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Results for “Retinal Detachment”

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At least 1,225 records · Page 68Linked to original sources

PubMed1978

Opsoclonus inducing retinal detachment with a macular hole.

A 34-year-old man was admitted to the eye department because of conjugate abnormal eye movements and visual field defect of the right eye. Cerebellitis with opsoclonus and retinal detachment with a macular hole were diagnosed. Corticosteroids, diazepam and antibiotics were given. When the opsoclonus was improved, an operation for the retinal detachment was performed as usual, and the retina was reattached. We consider that the opsoclonus greatly contributed to the occurrence and development of the retinal detachment.

Adult↗

PubMed1997

[Activity of cathepsin a in subretinal fluid in primary retinal detachment].

PURPOSE: To evaluate cathepsin A activity in the subretinal fluid in the primary retinal detachment. MATERIALS AND METHODS: The studies were performed on subretinal fluids taken from 38 patients operated for the primary retinal detachment. Duration of the detachment was contained between 1 week and 6 months. Cathepsin A activity was determined by the ninhydrin method with synthetic substrate (N-Cbz-Phe-Ala) at its optimum pH 5.0. RESULTS: Cathepsin A activity was demonstrated in all investigated fluids. The highest activity was found at about the 4th week of the detachment and then it decreased. No differences of enzyme activity according to sex and refraction error were found. CONCLUSION: The increasing proteolytic activity in the subretinal fluid could be an important factor in gradual degrading of the structure and function of the detached retina, because cathepsins are involved in digestion of outer segment proteins of rods and cones and degradation of mucopolysaccharide interphotoreceptor matrix. Retinal degradation during detachment is probably induced by both insufficient nutrition and the effect of increasing lysosomal enzymes.

Adult↗

PubMed1998

[A preliminary investigation on causes of failure of vitreoretinal surgery for complicated rhegmatogenic retinal detachments].

OBJECTIVE: To evaluate the failure causes of vitreoretinal surgery for complicated rhegmatogenic retinal detachment. METHODS: Vitreoretinal (VR) surgery was performed on 477 cases (479 eyes) with complicated rhegmatogenic retinal detachment, the operative procedures including vitrectomy, peeling of pre-retinal membrane, fluid-air exchange, inert gas (SF(6) or C(3)F(8)) or silicone tamponade. RESULTS: On discharge, the operation was effective in 349 eyes (72.87%) and failed in 130 (27.13%) eyes. CONCLUSION: The multiple stepwise multivariate regression shows that the factors significantly influencing VR surgery are silicone tamponade, giant retinal tears, SF(6) tamponade, iatrogenic tear, anterior proliferative vitreoretinopathy (PVR), subretinal proliferation, PVR, C(3)F(8) tamponade, operative frequency and choroidal detachments.

Adolescent↗

PubMedDate not supplied

Senile disciform macular degeneration complicated by massive hemorrhagic retinal detachment and angle closure glaucoma.

Six eyes developed angle-closure glaucoma secondary to total hemorrhagic retinal detachment that occurred as a rare complication of senile disciform macular degeneration. The patients were all elderly with known senile macular choroidal degeneration. They had no history of eye surgery and experienced sudden loss of vision followed by pain. Balloons of retinal detachment were pushed tightly against the lens in a characteristic "Y suture" appearance causing shallowing of the anterior chamber and glaucoma. Pathologic examination of three eyes revealed that the choroid was not detached but that a massive subretinal hemorrhage was present. Neovascular tissue in macular disciform lesions was found in every case and was the probable source of hemorrhage. Sheets of avulsed retinal outer segments were seen incarcerated in subretinal blood in two cases, and drainage of this subretinal blood in three cases did not restore useful vision.

Aged↗

PubMedDate not supplied

Retinal detachment in the Morning Glory syndrome. Pathogenesis and management.

A case of bilateral Morning Glory syndrome is presented, unusual because of a rhegmatogenous posterior pole retinal detachment in the left eye. Posterior pole retinal detachments have been described in association with this syndrome. This case report is the first presentation of a retinal tear located within the excavation surrounding the optic nerve. A surgical management approach is presented wherein vitrectomy and internal gas tamponade are utilized to reattach the retina.

