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Quiroz-Reyes MA, Quiroz-Gonzalez EA, Quiroz-Gonzalez MA, Lima-Gomez V. Postoperative Choroidal Vascular Biomarkers in Eyes with Rhegmatogenous Retinal Detachment-Related Giant Retinal Tears. Int J Retina Vitreous 2023; 9:45. [PMID: 37528479 PMCID: PMC10391839 DOI: 10.1186/s40942-023-00482-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
PURPOSE Choroidal vascularity index (CVI) and choriocapillaris flow area (CFA) are perfusion biomarkers relevant to retinal disease management. There is limited knowledge regarding these biomarkers in eyes that have been successfully treated for rhegmatogenous retinal detachment (RRD) due to giant retinal tears (GRTs). This study aimed to analyze the relationship between choroidal perfusion biomarkers and functional outcomes in surgically treated eyes with GRT-associated RRD and their fellow eyes. METHODS A total of 33 GRT eyes and 29 fellow eyes were included in this study. All RRD-GRT eyes were treated with vitrectomy and categorized into two groups based on whether additional scleral buckles (SB) were placed. Visual and choroidal features were compared between the groups. RESULTS The subjects had an average age of 55.18 years, a mean time of 2.36 weeks before surgery, and a mean follow-up time of 25.9 months. Best-corrected visual acuity (BCVA) was substantially worse in GRT eyes (1.9 logMAR) than in fellow control eyes (0.23 logMAR) but substantially improved after surgery (0.59 logMAR). There were no differences in the presurgical characteristics and BCVA between the eyes that did and did not undergo SB. Long-term CVI and CFA were lower in eyes with GRT than in their fellow eyes. Among eyes with GRT, those with SB had significantly lower CVI and CFA. Correlation analysis revealed that the CVI and CFA were positively correlated with visual outcomes (negative correlation with logMAR). CONCLUSION Despite successful surgical repair, long-term functional and choroidal evaluations showed permanent changes in eyes with GRT. Positive correlations between perfusion biomarkers and visual function suggest that better choroidal vasculature is associated with better visual outcomes. The results of this study highlight the benefits of analyzing choroidal vasculature biomarkers and the relationship between the choroidal anatomy and vision.
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Affiliation(s)
- Miguel A Quiroz-Reyes
- Retina Department of Oftalmologia Integral ABC, Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, Lomas de Chapultepec, 11000, Mexico City, Mexico.
| | - Erick A Quiroz-Gonzalez
- Retina Department of Oftalmologia Integral ABC, Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, Lomas de Chapultepec, 11000, Mexico City, Mexico
- Institute of Ophthalmology. Fundacion Conde de Valenciana, Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Calle Chimalpopoca 14. Col Obrera, 06800, Mexico, Mexico
| | - Miguel A Quiroz-Gonzalez
- Retina Department of Oftalmologia Integral ABC, Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, Lomas de Chapultepec, 11000, Mexico City, Mexico
| | - Virgilio Lima-Gomez
- Juarez Hospital, Public Assistance Institution (Nonprofit Organization), Av. Politecnico Nacional 5160, Colonia Magdalena de las Salinas, 07760, Mexico City, Mexico
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Malyugin BE, Shkvorchenko DO, Khurdaeva AG. [Long-term outcomes of treating rhegmatogenous retinal detachment with macular hole using platelet-rich blood plasma]. Vestn Oftalmol 2023; 139:6-10. [PMID: 37067926 DOI: 10.17116/oftalma20231390216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Currently there is no specific algorithm for treating rhegmatogenous retinal detachment complicated by macular hole. PURPOSE The study analyzed the long-term outcomes of surgical treatment of rhegmatogenous retinal detachment (RRD) complicated by macular hole (MH) using platelet-rich plasma (PRP) and local staining of the internal limiting membrane (ILM). MATERIAL AND METHODS This prospective open-label study included 27 patients (15 females and 12 males) aged 57 to 65 (59.2±7.2) years. In all studied cases, RRD complicated by MH was determined. The best corrected visual acuity (BCVA) before surgery was 0.05±0.01 (from 0.02 to 0.08). The average MH diameter measured with OCT was 576.3±150.4 μm (409 μm to 944 μm). After vitrectomy, a perfluororganic compound (PFOC) was injected into the MH area in amount of 2-3 optic nerve head diameters to prevent the ingress of dye under the retina, then the internal limiting membrane (ILM) was stained and removed. After sequential PFOC/air replacement, PRP was injected into the macular hole site. RESULTS AND DISCUSSION An increase in BCVA from 0.05±0.01 to 0.09±0.03 was observed in the preoperative period one month after surgery, with a further increase to 0.35±0.11 at the maximum follow-up time (two years). The MH was blocked and a glial scar was present in all cases according to OCT data. 1-2 years after the operation, all patients showed a favorable anatomical effect according to OCT data. According to computer microperimetry data, mean macular photosensitivity was 23.8±1.3 dB two years after the surgery. CONCLUSIONS This study shows a favorable anatomical and functional effect in patients with RRD and MH within a 2-year follow-up. A comparative study involving a larger cohort of patients is required to clarify the indications and contraindications for the use of the studied technique.
