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Nichani PAH, Dhoot AS, Popovic MM, Eshtiaghi A, Mihalache A, Sayal AP, Yu HJ, Wykoff CC, Kertes PJ, Muni RH. Scleral Buckling Alone or in Combination with Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment Repair: A Meta-Analysis of 7212 Eyes. Ophthalmologica 2022; 245:296-314. [PMID: 35533652 DOI: 10.1159/000524888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/01/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The efficacy and safety of scleral buckling (SB) versus combination SB and pars plana vitrectomy (SB+PPV) for rhegmatogenous retinal detachment (RRD) repair remains unclear. METHODS A systematic review and meta-analysis was conducted to identify comparative studies published from Jan 2000-Jun 2021 that reported on the efficacy and/or safety following SB and SB+PPV for RRD repair. Final best-corrected visual acuity (BCVA) represented the primary endpoint, while reattachment rates and ocular adverse events were secondary endpoints. A random-effects meta-analysis was performed, and 95% confidence intervals were calculated. RESULTS Across 18 studies, 3912 SB and 3300 SB+PPV eyes were included. Final BCVA was non-significantly different between SB and SB+PPV (20/38 vs. 20/66 Snellen; WMD=-0.11 LogMAR; 95%CI [-0.29,0.07]; P=0.23). Primary reattachment rate was similar between procedures (P=0.74); however, SB alone achieved a significantly higher final reattachment rate (97.40% vs. 93.86%; RR=1.03; 95%CI [1.00,1.06]; P=0.04). Compared to SB+PPV, SB alone had a significantly lower risk of postoperative macular edema (RR=0.69; 95%CI [0.47,1.00]; P=0.05) and cataract formation (RR=0.34; 95%CI [0.12,0.96]; P=0.04). The incidence of macular hole, epiretinal membrane, residual subretinal fluid, proliferative vitreoretinopathy, elevated intraocular pressure, and extraocular muscle dysfunction were similar between SB and SB+PPV. CONCLUSIONS There was no significant difference in final BCVA between SB+PPV and SB alone in RRD. SB alone offers a slightly higher final reattachment rate along with a reduced risk of macular edema and cataract. Primary reattachment rate and the incidence of other complications were similar between the two procedures.
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Affiliation(s)
- Prem A H Nichani
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada,
| | - Arjan S Dhoot
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Arshia Eshtiaghi
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Aman P Sayal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Hannah J Yu
- Retina Consultants of Texas, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Charles C Wykoff
- Retina Consultants of Texas, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
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202
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Zubricky RD, Platt SM. Comparison of Face-down Positioning Durations Following Silicone Oil Tamponade. Ophthalmic Surg Lasers Imaging Retina 2022; 53:285-292. [PMID: 35575742 DOI: 10.3928/23258160-20220415-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To analyze the rate and timing of retinal redetachments and other complications following pars plana vitrectomy for retinal detachment repair with silicone oil tamponade and the effect of face-down positioning duration on these endpoints. MATERIALS AND METHODS A retrospective study was performed on patients with retinal detachment repair via pars plana vitrectomy with silicone oil tamponade between 2015 and 2020. Surgery was performed by 10 physicians associated with a private retina practice in Cleveland, Ohio. Duration of postoperative face-down positioning was noted and patients were grouped by short (≤6 days) or long (≥7 days) durations. Outcome variables were retinal re-detachment, epiretinal membrane formation, cataract formation, and other complications. Timing and frequency of outcomes were noted and statistical analysis was performed. RESULTS The study was composed of 227 eyes. The mean age of patients was 62.09±13.65 years with 143 (63.00%) male and 84 (37.00%) female. Of the initial detachments, 63 (27.88%) were macula-on and 163 (72.12%) were macula-off. Overall, 128 (56.39%) patients were given instructions for face-down positioning for 6 days or less and 99 (43.61%) patients for 7 days or more. Retinal redetachment was seen in 42.19% of patients with face-down positioning ≤6 days and 29.29% of patients with face-down positioning ≥7 days (P = .045). No significant difference was found in epiretinal membrane formation or cataract formation (P >.05). CONCLUSION There was a lower rate of redetachment in patients who kept a face-down position for ≥7 days compared with ≤6 days. Further study to determine causality between duration of postoperative face-down positioning and retinal redetachment is recommended. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:285-292.].
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Abstract
PURPOSE This is the first case series of two instances of retinal tears due to an injury sustained while playing pickleball. METHODS Case series. RESULTS A 66-year old white man presented with a symptomatic retinal tear, localized retinal detachment, and mild vitreous hemorrhage nine days after he was hit in his left eye while playing pickleball. The patient was not wearing eye protection while playing. The patient was treated with cryotherapy, and after three weeks, the vitreous hemorrhage and retinal detachment resolved. In addition, a 60-year-old woman presented with a posterior vitreous detachment and a symptomatic retinal tear 1 month after blunt trauma to her left eye from a pickleball injury. She underwent successful laser retinopexy treatment. CONCLUSION Proper eye protection should be strongly considered while playing pickleball, especially in the elderly population or in individuals who are at higher risk for retinal detachment.
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204
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Abstract
PURPOSE To describe the ocular findings in a patient with glycogen storage disease II (Pompe disease). METHODS Case report. RESULTS A 14-year-old boy with Pompe disease was referred for evaluation of a retinal detachment in the left eye. Indirect ophthalmoscopy revealed bilateral fibrotic snowbanks and an inferior rhegmatogenous retinal detachment extending into the macula. Fluorescein angiography revealed mild diffuse perivascular leakage in both eyes. The retinal detachment was repaired with scleral buckling and cryotherapy. Workup for the etiology of the intermediate uveitis was unrevealing. CONCLUSION Enzyme replacement therapy has improved the survival of individuals with Pompe disease. With greater patient longevity, new ocular associations may continue to emerge. Whether intermediate uveitis is an ocular association of Pompe disease remains to be determined.
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Affiliation(s)
- Akshay S Thomas
- Duke University Eye Center, Durham, North Carolina; and
- Tennessee Retina, Nashville, Tennessee
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205
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Stenz EC, Yu HJ, Shah AR, Wong TP, Major JC, Benz MS, Wykoff CC, Patel SB. Outcomes of Eyes Undergoing Multiple Surgical Interventions after Failure of Primary Rhegmatogenous Retinal Detachment Repair. Ophthalmol Retina 2022; 6:339-346. [PMID: 35074559 DOI: 10.1016/j.oret.2022.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE To assess outcomes among eyes undergoing surgery for recurrent rhegmatogenous retinal detachment (RRD) and investigate variables that correlate with visual and anatomic outcomes. DESIGN Retrospective, consecutive case series. PARTICIPANTS Eyes in which initial RRD repair failed that underwent ≥2 surgeries for RRD repair between January 1, 2016, and December 31, 2020. METHODS A retrospective analysis of eyes that underwent ≥2 RRD repairs. Eyes with etiologies of retinal detachment other than RRD, previous vitreoretinal surgery, and proliferative diabetic retinopathy were excluded. One-way analysis of variance with Tukey honestly significant difference testing and multivariate regression analyses were used to assess statistical significance. MAIN OUTCOME MEASURES Anatomic success rate and habitual best recorded visual acuity (VA) at postoperative time intervals and at final follow-up. RESULTS The single-operation success rate (SOSR) among eyes that underwent primary RRD repair over a 5-year period was 92.4% (2021 of 2187 eyes). The remaining 166 eyes (164 patients) in which primary RRD repair failed were included in this study. Although the anatomic success rates after the second and third RRD repairs were lower than the SOSR (71.7% and 68.1%, respectively), the final anatomic success rates did not significantly differ between eyes that underwent ≥2 RRD repairs (range, 90.6%-100%) (P > 0.05), and final anatomic success was achieved in 95.8% of the eyes. The average VA at both postoperative time intervals and final follow-up decreased with an increased total number of RRD repairs. Eyes that received silicone oil endotamponade during the second RRD repair were 20.3% (P = 0.03) and 38.4% (P = 0.04) less likely to require a third RRD repair compared with eyes that received octafluoropropane and sulfur hexafluoride gases, respectively. Eyes that developed a third RRD due to proliferative vitreoretinopathy (PVR) (n = 43) were 110% more likely to require a fourth RRD repair than eyes that developed a third RRD due to a new tear or failure to reattach (n = 4) (P = 0.04). CONCLUSIONS In this series, the rates of anatomic success appeared consistent after each surgery when multiple reoperations were required for RRD. The VA decreased with an increased total number of RRD repairs, and the endotamponade choice might have affected the risk of additional reoperations. Proliferative vitreoretinopathy was a significant prognostic factor for RRD recurrence.
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Affiliation(s)
- Emma C Stenz
- John P. and Kathrine G. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas; Retina Consultants of Texas, Retina Consultants of America, Houston, Texas
| | - Hannah J Yu
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas
| | - Ankoor R Shah
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Tien P Wong
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - James C Major
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Matthew S Benz
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Charles C Wykoff
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Sagar B Patel
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas.
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206
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Alotaibi MD, Albakri AS, Alsulaiman SM. Pediatric Retinal Detachment in Homozygous Protein C Deficiency: Genetic and Phenotypic Description of a Single Family. Ophthalmic Surg Lasers Imaging Retina 2022; 53:293-296. [PMID: 35575743 DOI: 10.3928/23258160-20220414-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Homozygous protein C deficiency is a rare hypercoagulability disorder. This study describes the ocular manifestations and the genetic background in a family with two affected children. This is a retrospective review of ophthalmic examinations, investigations, genetic testing, and blood work-up of two children with homozygous protein C deficiency from a single family. A family with a positive history of consanguineous marriage was found to have two affected children with homozygous protein C deficiency. Abnormal visual behavior was the presenting symptom. Both children had bilateral total tractional retinal detachments at presentation. Skin manifestations included episodes of discoloration and bruising. Laboratory work-up revealed absent protein C activity. Genetic testing confirmed the presence of a homozygous pathogenic mutation in protein C gene (NM_000312.3: c.1297G>A: p.Gly433Ser). Homozygous protein C deficiency should be considered in the differential diagnosis of early-onset tractional retinal detachment in infancy. Although rare, the ophthalmologist may be the first to encounter the condition, and treatment with protein C replacement or anticoagulants may be life-saving. Examination under anesthesia with fluorescein angiography and laser treatment early in life may be warranted to preserve vision. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:293-296.].