Adolescent↗

PubMed1998

Macular serous retinal detachment caused by subretinal leakage in tilted disc syndrome.

OBJECTIVE: To describe a previously unreported complication of tilted disc syndrome: serous retinal detachment, caused by subretinal leakage, that mimics chronic idiopathic central serous chorioretinopathy (ICSC). DESIGN: Retrospective cohort study. PARTICIPANTS: Five patients (five eyes) participated. MAIN OUTCOME MEASURES: Fluorescein angiographic features were measured. RESULTS: All patients presented with visual loss and metamorphopsia. Fundus examination showed features typical of tilted disc syndrome, including obliquely directed long axis of the disc, situs inversus, retinal pigment epithelium conus, hypopigmentation and staphylomatous ectasia inferonasal to the optic disc, as well as a serous retinal detachment. Fluorescein angiography showed a site of leakage or multiple focal areas of staining and atrophy of the retinal pigment epithelium that correlated to the linear pigmentary changes observed at the junction with the inferior staphyloma. The fluorescein angiographic pattern was very similar to that of chronic ICSC. Spontaneous healing occurred in one case, and successful photocoagulation of the site of leakage was applied in two cases; two eyes could not be photocoagulated because of diffuse leakage in the macular region. CONCLUSIONS: To the authors' knowledge, macular serous retinal detachment due to subretinal leakage has not been reported as a complication of tilted disc syndrome. The authors hypothesize that choriocapillary and pigment epithelial disturbances at the junction of the inferior staphyloma permit the subretinal leakage, but the pathogenesis of this complication remains unclear. A study of larger series of such patients is needed to identify the most appropriate management of these cases, which first need to be differentiated from a chronic form of ICSC.

Adult↗

PubMed1987

Treatment of retinal detachments with multiple breaks by pneumatic retinopexy.

Pneumatic retinopexy is a recent innovation in the treatment of uncomplicated retinal detachments due to a superior retinal break extending for 30 degrees or less. We describe four patients with retinal detachments involving multiple breaks who were successfully treated by a modification of this technique. One case involved a calculation of the size of the gas bubble required to achieve tamponade of both breaks simultaneously. The gas was then administered in two sequential injections, as the volume was too large to be given in a single dose. In the remaining three cases, the gas bubble was rotated from the position of tamponade for one break into a position where tamponade of the second break or groups of breaks was achieved.

Adult↗

PubMedDate not supplied

Vitrectomy for vitreous bleeding and tractional retinal detachment in a case of Evans syndrome.

PURPOSE: To evaluate the effect of vitrectomy to treat Evans syndrome with vitreous bleeding followed by tractional retinal detachment. CASE: Vitrectomy was performed on a 21-year-old man with Evans syndrome who developed tractional retinal detachment in the left eye after experiencing vitreous bleeding and tissue proliferation related to the bleeding. OBSERVATIONS: After the proliferative tissue was removed and tractional retinal detachment corrected, the patient's visual acuity improved from 6/20 to 10/20. A small amount of residual proliferative tissue remained after the vitrectomy. CONCLUSIONS: Vitrectomy may be beneficial in patients with serious vitreous complications induced by hematological diseases such as Evans syndrome.

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↗

PubMedDate not supplied

Round atrophic holes in lattice degeneration--an important cause of phakic retinal detachment.

Round atrophic holes in lattice degeneration are an important cause of phakic retinal detachment. Detachments due solely to round holes in lattice accounted for almost 2.8% of all retinal detachments treated at Wills Eye Hospital from January 1970 to August 1973. These detachments had the following important characteristics: 1. One of the patients were under the age of 30 years. 2. Over 75% of the patients had refractive errors more myopic than -3 D spherical equivalent. 3. Inferior detachments were slightly more common than superior detachments. When located inferiorly, there was a tendency for slow progression as indicated by the frequent presence of pigmented demarcation lines. 4. Surgical repair with standard scleral buckling techniques was successful in 98% of these detachments. Young, moderate to highly myopic patients with round holes in areas of lattice degeneration seem to have a greater risk of developing this type of detachment. Patients with the triad of youth, myopia, and round holes in lattice degeneration deserve close observation.