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Affiliation(s)
- B E Malyugin
- 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
| | - A G Khurdaeva
- S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Moscow, Russia
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Reeves MGR, Afshar AR, Pershing S. Need for Retinal Detachment Reoperation Based on Primary Repair Method Among Commercially Insured Patients, 2003-2016. Am J Ophthalmol 2021; 229:71-81. [PMID: 33895151 PMCID: PMC10728497 DOI: 10.1016/j.ajo.2021.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/10/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine associations between primary repair, patient characteristics, and rhegmatogenous retinal detachment (RRD) reoperation. DESIGN Retrospective cohort study. METHODS We used administrative claims to identify enrollees with incident RRD treatment by laser barricade, pneumatic retinopexy (PR), pars plana vitrectomy (PPV), or scleral buckle (SB) between 2003 and 2016. Analysis excluded patients with less than 3 years of continuous enrollment, previous RRD diagnosis, or repair. We determined reoperation frequency (PPV, PR, or SB) within 90 days postrepair and used multivariable logistic regression to identify associations between reoperation and patient and primary repair characteristics. RESULTS Of 16,190 patients with documented primary RRD repair, 2,918 (18.0%) required reoperation within 90 days. Reoperation was significantly associated with male sex (odds ratio [OR] 1.24, P < .001), pseudophakia (OR 1.25, P < .001), vitreous hemorrhage (OR 1.22, P = .001), and worse systemic health (OR 1.19-1.25, P < .05, for Charlson Comorbidity Index ≥3). Pseudophakia had higher reoperation odds after all primary procedures except PPV. In addition, 28.7% of primary PR cases required reoperation, vs 19.1% of SB and 17.9% of PPV repairs. Adjusting for other patient characteristics, PR had highest odds of reoperation (OR 1.90, P < .001, vs primary PPV). Primary laser barricade had lowest odds of reoperation (OR 0.49, P < .001). PPV was the most frequent reoperation procedure. CONCLUSIONS Nearly 1 in 5 patients require reoperation within 90 days after primary RRD repair. Cases requiring only primary laser barricade had lowest reoperation odds, likely representing less severe RRDs. Primary PR had highest reoperation odds; PPV and SB were similar to each other. These findings are important for patient education and surgical decision-making.
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Affiliation(s)
- Mary-Grace R Reeves
- From the Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, (M.G.R.R., S.P.), Palo Alto
| | - Armin R Afshar
- Department of Ophthalmology, Wayne and Gladys Valley Center for Vision, University of California, (A.R.A.), San Francisco
| | - Suzann Pershing
- From the Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, (M.G.R.R., S.P.), Palo Alto; Veterans Affairs Palo Alto Health Care System, (S.P.), Palo Alto, California, USA.
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Corneal endothelial changes induced by pars plana vitrectomy with silicone oil tamponade for retinal detachment. Exp Ther Med 2021; 22:961. [PMID: 34335903 PMCID: PMC8290465 DOI: 10.3892/etm.2021.10393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/09/2021] [Indexed: 01/07/2023] Open
Abstract
Silicone oils are effective intraocular tamponade agents in the treatment of severe retinal detachments, because they maintain the adhesion between neurosensory retina and retinal pigment epithelium, thanks to their ability to remove aqueous humor from the surface of the retina. To understand their effectiveness, it is important to know the characteristics of silicone oils. Patients should be closely monitored due to many complications associated with intraocular silicon oil, such as inflammatory reaction, raised intraocular pressure, refraction disorders, cataract, and emulsification. This study presents corneal endothelial changes and some intraocular complications caused by silicone oil used as an intraocular tamponade agent in the case of vitrectomy for complex retinal detachments. The aim of the study was to demonstrate the damage of corneal endothelial cells after the use of silicone oil in patients with retinal detachment surgery. Endothelial specular microscopy measurements were performed and the changes of the following parameters demonstrated the corneal damage: Mean cell density, coefficient of variation, average cell area, percentage of hexagonal cells, and corneal thickness. Three months postoperatively, a statistically significant decrease was observed in the following analyzed parameters: Mean cell density (P=0.04), and percentage of hexagonal cells (P=0.002); the remaining parameters also had a linear decrease (coefficient of variation, average cell area), but were statistically insignificant. Three months postoperatively, the corneal thickness presented a slight increase. Silicone oils are powerful tools when used wisely and within the limits of their use. These are often recommended in cases of severe detachment of the retina in patients at high risk of experiencing intraoperative complications.
