51
|
Park SW, Lee JJ, Lee JE. Scleral buckling in the management of rhegmatogenous retinal detachment: patient selection and perspectives. Clin Ophthalmol 2018; 12:1605-1615. [PMID: 30214145 PMCID: PMC6124476 DOI: 10.2147/opth.s153717] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Although the technique of pars plana vitrectomy (PPV) develops rapidly, scleral buckling (SB) has several advantages over PPV for rhegmatogenous retinal detachment (RRD), including early visual rehabilitation and prevention of cataract progression. It is recommended to select the primary procedure for RRD by considering the advantages and disadvantages of each procedure based on the patient status. The vitreous body status affects the features of RRD. Vitreous liquefaction is an age-dependent process, resulting in the development of posterior vitreous detachment (PVD). RRD is usually associated with PVD, typically presenting with a retinal tear, strong vitreoretinal traction, and bullous detachment. In contrast, RRD may develop without PVD, and typically presents with a small atrophic hole, shallow detachment, and slow progression. RRD with less liquefied vitreous and no PVD can be managed successfully with SB alone even in the presence of subretinal strand as less liquefied vitreous acts as bio-tamponade blocking fluid passage. The strong traction induced by PVD and bullous detachment in an eye with extensively liquefied vitreous reduces the success rate of SB. PPV is gaining popularity as the primary procedure for RRD, especially in eyes with retinal tears, PVD, or pseudophakia. Nevertheless, SB remains the preferred procedure in young phakic patients without PVD.
Collapse
Affiliation(s)
- Sung Who Park
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea, .,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea,
| | - Jae Jung Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea, .,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea,
| | - Ji Eun Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea, .,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea,
| |
Collapse
|
52
|
Lin JB, Sein J, Van Stavern GP, Apte RS. Preoperative Electrophysiological Characterization of Patients with Primary Macula-involving Rhegmatogenous Retinal Detachment. J Ophthalmic Vis Res 2018; 13:241-248. [PMID: 30090179 PMCID: PMC6058558 DOI: 10.4103/jovr.jovr_161_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: To determine 1) which components of retinal function are impaired after rhegmatogenous retinal detachment, 2) which outer retinal pathways (rod- or cone-driven) are more severely affected, and 3) whether there is concomitant inner retinal dysfunction. Methods: We conducted a prospective observational study in a large academic institution. We performed preoperative electroretinography on eight patients to assess outer and inner retinal function. In all cases, a comparison between the eye with the detached retina and the control fellow eye was made. Results: Eyes with a detached retina had significantly lower a-wave and b-wave amplitudes with respect to both rod- and cone-dominated testing parameters (P < 0.05) and reduced 30 Hz flicker responses compared to fellow eyes (P < 0.05); the effect size was similar for all significantly reduced parameters (r~0.6). There were no significant differences between eyes with detached retinas and control fellow eyes with respect to b/a-wave ratios, a-wave latencies, or b-wave latencies. Conclusion: Patients with rhegmatogenous retinal detachment have preoperative outer retinal dysfunction equally affecting both rod- and cone-driven pathways, and they have minimal inner retinal dysfunction.
Collapse
Affiliation(s)
- Jonathan B Lin
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Julia Sein
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Gregory P Van Stavern
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Rajendra S Apte
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA.,Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
53
|
EFFICACY OF INTRAVITREAL INJECTION OF BEVACIZUMAB IN VITRECTOMY FOR PATIENTS WITH PROLIFERATIVE VITREORETINOPATHY RETINAL DETACHMENT: A Meta-analysis of Prospective Studies. Retina 2018; 38:462-470. [PMID: 28272285 DOI: 10.1097/iae.0000000000001584] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE To evaluate the effect of intravitreal injection of bevacizumab in vitrectomy for patients with proliferative vitreoretinopathy (PVR)-related retinal detachment. METHODS The PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from their earliest entries through October, 2016, to identify the studies that had evaluated the effects of intravitreal injection of bevacizumab in vitrectomy for eyes with PVR-related retinal detachment. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. The relevant data were analyzed using Stata 12.0 software. The weighted mean difference, relative risk, and their 95% confidence intervals were used to assess the strength of the association. RESULTS The authors' search yielded 133 records from which 3 studies that have examined the effects of intravitreal injection of bevacizumab (120 eyes with PVR-related retinal detachment) were included for review and analysis. Their meta-analyses showed that neither the best-corrected visual acuity nor retinal redetachment rate showed any clinically or statistically important difference between the nonbevacizumab and bevacizumab groups (P > 0.05). In addition, bevacizumab did not influence the interval between vitrectomy and retinal redetachment (P > 0.05). CONCLUSION Based on the available evidence, intravitreal injection of bevacizumab in vitrectomy for patients with PVR-related retinal detachment did not decrease retinal redetachment rate or improve visual acuity. Better-designed studies with larger simple sizes and longer follow-up periods are required to reach valid conclusions regarding benefits and harms. Moreover, evaluation of anti-vascular endothelial growth factor therapy on surgical outcomes in eyes with milder subtypes of PVR or no PVR, but deemed at high risk of PVR, may be worthy of future consideration.
Collapse
|
54
|
Jo J, Moon BG, Lee JY. Scleral Buckling Using a Non-contact Wide-Angle Viewing System with a 25-Gauge Chandelier Endoilluminator. KOREAN JOURNAL OF OPHTHALMOLOGY 2017; 31:533-537. [PMID: 29230977 PMCID: PMC5726988 DOI: 10.3341/kjo.2017.0044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/22/2016] [Indexed: 11/23/2022] Open
Abstract
Purpose To report the outcome of scleral buckling using a non-contact wide-angle viewing system with a 25-gauge chandelier endoilluminator. Methods Retrospective analyses of medical records were performed for 17 eyes of 16 patients with primary rhegmatogenous retinal detachment (RRD) without proliferative vitreoretinopathy who had undergone conventional scleral buckling with cryoretinopexy using the combination of a non-contact wide-angle viewing system and chandelier endoillumination. Results The patients were eight males and five females with a mean age of 26.8 ± 10.2 (range, 11 to 47) years. The mean follow-up period was 7.3 ± 3.1 months. Baseline best-corrected visual acuity was 0.23 ± 0.28 logarithm of the minimum angle of resolution units. Best-corrected visual acuity at the final visit showed improvement (0.20 ± 0.25 logarithm of the minimum angle of resolution units), but the improvement was not statistically significant (p = 0.722). As a surgery-related complication, there was vitreous loss at the end of surgery in one eye. As a postoperative complication, increased intraocular pressure (four cases) and herpes simplex epithelial keratitis (one case) were controlled postoperatively with eye drops. One case of persistent RRD after primary surgery needed additional vitrectomy, and the retina was postoperatively attached. Conclusions Scleral buckling with chandelier illumination as a surgical technique for RRD has the advantages of relieving the surgeon's neck pain from prolonged use of the indirect ophthalmoscope and sharing the surgical procedure with another surgical team member. In addition, fine retinal breaks that are hard to identify using an indirect ophthalmoscope can be easily found under the microscope by direct endoillumination.
Collapse
Affiliation(s)
- Jaehyuck Jo
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byung Gil Moon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joo Yong Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| |
Collapse
|
55
|
Kobayashi M, Iwase T, Yamamoto K, Ra E, Murotani K, Terasaki H. Perioperative factors that are significantly correlated with final visual acuity in eyes after successful rhegmatogenous retinal detachment surgery. PLoS One 2017; 12:e0184783. [PMID: 28902881 PMCID: PMC5597235 DOI: 10.1371/journal.pone.0184783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 08/30/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To determine the perioperative factors that are significantly correlated with the final visual acuity following reattachment of a macula-off rhegmatogenous retinal detachment (RRD) by vitrectomy. Methods Twenty-nine eyes of 29 patients with a successfully reattached RRD by vitrectomy were retrospectively analyzed. Spectral-domain optical coherence tomographic images of the macular regions were used to measure the thicknesses of the retinal layers and the integrity of the microstructures of the photoreceptors at 2 weeks, 1, 2, 3, 6, 9, and 12 months following the vitrectomy. The best-corrected visual acuities (BCVA) were evaluated at the same times. Results The improvement of the BCVA from the preoperative BCVA to that at postoperative Week 2 (-0.67 ± 0.69 logMAR units) was the largest change between adjacent observation periods for the entire study duration. It was significantly greater than the improvement between Week 2 and Month 12 (-0.32 ± 0.22 logMAR units; P<0.001). The thickness of the ellipsoid zone (EZ)-retinal pigment epithelium (RPE) increased significantly with time (P<0.001). The final BCVA was significantly correlated with the BCVA at Week 2 (r = 0.61, P<0.001), the EZ-RPE thickness at Week 2 (r = -0.40, P = 0.035), the integrity of the external limiting membrane (ELM) (r = -0.61, P = 0.003), and an intact EZ (r = -0.66, P = 0.001) at Week 2. Multiple stepwise regression analyses of the final BCVA showed that the BCVA at Week 2 (P = 0.017) and the integrity of the EZ at Week 2 (P = 0.006) were independent predictors of the final BCVA. Conclusions The significantly better BCVA and presence of an intact EZ at 2 weeks following vitrectomy and their significant correlations with the BCVA at Month 12 indicate that these perioperative values can be used to predict the BCVA at Month 12 after a reattachment of macula-off RRD following vitrectomy.
