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Results for “Retinal Detachment”

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At least 1,153 records · Page 64Linked to original sources

PubMed2006

Recurrent bullous retinal detachments from photodynamic therapy for idiopathic polypoidal choroidal vasculopathy.

PURPOSE: To report the recurrent bullous retinal detachments as complications of photodynamic therapy (PDT) for idiopathic polypoidal choroidal vasculopathy (IPCV). DESIGN: Interventional case report. METHODS: A pseudophakic 84-year-old-woman had IPCV and decreased vision. Angiography demonstrated macular leakage. PDT with verteporfin was applied. Two days later, visual acuity decreased from 20/50 to 20/400. Examination revealed extensive inferior subretinal fluid, which mimicked a pseudophakic rhegmatogenous retinal detachment. A scleral buckle was placed; no retinal breaks were identified. RESULTS: Vision and fluid resolved over three weeks. Four months later, examination revealed decreased vision and persistent leakage. Two days after repeat PDT, bullous exudative macular detachment recurred. Detachment resolved over two weeks; visual acuity returned to 20/50. CONCLUSION: IPCV that is treated with PDT may be complicated by iatrogenic bullous exudative retinal detachments that resemble rhegmatogenous detachments. Modified treatment parameters may reduce the risk of recurrence. The natural history likely includes spontaneous resolution and visual recovery.

Acute Disease↗

PubMed2002

[Pars plana vitrectomy for pseudophakic retinal detachment].

BACKGROUND: Pars plana vitrectomy, usually without additional buckling procedures, is the first choice for repair of pseudophakic retinal detachment at the Lucerne Eye Hospital. PATIENTS AND METHODS: In a retrospective study we analyzed a consecutive series of 129 eyes (122 patients) treated for pseudophakic retinal detachment. All underwent a primary pars plana vitrectomy. 97 % had retrobulbar anaesthesia. SF6 was used in 93 %, Si-oil in 7 %. An additional encircling band was placed in 5 %. Mean age was 65 years (24 - 92, +/- 13). Minimal follow-up was 8 months (8 - 66, median 25). RESULTS: Mean duration of surgery was 90 minutes (50 - 140, +/- 15). Severe PVR grade C was present in 17 %. Breaks in the inferior part of the retina were found in 52 % - the localisation had no influence on the anatomical or functional outcome. A difference between preoperative and intraoperative findings was noted in 46 % (missed breaks or lattice degenerations etc.). For general medical reasons, Si-oil was not removed in 4 eyes. Complete reattachment after the first operation was achieved in overall 91 % (oil-left eyes were considered as failure); in 95 %, if the oil-left eyes were excluded from the study; in 93 %, if the eyes with encircling band were not counted; in 95 % without encircling-band and oil-left eyes; in 93 % without PVR-C cases; 95 % without encircling-band/oil-left/PVR-C eyes. Median final visual acuity was 1.0, if the macula was not detached preoperatively and 0.8, if the macula was detached. Intraocular pressure problems (> 30 mm Hg < 12 h and/or > 25 mm Hg > 36 h) were noted in 28 %. Prophylactic or therapeutic antiglaucomatous medication was applied in 58 %. 14 % showed a transient fibrin reaction in the anterior segment. Refraction and ocular motility were not influenced by the surgery. CONCLUSION: Primary vitrectomy for pseudophakic retinal detachment is safe and effective. Transient elevation of the intraocular pressure is a frequent postoperative complication.

Adult↗

PubMed1985

Rhegmatogenous retinal detachment with subretinal exudates.

Two young patients with probable longstanding traumatic retinal detachments underwent successful surgical repair. Dramatic subretinal exudates and crystalline material gradually resorbed; however, poor final vision resulted. No predisposing condition other than the longstanding retinal detachments was noted in these patients.

Adult↗

PubMed1997

Our experience in minimized surgery for retinal detachment: first results.

