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At least 811 records · Page 45Linked to original sources

PubMedDate not supplied

Perfluorocarbon liquid in the management of complex retinal detachments.

1. Conventional techniques of pars plana vitrectomy, retinal membrane stripping, scleral buckling, fluid-air or fluid-gas exchange, and silicone oil injection are ineffective in 25% of the complex retinal detachments reported. 2. The properties of perfluorocarbon liquid--clear, water immiscible, specific gravity twice that of water--make it an important adjunct to treatment of complex retinal detachments. 3. Of great interest is the fact that research has shown that visual outcome is significantly better for eyes using perfluorocarbon to initially flatten the retina.

Fluorocarbons↗

PubMed2006

Inadvertent scleral perforation in eye muscle versus retinal detachment buckle surgery.

PURPOSE: Inadvertent scleral perforation is a recognized complication of eye muscle and retinal detachment buckle surgery. If these operations are performed by the same surgeon, it is unknown which of these procedures has a higher risk of scleral perforation. METHODS: In the period from 1999 until 2004, 427 eyes of 317 patients were operated using eye muscle surgery and 81 eyes of 80 patients with retinal detachment buckle surgery. All operations were performed by the same surgeon (JK). In a retrospective, single-center, comparative, observational study, the records of these patients were assessed to determine the number of scleral perforations with retinal damage or drainage of subretinal fluid. RESULTS: In the group receiving retinal detachment buckle surgery there were two cases of scleral perforation. In one case, scleral perforation occurred during buckle installation and in the other case during placement of a cerclage. The rate of scleral perforation was 2.5 % per patient and per eye in this group. In the group receiving eye muscle surgery no scleral perforations occurred. CONCLUSION: The number of scleral perforations was higher in retinal detachment buckle surgery than in eye muscle surgery, with all procedures having been performed by the same surgeon.

Adult↗

PubMedDate not supplied

[The surgical treatment of retinal detachment by temporary balloon buckling: the late results, reasons for inefficacy and indications].

Retinal detachments were for the first time treated using inflatable balloons in 1979 by Lincoff et al. A characteristic feature of this method is simplicity and low traumatism. Up to the present time it was used in the treatment of retinal detachments with single breaks or groups of breaks altogether not surpassing equatorially one o'clock on the fundus. We suggest several new modifications of balloons and a method permitting widening of indications for application of this technique (double and sectorial balloon buckling, combination of this technique with drainage of subretinal fluid, prevention of balloon buckling dislocation). The efficacy of balloon buckling procedures in patients with retinal detachments and various stages of proliferative vitreoretinopathy was assessed. Extrascleral balloon buckling was carried out in 159 eyes of 156 patients, including those with somatic diseases and senile ones, with detachments of the retina. The results were followed up for 5 years. Early reattachment of the retina was attained in 134 eyes (84.3%). In remote period redetachments occurred in 20 eyes, complete attachment was attained in 71.7% of cases (114 eyes).

Adolescent↗

PubMed1996

Rhegmatogenous retinal detachments in HIV-positive patients with ocular syphilis.

The purpose of this study is to report retinal manifestations of lues in human immunodeficiency virus (HIV)-positive patients and to suggest a method for treatment of rhegmatogenous retinal detachments in these patients. Two HIV-positive patients with bilateral retinitis were examined and treated at the authors' institution for a period of 14 months. Ocular syphilis was diagnosed clinically, confirmed by cerebrospinal fluid serologic testing, and treated with intravenous penicillin. Both patients experienced bilateral rhegmatogenous retinal detachments complicated by proliferative vitreoretinopathy after resolution of the active retinitis. All four eyes underwent surgical repair with trans pars plana vitrectomy, epiretinal membrane delamination, gas-fluid exchange, endolaser, scleral buckle, and silicone oil instillation. The recognition of ocular syphilis as a cause of retinal detachment in HIV-positive patients is important. Prompt intervention with the appropriate medical and surgical treatments may result in the preservation of vision in these patients.

Adult↗

PubMed1992

Oxygen-induced retinopathy in the rat: hemorrhages and dysplasias may lead to retinal detachment.

