: Case reports. CASE REPORT: A 46-year-old woman and a 70-year-old woman, both with high myopia, presented visual loss and a small MH associated with RSFD. Vitrectomy and gas tamponade were performed. However, both MHs enlarged postoperatively, resulting in progressive retinal detachment. Additional gas tamponade led to retinal reattachment. At the final visit, the MH was open in case 1 but closed in case 2. CONCLUSIONS: Although the benefit of vitrectomy is uncertain, RSFD and MHs can be associated in highly myopic eyes.

Aged↗
PubMed2003

Intraretinal silicone oil vacuoles after macular hole surgery with internal limiting membrane peeling.

PURPOSE: To report the detection of intraretinal silicone oil vacuoles after the use of a silicone oil tamponade for macular hole surgery with internal limiting membrane (ILM) peeling. DESIGN: Observational case report. METHODS: A 57-year-old woman with a recurrent macular hole in the left eye underwent macular hole surgery with ILM peeling and silicone oil tamponade. After early silicone oil emulsification was detected, the silicone oil was removed. RESULTS: Follow-up ophthalmoscopic examination and optical coherence tomography imaging revealed intraretinal silicone oil vacuoles in the area of ILM peeling. CONCLUSIONS: Internal limiting membrane defects may facilitate the entry of silicone oil into the retina, leading to accumulation of oil vacuoles. The use of silicone oil in macular hole surgery with ILM peeling may complicate the postoperative outcome.

Basement Membrane↗
PubMed2003

Laminated posterior vitreous cortex associated with idiopathic macular hole.

PURPOSE: To report an unusual preretinal opacity associated with an idiopathic macular hole (MH) that was identified by optical coherence tomography. DESIGN: Observational case report. METHODS: A 59-year-old woman with a preretinal linear opacity running across an MH was examined by optical coherence tomography. RESULTS: Optical coherence tomography showed a full-thickness MH with a superiorly hinged flap. The preretinal opacity was identified as a part of a laminated vitreous cortex that was perpendicularly attached to the apex of the flap. A horizontal scan showed a partly double-layered posterior vitreous cortex. Two months later, the linear opacity disappeared coincident with a complete posterior vitreous detachment. The MH was closed by vitrectomy with peeling of the internal limiting membrane. CONCLUSIONS: Optical coherence tomography identified an unusual ophthalmoscopic presentation of a preretinal opacity as a part of laminated vitreous cortex associated with a "can-opener" MH.

Eye Diseases↗
PubMed2003

Anatomical and visual outcome of macular hole surgery with infracyanine green-assisted peeling of the internal limiting membrane, endodrainage, and silicone oil tamponade.

PURPOSE: To evaluate the anatomical and visual outcome in macular hole patients who underwent surgery with infracyanine green-assisted internal limiting membrane peeling. DESIGN: A prospective case series with 51 consecutive eyes of 49 patients with idiopathic, iatrogenic, or traumatic Stage 2, 3, or 4 macular holes. METHODS: After removing the vitreous, in all eyes infracyanine green-assisted removal of the internal limiting membrane was performed. Patients older than 65 years of age underwent a simultaneous phacoemulsification. At the end of surgery, a silicone oil tamponade was used in all cases, and all patients were asked to position face down for 24 hours. Optical coherence tomography was performed preoperatively and postoperatively to determine the macular hole stage/size and the anatomical closure rate, respectively. RESULTS: The mean follow-up time was 9.8 months (range, 6-26 months). The overall median duration between the first symptoms and the surgery was 5 months. The overall anatomical success rate after one surgery was 92% (47 eyes), while that of chronic and nonchronic ones was 72.3% and 97.5%, respectively. The median preoperative visual acuity was 20/160 (range, 20/30 to counting fingers) and increased to 20/50 (range, 20/20 to 20/400) postoperatively. The mean increase in visual acuity was 3.7 lines (range, -4 to 10 lines). Of all 51 operated-on eyes, 26 (51%) eyes had a final visual acuity of 20/50 or better. CONCLUSIONS: These findings indicate that infracyanine green-assisted removal of the retinal internal limiting membrane appears to induce a high incidence of anatomical closure, with good visual outcome.

Adult↗
PubMed2003

Management of macular holes that develop after retinal detachment repair.