Collapse
Affiliation(s)
- Misato Kobayashi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- * E-mail:
| | - Kentaro Yamamoto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eimei Ra
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenta Murotani
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
56
|
Auger N, Rhéaume MA, Bilodeau-Bertrand M, Tang T, Kosatsky T. Climate and the eye: Case-crossover analysis of retinal detachment after exposure to ambient heat. ENVIRONMENTAL RESEARCH 2017; 157:103-109. [PMID: 28549308 DOI: 10.1016/j.envres.2017.05.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/12/2017] [Accepted: 05/13/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Retinal detachment is an important cause of visual loss, but the association with outdoor heat exposure has not been studied. Our objective was to determine the relationship between acute exposure to high outdoor temperature and risk of retinal detachment. MATERIALS AND METHODS We analysed 14,302 individuals with inpatient procedures for retinal detachment from April through September between 2006 and 2013 in the province of Quebec, Canada. Using a time-stratified case-crossover study design, we examined the association of retinal detachment with outdoor summer temperature the preceding week. We estimated odds ratios (OR) and 95% confidence intervals (CI) for mean weekly temperature according to subtypes of retinal detachment (traction, serous, rhegmatogenous, breaks), and assessed associations by age and sex. RESULTS Exposure to elevated temperature the preceding week was associated with a higher likelihood of traction detachment, but not other forms of retinal detachment. Associations were stronger at <75 years of age in both men and women. Relative to 15°C, a mean weekly temperature of 25°C was associated with an OR for traction detachment of 2.71 (95% CI 1.56-4.71) before 55 years, 2.73 (95% CI 1.61-4.64) at 55-64 years, and 1.98 (95% CI 1.30-3.02) at 64-75 years. DISCUSSION Elevated outdoor temperatures may be associated with an increased risk of traction retinal detachment. In light of climate change, a better understanding of the impact of heat waves on the eye and other sensory organs is needed.
Collapse
Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, 900 Saint-Denis, Montreal, Quebec, Canada H2X 0A9; Institut national de santé publique du Québec, 190 Crémazie E Blvd, Montreal, Quebec, Canada H2P 1E2.
| | - Marc-André Rhéaume
- University of Montreal Hospital Research Centre, 900 Saint-Denis, Montreal, Quebec, Canada H2X 0A9; Department of Ophthalmology, University of Montreal, 2900 Édouard-Montpetit, Montreal, Quebec, Canada H3T 1J4
| | - Marianne Bilodeau-Bertrand
- University of Montreal Hospital Research Centre, 900 Saint-Denis, Montreal, Quebec, Canada H2X 0A9; Institut national de santé publique du Québec, 190 Crémazie E Blvd, Montreal, Quebec, Canada H2P 1E2
| | - Tina Tang
- Faculty of Medicine, McGill University, 3655, Promenade Sir-William-Osler, Montreal, Quebec, Canada H3G 1Y6
| | - Tom Kosatsky
- National Collaborating Centre for Environmental Health, British Columbia Centre for Disease Control, 601 West Broadway, Vancouver, British Columbia, Canada V5Z 4C2
| |
Collapse
|
57
|
Iwase T, Kobayashi M, Yamamoto K, Yanagida K, Ra E, Terasaki H. Change in choroidal blood flow and choroidal morphology due to segmental scleral buckling in eyes with rhegmatogenous retinal detachment. Sci Rep 2017; 7:5997. [PMID: 28729551 PMCID: PMC5519709 DOI: 10.1038/s41598-017-05126-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/24/2017] [Indexed: 11/09/2022] Open
Abstract
Although scleral buckling is a well-established surgical treatment for rhegmatogenous retinal detachment (RRD), the procedure can reportedly cause problems in the ocular circulation. Segmental scleral bucking without a concomitant encircling procedure was performed on 46 eyes with successfully reattached macula-on RRD. Choroidal blood flow was assessed using laser speckle flowgraphy. Spectral-domain optical coherence tomography was used to image macular regions, to measure the subfoveal choroidal thickness (SFCT), and to calculate the luminal and the stromal areas by the binarization method preoperatively and 1, 4, 8 and 12 weeks postoperatively. Choroidal mean blur rate at the macula did not significantly change, while that at the buckle and unbuckle side significantly reduced at 8 weeks postoperatively in the operated eye (P = 0.007 and P = 0.017, respectively). The SFCT and the luminal area increased temporarily 1 week following surgery in the operated eye (P < 0.001). The trend of SFCT with time coincided with that of the luminal area (P < 0.001). Venous drainage obstruction induced by compression force of scleral buckling leads to SFCT thickening in the acute postoperative phase. The macular choroidal blood flow might be less susceptible because the blood flow at the macula, in contrast to the other areas, does not change following segmental scleral buckling.
Collapse
Affiliation(s)
- Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Misato Kobayashi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kentaro Yamamoto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kosei Yanagida
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eimei Ra
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
58
|
In Reply. Obstet Gynecol 2017; 129:947-948. [PMID: 28426607 DOI: 10.1097/aog.0000000000002027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
59
|
|
60
|
Sahanne S, Tuuminen R, Haukka J, Loukovaara S. A retrospective study comparing outcomes of primary rhegmatogenous retinal detachment repair by scleral buckling and pars plana vitrectomy in Finland. Clin Ophthalmol 2017; 11:503-509. [PMID: 28331284 PMCID: PMC5354527 DOI: 10.2147/opth.s128746] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment and an ophthalmic emergency. Here, we compared outcomes of primary RRD eyes operated with conventional scleral buckling (SB) with cryoretinopexy to those operated with standard pars plana vitrectomy (PPV). Methods This is an institutional, retrospective, register-based, observational, comparative study. Based on the surgical procedure, 319 eyes of 319 patients were divided into two groups: SB plus cryotherapy (n=50) and PPV (n=269). Changes in intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded at 30 days and reoperation rates within 180 days postoperatively. Results Eyes operated with PPV had less reoperations within the first 180 days as compared with SB eyes (P=0.001, log-rank test); however, changes in IOP were more prominent (mean ± standard deviation: +8.1±8.8 vs. +4.4±7.0 mmHg, respectively; P=0.006). Changes in BCVA did not differ between the surgical procedures. Conclusion PPV was associated with higher primary anatomic success rates and lower risk of reoperation but significant IOP elevation when compared to SB. These factors should be case-specifically considered when choosing treatment modality for primary RRD.
Collapse
Affiliation(s)
- Sari Sahanne
- Department of Anesthesiology, Helsinki University Central Hospital, Helsinki
| | - Raimo Tuuminen
- Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka
| | - Jari Haukka
- Hjelt Institute, Faculty of Medicine, University of Helsinki
| | - Sirpa Loukovaara
- Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| |
Collapse
|
61
|
|
62
|
Patching retinal breaks with Seprafilm for treating retinal detachments in humans: 9 years of follow-up. Eye (Lond) 2017; 31:776-780. [PMID: 28128794 DOI: 10.1038/eye.2016.329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/19/2016] [Indexed: 11/08/2022] Open
Abstract
PurposeTo describe the long-term surgical outcomes of four patients treated for retinal detachment using Seprafilm as a novel technique.MethodsRetinal breaks in four eyes were covered with Seprafilm using a transvitreal approach after cataract surgery, pars plana vitrectomy, fluid-air exchange, and laser photocoagulation. Neither long-standing gas nor silicone oil was used. The patients were not instructed to maintain a specific head positioning postoperatively.ResultsSuccessful retinal reattachment was achieved with a single surgery in all four eyes, and none developed proliferative vitreoretinopathy. The mean best-corrected visual acuity preoperatively and 9 years postoperatively were 20/97 and 20/33, respectively. The intraocular pressure increased several days postoperatively that lasted no longer than 2 weeks. Visual field defects either in the inferonasal or inferotemporal quadrant were detected postoperatively. The mean electroretinogram a- and b-wave amplitude ratios of the operated eyes to the fellow eyes were 0.68 and 0.64 preoperatively and 0.87 and 0.92 postoperatively, respectively. The mean corneal endothelial cell density was 2365 cells/mm2 preoperatively and 2592 cells/mm2 postoperatively.ConclusionCovering retinal breaks with Seprafilm may promote retinal reattachment without gas tamponade and postoperative head positioning. The visual outcomes 9 years postoperatively showed no apparent adverse effects of intraocular application of Seprafilm.