Adolescent↗

PubMed1997

Retinal detachment in AIDS: long-term results after repair with silicone oil.

AIMS: To study the long-term results of vitrectomy and silicone oil injection in AIDS patients with retinal detachment due to viral retinitis. METHODS: A consecutive series of 83 eyes in 75 AIDS patients who were treated with vitrectomy and silicone oil for retinal detachment due to viral retinitis was studied prospectively and followed until the last patient in the series had died. RESULTS: Median postoperative survival was 6 months, but 20% of patients survived 12 months or more. Whereas best corrected visual acuity was 20/100 or better in over half the patients 1-2 months after operation, there was a distressing decrease in acuity by 6 months, owing to a variety of factors. Patients operated on before macular detachment did not have significantly better postoperative vision than those operated within a week after macular detachment. Almost all patients who had already lost vision in the fellow eye and many who had cytomegalovirus retinitis in the fellow eye with retention of good vision had their quality of life improved by the surgery in that the operated eye eventually became the better seeing eye. In no patient whose fellow eye was normal and free of retinitis, however, did the operated eye ever become the better eye. CONCLUSIONS: Although the majority of patients recovered macular vision in the first 1-2 months after operation, there was a gradual decline in acuity thereafter, sometimes without obvious cause. The results of this series suggest that it may be reasonable to postpone surgery until the macula detaches and that patients whose fellow eye is free of retinitis with normal vision are unlikely to have their quality of life improved significantly by the surgery.

AIDS-Related Opportunistic Infections↗

PubMed2003

Laser and proton radiation to reduce uveal melanoma-associated exudative retinal detachments.

PURPOSE: To assess whether laser-induced hyperthermia in conjunction with proton irradiation of choroidal melanoma may more rapidly decrease exudative retinal detachments. DESIGN: Case-control study. METHODS: This was a single-center prospective phase 1 study of choroidal melanoma patients with exudative retinal detachments. These tumors did not overhang the optic disc, involve the fovea, or have greater than 40% involvement of the ciliary body. Patients were treated with laser-induced hyperthermia and proton radiation; results were compared with those of similar patients treated at the same institution with only proton radiation. Patients were followed up in an identical manner for loss of subretinal fluid, visual acuity change, and visual field alterations. RESULTS: All 11 patients treated with combined laser and proton therapy had resorption of subretinal fluid with a mean duration of retinal detachment of 193 days, compared with 263 days in the group treated with only proton therapy (P<.04). At 1 year, visual acuity was similar in both groups. CONCLUSIONS: Combined laser-induced hyperthermia and proton radiation may dissipate exudative detachments more rapidly than radiation alone.

Case-Control Studies↗

PubMedDate not supplied

Rhegmatogenous retinal detachment with Schwartz's syndrome following Nd:YAG laser peripheral iridectomy in the management of pigmentary glaucoma.

A case of rhegmatogenous retinal detachment complicated by Schwartz's syndrome following Nd:YAG laser peripheral iridectomy in the management of pigmentary glaucoma is described. A 36-year-old man underwent Nd:YAG laser peripheral iridectomy for pigmentary glaucoma. Three days later, he had a rhegmatogenous retinal detachment. The break remained open following scleral buckling with persistent subretinal fluid, "iridocyclitis," and elevated intraocular pressure. Two months later, the patient underwent revision of the scleral buckle. Following closure of the retinal break, the retina flattened, and within 2 weeks the "iridocyditis" resolved and the intraocular pressure decreased to approximately 20 mm Hg. Rhegmatogenous retinal detachment may occur following laser peripheral iridectomy, and suggests the necessity for a prospective dinical trial to evaluate the role of laser peripheral iridectomy in the management of pigmentary glaucoma.

Adult↗

PubMed1987

Transvitreal cyanoacrylate retinopexy in the management of complicated retinal detachment.

We used transvitreally delivered cyanoacrylate tissue adhesive to seal retinal breaks in 25 selected patients undergoing vitreous surgery for complicated retinal detachment. With a minimum follow-up period of six months, all but one retinal hole remained closed. Complete retinal reattachment posterior to the encircling buckle was achieved in 18 of 25 eyes (72%). In ten of 25 eyes (40%) the final visual acuity was 5/200 or better.