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207
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Csaky KG, Christie AH. ANATOMIC AND FUNCTIONAL IMPROVEMENT OF A DRUSENOID PIGMENT EPITHELIAL DETACHMENT: A CASE REPORT. Retin Cases Brief Rep 2022; 16:318-321. [PMID: 31958105 PMCID: PMC9022689 DOI: 10.1097/icb.0000000000000964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/PURPOSE Age-related macular degeneration is the most prevalent cause of permanent vision loss in the developed world. Drusenoid pigment epithelial detachments are a biomarker of age-related macular degeneration disease progression and typically result in poor visual prognosis. Low luminance visual acuity (LLVA) has been previously been shown to correlate with the severity of age-related macular degeneration. However, the degree of spontaneous improvement of this functional outcome is still under investigation. METHODS Observational clinical case report. RESULTS A drusenoid pigment epithelial detachment that increased in size with the development of hyperreflective foci spontaneously improved with restoration of normal foveal contour over the span of 41 months without progression to geographic atrophy or choroidal neovascularization. Although best-corrected visual acuity remained stable both before and after the pigment epithelial detachment resolution, low luminance visual acuity decreased from a baseline of 59 (20/63 -1) to 39 (20/160 -1) letters over 17 months. However, over the subsequent 24 months, low luminance visual acuity improved by 35 letters to 74 letters (20/32 -2). CONCLUSION Drusenoid pigment epithelial detachments can resolve without treatment. Low luminance visual acuity seems to correlate with the anatomic improvement and can improve spontaneously by more than six lines of vision.
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208
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Abstract
PURPOSE To illustrate with multimodal imaging a case of HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) complicated by bilateral multifocal serous retinal detachments, subretinal exudation, and papilledema. METHODS Case report. Fundus photography, spectral domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography were performed at presentation and the day after. We also present the SD-OCT follow-up at 8 days, 1 year, and 4 years. RESULTS A 25-year-old 5-month-pregnant Guinean woman complained about decreased visual acuity in the right eye. Eye fundus and multimodal imaging were abnormal in both eyes. Spectral domain optical coherence tomography showed the presence of multifocal serous retinal detachments, subretinal deposits, and intraretinal cysts. Indocyanin green angiography revealed an irregular choroidal perfusion and localized choroidal ischemia. Spectral domain optical coherence tomography also provided assessment of retinal changes during the long-term follow-up, showing tissue damage in the outer retina. CONCLUSION Serous retinal detachments during pregnancy can be the leading sign of HELLP syndrome-a potentially life-threatening condition. Spectral domain optical coherence tomography is a noninvasive and useful tool for its diagnosis and follow-up. ICG is important to confirm the choroidal ischemia and choroidal vascular abnormalities, underlying conditions leading to main sign of HELLP syndrome in the eye.
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209
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Wang JC, Qian CX, Comander JI. Repair of Rhegmatogenous Retinal Detachment in Choroideremia Secondary to Posterior Extramacular Retinal Hole. Ophthalmic Surg Lasers Imaging Retina 2022; 53:182-184. [PMID: 35417295 DOI: 10.3928/23258160-20220311-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Rhegmatogenous retinal detachment in choroideremia is a rare occurrence. The authors present a case of a 23-year-old man with choroideremia with a near-total rhegmatogenous retinal detachment. Fundus examination did not reveal any retinal breaks, but extensive preoperative optical coherence tomography detected a small posterior hole along the superior arcades. The retinal detachment was successfully managed with vitrectomy, perfluorooctane to confirm the absence of any peripheral breaks, endolaser, and 20% sulfur hexafluoride gas. Similar extramacular holes were found in the patient's other eye. Patients with choroideremia may develop posterior retinal breaks leading to retinal detachment.
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210
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Traboulsi EI. Preventing Retinal Detachment in Patients with Stickler Syndrome: The Effects of Preemptive Laser Photocoagulation. Ophthalmol Retina 2022; 6:261-262. [PMID: 35393073 DOI: 10.1016/j.oret.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
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211
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Ong SS, Ahmed I, Gonzales A, Al-Fakhri AS, Al-Subaie HF, Al-Qhatani FS, Alsulaiman SM, Mura M, Maia M, Kondo Kuroiwa DA, Maia NT, Berrocal MH, Wu L, Zas M, Francos JP, Cubero-Parra JM, Arsiwala LT, Handa JT, Arevalo JF. Vitrectomy versus Vitrectomy with Scleral Buckling in the Treatment of Giant Retinal Tear Related Retinal Detachments: An International Multicenter Study. Ophthalmol Retina 2022; 6:595-606. [PMID: 35304304 DOI: 10.1016/j.oret.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/26/2022] [Accepted: 03/09/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine the practice pattern for treating giant retinal tear (GRT) related detachments, and their anatomic and visual outcomes with pars plana vitrectomy (PPV) with or without scleral buckling (SB). DESIGN Retrospective cohort study. SUBJECTS Eyes with GRT detachments repaired from 2008-2020 with at least 6 months of follow-up from seven institutions in North and South America, Europe, and Asia. METHODS Eyes repaired using PPV versus PPV/SB were compared. MAIN OUTCOME MEASURES Anatomic and functional outcomes. RESULTS A comparable number of eyes underwent PPV (n=101) and PPV/SB (n=99). Except for prior intraocular surgery and lens status, no differences in baseline demographics, ocular characteristics, or intraoperative surgical adjuncts were observed. Overall single surgery anatomic success (SSAS) at 6 months and 1 year was similar between the groups (82.2% and 77.2% of PPV, and 87.9% and 85.7% of PPV/SB). However, when stratified by age, the 1-year SSAS rate was higher for PPV/SB (88.5%) than PPV (56.3%) (p=0.03) for children < 18 years. For both children and adults, mean best corrected visual acuity (BCVA) at baseline did not differ between the PPV and PPV/SB groups. However, for children, mean BCVA at 1 year was better in the PPV/SB than PPV groups (p=0.001) while for adults, no difference was found between the two groups. The mean time to first redetachment was 7.9 months in the PPV group and 5.5 months in the PPV/SB group (p=0.8). PVR was the most common cause for redetachment (70.4% of PPV and 93.8% of PPV/SB in redetached eyes; p=0.1). Postoperative complications were also similar between the two groups including ocular hypertension, epiretinal membrane, and cataract. CONCLUSIONS PPV and PPV/SB are equally popular among surgeons globally for managing GRT detachments and have comparable anatomic and visual outcomes in adults. In children, PPV/SB is superior to PPV for anatomic and functional success at one year. In adults, the relief of traction by the GRT may reduce peripheral traction and obviate the need for a SB. However, in children, a supplemental SB can be beneficial as complete vitreous shaving and posterior hyaloid detachment, and postoperative positioning are difficult in this group.
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Affiliation(s)
- Sally S Ong
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Ishrat Ahmed
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Anthony Gonzales
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Hamad F Al-Subaie
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Faisal S Al-Qhatani
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Marco Mura
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Mauricio Maia
- Vitreoretinal Surgery, Federal University of Sao Paulo, Brazil
| | | | | | | | - Lihteh Wu
- Asociados de Macula, Vitreo y Retina de Costa Rica, San Jose, Costa Rica
| | - Marcelo Zas
- Sección Retina, Hospital de Clínicas de la Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Juan Pablo Francos
- Sección Retina, Hospital de Clínicas de la Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Lubaina T Arsiwala
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland; Wilmer Biostatistics Center, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
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DeSouza PJ, Greven CM. REPAIR OF COMBINED TRACTION-RHEGMATOGENOUS RETINAL DETACHMENT AFTER CRYOABLATION OF A RETINAL CAPILLARY HEMANGIOBLASTOMA. Retin Cases Brief Rep 2022; 16:149-152. [PMID: 31842046 PMCID: PMC8860197 DOI: 10.1097/icb.0000000000000953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe a case of surgical repair of a total, combined traction-rhegmatogenous, retinal detachment with proliferative vitreoretinopathy after cryoablation of a retinal capillary hemangioblastoma. METHODS A case of a 47-year-old man presenting with a solitary, superotemporal retinal capillary hemangioblastoma in the right eye with serous retinal detachment and subfoveal fluid and exudates is reported. The hemangioblastoma was treated with cryoablation, but despite regression of the lesion, the patient developed a total combined traction-rhegmatogenous retinal detachment 6 weeks later. Vitrectomy, endolaser photocoagulation to tears adjacent to the original hemangioblastoma lesion, and silicone oil exchange was performed to repair the detachment. RESULTS Eighteen months after initial repair, the patient had silicone oil removal and cataract extraction with lens implantation. Final visual acuity improved from counting fingers to 20/50 with total retinal reattachment and regression of the retinal capillary hemangioblastoma. CONCLUSION Although uncommon, combined traction-rhegmatogenous retinal detachment can occur after cryoablation of a retinal capillary hemangioblastoma.
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Affiliation(s)
- Philip J DeSouza
- Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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213
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Liao A, Barnett J, Rehman I, Hamm D, Cribbs BE, Hendrick AM, Jain N, Yeh S, Hubbard GB, Yan J. Surgical Outcomes of Progressive Retinoschisis-Related Retinal Detachments: A 17-Year Survey From a Large Academic Center. Ophthalmic Surg Lasers Imaging Retina 2022; 53:132-138. [PMID: 35272560 DOI: 10.3928/23258160-20220211-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To provide an overview of progressive retinoschisis-related retinal detachment (RSRD) management at a tertiary referral center. MATERIALS AND METHODS Single-institution retrospective case series from January 1, 2003, to May 1, 2020. RESULTS Progressive RSRD occurred in 0.9% of patients with retinoschisis. Mean (range) age at time of surgery was 58.7 years (40.0 to 74.0). Ten eyes were initially treated with scleral buckle, three eyes with vitrectomy, and three eyes with combined scleral buckle and vitrectomy. Overall reattachment rate was 100.0%; single-surgery success was 56.2%. Proliferative vitreoretinopathy developed in 10.0% of scleral buckles, 33.3% of vitrectomies, and 33.3% of combined surgeries. CONCLUSIONS Progressive RSRD is rare and poses surgical management challenges. Final retinal attachment can be achieved successfully but often requires secondary and staged surgeries. Localization of outer retinal breaks may help guide surgical management. Further research-such as a large-scale, prospective, multicenter, randomized trial-would be needed to determine the optimal surgical technique. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:132-138.].