Collapse
|
63
|
Kim MJ, Heo JW. A Case of Silicone Band Migration Following an Encircling Procedure. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.3.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mi Jin Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jang Won Heo
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
64
|
Applying Sutureless Encircling Number 41 Band and Transscleral Chandelier-Assisted Laser Retinopexy for Scleral Buckling Procedure. J Ophthalmol 2017; 2017:4671305. [PMID: 29333292 PMCID: PMC5733179 DOI: 10.1155/2017/4671305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/12/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose To assess the outcome of sutureless encirlcing number 41 band and transscleral laser retinopexy in uncomplicated rhegmatogenous retinal detachment (RRD), using a wide-angle viewing system (WAVS) and chandelier endoillumination. Methods Prospective intervention study included 30 eyes of 30 patients presenting with RRD of recent onset indicated for SB. All cases were treated by sutureless encircling number 41 band and transscleral laser retinopexy. Visualization was provided by the Resight WAVS and a single 27-gauge chandelier endoillumination. Anatomical and visual outcomes were evaluated. Results The mean age of our group was 49.8 ± 12.3 years, and the mean duration of RD was 7 (0–50) days. Twenty-four eyes (80.0%) were phakic while the remaining 6 eyes (20%) were either pseudophakic or aphakic. The primary retinal reattachment rate was 83.3% (25 out of 30 eyes). LogMAR visual acuity improved from 1.3 (0.30–2.0) preoperatively to 1.0 (0.40–1.60) at first month (p = 0.002) and to 0.70 (0.20–1.92) at third month (p < 0.001). Conclusion Sutureless encircling number 41 band with chandelier-assisted transscleral laser retinopexy is a safe and effective technique for managing uncomplicated RRD. It provides a high primary success rate while eliminating the complications of cryotherapy, sutures, and broad buckles.
Collapse
|
65
|
|
66
|
Selected Disorders of the Eye. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
67
|
Zhai YR, Zhao Y, Zhong J, Li K, Lu CX, Zhang B. Sector mapping method for 3D detached retina visualization. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 134:149-153. [PMID: 27480739 DOI: 10.1016/j.cmpb.2016.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 05/25/2016] [Accepted: 07/01/2016] [Indexed: 06/06/2023]
Abstract
A new sphere-mapping algorithm called sector mapping is introduced to map sector images to the sphere of an eyeball. The proposed sector-mapping algorithm is evaluated and compared with the plane-mapping algorithm adopted in previous work. A simulation that maps an image of concentric circles to the sphere of the eyeball and an analysis of the difference in distance between neighboring points in a plane and sector were used to compare the two mapping algorithms. A three-dimensional model of a whole retina with clear retinal detachment was generated using the Visualization Toolkit software. A comparison of the mapping results shows that the central part of the retina near the optic disc is stretched and its edges are compressed when the plane-mapping algorithm is used. A better mapping result is obtained by the sector-mapping algorithm than by the plane-mapping algorithm in both the simulation results and real clinical retinal detachment three-dimensional reconstruction.
Collapse
Affiliation(s)
- Yi-Ran Zhai
- College of Electronics Information, Sichuan University, Chengdu 610065, China; Chengdu Qianjia Technology Co., Ltd, Chengdu 610211, China.
| | - Yong Zhao
- Chengdu Qianjia Technology Co., Ltd, Chengdu 610211, China
| | - Jie Zhong
- The Ophthalmology Department of Sichuan Province People's Hospital, Chengdu 610072, China
| | - Ke Li
- Key Laboratory for Neuro Information of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Cui-Xin Lu
- Key Laboratory for Neuro Information of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Bing Zhang
- College of Electronics Information, Sichuan University, Chengdu 610065, China
| |
Collapse
|
68
|
Alves C, Penedones A, Mendes D, Batel Marques F. A systematic review and meta-analysis of the association between systemic fluoroquinolones and retinal detachment. Acta Ophthalmol 2016; 94:e251-9. [PMID: 26846201 DOI: 10.1111/aos.12931] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 10/17/2015] [Indexed: 12/23/2022]
Abstract
PURPOSE Several pharmacoepidemiologic studies have been carried out evaluating the risk of retinal detachment associated with systemic fluoroquinolones. This meta-analysis aims to investigate such association, in the light of the best scientific evidence available. METHODS A literature search was conducted to identify relevant studies evaluating the risk for retinal detachment associated with systemic fluoroquinolones. A meta-analysis was performed to pool rate ratios (RRs). Meta-regressions were conducted aiming to evaluate the influence of time interval between fluoroquinolones use and retinal detachment diagnosis or treatment risk estimates. RESULTS Ten observational studies from seven publications were included. Overall, fluoroquinolones were not associated with an increased risk for retinal detachment [RR 1.47 (95% CI 0.95-2.27): p = 0.09; I(2) = 92.8%]. When the analysis was stratified according to different study designs, the result was statistically significant for retrospective cohort studies [RR 1.87 (95% CI 1.36-2.58); p < 0.001; I(2) = 0.0%] and for past users of fluoroquinolones, based on data from case-control studies [RR 1.07 (95% CI 1.01-1.12); p = 0.01; I(2) = 0.0%]. According to meta-regressions, the risk for retinal detachment did not vary due to different time intervals between fluoroquinolones prescription and retinal detachment occurrence. No statistically significant results were identified among studies evaluating only rhegmatogenous retinal detachments, as well as among studies that evaluated patients not requiring a prior ophthalmologist visit to be included. CONCLUSIONS In light of the current available evidence, systemic fluoroquinolones do not seem to be associated with retinal detachment.
Collapse
Affiliation(s)
- Carlos Alves
- Central Portugal Regional Pharmacovigilance Unit (UFC); Centre for Health Technology Assessment and Drug Research (CHAD); AIBILI - Association for Innovation and Biomedical Research on Light and Image; Coimbra Portugal
- School of Pharmacy; University of Coimbra; Coimbra Portugal
| | - Ana Penedones
- Central Portugal Regional Pharmacovigilance Unit (UFC); Centre for Health Technology Assessment and Drug Research (CHAD); AIBILI - Association for Innovation and Biomedical Research on Light and Image; Coimbra Portugal
- School of Pharmacy; University of Coimbra; Coimbra Portugal
| | - Diogo Mendes
- Central Portugal Regional Pharmacovigilance Unit (UFC); Centre for Health Technology Assessment and Drug Research (CHAD); AIBILI - Association for Innovation and Biomedical Research on Light and Image; Coimbra Portugal
- School of Pharmacy; University of Coimbra; Coimbra Portugal
| | - Francisco Batel Marques
- Central Portugal Regional Pharmacovigilance Unit (UFC); Centre for Health Technology Assessment and Drug Research (CHAD); AIBILI - Association for Innovation and Biomedical Research on Light and Image; Coimbra Portugal
- School of Pharmacy; University of Coimbra; Coimbra Portugal
| |
Collapse
|
69
|
Abstract
PURPOSE To describe a technique of wide-angle viewing as an educational tool in scleral buckling for rhegmatogenous retinal detachment. METHODS Retrospective comparative study of the reported technique was performed. Fourteen consecutive patients each who underwent Chandelier-assisted scleral buckling (CSB) or standard scleral buckling (SSB) using indirect ophthalmoscope were included. The primary outcome measure was the proportion of eyes that had successful reattachment of retina. RESULTS Mean study eye baseline visual acuity was 20/160 in the CSB group and 20/320 in SSB group. The primary reattachment rate was similar, with 13 of 14 eyes (92.85%) successfully attached in the CSB group and 12 of 14 eyes (85.71%) in the SSB group. The mean visual acuity improved from 20 of 160 to 20 of 80 in the CSB group, and 20 of 320 to 20 of 160 in the SSB group. The surgical time was significantly less in the CSB group (77.85 ± 16.37 minutes) compared with the SSB group (95.71 ± 26.59 minutes, P = 0.037). CONCLUSION Chandelier-assisted buckling had similar outcomes compared with standard buckling. It could be used as a valuable educational tool for teaching fellows by allowing them to simultaneously view the operative steps along with the surgeon.