This study included the first 35 patients with retinal detachment that underwent cryopexy and scleral segmental buckling by silicone sponge with nondrainage and without serclage after Lincoff. Precise localization of the retinal lesions and proper circumferential cryopexy was achieved intraoperatively under the guidance of indirect ophthalmoscope provided with +20/+30d biaspherical lens (Volk, USA). Mean age of the patients was 42 +/- 11 years. A single hole/break was visualized in 20%, two holes/breaks in 26%, and more than two holes/breaks in 40% of the patients; disinsertion of the retina of one quadrant was present in 14%. The duration of the disease was less than 3 months in 66% and more than 3 months in 34% of the patients. On the first postoperative day anatomical reattachment of the retina was achieved in 86% of the patients and in 14% of the resorption was delayed until day 7. Postoperative haemophthalmus, vitreitis, ischaemia of the anterior ocular segment, or elevated intraocular pressure were found in none of the patients. All patients were discharged with reattached retinas. Visual acuity was more than 0.5 in 60% and from 0.1 to 0.5 in 40% of the patients. At the last postoperative examination the visual acuity was 1.0 in 40%, 0.5-0.9 in 40% and 0.1-0.4 in 20% of the eyes. The retina was reattached in all patients. The method of minimized surgery for retinal detachment yields good anatomical and functional results. It helps to avoid the postoperative complications of conventional scleroplastic surgery with serclage and drainage.

Adult↗

PubMed1993

[Measurement of the subretinal fluid volume using B-scan ultrasonography. Report 2. Measurement of the decrease rate of subretinal fluid in patients with rhegmatogenous retinal detachment].

I have previously reported the use of video-ultrasonography and an image computerized system to measure the volume of subretinal fluid (SRF). This measurement system was now used for 19 eyes with rhegmatogenous retinal detachment during absolute rest in bed for 24 hours and double patching. The mean age was 55 years (range, 18-69 years). The retinal detachment involved two quadrants or less of the retina in all eyes. The decrease rate of SRF was 0.051 +/- 0.033 microliter/mm2/hour (mean +/- standard deviation); 0.074 +/- 0.033 microliter/mm2/hour in 9 eyes in which the duration of retinal detachment was 14 days or less and 0.030 +/- 0.009 microliter/mm2/hour in 4 eyes in which the duration was 15 days or more. The rate was 0.032 +/- 0.009 microliter/mm2/hour in 3 eyes with atrophic holes. Three eyes with macular holes, which had retinal detachment underlying extensive staphyloma showed a rate of 0.028 +/- 0.022 microliter/mm2/hour. Though absolute rest in bed and double patching cannot completely block a transfer of fluid from vitreous to subretinal space via retinal break, the decrease rate of SRF appears to reflect the absorption of SRF across the retinal pigment epithelium.

Adolescent↗

PubMed1992

[C2F6 in the treatment of retinal detachment associated to PVR: therapeutic trial].

We conducted a clinical trial on C2F6 as a retinal tamponade in the management of retinal detachment with proliferative vitreoretinopathy. Twenty seven eyes of 27 consecutive patients were enrolled in the study. Permanent retinal reattachment was achieved in 21 eyes (78%). The anatomic success rate was 85% in eyes with grade B PVR (17/20 eyes), and 57% in eyes with grade C and D PVR (4/7 eyes). The success rate was as high as that achieved in a previous series of eyes managed with the use of C3F8 combined with the same surgical technique. C2F6 shares the advantages of C3F8 in the management of retinal detachments complicated by proliferative vitreoretinopathy. However its absorption is more rapid as compared to C3F8. This is an advantage with regard to the postoperative disadvantages of gas tamponade. Further clinical use on a larger series of patients is required to confirmed the preliminary results.

Cryosurgery↗

PubMedDate not supplied

Successful treatment of rhegmatogenous retinal detachment secondary to globe perforation during peribulbar injection in a case of sympathetic ophthalmia.