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214
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Abdelhakim AH, Sebrow D, Bearelly S, Horowitz JD, Chen RWS. IPSILATERAL BULLOUS EXUDATIVE RETINAL DETACHMENT ASSOCIATED WITH EXTRACORPOREAL MEMBRANE OXYGENATION. Retin Cases Brief Rep 2022; 16:246-252. [PMID: 31800505 DOI: 10.1097/icb.0000000000000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE To describe the first known case of an extracorporeal membrane oxygenation (ECMO)-related complication in an adult. METHODS Case report. RESULTS A 34-year-old man awaiting a lung transplant for interstitial lung disease was connected to an ECMO circuit as a bridge to lung transplant, with a drainage catheter attached to his right internal jugular vein. Shortly after he was cannulated, he developed blurred vision in his right eye and was found to have a progressively worsening bullous exudative retinal detachment. After receiving a lung transplant and getting decannulated from ECMO, his bullous detachment rapidly improved. The patient's clinical course as well as his ophthalmic testing showed findings inconsistent with alternative diagnoses such as central serous chorioretinopathy. His findings were best explained as a complication of ECMO cannulation. CONCLUSION Extracorporeal membrane oxygenation may be associated with bullous exudative retinal detachment in rare cases where there is a possible anatomical or physiological predisposition.
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Affiliation(s)
- Aliaa H Abdelhakim
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Medical Center, New York, New York; and
- New York-Presbyterian Hospital Columbia Campus, New York, New York
| | - Dov Sebrow
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Medical Center, New York, New York; and
| | - Srilaxmi Bearelly
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Medical Center, New York, New York; and
| | - Jason D Horowitz
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Medical Center, New York, New York; and
| | - Royce W S Chen
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Medical Center, New York, New York; and
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Hamichi SE, Saigal K, Anzaldo EF, Gold A, Berrocal AM, Murray TG. Sequential Short Interval Anti-VEGF for the Treatment of Stage 4 Retinopathy of Prematurity. Ophthalmic Surg Lasers Imaging Retina 2022; 53:159-163. [PMID: 35272561 DOI: 10.3928/23258160-20220211-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 23-month-old girl born at 23 weeks' gestational age with a birth weight of 453 g and retinopathy of prematurity (ROP) stage 4A in 360° and plus disease in both eyes was treated in another institution with laser; her treatment was complicated with two cardiac arrests during the procedure. The patient was referred and treated at 31 weeks with repeated intravitreal bevacizumab injection in both eyes secondary to progressive ROP. Treatment with multiple anti-vascular endothelial growth factor (VEGF) therapy as monotherapy led to the resolution of a retinal detachment and full vascularization of the retina in both eyes. To the best of the authors' knowledge, this is the first description of a patient with stage 4A ROP treated solely with anti-VEGF after failed laser treatment that led to complete resolution of a retinal detachment without surgical intervention. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:159-163.].
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216
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Guo Y, Guo Y, Gu R, Yang Q, Zhu K, Shu Q, Gan D. Characteristics and visual prognosis of pediatric open globe injury in Shanghai, China. Ophthalmic Res 2022; 65:328-334. [PMID: 35231917 DOI: 10.1159/000523814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 02/17/2022] [Indexed: 11/19/2022]
Abstract
Introduction To describe the characteristics of open globe injury and the relationship between the complications and visual outcomes in children with this type of injury. Methods This was a retrospective chart review of 1664 children, under the age of 16 years, who were hospitalized for open globe injury between January 1, 2007, and December 31, 2015. Each patient's age, sex, cause and agent of injury, complications, visual acuity, and classification of ocular trauma were collected for review and analysis. Results The mean age was 5.6 ± 3.4 years. Right eyes were particularly vulnerable to injury (right eye:left eye ratio = 1.2:1). Traumatic cataract was the most common complication. The average initial and final best-corrected visual acuity (BCVA) were logMAR 2.04 ± 0.78 and logMAR 1.74 ± 0.88, respectively. Logistic regression analysis showed that hyphema (OR = 1.850), iris prolapse (OR = 1.702), vitreous hemorrhage (OR = 9.703), retinal detachment (OR = 11.938), endophthalmia (OR = 5.377), intraocular foreign body (OR = 3.346), and initial visual acuity < 0.05 (OR = 9.017) were risk factors for visual acuity < 0.05 at hospital discharge. Conclusion Open globe injury was most frequent in preschool children and boys. Right eyes were more vulnerable than left eyes. Poor visual outcomes were associated with hyphema, iris prolapse, vitreous hemorrhage, retinal detachment, endophthalmia, intraocular foreign body, and an initial visual acuity < 0.05.
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Affiliation(s)
- Yue Guo
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China,
| | - Yu Guo
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Ruiping Gu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Qian Yang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Ke Zhu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Qinmeng Shu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Dekang Gan
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key Laboratory of Myopia of State Health Ministry, Shanghai, China
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217
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Markan A, Ayyadurai N, Singh SR, Katoch D. Intraoperative haemorrhagic choroidal detachment during MicroIncision Vitrectomy Surgery (MIVS): a unique mechanism. BMJ Case Rep 2022; 15:e245307. [PMID: 35217551 PMCID: PMC8883204 DOI: 10.1136/bcr-2021-245307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/03/2022] Open
Abstract
Haemorrhagic choroidal detachment (HCD) is a dreaded intraoperative complication of ophthalmic surgery, despite being rare. Multiple systemic and ocular risk factors of HCD have been reported. Acute hypotony during surgery is considered one of the most important precipitating factors. We herein describe a series of events during pars plana vitrectomy surgery for management of rhegmatogeneous retinal detachment which lead to localised HCD. We believe that the pathogenesis of localised HCD is related to compressive decompressive forces during the final tie of the encircling element after fluid air exchange.
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Affiliation(s)
- Ashish Markan
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Nikitha Ayyadurai
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Simar Rajan Singh
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Deeksha Katoch
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
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218
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Kang MJ, Hwang JH, Lee JH, Sim HE, Oh WH. Massive Serous Retinal Detachment and Acute Intraoperative Rock-hard Eye Syndrome after Cataract Surgery: A Case Report. Korean J Ophthalmol 2022; 36:83-85. [PMID: 35172084 PMCID: PMC8849994 DOI: 10.3341/kjo.2021.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Min-Ji Kang
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Je Hyung Hwang
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jee Hye Lee
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ha Eun Sim
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Won Hyuk Oh
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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219
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Moussa G, Mathews N, Makhzoum O, Park DY. Retinal Detachment Repair With Vitrectomy: Air Tamponade Integration to a Vitreoretinal Service, Comparison With Gas Tamponade, and Literature Review. Ophthalmic Surg Lasers Imaging Retina 2022; 53:87-95. [PMID: 35148215 DOI: 10.3928/23258160-20220121-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Rhegmatogenous retinal detachment (RRD) repair by pars plana vitrectomy and gas tamponade (GT) has significant clinical and quality-of-life impacts compared with repair by short-acting air tamponade (AT). With AT, most authors minimize cryotherapy because of prolonged chorioretinal scar formation and use perfluorocarbon to maximize subretinal fluid drainage; this deviates from traditional technique, which discourages popularization of AT. PATIENTS AND METHODS Prospective 12-month study from January to December 2019 of all primary macula-on RRD cases. Patients fulfilling the inclusion criteria for the Pneumatic Retinopexy Versus Vitrectomy for Retinal Detachment Trial received AT and otherwise were assigned to receive GT. RESULTS Forty-six patients were enrolled: 22 (48%) receiving AT and 24 (52%) receiving GT. The primary success rate of AT was 21 (95%) and the primary success rate of GT was 23 (96%), with 100% final success. Cryopexy was used in 64% of AT cases and 58% of GT cases. Cataract surgery was required less when AT was used (1 [6%]) than when GT was used (3 [21%]). AT was used in 48% of primary macula-on RRD and 27% of all primary RRD cases. CONCLUSIONS AT has visual and anatomical outcomes comparable to those of GT with conventional vitrectomy techniques, with faster postoperative rehabilitation enabling a swift return to normal daily activities. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:87-95.].
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220
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Khanna S, Mackin AG, Dao DT, Komati R, Morocco PC, LaBelle JL, Shah HA, Blair MP. Exudative Retinal Detachment Following Chimeric Antigen Receptor T-Cell Therapy in Relapsed B-Cell Acute Lymphoblastic Leukemia. Ophthalmic Surg Lasers Imaging Retina 2022; 53:113-115. [PMID: 35148216 DOI: 10.3928/23258160-20220124-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Chimeric antigen receptor (CAR) T-cell therapy has become a novel approach in the treatment of many hematologic malignancies. However, ocular adverse effects have not been well described. This report presents a case of a pediatric patient with relapsed B-cell acute lymphoblastic leukemia with ocular involvement treated with CAR T-cell therapy who developed an exudative retinal detachment likely secondary to an inflammatory response to CAR T-cell therapy. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:113-115.].
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Abstract
PURPOSE To evaluate retrospectively if scleral buckling combined or not to cryopexy reduces fellow-eye retinal detachment (RD) in Stickler syndrome patients who lost their first eye due to RD. METHODS Retrospective review of 52 Stickler syndrome patients who received a 6-mm wide, 360° encircling scleral buckling. Thirty-nine (75%; Cryo + Group) also received cryo treatment, whereas the reminder 13/52 (25% Cryo - Group) did not. RESULTS Average follow-up was 15.6 ± 2.41 years. Five patients (5/52; 9.6%) developed a retinal detachment 2.6 ± 0.55 years after prophylactic treatment, respectively, 0/39 patients in the Cryo + Group and 5/13 in the Cryo - Group (P < 0.001). All five RD eyes were successfully reattached through revised episcleral surgery and adjunctive cryo treatment. Postop refraction changed an average -1.9 ± 0.74 diopters and best corrected visual acuity at the end of follow-up was 20/25 (0.1 ± 0.07 logarithm of the minimum angle of resolution), not significantly different from the rest of sample population who did not develop RD in their fellow eye. CONCLUSION Cryopexy significantly reduced the risk of RD in Stickler syndrome patients undergoing scleral buckling. If RD ensues, the presence of scleral buckling may ease surgical repair and improve final outcome.