Collapse
|
70
|
Vision-related quality of life, metamorphopsia, and stereopsis after successful surgery for rhegmatogenous retinal detachment. Eye (Lond) 2015; 30:40-5. [PMID: 26427988 DOI: 10.1038/eye.2015.171] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 07/12/2015] [Indexed: 11/08/2022] Open
Abstract
PurposeTo determine the relationship between vision-related quality of life, metamorphopsia, and stereopsis after successful surgery to correct rhegmatogenous retinal detachment (RRD).Patients and methodsData were obtained from 30 patients with RRD who had scleral buckle surgery or vitrectomy. Age, gender, duration of blurred vision, the best-corrected visual acuity (BCVA), extent of detachment, and the location of retinal tears were measured before surgery. Approximately 1 year after surgery, stereopsis was measured with the Randot stereo test, visual acuity (VA) was measured using a Snell VA acuity measurement at a distance of 5 m and was presented as a linear LogMAR value, metamorphopsia was examined using an M-chart, and vision-related quality of life was determined using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25).ResultsAll of the patients achieved anatomical retinal reattachment. There was a significant difference between preoperative BCVA (0.78±0.72) and BCVA 1 year postoperatively (0.25±0.25) (P<0.05). Twenty-three patients had visual distortion postoperatively, including vertical metamorphopsia (0.53±0.52°), and horizontal metamorphopsia (0.48±0.53°). Twenty patients had no stereopsis. The composite score of VFQ-25 was 76.60 postoperatively. Significant differences in postoperative BCVA, metamorphopsia, and VFQ-25 were found between macula-on and macula-off groups (all P<0.05). There was a negative correlation between VFQ-25 composite score and metamorphopsia (P<0.005); there was no significant correlation between VFQ-25 composite score and BCVA or stereopsis.ConclusionVision-related quality of life correlated with metamorphopsia, but did not correlate with VA or stereopsis.
Collapse
|
71
|
Park SW, Kwon HJ, Kim HY, Byon IS, Lee JE, Oum BS. Comparison of scleral buckling and vitrectomy using wide angle viewing system for rhegmatogenous retinal detachment in patients older than 35 years. BMC Ophthalmol 2015; 15:121. [PMID: 26362540 PMCID: PMC4566311 DOI: 10.1186/s12886-015-0109-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/04/2015] [Indexed: 11/23/2022] Open
Abstract
Background To compare scleral buckling (SB) and pars plana vitrectomy (PPV) using a wide angle viewing system (WAVS) for uncomplicated phakic rhegmatogenous retinal detachment (RRD). Methods The medical records of patients with uncomplicated phakic RRD were retrospectively reviewed. Eyes with pseudophakic or attached fovea were excluded. Patients treated with SB were classified as group B, and PPV using WAVS as group V. Primary success rate, visual acuity (VA), macular complications, and sustained subretinal fluid (SRF) were compared between groups. Results Seventy-two eyes were included in group B and 57 eyes in group V. Group B had better preoperative VA (1.38 ± 0.87 vs 1.84 ± 0.97 in LogMAR, P = 0.010), but worse final VA (0.51 ± 0.48 vs 0.30 ± 0.23, P = 0.012) than group V. The primary success rate of 94.7 % in group V was higher than 77.8 % in group B (P = 0.010). Final success rate was 100 % in both groups. There was no significant difference in macular complications between groups (P = 0.087). Sustained SRF was found in 22 eyes in group B (38.6 %), while only two eyes in group V exhibited sustained SRF (2.8 %, P < 0.001). Conclusions Pars plana vitrectomy using WAVS was more efficacious than SB for treating uncomplicated phakic RRD.
Collapse
Affiliation(s)
- Sung Who Park
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea. .,Biomedical Research Institute, Pusan National University Hospital, Pusan, South Korea.
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea.
| | - Ho Yun Kim
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea.
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea. .,Medical Institute, School of Medicine, Pusan National University, Pusan, South Korea. .,Biomedical Research Institute, Pusan National University Hospital, Pusan, South Korea.
| | - Boo Sup Oum
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea.
| |
Collapse
|
72
|
Abstract
Flashes and floaters are common ocular complaints. Flashes refer to aberrations of light that are seen in a patient's field of gaze. The flashes can be of varying sizes, colors, frequency, and durations, depending on the cause. Floaters are another common visual phenomenon caused by particles or debris in the vitreous gel of the eye that cause shadows and thus visual changes, especially against bright backgrounds and in brightly lit environments. Flashes and floaters can occur individually or together. This article discusses common causes of flashes and floaters to help with the triaging and management of these patients.
Collapse
Affiliation(s)
- Priya Sharma
- Wills Eye Hospital, General Ophthalmology Service, 840 Walnut Street, Suite 800, Philadelphia, PA 19107, USA
| | - Jayanth Sridhar
- Mid Atlantic Retina, Retina Service, Wills Eye Hospital, 840 Walnut Street, Suite 1020, Philadelphia, PA 19107, USA
| | - Sonia Mehta
- Vitreoretinal Diseases & Surgery Service, Wills Eye Hospital, Department of Ophthalmology, Thomas Jefferson University Hospital, 840 Walnut Street, Suite 1020, Philadelphia, PA 19107, USA.
| |
Collapse
|
73
|
Falkner-Radler CI, Graf A, Binder S. Vitrectomy combined with endolaser or an encircling scleral buckle in primary retinal detachment surgery: a pilot study. Acta Ophthalmol 2015; 93:464-469. [PMID: 25626910 DOI: 10.1111/aos.12663] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 12/15/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare pars plana vitrectomy and 360° endolaser therapy with pars plana vitrectomy and an encircling scleral buckle for the treatment of primary rhegmatogenous retinal detachments in a randomized pilot study including 60 patients. METHODS Main outcome measures were single-surgery anatomic success rate and final best-corrected visual acuity at 6 months follow-up. Cofactors analysed were complication rates, patients' comfort, refractive outcome and macula status assessed using a spectral-domain optical coherence tomography. RESULTS With differences between both treatment groups regarding type of the retinal detachment, localization of retinal tears (p = 0.0085) and the choice of the intraocular tamponade (p < 0.0202), there were no significant differences between the single-surgery anatomic success rate (93.33% both groups, p = 1.0) and the visual acuity at final follow-up (≤0.3 logMAR [logarithm of minimum angle of resolution] in 66.67% in the endolaser group versus 40.0% in the scleral buckle group, p = 0.0514). Questionnaire responses showed lower levels of patients' discomfort in the endolaser group. A significant difference between both groups was found in the refractive error change after surgery (-0.20 ± 0.51 dioptres in the endolaser group versus -0.88 ± 0.88 dioptres in the scleral buckle group, p = 0.0003). CONCLUSION Primary vitrectomy combined with 360° endolaser therapy seems to be as effective as vitrectomy combined with an encircling scleral buckle in patients with rhegmatogenous retinal detachment, with possible benefits of an improved patients' comfort and a more stable refractive status after surgery.
Collapse
Affiliation(s)
- Christiane I. Falkner-Radler
- Department of Ophthalmology; The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser Surgery; Rudolf Foundation Clinic; Vienna Austria
| | - Alexandra Graf
- Section of Medical Statistics; Center for Medical Statistics, Informatics and Intelligent Systems; Medical University of Vienna; Vienna Austria
| | - Susanne Binder
- Department of Ophthalmology; The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser Surgery; Rudolf Foundation Clinic; Vienna Austria
| |
Collapse
|
74
|
Kim KN, Lee HJ, Heo DW, Jo YJ, Kim JY. Combined cataract extraction and vitrectomy for macula-sparing retinal detachment: visual outcomes and complications. KOREAN JOURNAL OF OPHTHALMOLOGY 2015; 29:147-54. [PMID: 26028941 PMCID: PMC4446553 DOI: 10.3341/kjo.2015.29.3.147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 10/20/2014] [Indexed: 12/03/2022] Open
Abstract
Purpose To evaluate the visual outcome of combined phacoemulsification, intraocular lens implantation, and vitrectomy for macula-sparing rhegmatogenous retinal detachment. Methods The results of combined vitrectomy with cataract extraction were retrospectively analyzed in patients with preexisting cataracts and new-onset rhegmatogenous retinal detachment. To qualify, patients must also have had macular sparing in a region 6,000 µm in diameter on optical coherence tomography. The anatomical success rate, visual outcomes, and postoperative complications relating to visual acuity were evaluated. Results In 56 patients followed postoperatively for more than 12 months, the initial and final surgical success rate was 96.4% and 100%, respectively. The mean preoperative logarithm of the minimum angle of resolution visual acuity was 0.05 and decreased to 0.11 postoperatively (p < 0.001). Of the 56 patients, 20 (35.7%) had worse visual acuity postoperatively, compared with preoperatively (0.06 vs. 0.27, p < 0.001); these cases were comprised of six patients with epiretinal membranes, 12 patients with a posterior capsule opacity, and two patients with cystoid macular edema. In the remaining 36 patients, there were no significant differences in visual acuity preoperatively and postoperatively (0.04 vs. 0.03, p = 0.324). Conclusions In patients with cataracts who develop macula-sparing rhegmatogenous retinal detachment and whose visual prognosis is excellent assuming the retina can be reattached successfully, combined phacoemulsification, intraocular lens implantation, and vitrectomy might be an effective treatment. However, the visual prognosis is significantly affected by postoperative complications such as an epiretinal membranes, posterior capsule opacity, and cystoid macular edema. Therefore, further studies should examine methods to prevent these postoperative complications.