Adolescent↗

PubMed1988

Rhegmatogenous retinal detachment with a pit of the optic nerve head.

A 56-year-old myope developed a retinal detachment of the macular area and the temporal quadrants in his left eye that harbored a temporally-located pit of the optic nerve head. Under anesthesia a small peripheral retinal break was identified, and the retina was reattached successfully using cryotherapy and a limited scleral buckling procedure. Peripheral retinal breaks should be searched for in myopic eyes with optic pits and retinal detachments involving peripheral retinal quadrants.

Humans↗

PubMed1992

Surgical techniques and visual prognosis in retinal detachment due to macular hole.

In 250 eyes with retinal detachment due to macular hole, the visual prognosis of each surgical technique was evaluated. (1) Macular diathermy adversely affected the visual prognosis. (2) Macular buckling+macular diathermy produced a poorer visual prognosis than macular buckling alone. (3) The visual prognosis resulting from gas tamponade alone or vitrectomy+gas tamponade was better than that resulting from macular diathermy. It is not clear whether there is a significant difference in visual prognosis between gas tamponade alone and vitrectomy+gas tamponade. (4) Macular laser photocoagulation does not adversely affect the visual prognosis. Judging from these results, gas tamponade, which has the possibility of better visual prognosis and less operation stress, should be selected as the initial technique.

Electrocoagulation↗

PubMedDate not supplied

Surgical management of traumatic retinal detachment with perfluorocarbon liquid. The Vitreon Study Group.

BACKGROUND: To evaluate the effect of perfluoroperhydrophenanthrene on the outcome of traumatic retinal detachment with proliferative vitreoretinopathy, a retrospective study of 111 patients was performed at 35 tertiary care centers, both private practice and institutional. We believed that perfluoroperhydrophenanthrene would assist in manipulating the retina during surgery, removing intraocular foreign bodies, draining suprachoroidal hemorrhage, and reattaching the retina because of the perfluorocarbon's high specific gravity. METHODS: Of the 700 patients in the Vitreo study group, 111 with a history of trauma (109 had retinal detachment, 50 had proliferative vitreoretinopathy) were chosen for this study. Perfluoroperhydrophenanthrene was used intraoperatively to manipulate the retina hydrokinetically, remove intraocular foreign bodies, drain suprachoroidal hemorrhage, and to reattach the retina in the case of giant tears. RESULTS: Logistic multiple regression analysis was used to identify factors as being predictive of poor visual outcome. Factors predictive of poor visual outcome were: type of trauma (p = 0.0065) (ruptured globe); presence of giant retinal tear (p = 0.0253); and low preoperative visual acuity (p = 0.044). At the last follow-up examination, the reattachment rate was 75.6% (i.e., 84 eyes). Of those 84 eyes, 55 (49.5%) had achieved a visual acuity of > or = 5/200 and 34 (30.6%) had a visual acuity of > or = 20/200. In cases complicated by proliferative vitreoretinopathy, the final reattachment rate was 66%, with 40% of the eyes studied obtaining a visual acuity of > or = 5/200. CONCLUSIONS: Perfluoroperhydrophenanthrene has been used intraoperatively in the management of traumatic retinal detachments without any apparent ill effects.

Adolescent↗

PubMedDate not supplied

Bilateral retinal detachment in Marfan's syndrome.

PURPOSE: Bilateral retinal detachment (RD) in Marfan's syndrome (MS) has a typical preoperative, operative, and post-operative course. This study describes symmetry of retinal tears and bilateral RD surgery in five MS patients over a period of 15 years. METHODS: Six eyes with uncomplicated RD were operated on using the scleral buckling procedure, and four eyes with complicated RD were operated using a pars plana vitrectomy (PPV) and inner retinal tamponade with silicon oil. RESULTS: Complete retinal reattachment was achieved in seven eyes. Partial anatomical success with attached macula was achieved in one eye. The surgery failed in two eyes. Final visual acuity was between 0.66 and 0.33 in three eyes, and between 0.25 and 0.1 in five; two eyes had no light perception. CONCLUSIONS: The course of the bilateral retinal disease highly correlated with the symmetry of retinal defects.

Adolescent↗