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Affiliation(s)
| | - Tommaso Rossi
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | | | - Mario Stirpe
- IRCCS Fondazione G.B. Bietti ONLUS Rome, Italy; and
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222
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Sánchez Zamora P, Mejía Arnaud RA, Saz Castro R, Gómez Del Pulgar Vázquez B, Correa Barrera JJ. Bilateral serous retinal detachment in a patient with atypical presentation of preeclampsia due to HELLP syndrome. Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:114-118. [PMID: 35177366 DOI: 10.1016/j.redare.2020.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/24/2020] [Indexed: 06/14/2023]
Abstract
Exudative retinal detachment (ERD) is a rare complication that occurring in 1% of patients with preeclampsia, its incidence is increased when it is associated with HELLP syndrome. Preeclampsia is defined by the development of arterial hypertension and proteinuira occurs after 20 weeks of gestation until postpartum. HELLP syndrome (low platelets, hemolysis and elevated liver enzymes) is a severe form of preeclampsia. ERD in preeclampsia is related to choroidal ischaemia, in the vast majority of the cases associated with hypertensive retinopathy. However, it has been proposed that the combination of hypertension with a microangiopathic hemolysis, hipercoagulability and hypoalbuminemia are the main factors contributing to the development of ERD. Its treatment includes a rapid resolution of labor to reverse ocular manifestations and prevent visual sequels. We describe the case of a pregnant woman with atypical preeclampsia who, in the postpartum of a cesarean, presented an ERD concomitantly with a HELLP syndrome.
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Affiliation(s)
- P Sánchez Zamora
- Servicio de Anestesiología y Reanimación, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain.
| | - R A Mejía Arnaud
- Servicio de Anestesiología y Reanimación, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - R Saz Castro
- Servicio de Anestesiología y Reanimación, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | | | - J J Correa Barrera
- Servicio de Anestesiología y Reanimación, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
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223
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Russell JF. Whitish Outer Retinal Spots in Retinal Detachment: Longitudinal Follow-up, Multimodal Imaging, and Clinical Utility. Ophthalmol Retina 2022; 6:469-477. [PMID: 35114413 DOI: 10.1016/j.oret.2022.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To characterize the poorly understood phenomenon of whitish outer retinal spots that occasionally appear in retinal detachment (RD) DESIGN: Retrospective, consecutive case series SUBJECTS: Patients with RDs that had ophthalmoscopically-visible whitish outer retinal spots METHODS: All RDs with whitish outer retinal spots identified by one examiner over a 4-year interval were identified, and records were retrospectively reviewed. MAIN OUTCOME MEASURES Clinical and surgical observations, photography, and OCT RESULTS: Whitish outer retinal spots were visualized in 51 occurrences of RD: 45 in rhegmatogenous RDs (RRDs), 5 in tractional RDs (TRDs), and 1 in exudative RD (ERD). In RRDs the spots usually formed an arcuate band located between the causative retinal break and attached retina. However, 6 RRDs had spots located between a peripheral gutter of subretinal fluid (SRF) and attached retina. In 11 eyes, the spots were observed to appear over time and/or propagate to areas of detached retina more distal to the break. The spots corresponded to hyperreflective foci in the ellipsoid/interdigitation layers on OCT. The spots were isofluorescent on fluorescein angiography. The average duration of symptoms prior to surgical repair was 27.7 days. In 7 of 23 eyes surgically repaired by the author, the distribution of the spots assisted in localizing an occult retinal break. The spots sometimes appeared or persisted in areas of residual SRF but invariably resolved after retinal reattachment. CONCLUSIONS Whitish outer retinal spots can occur in all types of RD, not just RRDs. Observation of the spots can help to date an RD as subacute and should prompt surgery. Because the spots occur in distributions that reflect the path of spread of subretinal fluid, their position can be used to localize causative retinal breaks.
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Affiliation(s)
- Jonathan F Russell
- Institute for Vision Research and Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
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224
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Bavinger JC, Anthony CL, Lindeke-Myers AT, Lynch S, Xu LT, Barnett J, Levine D, Patel P, Shah R, Jain N, Rao P, Hendrick A, Cribbs BE, Yan J, Hubbard GB, Shantha JG, O'Keefe GD, Yeh S. Risk Factors for Retinal Detachment in Acute Retinal Necrosis. Ophthalmol Retina 2022; 6:478-483. [PMID: 35114414 DOI: 10.1016/j.oret.2022.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/13/2022] [Accepted: 01/24/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Retinal detachment (RD) is associated with poor visual outcome in patients with acute retinal necrosis (ARN). This research was undertaken to assess risk factors for RD in ARN. DESIGN Retrospective cohort study SUBJECTS: Patients diagnosed with ARN at a tertiary referral center from 2010-2020. METHODS Chart review was performed for all clinical and surgical encounters. Univariate and multivariate logistic analysis of demographic and clinical variables associated with RD was performed. Survival analysis with Kaplan-Meier estimates were performed to compare time to RD in HSV- and VZV-associated ARN. MAIN OUTCOME MEASURES Demographic information, clinical information including visual acuity, intraocular pressure (IOP), intraocular inflammation level, extent of retinitis, incidence and timing of retinal detachment, date of diagnosis, and treatments performed including intravitreal injections of antiviral medications. RESULTS Fifty-four eyes of 47 patients who were diagnosed with ARN were included with equal proportions of eyes (27, 50%) with VZV-ARN and HSV-ARN. Subjects with VZV-ARN were on average older, more likely to be male, and more likely to be immunosuppressed compared with subjects with HSV-ARN. Clinical characteristics were similar between eyes with VZV- and HSV-ARN, including initial visual acuity (VA), initial IOP, anterior segment inflammation, clock hours and posterior extent of retinitis. In univariate analysis of clinical and demographic variables associated with development of RD, initial VA (p = 0.0083) and greater clock hours of retinitis (p = 0.009) were significantly associated with RD. These two variables remained significant in multivariate logistic regression; worse VA at presentation had an odds ratio of 2.34 (95% CI: 1.01 - 5.44) (p = 0.042) and greater clock hours of retinitis had an odds ratio of 1.23 (95% CI: 1.02 - 1.47) (p = 0.025). Kaplan Meier survival analysis demonstrated no statistical difference in RD-free survival between HSV- and VZV-ARN. CONCLUSION Patients with VZV-ARN were more likely to be older, male, and immunosuppressed compared to HSV-ARN although no clear difference was observed in RD by viral etiology. Poor initial VA and clock-hours of retinitis were significantly associated with RD development and may be relevant for patient counseling and prognosis.
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Affiliation(s)
- J Clay Bavinger
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Casey L Anthony
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | | | - Stephanie Lynch
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Lucy T Xu
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Joshua Barnett
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - David Levine
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Purnima Patel
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Rachel Shah
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Nieraj Jain
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Prethy Rao
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Andrew Hendrick
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Blaine E Cribbs
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Jiong Yan
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - G Baker Hubbard
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Jessica G Shantha
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Ghazala D O'Keefe
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
| | - Steven Yeh
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia; Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska.
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225
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Lee CY, Chen HC, Huang JY, Lai CC, Yang SF, Wu WC. Elevated risk of mood disorders after the occurrence of recurrent retinal detachment: a population-based cohort study. Ophthalmologica 2022; 245:249-257. [PMID: 35026763 DOI: 10.1159/000521290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To investigate the risk of mood disorders in patients who experienced retinal detachment (RD) by using the National Health Insurance Research Database in Taiwan. METHODS Participants with a diagnosis of RD were regarded as the study group, and an age- and sex-matched group without a diagnosis of RD served as the control group. The outcomes related to mood disorders after RD included (1) psychiatric outpatient department visits; (2) behavioural therapy; (3) sleep or anxiety-related disorders; and (4) major depressive disorder (MDD). RESULTS A total of 4,129 participants diagnosed with RD and 16,516 non-RD individuals were enrolled in the study. There were no significant differences in the four mood disorder-related outcomes between the study and control groups. However, the patients with recurrent RD who received more than two treatments and female patients with RD who needed surgical treatment showed a higher probability of developing MDD than did the non-RD subjects (incidence rate: 0.96 versus 0.36; adjusted hazard ratio (aHR): 2.382, 95% CI: 1.032-5.496, log-rank P= 0.0325; and aHR: 6.895, 95% CI: 1.659-28.656, log-rank P= 0.0060, respectively). CONCLUSION Patients with recurrent RD and multiple surgeries and females with RD who needed surgical treatment were at greater risk for developing MDD.
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Affiliation(s)
- Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chi-Chun Lai
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shun-Fa Yang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
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226
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Hermoso-Fernández FM, Gonzalez-Gallardo C, Cruz-Rojo M. Retinal detachment in UGH Syndrome after cataract surgery. Rom J Ophthalmol 2022; 65:395-398. [PMID: 35087984 PMCID: PMC8764433 DOI: 10.22336/rjo.2021.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose: To report a case of retinal detachment (RD) in a UGH Syndrome after cataract surgery and to emphasize special aspects of the management, along with factors that must be considered. Methods: We present the case of a 56-year-old man who underwent cataract surgery with a capsulorhexis leak, but the implantation of the lens in the sac did not hinder. 8 months after surgery, he presented several episodes of hypertensive uveitis that produced a progression in the excavation of the optic nerve head from 3/10 to 9/10 despite the treatment with ocular hypotensive drugs. He went to the emergency department due to sudden loss of vision during which a complete hemovitreous with a zone of transillumination and atrophy of the temporal sector of the iris were observed. Echo-B showed inferior retinal detachment. The apposition of the intraocular lens over the temporal region of the iris was observed in anterior segment OCT. Scleral band pars plana vitrectomy surgery was performed. Results: Currently, the VA RE was 6/10 with controlled IOP without the need for treatment, the excavation was 9/10 and it preserved an island of inferior paracentral vision in the perimetry. Vitrectomy favored the posterior displacement of the lens, avoiding friction of the iris, thus eliminating outbreaks of hypertensive uveitis. Conclusions: It is important to be aware of the mechanisms of uveitis-glaucoma-hyphema (UGH) syndrome. It is necessary to identify postoperative signs to make a diagnosis as soon as possible. It is time to consider that UGH syndrome can be caused by any type of pseudophakic lens.
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Affiliation(s)
| | | | - María Cruz-Rojo
- Department of Ophthalmology, San Cecilio University Hospital, Granada, Spain
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227
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Erol MK, Bozdogan YC, Suren E, Gedik B. Treatment of a full-thickness macular hole and retinal detachment secondary to toxoplasma chorioretinitis that developed shortly after COVID-19: A case report. J Fr Ophtalmol 2022; 45:446-451. [PMID: 35034856 PMCID: PMC8733215 DOI: 10.1016/j.jfo.2021.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/14/2021] [Accepted: 12/23/2021] [Indexed: 11/19/2022]
Abstract
Although ocular toxoplasmosis is usually a self-limiting infection, it can lead to severe reduction in visual acuity due to intense vitreous inflammation or involvement of posterior segment structures. Depending on the severity of intraocular inflammation, serious complications, including epiretinal membrane or retinal detachment may develop. In this paper, we aim to present a case that complicated by both a full-thickness macular hole and retinal detachment secondary to toxoplasmosis chorioretinitis that developed shortly after the novel coronavirus disease (COVID-19) and discuss our treatment approach. After the patient was diagnosed based on a routine ophthalmological examination, fundus imaging, and serological examination, functional and anatomical recovery was achieved through systemic antibiotherapy and vitreoretinal surgery. Full-thickness macular hole and retinal detachment are rare complications of ocular toxoplasmosis. However, there are only few publications in the literature concerning these complications and their surgical treatment. In this case report, we demonstrated the success of vitreoretinal surgery combined with antibiotic therapy on the posterior segment complications of ocular toxoplasmosis.