Collapse
Affiliation(s)
- Kyoung-Nam Kim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea. ; Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Haeng-Jin Lee
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
| | - Dong-Won Heo
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
| | - Young-Joon Jo
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea. ; Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jung-Yeul Kim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea. ; Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
| |
Collapse
|
75
|
Shin IH, Lee SB, Kim JY, Jo YJ. A Case of Pseudomonas aeruginosaInfection after Scleral Buckling for Retinal Detachment. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.10.1646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Il Hwan Shin
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sung Bok Lee
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jung Yeul Kim
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Young Joon Jo
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
| |
Collapse
|
76
|
Selected Disorders of the Eye. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_134-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
77
|
van de Put MAJ, Hoeksema L, Wanders W, Nolte IM, Hooymans JMM, Los LI. Postoperative vision-related quality of life in macula-off rhegmatogenous retinal detachment patients and its relation to visual function. PLoS One 2014; 9:e114489. [PMID: 25460011 PMCID: PMC4252118 DOI: 10.1371/journal.pone.0114489] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 11/10/2014] [Indexed: 12/02/2022] Open
Abstract
Objective To determine the vision-related quality of life (VR-QOL) after surgery for macula-off rhegmatogenous retinal detachment (RRD) in relation to visual acuity, contrast acuity, and color vision. Methods In a prospective observational study, we included 55 patients with a macula-off RRD. Best corrected visual acuity (BCVA), color vision (saturated and desaturated color confusion indices (CCI)) and contrast acuity were measured at 12 months postoperatively in both the RRD eye and the fellow control eye, and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was filled out. Results Operated and fellow control eyes differed significantly in mean LogMAR BCVA (P<0.0001), median Log contrast acuity (P<0.0001), saturated CCI (P = 0.009), and desaturated CCI (P = 0.016). Significant correlations were observed between the NEI VFQ-25 overall composite score and postoperative LogMAR BCVA (R = −0.551, P<0.0001), contrast acuity (R = 0.472, P<0.0001), saturated CCI (R = −0.315, P = 0.023), and desaturated CCI (R = −0.283, P = 0.044). Conclusions A lower VR-QOL was highly correlated to a worse postoperative BCVA and contrast acuity and to a lesser extent to color vision disturbances.
Collapse
Affiliation(s)
- Mathijs A. J. van de Put
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- * E-mail:
| | - Lisette Hoeksema
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
| | - Wouter Wanders
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ilja M. Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Johanna M. M. Hooymans
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
| | - Leonoor I. Los
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
78
|
Mechanical models of the dynamics of vitreous substitutes. BIOMED RESEARCH INTERNATIONAL 2014; 2014:672926. [PMID: 25147810 PMCID: PMC4131473 DOI: 10.1155/2014/672926] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 07/09/2014] [Indexed: 11/18/2022]
Abstract
We discuss some aspects of the fluid dynamics of vitreous substitutes in the vitreous chamber, focussing on the flow induced by rotations of the eye bulb. We use simple, yet not trivial, theoretical models to highlight mechanical concepts that are relevant to understand the dynamics of vitreous substitutes and also to identify ideal properties for vitreous replacement fluids. We first recall results by previous authors, showing that the maximum shear stress on the retina grows with increasing viscosity of the fluid up to a saturation value. We then investigate how the wall shear stress changes if a thin layer of aqueous humour is present in the vitreous chamber, separating the retina from the vitreous replacement fluid. The theoretical predictions show that the existence of a thin layer of aqueous is sufficient to substantially decrease the shear stress on the retina. We finally discuss a theoretical model that predicts the stability conditions of the interface between the aqueous and a vitreous substitute. We discuss the implications of this model to understand the mechanisms leading to the formation of emulsion in the vitreous chamber, showing that instability of the interface is possible in a range of parameters relevant for the human eye.
Collapse
|
79
|
van de Put MAJ, Croonen D, Nolte IM, Japing WJ, Hooymans JMM, Los LI. Postoperative recovery of visual function after macula-off rhegmatogenous retinal detachment. PLoS One 2014; 9:e99787. [PMID: 24927502 PMCID: PMC4057275 DOI: 10.1371/journal.pone.0099787] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 05/17/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To determine which factors affect the recovery of visual function in macula off rhegmatogenous retinal detachment (RRD). METHODS In a prospective study of forty-five patients with a primary macula-off RRD of 24 hours to 6 weeks duration, the height of the macular detachment was determined by ultrasonography. At 12 months postoperatively, best corrected visual acuity (BCVA), contrast acuity, and color confusion indexes (CCI) were obtained. RESULTS Macular detachment was present for 2-32 (median 7) days before repair. A shorter duration of macular detachment was correlated with a better CCI saturé (p = 0.0026) and lower LogMAR BCVA (better Snellen visual acuity) (p = 0.012). Also, a smaller height of macular detachment was correlated with a lower LogMAR BCVA (p = 0.0034). A younger age and lower pre-operative LogMAR BCVA at presentation were both correlated with better postoperative contrast acuity in the total group (age: p = 1.7×10(-4) and pre-operative LogMAR BCVA: p = 0.0034). CONCLUSION Functional recovery after macula-off RRD is affected by the duration and the height of the macular detachment. Recovery of contrast acuity is also affected by age and BCVA at presentation. MEETING PRESENTATION ARVO annual meeting 2013, May 7, Seattle, Washington, United States of America. TRIAL REGISTRATION trialregister.nl NTR839.
Collapse
Affiliation(s)
- Mathijs A. J. van de Put
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Danna Croonen
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ilja M. Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Wouter J. Japing
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Johanna M. M. Hooymans
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
| | - Leonoor I. Los
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
80
|
Abstract
Ophthalmic sonography has been practiced for more than 50 years, but it is not an area of sonography that is familiar to many physicians and sonographers. However, it can be very helpful as a means to noninvasively evaluate for specific anomalies and also assist in cases of trauma. This article has been written to describe ocular sonography and its clinical capabilities in a wide variety of settings, from an individual physician office to a busy emergency department.
Collapse
|
81
|
Ghasemi Falavarjani K, Hashemi M, Modarres M, Hadavand Khani A. Intrasilicone oil injection of bevacizumab at the end of retinal reattachment surgery for severe proliferative vitreoretinopathy. Eye (Lond) 2014; 28:576-80. [PMID: 24556886 DOI: 10.1038/eye.2014.21] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 12/30/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the role of bevacizumab injected into the silicone oil at the end of retinal reattachment surgery for rhegmatogenous retinal detachment (RRD) associated with severe proliferative vitreoretinopathy (PVR) for prevention of postoperative PVR and compare the results with those without intrasilicone injection. METHODS In this prospective comparative interventional study, eyes with RRD with grade C PVR were included. Standard 20 gauge pars plana vitrectomy, and retinal reattachment was performed. In case group, 1.25 mg bevacizumab was injected into the silicone oil at the end of surgery. The rate of retinal redetachment associated with PVR was assessed. RESULTS In all 38 eyes of 38 patients (19 cases and 19 controls) with a mean age of 46.6 ± 18.3 years were studied. The two groups were matched for age, sex, preoperative visual acuity, presence of anterior and posterior PVR, extent of PVR, and history of previous retinal detachment surgery. Retinal redetachment with PVR occurred in nine (47.3%) and seven (36.8%) eyes in case and control groups, respectively (P=0.5). Extensive subretinal fibrous proliferations in addition to preretinal membranes occurred more in the case group (55.5 vs 14.3%). At final visit, visual acuity was similar between the two groups (1.6 ± 0.8 and 1.6 ± 0.6, respectively, P=0.9). CONCLUSION Intrasilicone injection of bevacizumab at the end of vitrectomy for RRD with severe PVR does not eliminate the risk of postoperative PVR.
Collapse
Affiliation(s)
- K Ghasemi Falavarjani
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Hashemi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Modarres
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - A Hadavand Khani
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
82
|
Ma Y, Ying X, Zou H, Xu X, Liu H, Bai L, Xu X, Zhang X. Cost-utility analysis of rhegmatogenous retinal detachment surgery in Shanghai, China. Ophthalmic Epidemiol 2014; 22:13-9. [PMID: 24527711 DOI: 10.3109/09286586.2014.884601] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To perform a short-term and a long-term cost-utility analysis of rhegmatogenous retinal detachment (RRD) surgery in Shanghai, China. METHODS A total of 117 patients who underwent RRD surgery at Shanghai First People's Hospital, Affiliated Shanghai Jiaotong University, and then underwent follow-up for at least 1 year, were included in the study. Costs associated with RRD surgery and time trade-off utility values before and after surgery were recorded. Short-term analysis was made for 1 year. Quality-adjusted life years (QALYs) gained by RRD surgery over the lifetime were calculated at a 3% discount rate in the long-term analysis. This study used the bootstrap method in statistical analysis and one-way sensitivity analyses to test robustness of the results. RESULTS Compared with no treatment, the mean incremental costs of RRD surgery was 11,384 Chinese yuan (CN¥) (US$1751); the mean additional QALYs gained was 0.05 (95% confidence interval [CI] 0.04-0.06) for 1 year and 0.88 (95% CI 0.64-1.13) for life expectancy; the incremental cost effectiveness ratio (ICER) was CN¥224,921 (US$34,603)/QALY for the short-term, and CN¥13,794 (US$2122)/QALY for the long-term. In short-term analysis, the ICER was CN¥150,087 (US$23,090)/QALY for scleral buckling surgery, and CN¥507,727 (US$78,112)/QALY for vitreous surgery. In the long-term analysis, the ICER was CN¥6280 (US$966)/QALY for scleral buckling, and CN¥30,756 (US$4732)/QALY for vitreous surgery. CONCLUSIONS For RRD patients, surgery increases QALYs. In a 1-year analysis, surgery is not a cost-effective treatment, however it is cost-effective over the lifetime.
