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At least 1,117 records · Page 62Linked to original sources

PubMed2002

Rhegmatogenous retinal detachment and seasonal variations.

Seasonal variations of rhegmatogenous retinal detachment (RRD) have been reported in only several studies, mostly from Central and northern Europe. In this study, seasonal incidence of RRD was determined and compared with sunlight exposure per season in the Mediterranean region of south Europe. The study was based on a retrospective review of medical records on 280 eyes of 272 consecutive hospital patients in the district of Split, Croatia, who were treated for primary nontraumatic phakic RRD over a 12-year period (1988-1999). The number of eyes with RRD recorded per season was 79 in summer, 71 in winter, 67 in spring and 63 in autumn. The average number of sunshine hours in Split was 1001 in summer, 698 in spring, 576 in autumn and 457 in winter. No seasonal variations in the occurrence of RRD and no correlation with the mean duration of sunlight exposure per season were found.

Croatia↗

PubMedDate not supplied

Diode laser transscleral retinopexy in rhegmatogenous retinal detachment surgery.

PURPOSE: To evaluate the safety and efficacy of transscleral diode laser for retinopexy in rhegmatogenous retinal detachment surgery. METHODS: Conventional retinal detachment surgery with transscleral diode laser retinopexy was performed on 52 eyes of 52 patients (22 female, 30 male), aged from 12 to 74 years (mean 51 + 4.1). RESULTS: Of the 52 eyes 36 (69%) were reattached in a single operation and adequate chorioretinal scars were achieved in 34 of them. Additional transpupillary laser photocoagulation was performed in two cases in the postoperative period. Retinal re-attachment was achieved with exoplant revision and transscleral laser retinopexy in six cases (12%). Ten cases (19%) with severe PVR were reattached with vitreoretinal surgery. CONCLUSIONS: Transscleral diode laser retinopexy was an effective and safe method, with accurate lesion location, concurrent permanent laser marks on the retina, and easy transmission through the extraocular muscles and solid buckling elements. Minor complications were minimized by gaining experience with the technique.

Adolescent↗

PubMed2002

[Application of confocal scanning laser Doppler retinal flowmetry in the measurement of fundus blood flow parameters after retinal detachment surgery].

OBJECTIVE: To discuss the influence of retinal detachment (RD) surgery on the blood flow of retina and optic nerve head. METHODS: Heidelberg Retina Flowmeter (HRF) was used to measure the blood flow of retina and optic nerve head in 62 eyes of 62 patients with postoperative rhegmatogenous RD surgery, including 34 eyes having undertaken vitreoretinal (VR) surgery and 28 eyes, scleral buckling (SB) surgery. Operative methods included scleral encircling procedure, cryotherapy, lensectomy, vitrectomy, perfluorodeclin liquid application, endolaser and C(2)F(6) gas or silicone oil tamponade. RESULTS: The blood flow volume (VOL), blood flow velocity (FLW) and the erythrocyte flow velocity (VEL) of fundus in the postoperative RD eyes were reduced in the comparison with those of the fellow control eyes. The VEL of temporal and nasal papillary disk rim had significant differences (P < 0.05). The VOL, FLW and VEL of the papillary vessel, VOL and FLW of temporal and nasal papillary disk rim, VOL of temporal and nasal juxtapapillary retina in the operative eyes were lower than those of the fellow eyes (P < 0.01). In the comparison between the eyes having undertaken VR surgery and the eyes undertaken SB surgery, the VOL, FLW and VEL of VR surgery were reduced more than those of SB surgery. The VEL of temporal and nasal papillary disk rim and nasal juxtapapillary retina and FLW of temporal juxtapapillary retina had significant differences (P < 0.05). VOL, FLW and VEL of silicone oil tamponade eyes were reduced more than those in the operative eyes without silicone oil tamponade. VOL of nasal papillary disk rim and juxtapapillary retina had significant differences (P < 0.05). VOL and VEL of temporal papillary disk rim, VOL of temporal juxtapapillary retina had very significant differences (P < 0.01). CONCLUSIONS: VR surgery and SB surgery of RD influence papillary and retinal VOL, FLW, VEL. The influence of VR surgery on the fundus blood flow is more significant than that of SB surgery. The silicone oil tamponade also influences the VOL and VEL of the fundus.

