Exudative retinal detachment following central retinal vein occlusion.
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Adult↗
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Results for “Retinal Detachment”
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Retinal detachment secondary to retinal branch vein occlusions.
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Aged↗
[Retinal detachment, caused by hyperaemia of the choroid? Remarks on the supposed relationship between retinal detachment and "indirect trauma" (author's transl)].
It was recently stressed by Scheerer that retinal detachment in a highly myopic eye may be caused by hyperaemia of the choroid, presumably occuring during heavy physical labour which is performed by a non-trained person. Clinical studies have shown, however, that choroidal detachment, resulting from either hemorrhagic, or serous accumulation of fluid during operative procedures or during postoperative periods, is not followed by retinal detachment. Also experimental occlusion of large choroidal vessels, associated with hyperaemia in the choroidal vasculature, does not lead to retinal changes inducing the separation of the neuroretina from the pigment epithelium layer. Thus, it is concluded that choroidal hyperaemia, possibly occuring during heavy physical labour, has no relationship to the development of a retinal detachment in a "disposed" eye.
Aged↗
[Attitude toward subretinal fluid and consequent treatment of idiopathic retinal detachment].
250 retinal detachments have had surgery for the first time: 70 with release of the subretinal fluid, 180 without release of the subretinal fluid. It appears that the postoperative intraocular conditions and functional results are better when drainage is not performed.
Adult↗
[A comparison between scleral buckling procedure and vitrectomy for the management of uncomplicated retinal detachment caused by posterior retinal break].
We reviewed conventional scleral buckling and vitrectomy for uncomplicated rhegmatogenous retinal detachment due to posterior retina break. A comparison was made for a consecutive series of 21 cases undergoing scleral buckling procedure and 15 cases receiving vitrectomy as the initial surgery. As regards surgical complications, in the scleral buckling procedure there was inadvertent severance or compression of the vortex veins in 16 (77%) of the 21 cases and postoperative choroidal detachment in 9 (43%). In vitrectomy, there were no remarkable intraoperative complications, but it led to progressive nuclear cataract in 10 (67%) of the 15 cases during the postoperative period. Both procedures produced successful retinal attachment with comparable visual recovery. The results indicate that vitrectomy is a useful procedure for cases of uncomplicated retinal detachment caused by deeply located retinal break.
Adult↗
[Lectin histochemical studies of retinal pigment epithelium in retinal detachment].
The retinal pigment epithelium (RPE) exhibits a broad spectrum of morphological changes under pathological conditions. Since RPE cells cannot be immunocytochemically characterized with certainty, lectin histochemical investigations were performed to study the lectin binding pattern of different morphological RPE variants in human globes. Normal RPE with attached retinas was compared to reactive changes in RPE following retinal detachment. Lectin binding sites were visualized by a modified PAP technique performed on paraffin-embedded tissue sections. Eight lectins of different sugar affinity (Con A, WGA, PNA, RCA 1, SBA, UEA 1, DBA, LPA) were tested for binding sites on the RPE. Both normal and reactively changed RPE possess receptors for Con A, WGA, PNA, and RCA 1. Modifications in the lectin binding pattern occurred simultaneously with the morphological changes within the RPE cells. RPE cells which form a monolayer on Bruch's membrane mainly have lectin binding sites in their apical portions. Proliferating and migrating RPE cells, especially RPE macrophages, which have withdrawn from the basal cell layer were found to contain lectin binding sites dispersed over the entire cytoplasm. RPE macrophages exhibited additional binding sites for the lectin SBA. These results indicate that RPE cell variants can be designated by means of their specific combination of lectin binding sites for Con A WGA, PNA, and RCA 1 not found on other cell types in the retina.
Humans↗
Risk factors for development of rhegmatogenous retinal detachment in patients with cytomegalovirus retinitis.
We studied 259 patients to determine the time-dependent risk and risk factors for the development of retinal detachment in patients with cytomegalovirus retinitis. The six-month and one-year retinal detachment rates (by eye) were 11% and 24%, respectively. Increasing retinal surface involvement outside of the posterior pole and the presence of retinitis activity were found to be the two covariates that best predicted retinal detachment. Eyes with peripheral involvement greater than 25% had a fivefold risk for detachment, compared to eyes with 10% involvement. If there was retinitis activity and more than 25% peripheral (external to major vascular arcades) involvement, the risk increased to 24-fold. The presence of a fellow eye with retinal detachment was not an independent risk factor. These observations should help in the design of a prophylactic trial intended to prevent retinal detachment and should also help ophthalmologists counsel patients with cytomegalovirus retinitis.
AIDS-Related Opportunistic Infections↗
Reduction of subretinal fluid after preoperative immobilization of the eyes with rhegmatogenous retinal detachment.