Rearing neonatal rats in hyperoxia induces the development of retinal hemorrhages and retinal dysplasia. Albino rats were placed in 80% oxygen immediately after birth and were exposed for either 5, 10, or 14 days, followed by sacrifice or exposure to normoxia for an additional 2, 4, 5, 7, 8, 10, 38, 45 or 56 days. Control rats were simultaneously raised in room air and sacrificed at the same times. All animals were enucleated and their eyes processed for light and electron microscopy. Eyecups were trimmed to facilitate cross-sectioning of the retina in the vertical meridian. No control rats showed signs of retinal hemorrhages or of dysplastic folds or rosettes. Nor did the retinas of rats killed immediately after oxygen exposure contain hemorrhages, but the incidence of retinal folds or rosettes in this group was 54%. For rats exposed to combinations of hyperoxia and brief normoxia (10 days or less), 40% suffered hemorrhages and 50% developed retinal folds or rosettes. Although hemorrhages were more prominent in rats subjected to longer periods of oxygen (73% of all rats exposed for 14 days followed by brief normoxia vs. 6% of those exposed for 5 days followed by brief normoxia), the incidence decreased with time post-exposure in room air. Hemorrhages occurred in 100% of the rats raised in oxygen for 14 days followed by 2 days in room air, and decreased to 50% by 7 days in room air and to 0% by 38 days, indicating a spontaneous resolution with time. In each case, the blood appeared to leak from the newly-forming vessels of the deep capillary net, with most of the red blood cells migrating to the subretinal space. Retinal fold or rosette formation, indicative of developmental dysplasia, occurred in a fraction of virtually all groups of exposed rats, and persisted at the longest post-exposure periods. These two manifestations of oxygen-induced retinopathy are emphasized because they lead to an abnormal separation of the retina from the epithelial layer, which may increase the likelihood of the most serious consequence of ROP--retinal detachment. In fact, all rats that endured post-exposure periods of 38 days or longer before sacrifice exhibited retinal detachment.

Animals↗

PubMed1980

Results and complications of surgery of retinal detachment with a macular hole.

About 96% of retinal detachments with a macular hole were cured by surgery. The most effective surgical procedure was diathermy with a macular buckling method and scleral infolding at the temporal part of the equatorial region, the rate of success being 100%. Only diathermy or diathermy plus scleral infolding at the temporal part of the equatorial region could reattach all detached retinas. Since macular buckling procedures made visual acuity worse, techniques without macular buckling should be used in cases without macular atrophy or degeneration of myopia. Retinal hemorrhage during or after operation was the most frequent complication (50%) of surgery for retinal detachment with a macular hole and occurred more frequently when macular buckling procedures were used. Macular hemorrhage caused deterioration of postoperative visual acuity.

Adolescent↗

PubMed1990

Seasonal variations of retinal detachment among Arabs in Kuwait.

The seasonal variation in the incidence of retinal detachment over the period from 1981 to 1987 inclusive was investigated. Highly significant associations were observed between this variation and both sunshine and temperature. Hence, it is suggested that heat or cold may be important additional factors in the development of retinal detachment in an already damaged retina. The occurrence of retinal detachment peaks over the winter months with the highest level being in the month of November, while there is a trough over the summer months.

Adolescent↗

PubMed1990

[ERG study of high degree myopia with retinal detachment].

The authors studied the ERG of 51 cases of bilateral high degree myopia with unilateral retinal detachment and 50 cases of normal eyes. It was found that ERG in the former were characterized by a marked drop in the amplitude of the a-wave, particularly in the eye of retinal detachment, for which the ERG further diminished or failed to appear depending on the duration and extent of the lesion. Since a-waves originate from the sensory visual cells, the result was consistent with the pathology of high degree myopia and retinal detachment. The authors hold that periodic ERG examinations for dynamic surveillance is useful in monitoring the development of retinal detachment in high degree myopia.

Adolescent↗

PubMed2006

The combined use of perfluorohexyloctane (F6H8) and silicone oil as an intraocular tamponade in the treatment of severe retinal detachment.