Collapse
Affiliation(s)
- Yingyan Ma
- Department of Ophthalmology, Shanghai First People's Hospital, Affiliated Shanghai Jiaotong University , Shanghai , China
| | | | | | | | | | | | | | | |
Collapse
|
83
|
Feltgen N, Walter P. Rhegmatogenous retinal detachment--an ophthalmologic emergency. DEUTSCHES ARZTEBLATT INTERNATIONAL 2014; 111:12-21; quiz 22. [PMID: 24565273 PMCID: PMC3948016 DOI: 10.3238/arztebl.2014.0012] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/09/2013] [Accepted: 09/09/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Rhegmatogenous retinal detachment is the most common retinological emergency threatening vision, with an incidence of 1 in 10 000 persons per year, corresponding to about 8000 new cases in Germany annually. Without treatment, blindness in the affected eye may result. METHOD Selective review of the literature. RESULTS Rhegmatogenous retinal detachment typically presents with the perception of light flashes, floaters, or a "dark curtain." In most cases, the retinal tear is a consequence of degeneration of the vitreous body. Epidemiologic studies have identified myopia and prior cataract surgery as the main risk factors. Persons in the sixth and seventh decades of life are most commonly affected. Rhegmatogenous retinal detachment is an emergency, and all patients should be seen by an ophthalmologist on the same day that symptoms arise. The treatment consists of scleral buckle, removal of the vitreous body (vitrectomy), or a combination of the two. Anatomical success rates are in the range of 85% to 90%. Vitrectomy is followed by lens opacification in more than 70% of cases. The earlier the patient is seen by an ophthalmologist, the greater the chance that the macula is still attached, so that visual acuity can be preserved. CONCLUSION Rhegmatogenous retinal detachment is among the main emergency indications in ophthalmology. In all such cases, an ophthalmologist must be consulted at once.
Collapse
|
84
|
Feltgen N, Heimann H, Hoerauf H, Walter P, Hilgers RD, Heussen N. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR study): Risk assessment of anatomical outcome. SPR study report no. 7. Acta Ophthalmol 2013; 91:282-7. [PMID: 22336429 DOI: 10.1111/j.1755-3768.2011.02344.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The 'Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study' (SPR study) is a randomized multicentre trial comparing primary vitrectomy (PV) and scleral buckling surgery (SB) for rhegmatogenous retinal detachment (RRD). This subanalysis was conducted to identify risk factors associated with anatomical outcomes. METHODS Relating the anatomical success results at the 1-year follow-up visit to pre- and intraoperative findings using multivariate statistical methods. RESULTS In the phakic subtrial, anatomical success was negatively associated with the number of breaks (p < 0.0001), break extension > 1 clock hour (p = 0.0005) and intraoperative use of cryotherapy (p = 0.0484). It was positively associated with retinal breaks with irregular edges (p = 0.0353) and subretinal fluid drainage (p = 0.0155). In the pseudophakic/aphakic subtrial, anatomical success was negatively associated with the number of retinal breaks (p = 0.0004) and previous YAG capsulotomy (p = 0.0256), and the combined effect of the surgical procedure and intraoperative use of laser (p = 0.0229). CONCLUSION Primary anatomical success is an important result for patients undergoing RRD surgery. Our data demonstrate that the final anatomical outcome is related to a higher preoperative number of breaks and cryotherapy in phakic eyes. Additional risk factors varied between phakic and pseudophakic subgroups. Our findings may be used to facilitate the prognosis of future patients with RRD.
Collapse
Affiliation(s)
- Nicolas Feltgen
- Department of Ophthalmology, Georg-August University Hospital, Goettingen, Germany.
| | | | | | | | | | | |
Collapse
|
85
|
Cheng HC, Lee SM, Lee FL, Liu JH, Kuan CH, Lin PK. Short-term external buckling with pneumatic retinopexy for retinal detachment with inferior retinal breaks. Am J Ophthalmol 2013; 155:750-6, 756.e1. [PMID: 23317649 DOI: 10.1016/j.ajo.2012.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 11/01/2012] [Accepted: 11/06/2012] [Indexed: 11/16/2022]
Abstract
PURPOSE To introduce a new approach for short-term external scleral buckling with pneumatic retinopexy for the management of rhegmatogenous retinal detachment with inferior retinal breaks. DESIGN Retrospective, noncomparative, interventional case series. METHODS A review of 33 consecutive eyes of 31 patients who underwent external buckling with pneumatic retinopexy for uncomplicated rhegmatogenous retinal detachment with inferior retinal breaks from December 2006 through December 2010. An external buckle was made of a 505 sponge sutured along the blunt side of a 279 tyre (MIRA Inc). The buckle was inserted deeply into the inferior fornix without suture after pneumatic retinopexy and was kept in place for 3 days. Primary and final anatomic outcomes, visual acuity, and adverse events were recorded. RESULTS All patients tolerated the procedure. The mean follow-up period was 24.0 months (range, 9 to 61 months). Primary success, defined as successful retinal reattachment within 6 months without further treatment, was achieved in 29 (87.9%) eyes. All patients attained final retinal reattachment (100%). Overall, the mean best-corrected visual acuity improved significantly at the end of follow-up (0.30 logarithm of the minimal angle of resolution units; Snellen equivalent, 6/12), compared with the preoperative best-corrected visual acuity (0.82 logarithm of the minimal angle of resolution units; Snellen equivalent, 6/38; P < .001). CONCLUSIONS Short-term external buckling with pneumatic retinopexy is a novel and effective treatment for rhegmatogenous retinal detachment with inferior retinal breaks, with a comparable success rate with other treatment methods. This approach also can avoid complications of long-term buckle implantation. Further comparative cohort studies may be necessary to compare the clinical efficacy with other conventional operations.
Collapse
Affiliation(s)
- Hui-Chen Cheng
- Department of Ophthalmology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
86
|
The Incidence of Rhegmatogenous Retinal Detachment in The Netherlands. Ophthalmology 2013; 120:616-622. [DOI: 10.1016/j.ophtha.2012.09.001] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 08/24/2012] [Accepted: 09/04/2012] [Indexed: 11/20/2022] Open
|
87
|
Abstract
OBJECTIVE To report a case of scleral buckle infection by Alternaria fungus. CASE REPORT A 75-year-old male who underwent rhegmatogenous retinal detachment repair 11 years ago developed a scleral buckle infection during the course of serial injections of bevacizumab for the treatment of wet age-related macular degeneration. Removal of the scleral buckle was done and culture results revealed Alternaria species. RESULTS The infected scleral buckle was removed and the patient received oral voriconazole. The patient's best corrected visual acuity changed from 20/50 preoperatively to 20/150 six months after the procedure. CONCLUSION Alternaria species may be encountered as a cause of scleral buckle infection.
Collapse
Affiliation(s)
- Sophie J Bakri
- Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA.
| | | |
Collapse
|
88
|
Zhai YR, Zhong J, Yan R, Li K, Zeng D. A novel method of obtaining 3D images of detached retina. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2012; 108:665-668. [PMID: 22153784 DOI: 10.1016/j.cmpb.2011.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 10/19/2011] [Accepted: 11/20/2011] [Indexed: 05/31/2023]
Abstract
We describe a new method of obtaining three-dimensional (3D) images of detached retina. Twelve-slice photos of the partial retina were obtained according to the twelve positions on a clock face. Twelve sections were then cut from these photos and joined together. Each sector was resized to match nearby sectors and the complete retinal picture was then created. A sphere mapping algorithm was used to map the two-dimensional (2D) picture to a sphere, which was then used to simulate the actual eyeball. Finally, a 3D image of the entire retina with a clearly visible detached section was created by the Visualization Toolkit (VTK).
