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At least 811 records · Page 45Linked to original sources
PubMed1994

Follow-up and ultrasonographic examination of patients with macular pseudo-operculum.

Twenty-nine patients (30 eyes) with pseudo-opercula were followed up for six to 65 months (mean, 24 months). Visual acuity was 20/30 or better in all but one eye that was amblyopic. Only one eye developed a decrease in visual acuity and changes interpreted as a stage 1 (foveal detachment induced by tangential traction of the cortical vitreous) impending hole. After vitrectomy visual acuity returned to 20/20. Ultrasonographic examination confirmed the presence of pseudo-opercula in all 22 eyes examined. We concluded that the a pseudo-operculum is a favorable prognostic sign and that its presence is demonstrable ultrasonographically.

Adult↗
PubMed1994

Fluorescein angiographic characteristics of macular holes before and after vitrectomy with transforming growth factor beta-2.

We evaluated the fluorescein angiographic features of full-thickness macular holes before and after vitrectomy, fluid-gas exchange, and instillation of transforming growth factor beta-2 in 43 eyes in a masked fashion to evaluate the angiographic characteristics of macular holes preoperatively and the changes that occur with successful and unsuccessful closure of the macular hole. Hyperfluorescence was present in the base of the macular hole preoperatively in 34 of 43 eyes (79.1%), was questionable in eight of 43 eyes (18.6%), and was definitely absent in only one of 43 eyes (2.3%). The hyperfluorescence in the base of the macular hole disappeared in 19 of 20 eyes (95%) with successful closure of the macular hole (P < .00001) and appeared to be caused by blocked fluorescence at the site of the macular hole. The photographic features of eyes with unsuccessful closure of the macular hole changed little, except that the size of the cuff of neurosensory detachment around the hole increased and was associated with decreased postoperative visual acuity. These angiographic changes support the presence of a glial tissue plug bridging a small defect in the fovea of eyes with successful closure of a macular hole.

Combined Modality Therapy↗
PubMed1989

Surgical management of retinal traction caused by toxocariasis.

We reviewed the results of vitreous surgery in 12 eyes of 12 patients with tractional macular detachment from Toxocara canis. We performed a vitrectomy and membrane peeling in all eyes, with additional scleral buckling in four eyes. After a minimum of six months' follow-up, ten of the 12 eyes (83%) had complete retinal reattachment. Visual acuity improved in seven eyes, two had no change, and three eyes had decreased visual acuity. Good postoperative vision correlated best with good preoperative vision. Preoperative traction retinal folds through the macula were associated with a poor visual outcome.

Adolescent↗
PubMed1989

Retinal detachment with breaks in the pars plicata of the ciliary body.

We studied four eyes with retinal detachment accompanied by a break in the nonpigmented epithelium in the pars plicata of the ciliary body in three patients with atopic dermatitis. Each eye had either ectopia lentis or coloboma of the lens. In the region of the lens malformation, ciliary processes were hypoplastic. These rudimentary ciliary processes were observed only in the anterior half of the pars plicata. At their posterior end, the ciliary nonpigmented epithelium had been ruptured and a break by zonular traction was apparent. In the other region of the pars plicata, ciliary processes were normal and no break was detected. The break in the pars plicata was treated by diathermy application and segmental scleral buckling, without subretinal fluid drainage, and with the resulting reattachment of the retina. Hypoplasia of ciliary processes is basically responsible for the development of a break in the pars plicata.

Adolescent↗
PubMed1989

Histopathology of tissue removed during vitrectomy for impending idiopathic macular holes.

Vitrectomy may prevent the progression of an impending macular hole by removing the layer of cortical vitreous from the posterior retina. To determine the nature of the cortical vitreous tissue, we identified and removed from the surface of the posterior retina a thin sheet of what appeared to be posterior cortical vitreous in 29 patients undergoing vitrectomy for an impending macular hole. In seven patients, the tissue was isolated for transmission electron microscopic study. Millipore filter specimens of the vitreous aspirates from all of the patients were studied by light microscopy. Vitreous condensates were present in all 29 specimens, fibrocellular membrane fragments were present in three, and fragments of internal limiting membrane were present in four. A collagen matrix was present in each of the seven specimens studied by electron microscopy, and in every specimen, the collagen's diameter was consistent with indigenous vitreous collagen. These findings confirm the presence of an acellular tissue layer on the posterior retina in eyes with an impending macular hole and indicate that it is usually indigenous vitreous collagen.