Adolescent↗

PubMed1992

[Serous retinal detachment. Value of acetazolamide].

The effect of acetazolamide in the treatment of chronic macular edema has been well established. The pharmacologic action of this product suggested possible efficacy in the treatment of serous retinal detachment. We studied 38 patients presenting with serous retinal detachments of various etiologies divided into four groups: age related macular degeneration, central serous chorioretinopathy or diffuse epithelial retinopathy, epiretinal membranes, and other causes. Treatment with acetazolamide, at a dosage of 0.375 g/day, in three divided doses was proposed for five weeks. We observed a reduction of metamorphopsia in all cases, a stability or even an improvement of visual acuity, and a resorption of serous retinal detachment confirmed by decreased pooling of fluorescein on the angiographic examination. Considering each etiology, clinical and angiographic findings demonstrated the value of this treatment, although this study was not prospective. The encouraging results observed in many cases, raise hopes concerning the treatment for these diseases, usually not amenable to treatment.

Acetazolamide↗

PubMed1997

[Measurements of serum and subretinal fluid before and after surgery of retinal detachment].

OBJECTIVES: To investigate the relationships between proliferative vitreoretinopathy (PVR) formation and the levels of human epidermal growth factor (h-EGF) and tumor necrosis factor (TNF) in serum and subretinal fluid (SRF) before and after surgery of retinal detachment with PVR. METHODS: Serum and SRF samples of 51 patients with retinal detachment and PVR were collected, and their h-EGF and TNF levels were measured by radioimmunoassays. RESULTS: In comparison with the control group, the levels of h-EGF and TNF in serum and SRF in retinal detachment with PVR group were higher but not statistically significant (P > 0.05). Their levels in the serum were not related to the severity of the disease, while their levels in SRF increased significantly with the increase of the severity of the disease, and these two factors were positively correlated (P < 0.05). 5 days after the surgery of retinal detachment, the h-EGF and TNF levels in serum increased significantly (P < 0.01) and the levels decreased within 30 days but not to normal. CONCLUSIONS: The h-EGF and TNF in SRF might have a synergic action and affect the formation and development of PVR. The h-EGF and TNF in serum take part in the repair of the operative trauma and inflammatory reaction. However, their high levels could interfere with the effect of operation.

Adult↗

PubMed2007

Steamroller versus basic technique in pneumatic retinopexy for primary rhegmatogenous retinal detachment.

PURPOSE: To compare the effectiveness and safety of the "basic" technique with those of the "steamroller" technique in pneumatic retinopexy (PR) for primary rhegmatogenous retinal detachment. METHODS: In this prospective study, 40 eyes of 40 patients with primary rhegmatogenous retinal detachment were treated with PR by argon laser photocoagulation. PR with the steamroller technique (steamroller group) was performed randomly on 21 eyes of 21 patients, and 19 eyes of 19 patients were treated with PR with the basic technique (basic group). Main outcome measures were visual acuity, anatomical outcome, rate of proliferative vitreoretinopathy (PVR) development, and postoperative complications. RESULTS: Mean follow-up +/- SD was 14.7 +/- 9.9 months (range, 6-48 months). Single-operation success rate for all patients was 70% (28/40 eyes). Single-operation success rate was 74% (14/19 eyes) for the basic group and 67% (14/21 eyes) for the steamroller group (P = 0.629). PVR grade C-1 developed in one eye (5%) in each group. Overall success rate, after reoperations, was 100% for each group. Preoperative logMAR (logarithm of the minimum angle of resolution) visual acuity +/- SD was 2.01 +/- 0.43 in the basic group and 1.89 +/- 0.45 in the steamroller group (P = 0.434). Postoperative logMAR visual acuity +/- SD was 0.64 +/- 0.42 in the basic group and 0.46 +/- 0.35 in the steamroller group (P = 0.152). There was no statistically significant difference between basic and steamroller groups in terms of postoperative complications (P > 0.05). CONCLUSION: Basic and steamroller techniques appear to be equally effective and safe in PR for primary rhegmatogenous retinal detachment. The risk for PVR development seems to be similar with either technique. Further studies with a large number of patients are required for a more reliable conclusion.