Collapse
Affiliation(s)
- Yi-ran Zhai
- Key Laboratory for Neuro Information of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, and The Ophthalmology Department of Sichuan Province People's Hospital, Chengdu 610054, People's Republic of China.
| | | | | | | | | |
Collapse
|
89
|
Persistent subfoveal fluid and increased preoperative foveal thickness impair visual outcome after macula-off retinal detachment repair. Retina 2012; 31:1505-12. [PMID: 21522038 DOI: 10.1097/iae.0b013e31820a6910] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the influence of subfoveal fluid and foveal thickness on visual outcome in patients who underwent reattachment surgery for rhegmatogenous retinal detachment (RRD). METHODS This prospective study included 53 patients who were undergoing successful scleral buckling surgery for primary RRD. A thorough ophthalmologic examination including best-corrected visual acuity, slit-lamp biomicroscopy, binocular indirect ophthalmoscopy, and optical coherence tomography scanning was performed preoperatively and during all subsequent follow-up visits at 1, 3, 6, 9, 12, and 24 months postoperatively. RESULTS Preoperative foveal thickness was significantly higher in the macula-off group (n = 38) compared with the macula-on group (n = 15) (P < 0.0001), whereas postoperative measurements were normal in both the groups. Linear mixed-model analysis revealed that persistent subfoveal fluid (P = 0.0004) was an independent predictor of a worse visual outcome after scleral buckling surgery for primary macula-off RRD, although the effect on visual outcome was small (0.1 logarithm of the minimal angle of resolution units). Moreover, increased preoperative foveal thickness was associated with a worse visual prognosis in macula-off RRD (P = 0.010). CONCLUSION Persistent subfoveal fluid and increased preoperative foveal thickness were associated with a worse visual prognosis in macula-off RRD patients, albeit the effect of persistent subfoveal fluid was small and temporary.
Collapse
|
90
|
Combined Baerveldt glaucoma implant and scleral buckling surgery for patients with retinal detachment and coexisting glaucoma. J Glaucoma 2012; 22:294-300. [PMID: 22210178 DOI: 10.1097/ijg.0b013e318241bc37] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report on the usefulness of combined Baerveldt glaucoma implantation (BGI) and scleral buckling surgery for patients with glaucoma requiring a scleral buckle for retinal detachment repair. METHODS Retrospective, consecutive, noncomparative, and interventional case series of 30 eyes (30 patients) that underwent simultaneous scleral buckle and BGI surgery, using a staged (group 1, n=21 patients) or nonstaged (group 2, n=9 patients) approach to BGI implantation. Successful intraocular pressure (IOP) control was defined as 6 mm Hg≤IOP≤18 mm Hg. RESULTS Although not statistically significant, mean best corrected visual acuity (LogMAR) improved from 2.0 before surgery to 1.7 after surgery (P=0.13) with a mean follow-up of 27.7 months. Of the 21 patients in group 1, only 13 (62%) required second-stage tube insertion at a mean of 7.0±8.0 months (range, 1 to 24 mo) postoperatively. For these eyes combined with group 2 eyes, mean IOP was reduced from 31.1±10.8 to 12.7±6.0 mm Hg (P<0.0001), and the mean number of glaucoma medications was reduced from 2.9±1.4 to 1.2±1.3 (P<0.001). Life table rates of successful IOP control were 90% and 80% at 12 and 24 months, respectively. CONCLUSIONS Combined scleral buckle and BGI is an effective technique for managing coexisting glaucoma and retinal detachment and provides the clinician with a useful surgical option while minimizing surgical risk.
Collapse
|
91
|
Ricker LJAG, Kijlstra A, Kessels AGH, de Jager W, Hendrikse F, La Heij EC. Adipokine levels in subretinal fluid from patients with rhegmatogenous retinal detachment. Exp Eye Res 2011; 94:56-62. [PMID: 22138416 DOI: 10.1016/j.exer.2011.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 11/10/2011] [Accepted: 11/15/2011] [Indexed: 01/02/2023]
Abstract
Adipokines have recently emerged as a novel group of mediators with important roles in inflammatory and immune responses and in the process of wound healing. This study investigated the involvement of several adipokines in the future development of proliferative vitreoretinopathy (PVR) following reattachment surgery for rhegmatogenous retinal detachment (RRD). A multiplex immunoassay was used to measure 6 different adipokines in 75 subretinal fluid samples collected during reattachment surgery for primary RRD. Twenty-one patients who developed a redetachment due to postoperative PVR after scleral buckling surgery (PVR group) were compared with age-, sex-, and storage-time-matched RRD samples from 54 patients with an uncomplicated postoperative course (RRD group). Levels of adiponectin (P = 0.006), cathepsin S (P = 0.001), and leptin (P = 0.041) were significantly elevated in the PVR group as compared to the RRD group. Levels of tissue inhibitor of metalloproteinase (TIMP)-1 were significantly lower in the PVR group than in the RRD group (P = 0.044). After correction for diabetes, body mass index (BMI), macular involvement, and preoperative PVR, the association between postoperative PVR development and adiponectin, cathepsin S, and TIMP-1 remained statistically significant (P < 0.05), whereas the significant correlation between PVR and elevated leptin levels was lost (P = 0.068). There were no significant differences in levels of chemerin (P = 0.351) and adipsin (P = 0.915). Of all adipokines investigated, multivariate logistic regression analysis showed that adiponectin was the exclusive predictor of the development of postoperative PVR after scleral buckling surgery (P = 0.003). Our findings indicate that, at the time of surgery for primary RRD, an altered expression of certain adipokines is associated with the future development of postoperative PVR.
Collapse
Affiliation(s)
- Lukas J A G Ricker
- Eye Research Institute Maastricht, Department of Ophthalmology, University Hospital Maastricht, Maastricht, The Netherlands.
| | | | | | | | | | | |
Collapse
|
92
|
Abstract
PURPOSE To assess trends and outcomes in retinal detachment (RD) surgery based on a retrospective, interventional, bicenter study. METHODS Baseline demographic data, surgical procedures, and outcomes from 230 patients with a diagnosis of primary rhegmatogenous RD, who underwent surgery between January 2007 and December 2008 at the Rudolf Foundation Clinic, Vienna (Center 1) and the Weill Cornell Medical College, New York, (Center 2) were analyzed using a regression model. RESULTS Besides the baseline parameters, lens status (P = 0.01), refraction (P = 0.01), retinal tears (P < 0.02), proliferative vitreoretinopathy (P = 0.02), and previous treatment (P < 0.02), the primary RD procedure (P < 0.0001) was significantly different between the 2 centers. In Center 1, scleral buckling was the most common primary RD procedure (66.19%) compared with vitrectomy (82.42%) in Center 2. Primary retinal reattachment (88.49% Center 1 vs. 84.62% Center 2, P = 0.43) and best-corrected visual acuity at the final follow-up (best-corrected visual acuity ≥ 0.3 logarithm of minimum angle of resolution 48.92% Center 1 vs. 47.25% Center 2, P = 0.78) were not significantly different between the 2 centers. CONCLUSION Although there is a trend toward primary vitrectomy, scleral buckling was preferred in the center in Vienna and primary vitrectomy in the center in New York. Despite the different primary RD procedures, anatomical and visual outcomes were comparable.
Collapse
|
93
|
Iserovich P, Qin Q, Petrukhin K. DPOFA, a Cl⁻/HCO₃⁻ exchanger antagonist, stimulates fluid absorption across basolateral surface of the retinal pigment epithelium. BMC Ophthalmol 2011; 11:33. [PMID: 22085910 PMCID: PMC3271048 DOI: 10.1186/1471-2415-11-33] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 11/15/2011] [Indexed: 11/25/2022] Open
Abstract
Background Retinal detachment is a disorder of the eye in which sensory retina separates from the retinal pigment epithelium (RPE) due to accumulation of fluid in subretinal space. Pharmacological stimulation of fluid reabsorption from subretinal space to choroid across the RPE has been suggested as a treatment strategy for retinal detachment. DPOFA, (R)-(+)-(5,6-dichloro 2,3,9,9a-tetrahydro 3-oxo-9a-propyl-1H-fluoren-7-yl)oxy]acetic acid, is an abandoned drug capable of inhibiting Cl-/HCO3- exchanger activity. We hypothesized that DPOFA may increase fluid absorption across basolateral surface of the RPE. Methods Reverse transcription polymerase chain reaction (RT-PCR) analysis of mRNA for six different transporters that may act as Cl-/HCO3- exchangers was conducted in bovine and human RPE to confirm that RPE from two species expresses the same repertoire of Cl-/HCO3- exchanger isoforms. The degree of amino acid homology between orthologous human and bovine RPE-specific isoforms was calculated after performing protein alignments. Transport of fluid across bovine RPE-choroid explants mounted in the Ussing chamber was used to assess the ability of DPOFA to modulate fluid absorption across the RPE. Results Using RT-PCR we showed that three isoforms (SLC4A2, SLC4A3, and SLC26A6) are strongly expressed in human and bovine RPE preparations. Amino acid comparisons conducted for RPE-specific isoforms support the use of bovine RPE-choroid explants as an adequate experimental system for assessing fluid absorption activity for DPOFA. Our data is consistent with the fact that DPOFA stimulates fluid absorption across the RPE in bovine RPE-choroid explants. Conclusions DPOFA seems to stimulate transport of water across the RPE in bovine RPE-choroid explants. Additional experiments are required to establish dose-dependent effect of DPOFA on fluid absorption in the bovine RPE-choroid experimental system.