BACKGROUND: The purpose of this study was to investigate the combined use of perfluorohexyloctane (F6H8) and 1,000-centistoke silicone oil as a long-term intraocular tamponade in the treatment of complicated retinal detachment. METHODS: Sixty consecutive eyes affected by complicated retinal detachment with (1) retinal breaks of the lower two quadrants and severe proliferative vitreoretinopathy, (2) inferior giant retinal tear, (3) penetrating trauma or (4) choroidal detachment underwent pars plana vitrectomy using a combined internal tamponade of F6H8 and silicone oil. The double filling (DF) was removed after 40-50 days. The anatomical outcome and the complications due to the DF are reported. RESULTS: Retinal reattachment was achieved in all but one patient. Thirty-eight (63%) eyes needed further surgery with silicone oil tamponade. Silicone oil was successfully removed in 22 eyes. Sixteen (27%) eyes had retained silicone oil at the last follow-up examination. One eye showed persistent retinal detachment despite further surgery. Main complications of the DF were recurrent retinal detachment of the upper retina in six (10%) eyes and membrane formation in 25 (42%) eyes. CONCLUSIONS: A combined internal tamponade of F6H8 and silicone oil may be a useful tool in the treatment of complicated retinal detachment involving the lower quadrants of the retina.

Adolescent↗

PubMedDate not supplied

Retinal detachment in focal dermal hypoplasia.

PURPOSE: Focal dermal hypoplasia is a systemic disease that includes well recognized ocular abnormalities. Retinal detachment has not previously been reported as a part of this syndrome. AIM: To report a case of focal dermal hypoplasia with an associated retinal detachment. METHODS: Single case report of a child with a colobomatous retinal detachment and the focal dermal hypoplasia syndrome. CONCLUSIONS: Retinal detachments may occur as part of the focal dermal hypoplasia syndrome. Expanding knowledge of this syndrome may help ophthalmologists diagnose this rare condition.

Choroid Diseases↗

PubMed2005

Clinical characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment in Taiwan.

PURPOSE: To evaluate the clinical features and surgical and visual outcomes of rhegmatogenous retinal detachment (RRD) in the pediatric population. DESIGN: Retrospective, noncomparative, interventional case series. METHODS: A review of patients under 18 years who underwent primary retinal detachment surgery at National Taiwan University Hospital from 1989 to 2003 was conducted. RESULTS: Included in the study were 152 eyes of 146 patients (mean age of 13.1 years). Male patients comprised 69.9% of the sample. Bilateral RRD was present in 4.1%. Etiologies included myopia >4 diopters (37.5%), trauma (32.9%), developmental anomaly (11.8%), previous surgery (5.9%), previous uveitis (3.9%), atopic dermatitis (2.6%), and unknown (5.3%). Macular detachment was found in 73.0%. The most common primary treatment was scleral buckling (61.2%). Single-operation reattachment was accomplished in 58.5% of patients and eventual reattachment in 78.3% of patients occurring in a mean of 1.5 (SD = 0.9) operations. Average postoperative follow-up time was 48.3 months. Visual improvement occurred in 42.8%, remained the same in 32.2%, and worsened in 19.1%. In the logistic regression model, statistically significant risk factors for poor surgical outcome were nonmyopic RRD (P = .026), macular involvement (P = .01), and presence of proliferative vitreoretinopathy (P = .07). CONCLUSIONS: Myopia >4 diopters was the most common etiology in retinal detachment in our sample, followed by trauma. Myopia (> -4.0 diopters) may be more common than previously reported. Most eyes (78.3%) were anatomically reattached after multiple surgeries. Retinal detachment not associated with myopia is a newly identified predictor for poor surgical outcomes.

Adolescent↗

PubMed2003

Outcomes of surgery for retinal detachment associated with proliferative vitreoretinopathy using perfluoro-n-octane: a multicenter study.