Adult↗

PubMed1995

[Retinal detachment after intracapsular and extracapsular cataract extraction].

In a retrospective study we reviewed the postoperative incidence of retinal detachment in a consecutive series of 762 eyes operated on with intracapsular cataract extraction and a consecutive series of 1351 eyes operated on with extracapsular cataract extraction. Follow-up time was 2 1/2-4 1/2 years in both series. The incidence of retinal detachment was 0.79% after intracapsular cataract extraction and 0.44% after extracapsular cataract extraction. The difference was not statistically significant. Age below 70 years was not statistically significantly correlated to retinal detachment.

Aged↗

PubMedDate not supplied

Comparison of scleral buckling and vitrectomy for retinal detachment resulting from flap tears in superior quadrants.

PURPOSE: To compare the surgical results of vitrectomy and scleral buckling for uncomplicated superior retinal detachment caused by flap tears. METHODS: Included in the study were 225 patients (225 phakic eyes) undergoing primary surgery by three surgeons between January 1990 and December 1996 for superior retinal detachment caused by flap tears (138 eyes by scleral buckling, 87 eyes by vitrectomy); all patients had been followed up for longer than 6 months after surgery. The choice of one of the two procedures was based on each surgeon's preference. The surgical outcome and the rate of complications were retrospectively compared between the two groups of eyes. RESULTS: Initial and final anatomical success rate were 92% and 100% after each procedure. Retinal redetachment after the initial procedure was due to new retinal breaks in 5 eyes, reopening of original breaks in 2 eyes of vitrectomy cases, and due to malpositioned buckle in 11 eyes of scleral buckling cases. Proliferative vitreoretinopathy occurred in 3 eyes of vitrectomy cases. CONCLUSION: Primary vitrectomy was as successful as scleral buckling for treating superior rhegmatogenous retinal detachment. Even though the high incidence of postoperative cataract formation was the major drawback, vitrectomy had some advantages over scleral buckling.

Adult↗

PubMed1992

Incidence and management of glaucoma after intravitreal silicone oil injection for complicated retinal detachments.

BACKGROUND: Intravitreal silicone oil injection used for managing complicated retinal detachments can be associated with elevated intraocular pressure (IOP). This study was undertaken to determine the incidence of glaucoma in patients who underwent silicone oil injection, as well as to evaluate the effectiveness of medical and surgical therapy in patients in whom glaucoma developed. METHODS: The postoperative courses of 50 eyes of 47 consecutive patients who underwent pars plana vitrectomy and silicone oil injection for the management of complicated retinal detachments were reviewed retrospectively. The outcomes of patients who underwent silicone oil removal and/or glaucoma surgery also were evaluated. RESULTS: The mean overall postoperative IOP before any glaucoma surgery was 16.7 +/- 9.3 mmHg (range, 0 to 45 mmHg), with a mean follow-up of 16.6 +/- 12.1 months (range, 2 to 51 months). Twenty-four (48%) eyes had postoperative IOPs of at least 25 mmHg and IOP elevations of at least 10 mmHg above the preoperative levels. Twenty-one (42%) eyes underwent complete removal of silicone oil and/or glaucoma surgery to effect IOP control. The IOPs were controlled to 21 mmHg or less (but > 5 mmHg) in 8 of 14 eyes that underwent removal of silicone oil alone, in 3 of 5 eyes that underwent Molteno implantation, and in 1 eye that underwent Nd:YAG transscleral cyclophotocoagulation, but not in 1 eye that underwent a modified Schocket procedure (mean follow-up, 13.5 +/- 11.0 months; range, 0.2 to 33 months). CONCLUSION: Intraocular pressure elevation is a common occurrence after intravitreal silicone oil injection. The underlying mechanism may often be multifactorial in nature. Patients in whom uncontrolled IOP develops may benefit from aggressive medical and/or surgical treatment with silicone oil removal, glaucoma implants, or cyclodestructive procedures.