BACKGROUND: Bullous retinal detachment may be difficult to handle with higher operative complications. Preoperative immobilization of the eyes might reduce subretinal fluid and facilitate surgical procedures. Factors influencing subretinal fluid absorption were analyzed. METHODS: Twenty-eight eyes with primary rhegmatogenous retinal detachment with preoperative binocular patching and complete bed rest for at least 12 hours were enrolled. Ultrasonography was performed before and after immobilization to estimate the reduction in subretinal fluid. RESULTS: The amount of reduction diverged in cases with an average of a 17.1% decrease in the maximal height of detachment. Retinal detachments in patients with smaller breaks and without vitreal traction or chronicity showed more significant reduction of subretinal fluid than did those patients with larger breaks and with vitreal traction or chronicity. On the other hand, break shape, height of retinal detachment, age, and gender had no obvious effect on subretinal fluid change. CONCLUSIONS: Preoperative immobilization of the eyes reduces the subretinal fluid in selected cases, which can decrease operative complications. Break size, vitreal traction, and chronicity are important factors affecting the absorption of subretinal fluid.
Adolescent↗
[Postoperative choroid detachment following microsurgery for rhegmatogenous retinal detachment].
PURPOSE: To evaluate the incidence, predisposing and prognosis factors of post-operative choroidal detachment after microsurgery of rhegmatogenous retinal detachment. MATERIALS AND METHODS: We conducted a retrospective study on a series of 595 consecutive rhegmatogenous retinal detachments referred before any previous failed surgery. Univariate statistical analysis of the data was conducted with evaluation of the odds ratio. RESULTS: Postoperative choroidal detachment developed in 23/595 eyes (3.8%). Significant predictive factors for post operative choroidal detachment included patient's age over 50 years, male gender, pseudophakia, retinal detachment higher than 90 degrees and giant tears. We found no correlation between postoperative choroidal detachment and the retinopexy method, subretinal fluid release and the type of scleral buckling procedure (segmental versus incercling). Postoperative choroidal detachment did not influence at a statistically significant level the postoperative outcome. Permanent retinal reattachment was achieved in 20 of the 23 eyes (87%) with postoperative choroidal detachment, and 564 of 572 eyes (93%) with no post-operative choroidal detachment (p > 0.05). Postoperative PVR occurred in 3 of the 23 eyes (13%) with postoperative choroidal detachment and 3 of the 572 eyes (5%) with no postoperative choroidal detachment (p > 0.05). The postoperative visual outcome was not influenced by the occurrence of postoperative choroidal detachment. CONCLUSION: Postoperative choroidal detachment after retinal detachment microsurgery is a rare complication. Its prognosis is good. The occurrence of postoperative choroidal detachment does not influence the postoperative outcome of retinal detachment microsurgery.
Adult↗
Management of retinal detachment associated with CMV retinitis in AIDS patients.
In patients with AIDS, the most important ocular opportunistic infection, CMV retinitis, can now be treated effectively with virostatic agents. Associated retinal detachment is encountered frequently, and its management has become increasingly significant to quality of life as improvements in medical care have helped to preserve vision and extend life expectancy. Although retinal detachment in these eyes is typically rhegmatogenous, the pathophysiology is distinctive due to the association with CMV retinitis which, even in remission, is characterised by atrophic changes at all levels of affected retina and alterations of the vitreous. Despite initially successful surgical reattachment, multiple, small, often posterior holes may develop because of progressive CMV infection. For these reasons, vitrectomy and silicone oil injection with scleral buckling may currently provide the best overall means of maintaining retinal reattachment and restoring visual function. Nevertheless, management must be individualised in each case, with the realisation that progressive visual loss frequently ensues from retinitis progression.
AIDS-Related Opportunistic Infections↗
Retinal detachment following the acute retinal necrosis syndrome.
Twenty-six patients with the acute retinal necrosis involving 32 eyes have been followed at the Bascom Palmer Eye Institute. Sixteen eyes developed retinal detachment and surgical repair was attempted in thirteen. Ten eyes were successfully reattached. Vitreous surgery was necessary in ten eyes and was performed in eight of the ten successful eyes. The clinical characteristics of the retinal detachments as well as the surgical procedures and results are presented.
Acute Disease↗
Retinal detachments with crescent-shaped retinal breaks in patients with atopic dermatitis.
BACKGROUND: There has been increasing number of reports of retinal detachments associated with atopic dermatitis. However, little is known about the etiology of these rhegmatogenous detachments. The authors encountered two patients with retinal detachments associated with a crescent-shaped retinal break combined with another break located at or anterior to the ora. METHODS: Preoperative and intraoperative findings in these cases were evaluated. RESULTS: In both cases, vitreoretinal adhesions were observed on the anterior and posterior edges of a crescent-shaped retinal break. Vitreous traction between the crescent-shaped retinal break and the break located at or anterior to the ora was also observed. No abnormalities were detected in the choroid in either case. A possible causative factor for the retinal detachments in these patients was the habit of rubbing and slapping their faces, apparently to alleviate extreme itching. CONCLUSION: Crescent-shaped retinal breaks, which were different from conventional horseshoe tears or atrophic retinal holes, were an interesting and unusual feature of two patients with atopic dermatitis and rhegmatogenous retinal detachments. These crescent-shaped retinal breaks may have been caused by ocular contusion.