PURPOSE: To report visual acuity and anatomical outcomes, as well as complications, of management of complex retinal detachment with proliferative vitreoretinopathy using pars plana vitrectomy and intraoperative perfluoro-n-octane (PFO), and to investigate clinical features associated with anatomical and visual acuity outcomes. DESIGN: Prospective, noncomparative, interventional multicenter study. METHODS: The study included 555 patients (555 eyes) 15 months of age or older who underwent pars plana vitrectomy for complex retinal detachment associated with proliferative vitreoretinopathy with intraoperative PFO at 24 study sites between April 1994 and February 1996. Main outcome measures included visual acuity and rates of retinal reattachment, reoperation, retained PFO, corneal edema, elevated intraocular pressure ([IOP] > 25 mm Hg), hypotony (IOP < 5 mm Hg), and cataract. All outcome measures were assessed at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively and at the last examination. RESULTS: The study included 555 eyes of 555 patients followed up at a median of 5.6 months. Visual acuity of 20/200 or better was recorded in 51 (10%) patients preoperatively and 85 (24%) at 6 months postoperatively. Among the 465 eyes with both preoperative and final visual acuities available, postoperative visual acuity improved in 274 (60%) eyes, remained stable in 106 (23%), and worsened in 85 (18%) eyes. Six-month follow-up data were obtained for 356 (65%) eyes; the retina was attached in 279 (78%) eyes and retained PFO was noted in 20 (6%). Throughout follow-up, 238 of 555 (43%) eyes underwent reoperation for recurrent retinal detachment. At 6 months, corneal edema, elevated IOP, and hypotony were noted in 26 of 356 (7%), 6 of 356 (2%), and 48 of 356 (15%) eyes, respectively. Of the 114 phakic eyes without significant cataract preoperatively, 105 (92%) developed a significant cataract or underwent cataract surgery during study follow-up. Operative factors significantly (P <.05) associated with recurrent retinal detachment include female gender, creation of a relaxing retinotomy, and the use of sulfur hexafluoride (SF(6)) gas tamponade, air tamponade, or no tamponade (compared with perfluoropropane [C(3)F(8)] or silicone oil tamponade). Factors significantly associated with final vision of 20/200 or better include first operation anatomic success, prior scleral buckling procedure, no diabetes mellitus, no prior vitrectomy, no silicone oil retinal tamponade, and no relaxing retinotomy. Cases that require relaxing retinotomy generally represent more severe cases of complex retinal detachment and, therefore, relaxing retinotomy is likely associated with a poorer visual outcome owing to the nature of the cases selected for this procedure. CONCLUSIONS: In the management of complex retinal detachment associated with proliferative vitreoretinopathy, pars plana vitrectomy and use of intraoperative PFO was associated with retinal reattachment and preserved visual acuity in most eyes.

Adolescent↗

PubMed1991

Exudative retinal detachment in familial pulmonary hypertension.

In a family with pulmonary hypertension, one woman developed bilateral exudative retinal detachments and her daughter developed a unilateral exudative retinal detachment during pregnancy. Treatment with Acetazolamide provided quick recovery in the bilateral case, whereas the unilateral exudative detachment recovered without treatment after delivery. Exudative retinal detachments have not previously been associated with pulmonary hypertension.

Acetazolamide↗

PubMedDate not supplied

Preoperative factors influencing anatomic success rates following retinal detachment surgery.

The percentages of retinal detachment surgical cure rates determined in this study should not be regarded too literally. At least ten preoperative factors have been described which, acting in isolated fashion, are associated with decreased rates of retinal reattachment. Among these factors are visual acuity of 20/60 or less, myopia, preretinal membrane formation, alphakia, pars plana detachment, reoperation, age over 80 years, vitreous membranes, giant tear, and choroidal detachment. Usually there are several influential factors acting simultaneously. The behavior patterns of combinations of predictive factors have not been determined. In addition, there are undoubtedly some factors which are insignificant when acting alone but which have an adverse influence when arranged in certain combinations. More sophisticated analysis would be required to confirm this hypothesis.

Adolescent↗

PubMed1995

Phakic retinal detachments in the elderly.

PURPOSE: To discover if clinical nontraumatic phakic retinal detachments in the elderly possess characteristics that distinguish them from similar cases in younger persons. METHODS: A retrospective study of 100 consecutive cases in patients aged 70 years and older was performed. Recorded data included patient age and sex, type and location of retinal break, extent of detachment, and associated vitreoretinal pathology. RESULTS: Approximately 90% of retinal breaks were horseshoe tears, and the majority were located in the superior temporal quadrant. Horseshoe tears confined to the posterior margin of the vitreous base were responsible for retinal detachments in 30% of cases, and an additional 36% of breaks were located anterior to the equator. CONCLUSION: The incidence of this type of anterior break is higher than that previously described for phakic retinal detachments, although previous studies have not discussed break types as a function of old age. Anterior horseshoe tears, which cause many phakic retinal detachments in the elderly, may not be caused by acute posterior vitreous detachment, but rather to persistent chronic traction on the vitreous base after posterior vitreous detachment.