PURPOSE: To study the characteristics and management of macular holes that develop after prior rhegmatogenous retinal detachment (RD) repair. DESIGN: Retrospective, interventional, consecutive case series. METHODS: The setting was a clinical practice. The case records of all of our patients (n = 12) who developed a new full-thickness macular hole after prior RD repair over an 8-year period were examined. Patients who developed a macular hole after prior RD repair were offered either surgical repair of the macular hole or continued observation. For eyes that underwent macular hole repair, main outcome measures included macular attachment status and postoperative visual acuity. RESULTS: Twelve full-thickness macular holes were detected in a series of 2,380 eyes (0.5% prevalence), which had undergone surgery for prior primary RD. Ten macular holes developed after scleral buckling surgery, two after pneumatic retinopexy, and none were seen after primary vitrectomy. The fovea had been detached in 11 of the 12 eyes at the time of RD. The median time to macular hole diagnosis after RD repair was 3.4 months (range, 0.3-161 months). Eight of the eight eyes (100%) undergoing surgical repair achieved macular reattachment with a median of 3.5 lines of visual improvement at a median of 14.8 months of follow-up. Seven of these eight eyes had an improvement in visual acuity of at least 3 Snellen lines, and four of the eight had at least 20/40 visual acuity postoperatively. Four eyes with macular holes were observed. CONCLUSIONS: Macular holes developed in less than 1% of eyes that had previously undergone repair of rhegmatogenous RD. In our series, these atypical holes were seen predominantly after macula-off detachments, most commonly occurring after scleral buckling procedures. They were effectively repaired using conventional pars plana vitrectomy with long-acting gas tamponade and a variety of adjuvant therapies. A good visual outcome is possible with this approach.

Adult↗
PubMed2003

Optical coherence tomographic observations before and after macular hole formation secondary to laser injury.

PURPOSE: To describe the ophthalmoscopic and optical coherence tomographically determined retinovitreous interface before and after the development of a macular hole secondary to an accidental laser injury. DESIGN: Observational case report. METHODS: Ophthalmoscopic and optical coherence tomography (OCT) findings in a 53-year-old man were evaluated before and after the macular hole formation secondary to a laser injury. Visual function was followed for 9 months after surgery. RESULTS: A 53-year-old man sustained injury to his right eye by a Ti: Sapphire laser. On the following day, his corrected visual acuity was 0.3, and a small pigment epithelial atrophy was present in the right foveal area. No macular hole was detected by OCT and the retinovitreal interface was normal. Fifty-three days later, a full-thickness macular hole appeared, and no posterior vitreous detachment was detected by OCT. The hole was closed by surgery with final best-corrected visual acuity of 0.7. CONCLUSIONS: Macular holes can develop without visible traction on the retina and can occur long after retinal injury.

Eye Injuries↗
PubMed2003

Macular hole closure after peribulbar steroid injection.

PURPOSE: To report the closure of a macular hole after a peribulbar corticosteroid injection in a patient with anterior uveitis associated with human leukocyte antigen B*27. DESIGN: Interventional case report.The patient was evaluated by comprehensive ophthalmic check-up and optical coherence tomography. RESULTS: A healthy 50-year-old woman presented to our service with active human leukocyte antigen B*27-associated anterior uveitis, macular hole in the right eye and macular edema in the left eye. Visual acuity was 20/200 in both eyes. Peribulbar injections of triamcinolone acetonide were administered in both eyes. Three months later, visual acuity improved to 20/50 in both eyes, and the uveitis was in complete remission. Optical coherence tomography verified that the macular hole in the right eye was closed. CONCLUSIONS: Inflammation and macular edema might be contributing factors in macular hole formation in patients with uveitis. This case indicates that treatment of inflammation and macular edema might lead to macular hole closure in similar cases.

Female↗
PubMed2003

Residual triamcinolone acetonide in the macular hole after vitrectomy.

PURPOSE: To report a case of vitrectomy using intraocular triamcinolone acetonide (TA), in which TA remained in the macular hole after surgery. DESIGN: Observational case report. METHODS: A 60-year-old Japanese man had a Stage II macular hole in the right eye with best-corrected visual acuity of 20/50. A pars plana vitrectomy using TA was performed. Visual acuity and anatomic results were followed up for a period of 8 weeks. RESULTS: On the sixth postoperative day, residual TA deposition was observed in the macular hole. On the 14th postoperative day, no residual TA was found and the macular hole was successfully closed. The best-corrected visual acuity of the right eye improved to 20/15. CONCLUSIONS: Residual TA in the macular hole after vitrectomy did not interfere with macular hole repair either anatomically or functionally.

Combined Modality Therapy↗