Adolescent↗

PubMed2000

[Complications of retinal detachment surgery].

PURPOSE: The complications observed after 350 surgically treated retinal detachment in the Hospital Universitario de Málaga are retrospectively estudied. METHODS: All the patients attended in our emergency service, surgically treated after retinal detachment diagnosis, are studied. Neither admission requirement nor preselection of patients was established for this study. RESULTS: From the whole of 317 patients, 130 were myopic (41%); previous cataract surgery was present in 32.1%. Retinal reattachment was achieved in 67.9% after the first procedure, in 80.8% after a second and in 82.8% after the third. A relapsed detachment was observed in 112 cases (32%), 62 of which were retreated, observing in 20% a new tear as relapse cause. In one case (0.3%), a permanent central retinal artery after intravitreus gas injection was present. CONCLUSIONS: Neither a prior selection of cases nor the establishment of admission criteria does contribute to a lower success rate after a first procedure. Only in 16.1% of retreated relapse detachment the persistent filtration of the treated tear could be involved as relapse cause. A case of complete blindness after intravitreous injection is worth-noting for its severity and dramatism.

Adolescent↗

PubMed2002

Vitreous surgery in highly myopic retinal detachment resulting from a macular hole.

PURPOSE: This study aimed to assess the therapeutic effect of vitreous surgery in conjunction with photocoagulation for highly myopic retinal detachment resulting from a macular hole. METHODS: Sixty-two consecutive highly myopic patients (65 eyes) with retinal detachment from macular holes underwent vitreous surgery. Gas tamponade in conjunction with laser photocoagulation was performed in 46 eyes (44 cases, group 1); gas tamponade only was performed in 12 eyes (11 cases, group 2); and silicone oil tamponade only was performed in seven eyes (seven cases, group 3). Additional laser photocoagulation was given in group 1 if necessary. The anatomical and functional success rates were compared between the groups. RESULTS: Primary retinal reattachment was achieved in 43 eyes (93.5%) in group 1, seven eyes (58.3%) in group 2 and four eyes (57.1%) in group 3. Final visual acuity was 6/60 or more in 24 eyes (52.2%) in group 1, in six eyes (50.0%) in group 2 and in three eyes (42.9%) in group 3. The initial retinal reattachment rate was significantly higher in group 1 than in group 2 (P = 0.0075) and group 3 (P = 0.0248). The macular hole was completely closed in 18 eyes in group 1 and one eye in group 2 after 2 months or longer. A thin fibrous membrane and scar could be easily noticed beneath the macula in 15 eyes. CONCLUSION: Vitreous surgery in conjunction with laser photo-coagulation can improve the surgical success rate for highly myopic retinal detachment resulting from a macular hole.

Female↗

PubMed2005

Detection of connective tissue growth factor in subretinal Fluid following retinal detachment: possible contribution to subretinal scar formation, preliminary results.

UNLABELLED: Connective tissue growth factor (CTGF) has been shown to be substantially involved in various processes of fibrosis. Herein we report on the presence of CTGF in the subretinal fluid (SRF) of patients with retinal detachment. METHODS: Samples of SRF were collected from 10 patients during retinal detachment surgery. Specific ELISA analysis was performed with goat IgG against human CTGF. RESULTS: CTGF was above the detection limit of the assay in all samples. On average the concentration of CTGF in SRF was 10 ng/ml (SD 3.7, range 3.7-15.7 ng/ml). There was an increase in the CTGF concentration with time between the diagnosis of retinal detachment and surgery (correlation r = 0.67). CONCLUSION: CTGF appears to be a constant component of the fluid accumulating in the subretinal space after retinal detachment. The origin of subretinal CTGF and its physiological importance is still unclear. The known effects of CTGF, however, suggest that it may be involved in both the physiological processes of wound healing in the subretinal space and also in the pathological events such as subretinal fibrosis. The observed increase in CTGF concentration with time suggest that CTGF plays a role in the pathophysiology of subretinal scarring in cases of delayed retinal surgery.