Rhegmatogenous retinal detachment followed peribulbar injection in a patient with preexisting sympathetic ophthalmia. Inadvertent globe perforation resulted in subsequent rhegmatogenous retinal detachment. Scleral buckling and pars plana vitrectomy reattached the retina. The histopathology of the subretinal fibrotic tissue confirmed the diagnosis.

Adult↗

PubMed1986

Antiviral therapy with ganciclovir for cytomegalovirus retinitis and bilateral exudative retinal detachments in an immunocompromised child.

A child with bilateral cytomegalovirus (CMV) retinitis, vitritis, and exudative retinal detachments, who was in remission from stage IV neuroblastoma and status post-chemotherapy and autologous bone marrow transplantation, was treated with ganciclovir. The drug is a new acyclic nucleoside antiviral drug with potent antiCMV activity. There was bilateral retinal reattachment, clearing of vitritis and regression of retinal exudates and hemorrhages, with concomitant resolution of viral shedding in urine and blood, on ganciclovir 7.5 mg/kg per day. There was recurrence of exudative detachments, vitritis and retinitis when the dose was reduced to 2.5 mg/kg per day, and regression of these findings when the dose was again increased to 7.5 mg/kg per day. Despite continued therapy at this dose, a relapse occurred. When the dose of drug was doubled to 15 mg/kg per day, there initially was a partial therapeutic response, followed by a subsequent relapse. No further response was seen when the dose was increased to 19.5 mg/kg per day. This patient was treated with ganciclovir for a total of 192 days. No adverse reactions to ganciclovir were seen. On the last day of drug administration, there were persistent bilateral exudative retinal detachments and progressive optic nerve head involvement with optic disc pallor, despite quiescence of the retinitis.

Acyclovir↗

PubMed1976

Juvenile retinal detachment.

We feel that the management of juvenile retinal detachment can best be improved by earlier diagnosis. School vision-screening tests should be encouraged, and long-term followup of patients with high myopia, aphakia, and retrolental fibroplasia should be practiced. The peripheral retina should be examined in all traumatized eyes since delayed detachment is the rule. When retinal breaks are found in high-risk eyes, in our opinion, prophylactic treatment is indicated.

Adolescent↗

PubMed1996

Inhibition of retinal pigment epithelial cell-induced tractional retinal detachment by disintegrins, a group of Arg-Gly-Asp-containing peptides from viper venom.

PURPOSE: Integrin-mediated extracellular matrix (ECM) attachment plays an important role in vitreous contraction of retinal pigment epithelial (RPE) cells. Disintegrins, a group of Arg-Gly-Asp (RGD)-containing peptides from viper venom, are potential anti-adhesion agents that interfere with integrin-ECM binding. This study was performed to determine whether disintegrins were effective in inhibiting RPE cell-induced matrix attachment in vitro and tractional retinal detachment in a rabbit model in vivo. METHODS: Two disintegrins, echistatin from viper Echis carinatus and flavoridin from Trimeresurus flavoviridis, were used. The expression of integrins on the surface of bovine and rabbit RPE cells was examined by indirect immunofluorescent stain with specific anti-integrin monoclonal antibodies. The inhibitory effect of disintegrins on RPE cell-mediated ECM attachment and vitreous contraction was evaluated with cell adhesion and vitreous contraction assays. In the in vivo model, rabbit eyes were injected intravitreously with either homologous rabbit RPE cells alone or together with disintegrins to induce tractional retinal detachment. The cytotoxic effect of disintegrins was examined with a cell proliferation assay using the alamar blue method. Retinal toxicity of disintegrins was evaluated with electroretinograms and histologic examination of the rabbit eyes. RESULTS: Bovine and rabbit RPE cells showed the positive staining for the integrins alpha 2 beta 1 and alpha 5 beta 1 on cell surface. Disintegrins, echistatin, and flavoridin inhibited RPE cell attachment to the ECM. The potency of disintegrins was 150 to 300 times higher than that of Gly-Arg-Gly-Asp-Ser (GRGDS) peptide. The disintegrins also inhibited RPE cell-induced vitreous contraction in a dose-dependent manner, whereas the GRGDS peptide had no effect. In the in vivo experiment, echistatin (50 microgram/ml) or flavoridin (80 microgram/ml) significantly inhibited RPE cell-induced tractional retinal detachment compared with the control group at week 2 (P< 0.05) and week 4 (P< 0.01) after surgery. Disintegrins were nontoxic to RPE cells and rabbit retina as evaluated by cytotoxicity tests, electroretinograms, and histologic examinations. CONCLUSIONS: The disintegrins were effective in inhibiting RPE cell attachment to the ECM and vitreous contraction in vitro. They also were effective in suppressing RPE cell-induced tractional retinal detachment in the rabbit eyes. They were nontoxic. Disintegrins and their analogs might be potential anti-adhesion therapeutic agents in the treatment of proliferative vitreoretinopathy.

