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Mansour AM, López-Guajardo L, Belotto S, Lima LH, Charbaji AR, Schwartz SG, Wu L, Smiddy WE, Ascaso J, Jürgens I, Foster RE, Elnahry AG, Sinawat S, Pinilla I, Pérez-Salvador García E, Suarez Leoz M, Olivier Pascual N, Zago Ribeiro L, Arroyo Castillo R, Navea A, Kadayifcilar S, Ellabban AA, Rey A, Mansour HA, Tripathy K, Kozak I, Uwaydat SH, Valero MS, Cobo-Soriano R, Díaz-Barreda MD, Monje Fernández L, González Del Valle F, López Liroz I, Vazquez Cruchaga E, Fonollosa A, Esteban Floria O, Relimpio Lopez MI, Shah G, Wingelaar MJ, Ravani R, Donate-López J, Rubio Velázquez E, Parodi M. Recovery course of persistent posterior subretinal fluid after successful repair of rhegmatogenous retinal detachment. Eur J Ophthalmol 2024; 34:1217-1227. [PMID: 37901895 DOI: 10.1177/11206721231210693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
PURPOSE To investigate best corrected visual acuity (BCVA), subretinal fluid (SRF) absorption time or ellipsoid zone (EZ) restoration time and various variables in patients with persistent SRF after successful primary repair of rhegmatogenous retinal detachment (RRD). METHODS This retrospective multicenter study allowed independent analysis of the healing pattern by two observers based on composite of serial cross-sectional macular optical coherence tomography (OCT) scans. Univariate and multivariate analyses were implemented. RESULTS One hundred and three cases had persistent SRF after pars plana vitrectomy, scleral buckling, or pneumatic retinopexy. By univariate analysis, SRF resolution time correlated positively with the number of retinal breaks (p < 0.001) and with increased myopia (p = 0.011). Using multivariate analysis, final BCVA (log MAR) correlated positively with age, duration of RRD, initial BCVA (OR = 3.28; [95%CI = 1.44-7.47]; p = 0.015), and SRF resolution time (OR = 0.46 [95%CI 0.21-1.05]; p = 0.049). EZ restoration time was longer with increasing number of retinal tears (OR = 0.67; [95%CI 0.29-1.52]; p = 0.030), worse final BCVA, and presence of macula-off RRD (OR = 0.26; [95%CI 0.08-0.88]; p = 0.056). SRF resolution time correlated marginally with prone position. CONCLUSIONS Residual posterior SRF is more common in eyes with multiple breaks or in myopic eyes. Final BCVA is better in younger subjects and in eyes with shorter duration of RRD. Persistent SRF is a self-limited disorder with a mean resolution of 11.2 months with good visual prognosis improving from a mean baseline logMAR of 1.08 to 0.25 at one year.
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Affiliation(s)
- Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
- Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon
| | | | | | - Luiz H Lima
- Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Abdul Razzak Charbaji
- Department of Applied Statistics & Research Methods, Lebanese American University, Beirut, Lebanon
| | | | - Lihteh Wu
- Asociados de Macula Vitreo y Retina de Costa Rica, San José, Costa Rica
| | - William E Smiddy
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | - Javier Ascaso
- Department of Surgery, University of Zaragoza, Zaragoza, Spain
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | | | | | - Ayman G Elnahry
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Isabel Pinilla
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | | | - Marta Suarez Leoz
- Department of Ophthalmology, Hospital Universitario de Burgos, Burgos, Spain
| | - Nuria Olivier Pascual
- Department of Ophthalmology, Complejo Hospitalario Universitario de Ferrol, Galicia, Spain
| | - Lucas Zago Ribeiro
- Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Rosa Arroyo Castillo
- Department of Ophthalmology, Complejo Hospitalario Universitario de Ferrol, Galicia, Spain
| | | | - Sibel Kadayifcilar
- Department of Ophthalmology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Abdallah A Ellabban
- Department of Ophthalmology, Suez Canal University, Ismaïlia, Egypt
- Department of Ophthalmology, Hull University Teaching Hospitals, Hull, UK
| | - Amanda Rey
- Institut Català de Retina, Barcelona, Spain
| | - Hana A Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Koushik Tripathy
- Department of Ophthalmology, ASG Eye Hospital, Kolkata, West Bengal, India
| | | | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas Medical School, Little Rock, Arkansas, USA
| | | | - Rosario Cobo-Soriano
- Department of Ophthalmology, Hospital Universitario del Henares, Universidad Francisco de Vitoria, Madrid, Spain
| | - María Dolores Díaz-Barreda
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Laura Monje Fernández
- Department of Ophthalmology, Complejo Asistencial Universitario de León, León, Spain
| | | | | | | | - Alex Fonollosa
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
| | - Olivia Esteban Floria
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
| | | | | | | | - Raghav Ravani
- Department of Ophthalmology, ASG Eye Hospital, Kolkata, West Bengal, India
| | | | | | - Maurizio Parodi
- Department of Ophthalmology, University Vita-Salute Milan, Milan, Italy
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Cheng FH, Lin HH, Zhu YC, Chen WJ, Wu CX, Wu YY, Zhang ZD, Pan QT. PERSISTENT SUBRETINAL FLUID AFTER VITRECTOMY FOR MACULAR HOLE-ASSOCIATED RETINAL DETACHMENT. Retina 2024; 44:782-790. [PMID: 38237083 DOI: 10.1097/iae.0000000000004050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2024]
Abstract
PURPOSE To evaluate the incidence, associated factors, and outcome of persistent subretinal fluid (SRF) after vitrectomy for macular hole-associated retinal detachment (MHRD). METHODS A total of 158 eyes from 156 patients with MHRD who achieved macular hole closure after primary vitrectomy were included in the analysis; persistent SRF was defined as the presence of SRF for more than 1 month after first surgery. Preoperative and postoperative parameters were analyzed for their relationship with SRF development. RESULTS Persistent SRF was observed in 19 eyes (12.0% of 158) postoperatively. Seven eyes (36.8% of 19) with persistent SRF eventually displayed complete absorption during follow-up. Univariate analysis revealed that eyes with persistent SRF were statistically associated with internal limiting membrane inverted flap, duration of symptoms, tamponade (perfluoropropane/silicone oil: 14/5 vs. 35/104, P < 0.001), and MHRD subtype (Type 1/Type 2/Type 3: 15/4/0 vs. 60/40/39, P = 0.003). In multivariate analysis, only internal limiting membrane inverted flap (odds ratio, 15.778, 95% confidence interval, 3.170-78.523; P = 0.001) was positively associated with persistent SRF. There were no significant differences in best-corrected visual acuity improvement ( P = 0.425) between the SRF involved foveal and without involved foveal groups and no significant differences between the SRF complete absorption and incomplete absorption groups. CONCLUSION Absorption of persistent SRF may be more difficult in MHRD eyes than in ordinary rhegmatogenous retinal detachment eyes. The internal limiting membrane inverted flap in MHRD was associated with a greater likelihood of persistent SRF. The location and incomplete absorption of persistent SRF did not seem to be associated with the final visual outcome.