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Shao Y, Yang L, Zhu PW, Su T, Zhou XZ, Li B, Shi WQ, Lin Q, Min YL, Yuan Q, Ye L, Zhou Q. Functional connectivity density alterations in middle-age retinal detachment patients. Brain Behav 2021; 11:e01783. [PMID: 33645927 PMCID: PMC8035440 DOI: 10.1002/brb3.1783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 07/02/2020] [Accepted: 07/19/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Middle-age patients with retinal detachment (RD) exhibit a loss of visual information, and previous studies of functional magnetic resonance imaging (fMRI) have demonstrated abnormal spontaneous activity in the RD brain. Therefore, this study assessed changes in local functional connectivity density (lFCD) and long-range functional connectivity density (longFCD) in middle-age RD patients during resting-state FC. METHODS In total, 32 middle-age patients with RD (18 men and 14 women), and 32 age-, sex-, and education-matched normal controls (NCs) (18 men and 14 women) were recruited and underwent functional magnetic resonance examination in the resting state. Two-sample t test was performed to compare lFCD and longFCD between groups. Receiver operating characteristic (ROC) curves were generated to distinguish middle-age RD patients from NCs. RESULTS Compared with NCs, middle-age RD patients demonstrated increased lFCD values in the right inferior temporal gyrus, and increased longFCD values in the bilateral inferior frontal gyri, left superior and middle frontal gyrus, bilateral inferior temporal gyri, and left cerebellum posterior lobe. Middle-age RD patient exhibited decreased lFCD values in the left cuneus, right lingual gyrus, and left middle frontal gyrus. They also had lower longFCD values in the left lingual gyrus and left inferior occipital gyrus. ROC curve analysis showed excellent accuracy of the specific areas under the curve. CONCLUSION Our results reveal that middle-age RD patients exhibited variations of binarized lFCD and longFCD in specific brain areas, which provides insight into the pathological mechanism of RD patients with acute visual loss.
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Affiliation(s)
- Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lin Yang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pei-Wen Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Su
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian Province, China
| | - Xue-Zhi Zhou
- Department of Ophthalmology, Xiangya Hospital, Central South University, Hunan Province, Changsha, China
| | - Biao Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wen-Qing Shi
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qi Lin
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - You-Lan Min
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qing Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lei Ye
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qiong Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Liao L, Zhu XH. Advances in the treatment of rhegmatogenous retinal detachment. Int J Ophthalmol 2019; 12:660-667. [PMID: 31024823 PMCID: PMC6469565 DOI: 10.18240/ijo.2019.04.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 12/08/2018] [Indexed: 12/15/2022] Open
Abstract
The pathogenesis of rhegmatogenous retinal detachment depends on three factors, namely, retinal rupture, vitreous liquefaction and traction causing the retina to separate from the pigment epithelium, among which retinal rupture is the most important. Retinopathy is caused by a gap between the neurosensory retina and the retinal pigment epithelium, which severely damages the visual function of the patient. Therefore, early clinical discovery, prevention and selection of an appropriate treatment are important. This article reviews progress in the treatment of retinal detachment.
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Affiliation(s)
- Li Liao
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Xiao-Hua Zhu
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
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Long-term Clinical Results of Vitrectomy and Scleral Buckling in Treatment of Rhegmatogenous Retinal Detachment. ScientificWorldJournal 2019; 2019:5416806. [PMID: 30956624 PMCID: PMC6431356 DOI: 10.1155/2019/5416806] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 02/15/2019] [Accepted: 02/24/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose Most studies about retinal detachment cover a limited follow-up period. The purpose of this research is to assess the long-term results after pars plana vitrectomy (PPV) and scleral buckle (SB) surgery in patients with rhegmatogenous retinal detachment (RRD). Methods 155 patients with RRD are treated either with SB or PPV with a mean follow-up of more than 5 years. Retrospective analysis of patient data with RRD was performed between January 2006 and June 2008 at a tertiary eye clinic. Results Overall primary success rate was 85.2% (PPV: 84.6%, SB: 89.5%; p=0.57). 90.5% of redetachments appeared within the first 124 days. No significant different success rate was found for vitrectomy with and without additional encircling band (p=0.09). No advantage of a supplemental encircling band in cases of preoperative inferior breaks was seen (p=0.81). Patients of SB group were treated more frequently in follow-up time because of epiretinal membrane (ERM) (SB: 15.5% versus PPV: 7.3%). No patient of the PPV group without intraoperative use of endolaser cerclage (14.7%) had any peeling surgery postoperatively. Conclusion Redetachment rates of both methods are comparable in a clinical setting where PPV is considered a suitable method for pseudophakic patients and in complex cases and SB was performed in younger phakic patients with clearly identified retinal tears. PPV seems to show a more heterogenous pattern of complications. No advantage of a supplemental encircling band could be found in these case series of patients with primary RRD. No relevant long-term risk of redetachment was seen after SB.
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Muñoz Negrete FJ. The long way to impact factor. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2016; 91:1-2. [PMID: 26724329 DOI: 10.1016/j.oftal.2015.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 06/05/2023]
Affiliation(s)
- F J Muñoz Negrete
- Servicio de Oftalmología, Hospital Universitario Ramón y Cajal,IRYCIS, Universidad de Alcalá, Madrid, España.
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