Amino Acid Sequence↗

PubMed1995

Selective loss of blue cones and rods in human retinal detachment.

OBJECTIVE: To determine if there are histopathologic changes in the outer retina that could explain the blue-yellow color confusion previously described following rhegmatogenous retinal detachment in humans. METHODS: Ten eyes with traumatic retinal detachments were studied. Eight of the eyes were removed from 2 1/2 to 11 days following trauma. In the remaining two eyes, the retinas were successfully reattached. Enzyme histochemical studies for carbonic anhydrase and immunochemical studies for S antigen were performed to distinguish blue cones from red/green cones. RESULTS: With the 2 1/2- to 4-day-old detachments, nearly all of the carbonic anhydrase-negative (blue-sensitive) cones and many of the rods were seen to have signs of irreversible necrosis, including extreme swelling of the inner segments and mitochondria, loss of the outer segments, and pyknotic and displaced nuclei. In the 6- and 11-day-old detachments, almost all of the carbonic anhydrase-negative cones and many rods were missing. Blue cones were essentially absent from the reattached retinas, and there were only about half the normal number of rods. CONCLUSIONS: Rhegmatogenous retinal detachment results in rapid and almost total loss of the blue cones. Significant rod loss also occurs in this type of detachment but the red/green cones are comparatively resistant to damage. These findings could explain the observed blue-yellow color confusion in such patients. We discuss other clinical implications.

Acute Disease↗

PubMedDate not supplied

Primary vitrectomy for bullous rhegmatogenous retinal detachments due to complex breaks.

INTRODUCTION: The role of vitrectomy for the treatment of uncomplicated retinal detachments has not been clearly defined. This study reports the results of a series of eyes with bullous rhegmatogenous retinal detachment (RRD) due to complex breaks that were managed by primary vitrectomy. METHODS: The study consisted of a consecutive series of 22 eyes (22 patients) with a bullous RRD not complicated by proliferative vitreoretinopathy (PVR) associated with large, multiple, or posterior breaks. All eyes underwent vitrectomy, injection of perfluorocarbon liquid (PFCL), cryopexy and gas tamponade as the primary procedure. Encircling scleral bands were placed in all cases. Follow-up ranged from 6 to 24 months (mean 10.9 +/- 6.5 months). RESULTS: Anatomical retinal re-attachment was achieved in all eyes after one operation. Best-corrected final visual acuity was improved in all cases. Complications included progressive posterior subcapsular and nucleosclerotic cataract in four (22%) of the 18 phakic eyes and epiretinal membrane in one patient. CONCLUSIONS: These results, together with the relatively low incidence of complications, lead us to conclude that this technique is an effective method for treatment of bullous RRD not complicated by PVR associated with technically difficult breaks. A controlled, prospective, randomized study would be necessary to thoroughly assess the advantages of vitrectomy over scleral buckling alone in these cases.

Adult↗

PubMed1990

[Functional and anatomic results with intra-ocular tamponade in retinal detachment surgery].