Collapse
Affiliation(s)
- Pavel Iserovich
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | | | | |
Collapse
|
94
|
Romano MR, Vinciguerra P, Radice P, Scialdone A, Valldeperas X, Romano V, Romano F, Costagliola C. Outer retinal layers. Ophthalmology 2011; 118:1006-1006.e2. [PMID: 21539987 DOI: 10.1016/j.ophtha.2010.11.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Accepted: 11/22/2010] [Indexed: 10/18/2022] Open
|
95
|
Mehta S, Blinder KJ, Shah GK, Grand MG. Pars plana vitrectomy versus combined pars plana vitrectomy and scleral buckle for primary repair of rhegmatogenous retinal detachment. Can J Ophthalmol 2011; 46:237-41. [PMID: 21784208 DOI: 10.1016/j.jcjo.2011.05.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 09/20/2010] [Accepted: 11/05/2010] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare pars plana vitrectomy (PPV) with PPV and scleral buckle (PPV/SB) for repair of rhegmatogenous retinal detachment (RRD). DESIGN A retrospective chart review. PARTICIPANTS Patients who underwent PPV or PPV/SB for RRD repair at a single institution. METHODS A retrospective chart review of patients in two different treatment groups and analysis of the anatomic and functional results. RESULTS Single-surgery anatomic success was achieved in 31 of 37 (83.8%) phakic eyes that underwent PPV and in 66 of 68 (97.1%) phakic eyes that underwent PPV/SB (p = 0.0216). Among pseudophakic eyes, 42 of 48 (87.5%) in the PPV group and 62 of 66 (93.9%) in the PPV/SB group achieved single-surgery reattachment (p = 0.3175). Visual acuity improvement was marginally greater in the PPV group among phakic (p = 0.4898) and pseudophakic (p = 0.2465) eyes. CONCLUSIONS PPV/SB may be associated with a decreased risk for retinal redetachment when compared to PPV for repair of phakic RRD. In pseudophakic eyes, the anatomic success rate between the two techniques appears to be similar.
Collapse
Affiliation(s)
- Sachin Mehta
- Retinal Consultants of Arizona, Phoenix, AZ, USA
| | | | | | | |
Collapse
|
96
|
Interleukin and growth factor levels in subretinal fluid in rhegmatogenous retinal detachment: a case-control study. PLoS One 2011; 6:e19141. [PMID: 21556354 PMCID: PMC3083411 DOI: 10.1371/journal.pone.0019141] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 03/28/2011] [Indexed: 11/25/2022] Open
Abstract
Background Rhegmatogenous retinal detachment (RRD) is a major cause of visual loss in developed countries. Proliferative vitreoretinopathy (PVR), an eye-sight threatening complication of RRD surgery, resembles a wound-healing process with inflammation, scar tissue formation, and membrane contraction. This study was performed to determine the possible involvement of a wide range of cytokines in the future development of PVR, and to identify predictors of PVR and visual outcome. Methodology A multiplex immunoassay was used for the simultaneous detection of 29 different cytokines in subretinal fluid samples from patients with primary RRD. Of 306 samples that were collected and stored in our BioBank between 2001 and 2008, 21 samples from patients who developed postoperative PVR were compared with 54 age-, sex-, and storage-time–matched RRD control patients who had an uncomplicated postoperative course during the overall follow-up period. Findings Levels of IL-1α, IL-2, IL-3, IL-6, VEGF, and ICAM-1 were significantly higher (P<0.05) in patients who developed postoperative PVR after reattachment surgery than in patients with an uncomplicated postoperative course, whereas levels of IL-1β, IL-4, IL-5, IL-7, IL-9, IL-10, IL-11, IL-12p70, IL-13, IL-15, IL-17, IL-18, IL-21, IL-22, IL-23, IL-25, IL-33, TNF-α, IFN-γ, IGF-1, bFGF, HGF, and NGF were not (P>0.05). Multivariate logistic regression analysis revealed that IL-3 (P = 0.001), IL-6 (P = 0.047), ICAM-1 (P = 0.010), and preoperative visual acuity (P = 0.026) were independent predictors of postoperative PVR. Linear regression analysis showed that ICAM-1 (P = 0.005) and preoperative logMAR visual acuity (P = 0.001) were predictive of final visual outcome after primary RRD repair. Conclusions/Significance Our findings indicate that after RRD onset an exaggerated response of certain cytokines may predispose to PVR. Sampling at a time close to the onset of primary RRD may thus provide clues as to which biological events may initiate the development of PVR and, most importantly, may provide a means for therapeutic control.
Collapse
|
97
|
Abstract
BACKGROUND The pathogenesis of rhegmatogenous retinal detachment is complex, and our knowledge of the exact mechanism of vitreoretinal attachment and detachment remains incomplete. METHODS We performed a Medline, Ovid, and EMBASE search using search words rhegmatogenous, retinal detachment, vitreous, and retinal adhesion. All appropriate articles were reviewed, and the evidence was compiled. RESULTS Cortical vitreous contains fibrillar collagens type II, V/XI, and IX. The inner limiting membrane of the retina contains collagens type I, IV, VI, and XVIII as well as numerous other glycoproteins and potential adhesion molecules. The distribution and age-related changes in the structure of these molecules play an important role in the formation of a retinal break, which may compromise and disrupt the normal mechanisms of neurosensory retinal adhesion. CONCLUSION Rhegmatogenous retinal detachment development is intimately related to changes in the fibrillar structure of the aging vitreous culminating in posterior vitreous detachment with regions of persistent and tangential vitreoretinal traction predisposing to retinal tear formation. A complex interplay of factors such as weakening of vitreoretinal adhesion, posterior migration of the vitreous base, and molecular changes at the vitreoretinal interface are important in predisposing to focal areas of vitreoretinal traction precipitating rhegmatogenous retinal detachment. Once formed, the passage of liquefied vitreous through a retinal break may overwhelm normal neurosensory-retinal pigment epithelium adhesion perpetuating and extending detachment and causing visual loss. To understand the molecular events underlying rhegmatogenous retinal detachment so that new therapies can be developed, it is important to appreciate the structural organization of the vitreous, the biology underlying vitreous liquefaction and posterior vitreous detachment, and the mechanisms of vitreoretinal attachment and detachment.
Collapse
|
98
|
|
99
|
Wykoff CC, Smiddy WE, Mathen T, Schwartz SG, Flynn HW, Shi W. Fovea-sparing retinal detachments: time to surgery and visual outcomes. Am J Ophthalmol 2010; 150:205-210.e2. [PMID: 20541738 DOI: 10.1016/j.ajo.2010.03.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Revised: 03/01/2010] [Accepted: 03/06/2010] [Indexed: 11/26/2022]
Abstract
PURPOSE To study the effect of the duration from initial evaluation to repair on outcomes for fovea-sparing rhegmatogenous retinal detachment (RRD). DESIGN Retrospective, single-surgeon, consecutive case series. METHODS Medical records were reviewed for preoperative and intraoperative factors possibly associated with visual and anatomic outcomes for all patients undergoing scleral buckling procedure (SBP) for fovea-sparing, primary RRD between 1989 and 2004. RESULTS Fifty-five percent of 199 patients had symptoms for < or = 7 days, 83% had best-corrected visual acuity (BCVA) > or = 20/40, and 33% had a RRD that had extended to within the macular arcade vessels. Eighty-five percent were operated within 3 days, including 56% within 24 hours. One case progressed to fovea-off status before surgery 4 days after initial evaluation (0.5%). The single-operation success rate was 88% and final anatomic success was 99.5% (1 patient refused reoperation). Eighty-six percent were examined postoperatively for at least 2 months; 73% had > or = 20/40 vision. The strongest predictor of postoperative BCVA was initial BCVA (r = 0.47; P < .001). There was no statistically significant difference in postoperative BCVA or single-operation success rate at any point within 3 days of initial examination. No statistically significant correlation was found between postoperative BCVA and duration of symptoms, RRD location, direction of the closest approach of the RRD to the fovea, or need for reoperation. CONCLUSIONS Progression to fovea-off status was rare in this series when a selectively urgent, but not strictly emergent, surgical approach was employed for fovea-sparing RRD.
Collapse
|
100
|
Leiderman YI, Miller JW. Proliferative vitreoretinopathy: pathobiology and therapeutic targets. Semin Ophthalmol 2009; 24:62-9. [PMID: 19373688 DOI: 10.1080/08820530902800082] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The cell biology and molecular mediators of proliferative vitreoretinopathy continue to be elucidated. The purpose of this review is to summarize contemporary findings in the visual and neurosciences relevant to the pathophysiology of proliferative vitreoretinopathy, with an emphasis on the biologic mediators that represent potential therapeutic targets.
Collapse
Affiliation(s)
- Yannek I Leiderman
- Retina Service, The Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA. Yannek
| | | |
Collapse
|