Aged↗

PubMed1999

[Multicenter retrospective study of retinal detachment associated with atopic dermatitis].

PURPOSE: Epidemiological and clinical study of retinal detachment associated with atopic dermatitis. METHODS: A multicenter retrospective study. RESULTS: We analyzed 417 eyes of 348 patients operated on during the 5 years from 1989 to 1993 and followed up for more than 6 months by vitreo-retina specialists in 33 hospitals throughout Japan. The number of eyes operated increased yearly from 42 in 1989 to 132 in 1993. These were 2.3% of the average number of the eyes operated on for rhegmatogenous retinal detachment during the same period, but when restricted to the Kanto area or further to Tokyo only, the percentage was as high as 3.8% and 4.7% respectively. Clinical characteristics of retinal detachment previously reported, such as traumatic slapping or rubbing of the lids by patients as the most possible pathogenetic factor, and high incidence of cataract and proliferative vitreoretinopathy, were confirmed. The primary surgical procedure was scleral buckling in 78% of the cases and vitreous surgery in 22%, and initial and final reattachment rates were 75.3% and 92.6%, respectively.

Adolescent↗

PubMed1999

The influence of retinal detachment surgery on perioperative blood fibrinolysis.

PURPOSE: To evaluate perioperative changes in fibrinolysis in patients undergoing retinal detachment surgery. MATERIAL: Prospective study of 56 patients (30 male, 26 female), aged from 19 to 82 (mean: 53, SD = 16.8) years, subjected to retinal detachment surgery (encirclement with scleral buckling) performed under general anaesthesia. Excluded were patients with vein or arterial disease and with other factors which could change evaluated parameters. METHOD: Blood was sampled from cubital vein one day before surgery, immediately after induction of anaesthesia but before surgery, immediately after the completion of the operation but before the termination of anaesthesia and after operation (on the 1(st) and 4(th) day). In the citrate plasma of patients studied, tissue plasminogen activator (t-PA), plasminogen activator inhibitor type 1 (PAI-1), plasmin-alpha(2)-antiplasmin (PAP) complexes, fibrin-fibrinogen degradation products (FDP) and euglobulin lysis time (ELT) were measured. RESULTS: In the group studied intraoperative values of t-PA Ag, PAP and FDP were significantly higher, PAI-1 Ag concentration decreased and ELT was reduced. These results indicate a significant activation of fibrinolysis during the retinal detachment surgery. On the first postoperative day the fibrinolytic activity was reduced (decrease in t-PA Ag and FDP concentration and prolongation of ELT). CONCLUSION: During retinal detachment surgery the patients reveal activation of fibrinolysis in systemic circulation.

Adult↗

PubMed1997

Reopening of macular holes in highly myopic eyes with retinal detachments.

BACKGROUND: Gas tamponade with or without vitrectomy is commonly used to treat retinal detachment resulting from a macular hole in a highly myopic eye. Redetachment of the retina occurs frequently, however, and the pathogenesis of redetachment is unclear. One possible mechanism leading to redetachment is tangential traction caused by an epiretinal membrane of the posterior retina. METHODS: Eleven consecutive highly myopic eyes with retinal detachment resulting from a macular hole were treated by vitrectomy, gas or silicone oil tamponade, and removal of an epiretinal membrane. Surgical outcomes and clinical characteristics of these patients were reviewed. RESULTS: An epiretinal membrane was found to be present in all eyes. Of 11 eyes, removal of an epiretinal membrane was complete in six eyes, and macular holes remained closed in all 6 eyes. In five of the 11 eyes, removal of the epiretinal membrane was incomplete. In four of these five eyes, the macular hole reopened. CONCLUSION: Reopening of the macular holes most likely were caused by tangential traction of the remaining epiretinal membranes. It seems that it is important to remove epiretinal membranes as completely as possible during vitrectomy for retinal detachment resulting from a macular hole in a highly myopic eye.

Aged↗