To analyze the anatomical and functional results with silicone oil and gas tamponade, we reviewed our last 506 consecutive surgical procedures for rhegmatogenous retinal detachment. In combination with vitreous surgery, silicone oil was used in 4% and expanding gas in 15%. The anatomical success rate with silicone oil was 68% and with gas tamponade 79%. A visual acuity of 0.05 or better was achieved in 36% of the eyes treated with silicone oil versus 67% of the eyes treated with gas tamponade. Although the more advanced stages of proliferative vitreoretinopathy were in the silicone group, our results confirm the findings of other investigators: despite the high anatomical success rate with silicone oil, the functional results are poor. Because many complicated cases of retinal detachment can also be treated successfully with gas tamponade, silicone oil should remain the last option in retinal detachment surgery.

Follow-Up Studies↗

PubMed1990

[Retinal detachment caused by desinsertion at the ora serrata. Epidemiologic aspects and prognosis].

A study about 44 retinal detachments showed 44 cases of retinal detachment due to desinsertions at the ora serrata, including all etiologies. We found that most of the cases were young people (80% before 40 years old), and male and functional results were relatively poor (60%). In "idiopathic" cases and due to the ocular contusions, the rates of good anatomic results were respectively 86% and 95%, and visual acuity was improved in 70% and 81% of the eyes.

Adolescent↗

PubMed1983

Temporary use of silicone oil in the treatment of special cases of retinal detachment.

Temporary use of intraocular silicone oil has first been described for the treatment of retinal detachments with massive periretinal proliferation. The technique has been proved to be safe and helpful and is now used for the management of other desperate retinal detachments, such as those with traumatic fibrous ingrowth, giant tear, posterior hole, and choroidal coloboma.

Choroid↗

PubMed1983

Bilateral rhegmatogenous retinal detachment associated with unilateral choroidal melanoma.

A patient with bilateral rhegmatogenous retinal detachment associated with a unilateral choroidal melanoma is presented. It appears that there is no causative relationship between these two findings in this case. The clinician should be advised that these two phenomena are not as rare as was once thought, and an index of suspicion should be maintained whenever one is evaluating a patient with retinal detachment.

Aged↗

PubMed2003

Light scatter causes the grayness of detached retinas: implications for vision loss in retinal detachment.

OBJECTIVE: To investigate the cause of the gray appearance of the detached retina. METHODS: The effects of ex vivo bovine retinas and Scotch (3M, Minneapolis, Minn) tape on light scattering were predicted based on mathematical modeling and examined empirically on an optical bench. Images were collected with a CCD [charged-coupling device] camera connected to a microcomputer with an image grabber. The clarity of the image was calculated as the standard deviation, sigma. RESULTS: Calculations predicted a gaussian distribution of laser light scattering with increased diffusion with increasing distance from the medium to the target. The image clarity, sigma, increased rapidly in the first 50 micro m of separation of the retina and tape from the test target and the rate of increase diminished thereafter. Removal of the outer retina with an excimer laser improved retinal transparency. CONCLUSIONS: Data explain that the gray appearance of the detached retina results from light scattering. This phenomenon likely results, at least in part, because of the irregular outer retinal surface at the level of the photoreceptors. Clinical Relevance The findings suggest that visual loss in retinal detachment may result, in part, from optical properties of the detached retina and have implications for visual recovery and subretinal surgery.

Animals↗

PubMed2000

Bilateral serous retinal detachment associated with Alport's syndrome.

We report a 14-year-old girl with Alport's syndrome who developed bilateral exudative retinal detachment in the macula. With the development of chronic renal failure, bilateral serous retinal detachment appeared which had the retinal flecks characteristic of Alport's syndrome. The serous detachment was resolved and vision recovered following intensive hemodialysis. As far as we know this is the first case with documentation of the onset and resolution of serous retinal detachment in Alport's syndrome.

Adolescent↗