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Affiliation(s)
- M K Erol
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - Y C Bozdogan
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey.
| | - E Suren
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - B Gedik
- Serik State Hospital, Antalya, Turkey
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228
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Malyugin BE, Sobolev NP, Shkvorchenko DO, Fomina OV, Lanevskaya NI, Obraztsova MR. [Outcomes of surgical treatment of rhegmatogenous retinal detachment after phaco surgery and implantation of a trifocal intraocular lens in patients with myopia (clinical observations)]. Vestn Oftalmol 2022; 138:73-81. [PMID: 35801884 DOI: 10.17116/oftalma202213803173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To analyze visual functions in moderate and high myopic patients with retinal detachment that developed after implantation of a trifocal intraocular lens (IOL). MATERIAL AND METHODS The study analyzed the functional outcomes achieved in 3 patients (4 eyes) with retinal detachment developed after implantation of AcrySof IQ PanOptix («Alcon», USA) and AT LISA tri 839 MP («Carl Zeiss Meditec», Germany) during the follow-up period of 24 months. Patient examination included measurements of visual acuity at far (4 and 5 m), near (40 cm) and intermediate distances (60 cm, 80 cm), spatial contrast sensitivity, spherical equivalent of refraction, and a survey of patients for subjective satisfaction of the obtained vision. RESULTS In four eyes of three patients with moderate and high myopia, rhegmatogenous retinal detachment was diagnosed during the follow-up period at 4 to 12 months after phacoemulsification of cataract with trifocal IOL implantation. The best visual indicators were found in patient N. as a result of surgical treatment of bilateral rhegmatogenous retinal detachment due to high myopia: visual acuity (VA) at far distance was 1.0 for each eye (with 100 points on the VF-14 questionnaire). In patients P. and M., after the development of unilateral rhegmatogenous retinal detachment, complete retinal reattachment was achieved after surgery with VA at far distance 0.55 (OS) in patient P. and 0.4 (OD) in patient M. (95 and 86 points on VF-14, respectively). CONCLUSION Good visual functions were achieved in three patients with trifocal IOL after surgical treatment of the rhegmatogenous retinal detachment that developed due to myopia. The implanted trifocal IOL did not affect the effectiveness of vitrectomy. After the treatment patients retained the ability to see at different distances.
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Affiliation(s)
- B E Malyugin
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - N P Sobolev
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - D O Shkvorchenko
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - O V Fomina
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - N I Lanevskaya
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - M R Obraztsova
- S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
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Huang L, Liang T, Lyu J, Jin H, Zhao P. CLINICAL FEATURES AND SURGICAL OUTCOMES OF ENCIRCLING SCLERAL BUCKLING WITH CRYOTHERAPY IN FAMILIAL EXUDATIVE VITREORETINOPATHY-ASSOCIATED RHEGMATOGENOUS RETINAL DETACHMENT. Retina 2022; 42:55-63. [PMID: 34393211 DOI: 10.1097/iae.0000000000003280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the clinical features and surgical outcomes of encircling scleral buckling surgery with cryotherapy in familial exudative vitreoretinopathy (FEVR) patients with rhegmatogenous RD. METHODS This study was a consecutive, retrospective interventional case series. Clinical features, including the FEVR stage, proliferative vitreoretinopathy grade, range of RD and degeneration, and presence of retinal breaks, and surgical outcomes, including the success rate, best-corrected visual acuity, and myopic shift, were analyzed. RESULTS There were 16 eyes with Stage 3A FEVR and eight eyes with Stage 4A FEVR. 13 eyes had Grade A proliferative vitreoretinopathy, and 11 eyes had Grade B proliferative vitreoretinopathy. Retinal reattachment was achieved in 22 of 24 eyes (91.67%) with FEVR-rhegmatogenous RD after initial encircling scleral buckling surgery. The best-corrected visual acuity improved from a mean of 1.08 ± 0.86 logarithm of the minimum angle of resolution preoperatively to 0.45 ± 0.41 logarithm of the minimum angle of resolution postoperatively (P < 0.01). A myopic shift of -2.39 ± 1.38 (range, -1 to -6) diopter (P < 0.01) was observed. The mean follow-up period was 34.5 ± 27.7 (range, 7-104) months. CONCLUSION Our study clarified the efficacy of encircling scleral buckling surgery with cryotherapy in FEVR-rhegmatogenous RD with Stage 3A or 4A FEVR and Grade A or B proliferative vitreoretinopathy, especially in patients with multiple retinal holes.
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Affiliation(s)
- Liuhui Huang
- Department of Ophthalmology, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China; and
- Department of Ophthalmology, Tenth People's Hospital Affiliated with Shanghai Tongji University School of Medicine, Shanghai, China
| | - Tingyi Liang
- Department of Ophthalmology, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China; and
| | - Jiao Lyu
- Department of Ophthalmology, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China; and
| | - Haiying Jin
- Department of Ophthalmology, Tenth People's Hospital Affiliated with Shanghai Tongji University School of Medicine, Shanghai, China
| | - Peiquan Zhao
- Department of Ophthalmology, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China; and
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230
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Ahmed N, Mahar PS, Rehman AU, Soomro AQ, Ateeq A, Bhutto IA, Younus M. Efficacy Of Diode Laser In The Management Of Glaucoma Following Intravitreal Silicone Oil Injection In Complicated Retinal Detachment. J Ayub Med Coll Abbottabad 2022; 34:31-35. [PMID: 35466622 DOI: 10.55519/jamc-01-8981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Intravitreal silicone oil injection has been used to manage complicated retinal detachment. This study aims to analyse the efficacy of diode laser (TSCPC) in the management of secondary glaucoma following intravitreal silicone oil injection in complex retinal detachment surgery. METHODS The medical records of 58 eyes of 58 patients retrospectively were reviewed. Patients who underwent TSCPC for the management of secondary glaucoma following intravitreal silicone oil injection in complex retinal detachment were included. Procedure performed under local anaesthesia. The laser power was set at 1500-2200 mW for 2 sec. At each follow-up visit, patients went under charting of their IOP measurements with anterior segment and fundus examination. Post procedural follow up visits were carried out as; at 1 week, 1st, 3rdand 6thmonths. The efficacy was measured as reduction in IOP up to ≤20 mmHg without further needs for medications at 6 months. RESULTS The IOP was reduced up to 19.26±10.15 mmHg. Comparisons of IOP at each interval with pre-treatment showed significant difference with p<0.0001. The efficacy of procedure was achieved in 77.6% patients. Age, gender and pre-operative IOP showed significant association with p<0.05. CONCLUSIONS Diode laser TSCPC was effective and safe in reducing IOP. The IOP decreases gradually over six month follow up. The procedure is simple and cost-effective yet reasonably afforded by patients in low resources population. In spite of the retained intravitreal silicon oil patients with failed medical treatment for uncontrolled IOP can be treated with TSCPS.
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Affiliation(s)
- Nasir Ahmed
- Isra Postgraduate Institute of Ophthalmology, Karachi
| | | | | | | | - Asim Ateeq
- Isra Postgraduate Institute of Ophthalmology, Karachi
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Naravane AV, Belin PJ, Pierce B, Quiram PA. Risk and Prevention of Retinal Detachments in Patients with Stickler Syndrome. Ophthalmic Surg Lasers Imaging Retina 2022; 53:7-11. [PMID: 34982001 DOI: 10.3928/23258160-20211213-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To report the impact of prophylactic laser retinopexy in the prevention of retinal detachments (RDs) in patients with Stickler syndrome. PATIENTS AND METHODS This was a retrospective, comparative case series of patients with Stickler syndrome from the year 2000 to 2019. We compared the rate of RDs between individuals who did and did not receive prophylactic laser therapy. In patients with an RD, we compared the rate of RD in the fellow eye with and without prophylactic laser treatment. RESULTS A total of 95 eyes were identified. Fifty-four percent of the overall population was female. The RD rate was 26.7% among eyes without previous prophylactic laser retinopexy and 4.6% among eyes with previous prophylactic laser retinopexy. A Cox proportional model revealed that laser prophylaxis treatment had a statistically significant effect on the risk of RD or retinal tear during the 25-year survival period from birth (P = .034). Eyes receiving treatment were 70% less likely to experience RD or retinal tear (hazard ratio, 0.297; 95% CI, 0.097 to 0.913). CONCLUSIONS This study's results suggest a potential role for prophylactic laser retinopexy in the prevention of rhegmatogenous RD among patients with a clinical diagnosis of Stickler syndrome. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:7-11.].
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232
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Forgáč F, Sekerešová M, Černák M. EN BLOC RESECTION OF RETINAL VASOPROLIFERATIVE TUMOR USING 23G VITRECTOMY. A CASE REPORT. Cesk Slov Oftalmol 2022; 78:206-213. [PMID: 35922148 DOI: 10.31348/2022/22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Retinal vasoproliferative tumor is one of the benign vascular tumors which in advanced stages leads to exudative retinal detachment with the formation of epiretinal and subretinal membranes. In such advanced stages, one of the therapeutic options is pars plana vitrectomy. This article presents the case of a patient on whom was performed 23-gauge pars plana phacovitrectomy with en bloc resection of the tumor followed by histological confirmation. CASE REPORT A 70-year-old patient with a one-year history of unilateral loss of vision in his left eye was admitted to our clinic for examination in February 2018. At admission, the best corrected visual acuity in the right eye was 1.0, and in the left eye was light perception. Based on the clinical picture, sonographic examination of the eye, and fluorescein angiography, the patient was diagnosed with a retinal vasoproliferative tumor. Due to the advanced stage of disease, we proceeded with surgical intervention. We performed 23-gauge phacovitrectomy with a bloc resection of the tumor. Subsequent histological examination confirmed the presence of the presumed tumor. The follow-up exam a few months later showed a completely attached retina with silicone oil tamponade, without exudative retinopathy. However, the best corrected visual acuity improved only slightly to the ability to count fingers at one meter. CONCLUSION Pars plana vitrectomy with en bloc resection of retinal vasoproliferative tumor is one of the therapeutic modalities in advanced stages.