Aged↗

PubMed1996

Retinal detachment after clear lens extraction in 41 eyes with high axial myopia.

PURPOSE: Clear lens extraction is a surgical procedure to correct high axial myopia. The authors explain how this technique may lead to serious vitreoretinal complications. METHODS: The study included 41 eyes of 39 patients aged 25 to 58 years (mean, 37.5 years) with high axial myopia (14-29 diopters; mean, 19.5 diopters) operated on for retinal detachment after clear lens extraction. Retinal detachment occurred 1 month to 4 years after lens extraction, except for two eyes that also had intraoperative choroidal hemorrhages. RESULTS: Twenty-six of the 41 eyes had undergone 360 degree prophylactic retinopexy on preequatorial areas; in four eyes, the retinal breaks occurred along the edge of the prior circumferential photocoagulation. Seventeen eyes exhibited proliferative vitreoretinopathy of various grades. The retina was reattached in 36 eyes. Only nine eyes achieved final visual acuity of 20/60 or better. CONCLUSIONS: Although the authors do not report the actual incidence of retinal detachment after clear lens extraction, they indicate that potentially blinding complications can occur after this surgical procedure, despite prophylactic treatments.

Adult↗

PubMed1999

Limiting photoreceptor death and deconstruction during experimental retinal detachment: the value of oxygen supplementation.

PURPOSE: To assess the role of hypoxia in causing the death and deconstruction of photoreceptors in detached retinas and the effectiveness of supplemental oxygen in limiting such damage. METHODS: Retinal detachment was induced surgically in the right eye of each of 10 cats. The cats were allowed to survive surgery for 3 days. Two were kept for these 3 days in normoxia (room air, 21% oxygen) and eight in hyperoxia (70% oxygen). The retinas were examined for cell death by use of labels for normal and fragmenting DNA, with antibodies and a cone sheath-specific lectin to demonstrate the status of their inner and outer segments, the synaptic structures of the outer plexiform layer, and the distribution of basic fibroblast growth factor (bFGF) and with in situ hybridization to demonstrate bFGF mRNA. RESULTS: Retinal detachment without oxygen supplementation caused the death of some photoreceptors; the loss of cytochrome oxidase from the inner segments and the collapse of the outer segments of surviving photoreceptors; the loss of synaptophysin profiles from the outer plexiform layer; and the loss of bFGF protein from retinal neurons and neuroglia but not from retinal vessels. Oxygen supplementation (hyperoxia) during detachment mitigated all these changes, reducing photoreceptor death, maintaining the specialized structures of surviving photoreceptors, and stabilizing the bFGF within the retina. CONCLUSIONS: In experimental retinal detachment, hypoxia caused by the separation of outer retina from its normal source of nutrients is a factor in inducing the death and deconstruction of photoreceptors as well as in the loss of bFGF from the detached retina. Hyperoxia offered to human patients between diagnosis of retinal detachment and surgery may enhance the function of the reattached retina.

Animals↗

PubMed2006

Horizontal and vertical micropsia following macula-off rhegmatogenous retinal-detachment surgical repair.

BACKGROUND: Dysmetropsia or distorted image size perception (smaller: micropsia; larger: macropsia) is known to occur after successful surgical re-attachment for macula-off rhegmatogenous retinal detachment. However, the vertical and horizontal components of size distortion have not been previously quantified separately. The purpose of this article is to describe horizontal and vertical dysmetropsia occurring in patients following pars plana vitrectomy and gas treatment (octafluoropropane, C(3)F(8) or sulfur hexafluoride, SF(6)) for macula-off rhegmatogenous retinal detachment. MATERIAL AND METHODS: Four patients (mean+/-SD, 59+/-8 years; three women and one man) who had had pars plana vitrectomy and gas treatment for macula-off rhegmatogenous retinal detachment 6-7 months earlier underwent ocular examination, best corrected visual acuity test, threshold horizontal and vertical dysmetropsia measurement using a computerised version of the New Aniseikonia Test, slit-lamp examination and optical coherence tomography of the macula. RESULTS: All patients had binocular visual complaints including difficulty judging distances or reading, rivalry or asthenopia. The logMAR visual acuity (mean+/-SD) in the operated eye was 0.52+/-0.199 and 0.02+/-0.171 in the unaffected eye. All patients perceived the image as smaller (micropsia) with the affected eye, with differences ranging from -9 to 0%. Four patients showed 3% or more size difference between horizontal and vertical meridians. CONCLUSIONS: Dysmetropsia does occur in symptomatic patients following successful surgical repair of macula-off rhegmatogenous retinal detachment by pars plana vitrectomy and gas treatment. The effect on image size is heterogenous across the retinal area affected.