Collagen↗
PubMed1983

Comparison of lesions predisposing to rhegmatogenous retinal detachment by race of subjects.

Because rhegmatogenous retinal detachments are thought to be much less common in blacks than in whites, we compared the incidence of various lesions known to cause or predispose to this condition (synchysis senilis, posterior vitreous detachment, breaks, tears, and holes of the peripheral fundus, and lattice degeneration of the retina) in a series of postmortem eyes on the basis of race. Our statistical analysis also included trauma, myopia, and chorioretinitis. The series included 322 black subjects and 2,012 white subjects. The subjects ranged in age from 20 to 93 years at the time of death. Although the initial data showed a racial difference in the incidence of synchysis senilis of grade 3 (50% destruction) or higher and posterior vitreous detachment (P = .033 and P = .021, respectively), we found no difference when the data were age-corrected.

Adult↗
PubMed1993

Risk of decreased visual acuity in full-thickness idiopathic macular holes.

We studied 169 eyes of 149 patients with a full-thickness idiopathic macular hole to ascertain the risk factors of enlargement of the hole or the surrounding retinal detachment and subsequent decreased visual acuity. Eyes were divided as follows: group A, 48 eyes with no posterior vitreous detachment and a hole 400 microns or smaller; group B, 77 eyes with no posterior vitreous detachment and a hole 400 microns or larger; group C, 13 eyes with posterior vitreous detachment and a hole 400 microns or smaller; group D, 31 eyes with posterior vitreous detachment and a hole 400 microns or larger. In group A, the macular hole enlarged in 37 eyes (77%); the retinal detachment enlarged in 35 eyes (73%); and visual acuity decreased by two or more Snellen lines in 28 eyes (58%). These percentages were significantly higher than those in group B (P = .01, P = .01, and P = .01, respectively), group C (P = .02, P = .01, and P = .01, respectively), and group D (P = .01, P = .05, and P = .01, respectively). Eyes without posterior vitreous detachment with a full-thickness idiopathic macular hole 400 microns or smaller may have a greater risk of an enlarged macular hole, surrounding retinal detachment, and subsequent visual loss.

Aged↗
PubMed1991

Recognition and removal of the posterior cortical vitreous during vitreoretinal surgery for impending macular hole.

Vitreoretinal surgery for impending macular hole includes recognition and removal of the posterior cortical vitreous. Previously described surgical techniques for removal of cortical vitreous used either rigid instruments (a tapered extrusion needle or a barbed microvitreoretinal blade) or a short fenestrated soft-tipped suction needle. We used a technique with the cannulated extrusion needle that detects the presence of the posterior cortical vitreous and facilitates safe removal of this layer from the retina. Although this technique is most useful when performing vitrectomy for impending macular hole, it may also be used during vitrectomy for other conditions with uncertain detachment of the posterior cortical vitreous.

Aged↗
PubMed1995

Visual acuity as a prognostic indicator in stage I macular holes. The Vitrectomy for Prevention of Macular Hole Study Group.

PURPOSE/METHODS: To evaluate the role of initial visual acuity as a factor for progressive loss of vision or progression to a full-thickness macular hole in eyes with stage I macular holes (tractional foveal detachment without dehiscence). The study population included 35 patients with stage I macular holes with best-corrected visual acuity of 20/25 to 20/80 in one eye, and a full-thickness macular hole in the fellow eye. RESULTS/CONCLUSIONS: Eyes with stage I macular holes with best corrected visual acuity between 20/50 and 20/80 had a 66% (ten of 15 eyes) rate of progression to full-thickness macular hole, whereas eyes with best-corrected visual acuity of between 20/25 and 20/40 had a 30% (six of 20 eyes) risk of progression to full-thickness macular hole. The risk of progression to macular hole is significantly higher in eyes with stage I macular holes with best-corrected visual acuity of 20/50 or worse (P = .03).

Aged↗
PubMed1995

Progression of nuclear sclerosis and long-term visual results of vitrectomy with transforming growth factor beta-2 for macular holes.