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Abstract
RATIONALE Breast carcinoma is the most common primary source of choroidal metastasis (CM). In the present case, esophageal cancer was the primary tumour, brain metastasis occurred, and CM occurred later in the left eye with 2 retinal detachments, which is very rare. PATIENT CONCERNS A 62-year-old man complained of a sudden decrease in visual acuity consisting of a small shadow in front of his left eye with a sensation of covered vision after 1 cycle of systemic chemotherapy and radiotherapy for resected esophageal cancer with brain metastasis. Fundus examination revealed exudative retinal detachment without retinal tears. CM with exudative retinal detachment was also considered. The patient refused further treatment. After the second cycle of chemotherapy, there were no significant changes in the retina and visual acuity improved. However, after craniocerebral surgery for brain metastasis, the visual acuity decreased again and showed 3 choroidal masses with macular involvement and retinal detachment but without retinal tears. DIAGNOSIS The final diagnosis was CM with retinal detachment. INTERVENTIONS The patient was advised to undergo enucleation of the left eye during the second retinal detachment, but he refused. OUTCOMES Two months after the second retinal detachment, the patient died of systemic metastases. LESSONS It is important to consider CM when the first retinal detachment and known cancer are diagnosed. At present, it is necessary to develop a standardised treatment plan as well as a multidisciplinary approach to early diagnosis, combined treatment, and timely intervention for such cases.
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Affiliation(s)
- Shu-Hua Lin
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji Jilin, China
| | - Yong-Gen Xu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Jing-Hua Zhao
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji Jilin, China
| | - Hong Cui
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji Jilin, China
| | - Hua Jin
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji Jilin, China
| | - Yu-Jie Jia
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji Jilin, China
| | - Jian Zhao
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji Jilin, China
| | - Ying-Jun Li
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji Jilin, China
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234
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Abstract
Acute retinal necrosis (ARN) is a rare ocular emergency caused mainly by viral entities. ARN may be caused by Herpes zoster virus (HZV) and Herpes simplex virus (HSV), both HSV-1 and HSV-2. ARN mostly present in 20-60 years old immunocompetent adults. A 7-year-old girl presented to the eye clinic with complaints of left eye redness noted by her mother for 2-3 days. On examination with indirect ophthalmoscopy, no hypopyon was seen in either eye. In the left eye fundus view was hazy. Ultrasound B-scan performed showed exudative retinal detachment. PCR of ocular fluid was positive for HSV-1 DNA. The patient was started on topical steroids and antibiotics and systemic antivirals. In addition, she also received intravitreal ganciclovir 4 mg/0.1 mL three times under general anaesthesia. At her last follow-up, 3 years from her presentation, her right eye examination was within normal limits, and left eye showed thick vitreous bands with a posterior vitreous detachment, and left inferotemporal retinal scarring.
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Affiliation(s)
- Benish Aslam Perhiar
- Section of Ophthalmology, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Ma Rehman Siddiqui
- Section of Ophthalmology, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Shahnaz Ibrahim
- Department of Pediatric and Child Health, Aga Khan University Hospital, Karachi, Pakistan
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Grassi P, Melville S, Hariprasad AS, Winder S, Ramkissoon Y, Spiteri-Cornish K, Cabrera RG, Subramani S, Chawla A. STRUCTURAL AND FUNCTIONAL MACULAR CHANGES AFTER RETINECTOMY FOR RETINAL DETACHMENT COMPLICATED BY PROLIFERATIVE VITREORETINOPATHY. Retina 2021; 41:2531-2539. [PMID: 34228410 DOI: 10.1097/iae.0000000000003250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report anatomical and functional outcomes of nonprimary retinectomy for rhegmatogenous retinal detachment with Grade C proliferative vitreoretinopathy, to assess the structural and functional macular changes in successful eyes. METHODS Retrospective single-center cohort study: one hundred-one consecutive retinectomies of 101 eyes affected by rhegmatogenous retinal detachment with C proliferative vitreoretinopathy between January 2014 and February 2020 were included. RESULTS The mean preoperative best-corrected visual acuity (BCVA) was 1.48 ± 0.71 logarithm of the minimal angle of resolution (20/604 Snellen equivalent). The anatomical success rate was 78.2% after one retinectomy and 83.1% after two retinectomies. The final BCVA ≥ 20/200 was achieved in 29% of cases, 8% gained ≥ 20/80. The final mean postoperative BCVA of successes with oil in situ was 1.68 ± 0.59 (20/957 Snellen equivalent) compared with 1.07 ± 0.63 logarithm of the minimal angle of resolution (20/235 Snellen equivalent) of successes after oil removal (P = 0.00005). Postoperative macular optical coherence tomography was obtained from 60/84 successes (71%). The normal macular profile was found in 3%, whereas majority demonstrated exudative maculopathy (51.5%), macular atrophy (22%), tractional maculopathy (21.5%), and macular disciform scar (2%). Bivariate linear relationship between final central foveal thickness and BCVA was statistically significant (P = 0.000013). CONCLUSION Satisfactory anatomical and functional outcome is possible after retinectomy for C proliferative vitreoretinopathy. Positive prognostic factors include the removal of oil without redetachment, normal macular status, and lower central foveal thickness. The functional outcome was influenced by macular changes, as final BCVA and central foveal thickness correlated.
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Affiliation(s)
- Piergiacomo Grassi
- Department of Ophthalmology, Clinical Fellow in Vitreoretinal Surgery, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Vitreoretinal Surgery, Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Saffron Melville
- University of Sheffeld Medical School, Sheffield, United Kingdom ; and
| | | | - Stephen Winder
- Department of Ophthalmology, Consultant Ophthalmic and Vitreoretinal Surgeon, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Yashin Ramkissoon
- Department of Ophthalmology, Consultant Ophthalmic and Vitreoretinal Surgeon, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Kurt Spiteri-Cornish
- Department of Ophthalmology, Consultant Ophthalmic and Vitreoretinal Surgeon, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Raquel G Cabrera
- Department of Ophthalmology, Consultant Ophthalmic and Vitreoretinal Surgeon, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Siddharth Subramani
- Department of Ophthalmology, Consultant Ophthalmic and Vitreoretinal Surgeon, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Anand Chawla
- Department of Ophthalmology, Consultant Ophthalmic and Vitreoretinal Surgeon, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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Chihara E, Chihara T, Matsuzaki S. MÜLLER CELL CONE-ASSOCIATED FOVEAL DETACHMENT AS A RISK FACTOR FOR VISUAL ACUITY LOSS AFTER GLAUCOMA FILTERING SURGERY. Retina 2021; 41:2571-2577. [PMID: 34009183 DOI: 10.1097/iae.0000000000003216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine hypotony-associated foveal lesions (FovLs) using optical coherence tomography, and to assess the risk factors of visual deterioration after glaucoma filtering surgery. METHODS Parameters that may be associated with postsurgical deterioration of visual acuity were retrospectively studied in 44 eyes of 44 patients who experienced postsurgical intraocular hypotension ≤6 mmHg between 2015 and 2019. RESULTS Six eyes (14%) had FovLs, such as detachment of photoreceptors (5 eyes, 11%) and acquired vitelliform lesions (1 eye, 2%) at 3 months after trabeculectomy. Logistic regression analysis revealed that hypotony maculopathy (P = 0.0141 at 3 months) and FovLs (P = 0.0486 and 0.0296 at 3 and 12 months, respectively) were significant risk factors for Visual acuity loss after trabeculectomy. The FovLs were located just behind the Müller cell cone. Visual acuity at 3 and 12 months after surgery in patients with FovLs was significantly lower than in those without FovLs (P = 0.0013 and P = 0.006, respectively). Epiretinal membrane was more common in eyes with FovLs (5 of 6 eyes, 83%) than in eyes without FovLs (7 of 38 eyes, 18%; P = 0.0037). CONCLUSION Müller cell cone-associated FovLs lead to long-lasting visual acuity loss after filtering surgery.
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Affiliation(s)
- Etsuo Chihara
- Department of Ophthalmology, Sensho-kai Eye Institute, Kyoto, Japan
- Department of Ophthalmology, Shimane University, Matsue, Japan
| | - Tomoyuki Chihara
- Department of Ophthalmology, Kansai Medical University, Hirakata, Japan; and
| | - Shoko Matsuzaki
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Carducci NM, Li KX, Moinuddin O, Besirli CG, Wubben TJ, Zacks DN. Clinical Presentation and Outcomes of Rhegmatogenous Retinal Detachments During the COVID-19 Lockdown and Its Aftermath at a Tertiary Care Center in Michigan. Ophthalmic Surg Lasers Imaging Retina 2021; 52:593-600. [PMID: 34766850 DOI: 10.3928/23258160-20211015-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate the effect of the coronavirus disease 2019 (COVID-19) lockdown on the presentation and management of acute, primary rhegmatogenous retinal detachment (RRD). PATIENTS AND METHODS This was a single-center, consecutive case series with historic controls, examining patients during the COVID-19 "stay-at-home" order (March 24 to June 1, 2020), the subsequent reopening phase (June 1 to July 31, 2020), and corresponding preceding intervals (March 24 to July 31, 2016 to 2019). RESULTS Despite a significant increase in patients presenting with macula-off RRD during the COVID-19 lockdown compared to the 2016 to 2019 timeframe (P = .03), the rate of single surgery anatomical success was similar between all groups (P = .66), as was final visual acuity (P = .61). No delays between presentation and surgical intervention were observed during the lockdown (P = .49). CONCLUSIONS Despite the limitations of the COVID-19 lockdown, patients underwent surgery in a timely manner and achieved comparable visual outcomes to controls before COVID-19. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:593-600.].