Aged↗

PubMedDate not supplied

Fibrinolytic response to retinal detachment surgery under general or local anesthesia.

PURPOSE: To evaluate perioperative changes in fibrinolysis in patients undergoing retinal detachment surgery under general or local anesthesia. PATIENTS: Prospective study of 81 patients (43 male, 38 female), aged from 15 to 82 (mean 50.7 SD = 17.8) years, undergoing retinal detachment surgery (encirclement with scleral buckling) under general anesthesia (group A), and 14 patients (6 male, 8 female) aged from 15 to 78 (mean 52.9, SD =19.8) years, operated under local anesthesia (group B). Excluded were patients with venous or arterial disease or other factors that could change the parameters investigated. METHODS: Blood was sampled from a cubital vein one day before surgery, immediately after induction of anesthesia but before surgery, immediately after completion of the operation but before the termination of anesthesia and after the operation (on days 1 and 4). In patients' citrated plasma, tissue plasminogen activator antigen (t-PA-Ag), plasminogen activator inhibitor type 1 antigen (PAI-1 Ag) and activity (PAI-1), fibrin-fibrinogen degradation products (FDP) and euglobulin lysis time (ELT) were measured. RESULTS. The pattern of changes in perioperative fibrinolytic activity was similar in both groups. Intraoperative levels of FDP were significantly higher and ELT shorter than preoperatively. In both groups t-PA Ag concentration was significantly increased on the first postoperative day. There were no changes in PAI-1 in both groups. Postoperatively, the FDP concentration was reduced and ELT prolonged. CONCLUSIONS: Retinal detachment surgery induces intraoperative activation of fibrinolysis in the systemic circulation regardless of the type of anesthesia.

Adolescent↗

PubMed1984

Retinal detachment and pseudophakos.

Over a 2-year period 14 cases of retinal detachment after implantation of intra-ocular lenses were seen. The problems encountered in dealing with this type of retinal detachment are described. Attention is given to the difficulties encountered during pre-operative examination, surgery and the postoperative period.

Humans↗

PubMed1998

[Vitrectomy for treatment of retinal detachment caused by macular hole].

OBJECTIVE: To evaluate the effect of vitrectomy and autoserum for treatment of retinal detachment caused by macular hole. METHODS: 19 eyes with retinal detachment caused by macular hole were treated with gas tamponade (C(3)F(8)). The follow-up periods ranged from 6 to 24 months. In the case whose macular hole failed to heal, removal of the remains of prefoveal membrane and/or scratching at the retinal pigment epithelium (RPE) and placing autoserum for 7 minutes in the macular hole were performed. RESULTS: Closure of macular hole was obtained in 15 eyes (80%). The postoperative visual acuity was 0.05 - 0.4. Macular hole failed to heal in 4 eyes. In one eye the remains of prefoveal membrane were removed; in another 3 eyes, in the macular hole scratching at the retinal pigment epithelium (RPE) and placing autoserum were performed and C(3)F(8) tamponade was used. Anatomical cure was obtained in all the 4 eyes. The final visual acuity was 0.1 or better. CONCLUSION: The findings show that removal of prefoveal membrane is imperative. Scratch at RPE with placement of autoserum in the macular hole is effective for the macular hole which has failed to respond to conventional vitrectomy with air tamponade.

Aged↗