Adolescent↗
Retinal detachments in patients with cytomegalovirus retinitis.
Retinal detachments are a recognized complication of cytomegalovirus retinitis. In a series of 145 patients with cytomegalovirus retinitis, 38 (26%) developed retinal detachments. The cumulative probability of a retinal detachment 1 year after the diagnosis of cytomegalovirus retinitis was 50%. Detachments were associated with increased size of the cytomegalovirus lesion and with lesions extending anteriorly up to the ora serrata. Treatment with an anticytomegalovirus drug appeared to delay the time to detachment. Median survival time after the diagnosis of retinal detachment was 9 months. In our study, vitrectomy with silicone oil as the initial surgical procedure was the most effective approach. Successful anatomic reattachment of the retina was achieved in 70% of patients undergoing this procedure. Despite the success of surgery, the visual outcome was disappointing, with only 20% of eyes achieving a final visual acuity of 5/200 or better.
Acquired Immunodeficiency Syndrome↗
Repair of retinal detachment caused by cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome.
Twenty-two eyes of 19 patients with the acquired immunodeficiency syndrome who had pars plana vitrectomy and silicone-oil injection after retinal detachment caused by cytomegalovirus retinitis were studied. All patients but one were monitored until time of death. The postoperative survival time and the factors that predicted anatomic success (retinal attachment) and functional success (visual acuity) were analyzed. No intraoperative complications were encountered. The mean survival time after surgery was four months. Of all of the preoperative and intraoperative factors studied, only the duration of cytomegalovirus retinitis was predictive of survival (P less than .03). The anatomic success rate was 89.5% (17 of 19 patients). None of the factors showed a trend or statistical significance in relation to anatomic success. Fifteen of 19 patients (79%) had lost at least two lines of Snellen visual acuity at time of death. Vision declined in a bimodal pattern (within the first postoperative month and after four months postoperatively). The optic nerve was pink and well perfused preoperatively in 16 of 19 patients (81.8%), but optic-nerve atrophy was observed postoperatively in 18 of 19 patients (95.5%). There was a trend for functional success to be influenced by increased intraocular pressure and optic-nerve atrophy, although our sample size was too small for statistical significance.
Acquired Immunodeficiency Syndrome↗
Localized retinal detachment with combined central retinal artery and vein occlusion after retrobulbar anesthesia.
The authors report a patient who was observed to have a localized retinal detachment with combined central retinal artery and vein occlusion after cataract surgery performed with retrobulbar anesthesia. The authors propose that this condition resulted from injection of the anesthetic mixture into the optic nerve. No acute neurologic symptoms occurred, but visual loss was severe and permanent. This case adds to the previously reported spectrum of complications from retrobulbar anesthesia.
Adult↗
Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaks.
AIM: The use of adjunctive scleral buckling during vitrectomy for retinal detachment associated with inferior breaks has been the recent focus of some debate. It has been suggested that any benefit might be outweighed by potential complications associated with buckling surgery. The purpose of this study was to compare the success rate of vitrectomy, gas, and supplementary scleral buckling with the results of two recently published case series suggesting that acceptable results in inferior break detachments can be achieved with vitrectomy and gas alone. METHODS: A retrospective analysis of 60 consecutive patients with inferior break retinal detachments was conducted. All patients underwent vitrectomy, gas, and scleral buckling. In all cases, fellow eyes were examined under anaesthesia for retinal breaks if posterior vitreous detachment (PVD) had occurred at the time of presentation. Demographics, preoperative, and postoperative complications and outcome were recorded. RESULTS: Primary retinal attachment at 3 months was achieved in 95% of patients. This exceeds success rates of published data of patients who underwent vitrectomy and gas without buckling (81-89%). In patients with PVD in the fellow eye, 53% had horseshoe tears and all were treated with cryopexy. No sight-threatening complications occurred, but five patients developed minor buckle-related complications postoperatively. CONCLUSION: Supplementary scleral buckling is a safe procedure that improves and enhances primary success rates in inferior break detachments over vitrectomy and gas without buckling. There is a high rate of PVD-related breaks requiring treatment in the fellow eyes.
Female↗
[Aphakic retinal detachment. III. Age of cataract extraction and retinal detachment, and interval between two events (author's transl)].
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Adult↗
Exudative retinal detachment following central and hemicentral retinal vein occlusions.
We describe five eyes of five patients that developed an exudative retinal detachment following a central retinal vein occlusion (including one eye with a hemicentral [hemispheric] retinal vein occlusion). The time interval between the occurrence of the vein occlusion and the appearance of the retinal detachment ranged from 7 to 36 weeks in the four cases seen in the acute period. Each detachment involved the posterior retina and was associated with the development of marked retinal ischemia. Neovascular glaucoma occurred in two cases. The subretinal fluid completely or partially resorbed in the four eyes that were treated with retinal photocoagulation, but the final visual acuity was poor in all cases. Exudative retinal detachment is a potential complication of central retinal vein occlusion and in this series was associated with a poor visual prognosis.
Adolescent↗