PURPOSE: We studied the progression of cataracts and visual acuity up to 36 months after vitrectomy and instillation of transforming growth factor beta-2 for treatment of full-thickness macular holes. METHODS: Sixty-four eyes with idiopathic and two with traumatic macular holes in this prospective consecutive series were divided into the following two groups: 56 phakic eyes were treated with 70, 330, or 1,330 ng of transforming growth factor beta-2 to study the progression of cataracts, and 31 phakic or pseudophakic eyes were treated with 1,330 ng of transforming growth factor beta-2 to study the long-term visual acuity after macular hole surgery. RESULTS: Eyes in the cataract progression study had a mean preoperative nuclear sclerosis grade of 0.4, which increased to 2.4 on final lens examination at a mean of 12.4 months postoperatively. The amount of nuclear sclerosis increased progressively with duration of follow-up, and 16 (76%) of 21 eyes followed up for 24 months or more required cataract extraction. The mean preoperative posterior subcapsular cataract grade was 0.0 and increased only slightly to 0.25 on final lens examination. All eyes had initial successful closure of the macular hole, but the macular hole reopened in two eyes (between six and 12 months and at 19 months) for an overall success rate of 29 (93.5%) of 31 eyes at a mean of 19.5 months. The visual acuity increased two or more Snellen lines in 29 (93.5%) of 31 eyes. The final visual acuity was 20/40 or better in 23 (74%) of 31 eyes and the visual improvement was stable in eyes followed up for three years. CONCLUSIONS: Nuclear sclerotic cataracts progress substantially after macular hole surgery with a long-acting intraocular gas tamponade. The visual acuity often decreases 12 or more months after vitrectomy because of cataract progression, but the visual results of vitrectomy and transforming growth factor beta-2 for macular holes are excellent when the cataracts are removed.

Adolescent↗
PubMed1995

Early stage of macular hole in a severely myopic eye.

PURPOSE/METHODS: A progressive early stage of macular hole developed in a severely myopic eye of a 37-year-old woman. RESULTS/CONCLUSIONS: The patient improved after pars plana vitrectomy, peeling of the posterior hyaloid, and gas-fluid exchange. Biomicroscopic, ultrasonographic, and intraoperative findings support the theory of cortical vitreous traction as the cause of macular hole in severely myopic eyes.

Adult↗
PubMed1987

Low viscosity liquid fluorochemicals in vitreous surgery.

Low viscosity liquid fluorocarbons have physical properties potentially useful as intraoperative adjuncts during vitreous surgery for complicated retinal detachments. These substances are optically clear, have specific gravity greater than that of water, and interfacila tension properties similar to those of silicone oil. In four patients who had complicated retinal detachments I used perfluorotributylamine and perfluorodecalin during vitreous surgery. Two giant retinal tears were flattened intraoperatively without turning the patient into the prone position. In two patients with severe proliferative vitreoretinopathy, perfluorotributylamine allowed adequate retinal tamponade and avoided a posterior retinotomy for internal drainage of subretinal fluid. Endophotocoagulation was applied.

Adolescent↗
PubMed1987

Myopic cracks, angioid streaks, and traumatic tears in Bruch's membrane.

We studied the pattern of break formation in 60 eyes with myopic lacquer cracks, angioid streaks, or traumatic tears in Bruch's membrane, using a graphics composition technique and computer analysis of digitized images. Lacquer cracks were found in a reticular distribution within a posterior staphyloma; angioid streaks occurred in a spider-web configuration centered on the optic nerve; traumatic tears were characteristically curved, perineural, and eccentric temporally. The specific break patterns imply the operation of biomechanical forces.

Adolescent↗
PubMed1985

Results of conventional vitreous surgery for proliferative vitreoretinopathy.

During a five-year period (1978 through 1982), we used conventional vitreous surgery techniques to treat patients who had recurrent retinal detachment as the result of proliferative vitreoretinopathy. At a six-month follow-up, 24 (33%) of 72 patients achieved total retinal reattachment; 14 patients regained ambulatory vision (5/200 or better) after one operation. Only 12 patients were reoperated on; four achieved retinal reattachment. Anatomic success correlated with a lesser grade of proliferative vitreoretinopathy and an absence of detectable retinal breaks. Creation of iatrogenic retinal tears and broad scleral buckling and an extended interval between the initial detachment and vitreous surgery did not improve the prognosis.

Eye Diseases↗