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Nanda R, Sahu S, Takkar B, Padhy SK. Postvitrectomy full-thickness macular hole and retinal detachment in a case of polypoidal choroidal vasculopathy. BMJ Case Rep 2021; 14:e246503. [PMID: 34772684 PMCID: PMC8593717 DOI: 10.1136/bcr-2021-246503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ridham Nanda
- Ophthalmology, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Suman Sahu
- Ophthalmology, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Brijesh Takkar
- Ophthalmology, LV Prasad Eye Institute, Hyderabad, India
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Heo H, Lambert SR. Incidence of retinal detachment after lens surgery in children and young adults with nontraumatic ectopia lentis. J Cataract Refract Surg 2021; 47:1454-1459. [PMID: 33929802 PMCID: PMC8490488 DOI: 10.1097/j.jcrs.0000000000000667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/09/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine the incidence of retinal detachment after lens surgery in children and young adults with nontraumatic ectopia lentis. SETTING Population-based claims data. DESIGN Population-based retrospective cohort study. METHODS Patients with nontraumatic ectopia lentis aged 30 years or younger who had undergone lens surgery with or without intraocular lens (IOL) implantation and had 1 year or greater continuous enrollment after lens surgery were included in the Optum deidentified Clinformatics Data Mart Database (2003 to 2019) and IBM MarketScan Databases (2007 to 2016). Both databases were assessed for sex, age, etiology of ectopia lentis, IOL implantation, and postoperative retinal detachment separately. Univariate and multivariate analyses were conducted to identify the risk factors for postoperative retinal detachment. RESULTS Among a total of 298 eyes (210 patients), IOL implantation was coupled with lens surgery in 151 eyes (49.8%) that underwent lens surgery for nontraumatic ectopia lentis. The median follow-up was 32 months in aphakic eyes and 29 months in pseudophakic eyes. Patients undergoing IOL implantation were older at the time of lens surgery (median age: no IOL, 6 years; IOL, 16 years; P < .001). Retinal detachment developed in 13 patients (14 eyes [4.7%]) 14 eyes (4.7%). Older age was the baseline characteristic that correlated most closely with the risk for retinal detachment (P = .05). CONCLUSIONS The rate of retinal detachment was similar with or without IOL implantation after lens surgery for nontraumatic ectopia lentis in children and young adults.
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Affiliation(s)
- Hwan Heo
- Department of Ophthalmology, Stanford University School of
Medicine, Palo Alto, California
- Department of Ophthalmology, Chonnam National University
Medical School and Hospital, Gwangju, Republic of Korea
| | - Scott R. Lambert
- Department of Ophthalmology, Stanford University School of
Medicine, Palo Alto, California
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Abstract
PURPOSE To report a case of failed endolaser retinopexy in patient taking pazopanib and possible association with impaired retinal remodeling. METHODS Case report. RESULTS A 68-year-old man with a history of radiation-induced high-grade metastatic mediastinal leiomyosarcoma, on pazopanib 600 mg daily, presented with a superior retinal tear 2 months after initiating pazopanib. The patient was treated with pars plana vitrectomy and endolaser retinopexy without any immediate complications. One month postoperatively, the patient was found to have a new superior macula-sparing rhegmatogenous retinal detachment extending through the laser barricade nasally. A large proportion of the laser lesions in this area had notably remained chalk-white. The patient underwent pars plana vitrectomy with scleral buckling, and repeat endolaser retinopexy. Pazopanib therapy was stopped 1 week later in consultation with the oncology team and was reinitiated after the retina seemed stable under silicone oil for several weeks. The scars from the patient's repeat endolaser retinopexy remained pale white at his clinic visit 2 months after the procedure, and at that time, his initial laser scars had only just begun to darken with pigment. Four and a half months after the initial vitrectomy and endolaser retinopexy, and three and a half months after his repeat vitrectomy and endolaser retinopexy, all the patient's laser scars have developed increased pigment, and his retina remains completely flat under silicone oil tamponade. CONCLUSION Pazopanib may have had an adverse effect on retinal wound healing after vitrectomy with endolaser retinopexy, leading to persistence of pale laser lesions many weeks after laser application. It is possible that this may have impaired the typical development of chorioretinal laser scar formation and led to subsequent retinal detachment.
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Affiliation(s)
- Jacob Lifton
- Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California
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Gui W, Au A, Rabina G, Kapelushnik N, Cohen S, Masarwa D, Hosseini H, Heilweil G, Schwartz S, Loewenstein A, Schwartz SD. PIGMENT EPITHELIAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION: Long-Term Visual Acuity May Improve With Higher Injection Index. Retina 2021; 41:2229-2235. [PMID: 34673665 DOI: 10.1097/iae.0000000000003224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To define injection index (II) and assess its impact on visual acuity (VA) in pigment epithelial detachment from age-related macular degeneration over 5 years. METHODS Injection index is defined as the mean anti-vascular endothelial growth factor injections per year from presentation. A retrospective study of 256 eyes in 213 patients was performed. Patients were stratified by II (high: ≥9, low: <9). RESULTS Baseline characteristics showed no differences across II groups. Mean (range) follow-up, in years, was 5.02 (1.04-12.74) for all patients. Mean logMAR VA (Snellen VA) were 0.60 (20/80) and 0.56 (20/73) at baseline, 0.52 (20/66) and 0.59 (20/78) at Year 1, 0.45 (20/56) and 0.67 (20/94) at Year 2, 0.38 (20/48) and 0.66 (20/91) at Year 3, 0.41 (20/51) and 0.89 (20/155) at Year 4, and 0.35 (20/45) and 0.79 (20/123) at Year 5 for the high and low II groups, respectively. Linear regression analysis showed a gain of 0.5 approxETDRS letters with each additional injection per year. CONCLUSION Increased II was associated with better mean VA, suggesting that long-term continuous vascular endothelial growth factor suppression may improve VA in eyes thought to carry poor prognoses.
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Affiliation(s)
- Wei Gui
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and
| | - Adrian Au
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and
| | - Gilad Rabina
- Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Noa Kapelushnik
- Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Shai Cohen
- Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Dua Masarwa
- Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Hamid Hosseini
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and
| | - Gad Heilweil
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and
| | - Shulamit Schwartz
- Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Anat Loewenstein
- Department of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Steven D Schwartz
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and
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243
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Bloch E, Flores-Sánchez B, Georgiadis O, Sundaram V, Saihan Z, Mahroo OA, Webster AR, da Cruz L. AN ASSOCIATION BETWEEN STELLATE NONHEREDITARY IDIOPATHIC FOVEOMACULAR RETINOSCHISIS, PERIPHERAL RETINOSCHISIS, AND POSTERIOR HYALOID ATTACHMENT. Retina 2021; 41:2361-2369. [PMID: 33840784 PMCID: PMC7611880 DOI: 10.1097/iae.0000000000003191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Stellate nonhereditary idiopathic foveomacular retinoschisis is a disorder characterized by splitting of the retina at the macula, without a known underlying mechanical or inherited cause. This study investigates demographic, anatomical, and functional characteristics of subjects with stellate nonhereditary idiopathic foveomacular retinoschisis, to explore potential underlying mechanisms. METHODS In this single-site, retrospective, and cross-sectional, observational study, data were collected from 28 eyes from 24 subjects with stellate nonhereditary idiopathic foveomacular retinoschisis. Descriptive statistics were reported, based on the observed anatomico-functional features. RESULTS The visual acuity remained stable (median 20/20) in all subjects over a median follow-up of 17 months. All cases demonstrated foveomacular retinoschisis within Henle's fiber layer, at the junction of the outer plexiform and outer nuclear layers. This schisis cavity extended beyond the limits of the macular OCT temporally in all eyes. In most affected eyes, there were documented features of peripheral retinoschisis and broad attachment of the posterior hyaloid at the macula. Functional testing in a cross-sectional subset demonstrated normal retinal sensitivity centrally but an absolute scotoma peripherally. CONCLUSION Stellate nonhereditary idiopathic foveomacular retinoschisis seems to be associated with peripheral retinoschisis and anomalous or incomplete posterior hyaloid detachment. Despite chronic manifestation, this does not significantly affect central visual function but can manifest with profound loss of peripheral visual function.
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Affiliation(s)
- Edward Bloch
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, United Kingdom
- Wellcome EPSRC Centre for Interventional and Surgical Sciences, University College London, United Kingdom
| | - Blanca Flores-Sánchez
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, United Kingdom
| | - Odysseas Georgiadis
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, United Kingdom
| | - Venki Sundaram
- Department of Ophthalmology, Luton and Dunstable University Hospital, United Kingdom
| | - Zubin Saihan
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Omar A. Mahroo
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, United Kingdom
| | - Andrew R. Webster
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, United Kingdom
| | - Lyndon da Cruz
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, United Kingdom
- Wellcome EPSRC Centre for Interventional and Surgical Sciences, University College London, United Kingdom
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244
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Tung HF, Chen YL, Tung HY, Tung HW, Chen SN. FOVEAL DISPLACEMENT IN EYES WITH EPIRETINAL MEMBRANE AFTER VITRECTOMY AND MEMBRANE PEELING. Retina 2021; 41:2246-2252. [PMID: 33958532 DOI: 10.1097/iae.0000000000003200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the foveal movement in eyes with epiretinal membrane after vitrectomy and membrane peeling. METHODS A retrospective review of 85 eyes with epiretinal membrane treated with vitrectomy, membrane peeling, and internal limiting membrane removal. Using a self-designed computer program to compare the preoperative and postoperative images of optical coherence tomography to measure the amount of foveal movement. Analyze the relationships between foveal displacement, preoperative and postoperative best-corrected visual acuity, central foveal thickness, and the stage of epiretinal membrane. RESULTS Most of the fovea were nasally shifted. More movement happened in the first month and almost finished in the first year. The greater degree of foveal displacement was correlated with poorer initial visual acuity and thicker central foveal thickness. In considering with the ectopic inner foveal layer staging of epiretinal membrane by structural optical coherence tomography, the foveal realignment is greatest in Stage 4 (394.47 ± 171.44 µm), followed by Stage 1 (251.21 ± 135.40 µm), Stage 2 (235.70 ± 147.51 µm), and Stage 3 (219.86 ± 117.91 µm) at the postoperative 1 month. CONCLUSION Most eyes of epiretinal membrane had the foveal moved nasally after membrane peeling and internal limiting membrane peeling. The larger amount of foveal movement was correlated with poorer initial best-corrected visual acuity. Dystopia fovea may be another factor affecting visual acuity in addition to other biomarkers in optical coherence tomography.
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Affiliation(s)
- Hsiao-Fan Tung
- Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan
| | - Yi-Ling Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan
| | - Hsiao-Yu Tung
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Hsiao-Wei Tung
- Department of electrical and computer engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - San-Ni Chen
- Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan
- Department of Optometry, Da-Yeh University, Changhua City, Taiwan; and
- Department of Medicine, School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
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245
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Bryan EA, Cruz-Iñigo YJ, Brems RN, Bryan JS. ACUTE MACULAR EDEMA WITH SEROUS RETINAL DETACHMENT AFTER CATARACT SURGERY IN A VITRECTOMIZED EYE: A CASE REPORT. Retin Cases Brief Rep 2021; 15:745-748. [PMID: 31274848 DOI: 10.1097/icb.0000000000000884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To present the first case of acute macular edema with serous retinal detachment after cataract surgery in a vitrectomized eye. METHODS A 63-year-old female patient, with history of pars plana vitrectomy and epiretinal membrane removal, underwent uneventful phacoemulsification surgery with injection of standard intracameral dose of cefuroxime (1 mg/0.1 mL of solution) at the end of the procedure. RESULTS First day after cataract surgery, visual acuity did not correlate with anterior segment findings, and funduscopic eye examination revealed acute macular edema with serous retinal detachment, which was confirmed by spectral domain optical coherence tomography. Fluorescein angiography showed no retinal or choroidal hyperpermeability. At 2-week follow-up visit, visual acuity had significantly improved, and there was complete resolution of macular edema and subretinal fluid. CONCLUSION The current case suggests that acute macular edema with serous retinal detachment after cataract surgery with standard cefuroxime prophylaxis can occur even in vitrectomized eyes. A high level of suspicious is needed when visual acuity does not correlate with anterior segment findings immediately after cataract surgery. Similar to reports from nonvitrectomized eyes, visual prognosis was favorable.
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Affiliation(s)
- Eric A Bryan
- Barrett, The Honors College at Arizona State University, Tempe, Arizona
| | | | | | - J Shepard Bryan
- Barrett, The Honors College at Arizona State University, Tempe, Arizona
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246
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McCarthy K, Liu K, Kokame GT, Merrill PT, Gilca M, Cohen J. First Case of Subretinal Ocular Angiostrongyliasis Associated with Retinal Detachment in the United States. Hawaii J Health Soc Welf 2021; 80:40-44. [PMID: 34820635 PMCID: PMC8609198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Angiostrongylus cantonensis, commonly known as the rat lungworm, is mostly found in Asia, the Pacific Basin, and the Caribbean, but is also endemic in Hawai'i, especially on the Island of Hawai'i. Ocular angiostrongyliasis is an uncommon but previously reported complication associated with permanent vision loss. This is the first reported case of ocular angiostrongyliasis involving the retina or posterior segment of the eye in the US. A 24-year-old male from Chicago visited the Island of Hawai'i, where he worked on a farm and ate a vegetarian diet. When he returned to Chicago, he became sick and was hospitalized for eosinophilic meningitis. One month later, he developed a retinal detachment which required surgical repair involving a pars plana vitrectomy. During the reattachment of the retina during surgery, a live motile was identified nematode in the subretinal space. An endolaser probe immobilized and killed the nematode, and it was subsequently extracted through the sclerotomy. Thermal scars around all retinal holes including the retinotomy site were made to stabilize the retina, and perfluoropropane gas was injected to achieve temporary tamponade. Thereafter, the patient's cerebrospinal fluid returned positive for angiostrongylus cantonensis antibodies. During extended follow-up, the patient eventually lost all vision in the affected eye due to recurrent retinal detachment. This case of ocular angiostrongyliasis demonstrates the importance of obtaining travel history from endemic areas, knowing the risk of developing eosinophilic meningitis, and understanding the risk of permanent vision loss in cases involving the retina.
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Affiliation(s)
- Kayne McCarthy
- University of Hawai‘i John A. Burns School of Medicine, Honolulu, HI (KM, KL,GTK)
| | - Keke Liu
- University of Hawai‘i John A. Burns School of Medicine, Honolulu, HI (KM, KL,GTK)
| | - Gregg T. Kokame
- University of Hawai‘i John A. Burns School of Medicine, Honolulu, HI (KM, KL,GTK)
- University of Hawai‘i John A. Burns School of Medicine, Department of Surgery, Honolulu, HI (GTK)
- Retina Consultants of Hawai‘i, Honolulu, HI (GTK)
| | | | - Marina Gilca
- Rush University Medical Center, Chicago, IL (MG, JC)
- Illinois Retina Associates, Chicago, IL (MG, JC)
| | - Jack Cohen
- Rush University Medical Center, Chicago, IL (MG, JC)
- Illinois Retina Associates, Chicago, IL (MG, JC)
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247
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Verhoekx JSN, van Overdam KA, Gishti O, van Leeuwen R, Crama N. [Acute onset of floaters, even without flashes, is an urgent ophthalmic warning sign]. Ned Tijdschr Geneeskd 2021; 165:D5850. [PMID: 34854588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Acute onset of floaters is most likely caused by a posterior vitreous detachment (PVD). A PVD can lead to a retinal tear and subsequently to a retinal detachment with permanent vision loss if left untreated. A patient who presents to a primary care physician with acute onset of floaters, in the absence flashes or visual field loss, is often referred to an ophthalmologist without urgency. In the current Dutch general practitioners standard, acute onset or increase of floaters, without flashes or visual loss, is not included as a reason for urgent referral to an ophthalmologist. Patients who present with acute onset of floaters without flashes have a 14-23% risk of having a retinal tear. Risk factors for developing a retinal tear are high myopia, trauma, cataract surgery, or a retinal tear or retinal detachment in the past medical or family history. Patients with acute onset of floaters should be triaged for urgent ophthalmologic assessment.
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248
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Ward TE, Meirick T, Reiss B, Stacey AW. Regression of Intraocular Rosai- Dorfman Disease Following Treatment with Photodynamic Therapy. Ophthalmic Surg Lasers Imaging Retina 2021; 52:568-571. [PMID: 34661466 DOI: 10.3928/23258160-20210905-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Rosai-Dorfman disease (RDD), a rare form of histiocytosis, has been reported to cause choroidal masses and subsequent serous retinal detachments. We present a case of RDD associated with a choroidal mass and retinal detachment that did not respond to corticosteroid treatment and regressed after treatment with photodynamic therapy (PDT). Following treatment, the patient had a successful anatomic and clinical outcome, with no recurrence of serous detachment and 20/25 visual acuity. This is the first report of choroidal RDD successfully treated with PDT. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:568-571.].
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249
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Lee WH, Kim BJ, Han YS. Bilateral retinal pigment epithelial tears in acute central serous chorioretinopathy without bullous retinal detachment: A case report. Medicine (Baltimore) 2021; 100:e27391. [PMID: 34596164 PMCID: PMC8483866 DOI: 10.1097/md.0000000000027391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/15/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Several reports have described retinal pigment epithelial (RPE) tears in central serous chorioretinopathy (CSC). However, there have been no reports of spontaneously large RPE tears in acute CSC without bullous retinal detachment (RD). Herein, we report and provide sequential images of a case of bilateral spontaneous large RPE tears in patient with acute CSC without bullous RD. PATIENT CONCERNS An 88-year-old female patient was admitted with impaired vision in both eyes, which began 10 days prior. The visual acuity was 0.4 and 0.5 in the right and left eye, respectively. She had started taking oral steroids 2 weeks prior for polymyalgia. DIAGNOSIS Ophthalmologic examinations, including fundus photography, optical coherence tomography, and fluorescence angiography, were performed, and she was diagnosed with steroid-induced acute CSC in both eyes with large pigment epithelial detachment (PED) of approximately 4-disc diameter. Discontinuation of steroids and follow-up ophthalmic examinations were performed. However, a spontaneous large RPE tear occurred in the right eye. INTERVENTIONS We performed follow-ups more frequently and CSC treatment such as laser photocoagulation, photodynamic therapy, and anti-vascular endothelial growth factor injections were not performed. OUTCOMES Nine months later, a spontaneous large RPE tear occurred sequentially in the left eye. Her final visual acuity was 0.3 and 0.15 in the right and left eye, respectively. LESSONS Patients may spontaneously develop large RPE tears in both eyes, despite no treatment for acute CSC with non-bullous RD. Large PED and old age may affect this. Therefore, for a CSC patient with a large PED and advanced age, attention must be paid when determining treatment.
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Affiliation(s)
- Woo Hyuk Lee
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Bum Jun Kim
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Yong Seop Han
- Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
- Health Science Institute, Gyeongsang National University, Jinju, Republic of Korea
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250
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Zanzottera EC, Marchese A, Bandello F, Coppola M. Intraocular perfluorodecalin and silicone oil tamponade (double filling) in the management of complicated retinal detachment: functional and anatomical outcomes using small-gauge surgery. Graefes Arch Clin Exp Ophthalmol 2021; 260:1105-1112. [PMID: 34550420 PMCID: PMC8455801 DOI: 10.1007/s00417-021-05395-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 01/02/2023] Open
Abstract
Purpose To describe the functional and anatomical results of complicated retinal detachment (RD) treated with small-gauge pars plana vitrectomy (PPV) and combined perfluorodecalin and polydimethylsiloxane tamponade (double filling, DF). Methods Retrospective analysis of consecutive patients with complex RD (severe proliferative vitreoretinopathy, inferior/posterior/giant retinal tears, and traumatic detachments) treated with small-gauge PPV, membrane peeling, and DF at the Department of Ophthalmology at San Gerardo Hospital, Monza, Italy. Main outcome measures included best-corrected visual acuity (BCVA), rates of retinal reattachment, and complications. Results This study included 15 patients with a median follow-up (FU) of 6 months (range 1–22). Three patients with early retinal redetachment under tamponade and FU shorter than 3 months were excluded from the final functional analysis, but they were considered anatomical failure. At the last examination, BCVA improved in 50% of patients and remained stable in 25% of patients and anatomical success was achieved in 73% of eyes, 64% of them without any endotamponade. Three eyes had retinal redetachment after perfluorodecalin/silicone oil exchange because of diffuse proliferative vitreoretinopathy (PVR) and required reoperation to achieve retinal attachment. In eyes with anatomical success, macular pucker was the most frequent long-term complication (27%). Conclusion In the management of complex RD, small-gauge pars plana vitrectomy, and double filling endotamponade using wide-angle viewing systems was a well-tolerated and effective technique to preserve visual acuity and achieve anatomical success.
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Affiliation(s)
- Emma Clara Zanzottera
- Department of Ophthalmology, Department of Ophthalmology, San Gerardo Hospital, via Gian Battista Pergolesi 33, 20900, Monza, Italy.
| | - Alessandro Marchese
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michele Coppola
- Department of Ophthalmology, Department of Ophthalmology, San Gerardo Hospital, via Gian Battista Pergolesi 33, 20900, Monza, Italy
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