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Affiliation(s)
- Feng-Hui Cheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Dhoot AS, Popovic MM, Nichani PAH, Eshtiaghi A, Mihalache A, Sayal AP, Yu H, Wykoff CC, Kertes PJ, Muni RH. Pars Plana Vitrectomy versus Scleral Buckle: A Comprehensive Meta-Analysis of 15,947 Eyes. Surv Ophthalmol 2021; 67:932-949. [PMID: 34896191 DOI: 10.1016/j.survophthal.2021.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
Abstract
Pars plana vitrectomy (PPV) and scleral buckling (SB) are two of the most common surgical treatments for rhegmatogenous retinal detachment (RRD). This meta-analysis compares the efficacy and safety of PPV and SB for RRD. A systematic literature review was performed using Ovid MEDLINE, EMBASE and Cochrane CENTRAL from 2000 to June 2021. Comparative studies, randomized controlled trials and observational studies investigating PPV and SB for RRD repair were included. The primary endpoint was final best- corrected visual acuity (BCVA). Secondary endpoints were reattachment rates, total operation time, and incidence of adverse events. Subgroup analyses including phakic status, presence of PVR-C or greater at baseline, and macular attachment status were conducted. Across 41 studies (8 RCTs, 33 observational studies), 5,401 SB and 10,546 PPV eyes were included. SB achieved a statistically significant, but likely not clinically significant, better final BCVA than PPV (0.38 ± 0.53 vs. 0.33 ± 0.53 logMAR (20/48 vs. 20/43 Snellen); weighted mean difference [WMD]: 0.07; 95% confidence interval: [0.02-0.11]; P=0.005). SB had a better final BCVA compared to PPV in observational studies (P=0.007) but not in RCTs (P=0.21). SB had a lower incidence of post-operative cataract formation (P<0.00001) and iatrogenic breaks (P<0.00001), but a higher incidence of choroidal hemorrhage (P=0.007), choroidal detachment (P=0.004), and residual subretinal fluid (RSRF) (P<0.00001). Primary (86.5% vs. 84.8%; P=0.13) and final (96.7% vs. 97.7%; P=0.12) reattachment rates were similar between PPV and SB. PPV had a significantly higher primary reattachment rate in RCTs (P=0.02) but not in observational studies (P=0.30). SB was associated with a better final BCVA than PPV; however, this result was primarily driven by observational studies and phakic patients who developed cataracts. Primary and final reattachment rates were similar between the comparators. SB was associated with a significantly lower incidence of iatrogenic breaks and cataracts, while PPV was associated with a reduced risk of choroidal detachment, subretinal hemorrhage, and RSRF.
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Affiliation(s)
- Arjan S Dhoot
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Prem A H Nichani
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Arshia Eshtiaghi
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Aman P Sayal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Hannah Yu
- Retina Consultants of Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, United States of America
| | - Charles C Wykoff
- Retina Consultants of Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, United States of America
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada.
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Coppola M, Marchese A, Cicinelli MV, Rabiolo A, Giuffrè C, Gomarasca S, Querques G, Bandello F. Macular optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment. Eur J Ophthalmol 2020; 30:805-816. [DOI: 10.1177/1120672120911334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The primary aim of this study was to summarize and illustrate the main structural cross-sectional optical coherence tomography findings encountered after vitreoretinal surgery for rhegmatogenous retinal detachment. This was a non-systematic review of literature on structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment. Adequate illustrations of the main findings described were found after a retrospective analysis of imaging and charts of patients operated at the department where this study was performed. The main structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment included persistent subretinal fluid, subretinal blebs, retinal folds, subretinal perfluorocarbon liquids, macular alterations related to silicone oil, epiretinal membranes, proliferative vitreoretinopathy, cystoid macular edema, macular holes, and recurrent retinal detachment. In conclusion, optical coherence tomography was a useful tool after vitreoretinal surgery for rhegmatogenous retinal detachment. Some optical coherence tomography findings may not be evident on fundus examination, and optical coherence tomography can reveal essential details for the clinical management and the visual prognosis. Other findings, despite being visible on funduscopic examination, may be better assessed with the aid of optical coherence tomography. All these elements contribute to support the importance of tomographic assessment in the follow-up of eyes treated for vitreoretinal conditions.
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Affiliation(s)
- Michele Coppola
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
| | - Alessandro Marchese
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Vittoria Cicinelli
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandro Rabiolo
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Chiara Giuffrè
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Giuseppe Querques
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Lai TT, Huang JS, Yeh PT. Incidence and risk factors for cystoid macular edema following scleral buckling. Eye (Lond) 2016; 31:566-571. [PMID: 27935601 DOI: 10.1038/eye.2016.264] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/04/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo investigate the incidence of cystoid macular edema (CME) after scleral buckling (SB) and verify the possible risk factors of CME.MethodsA retrospective, non-comparative, interventional case series study was conducted. Clinical charts of 130 consecutive patients who were underwent successful SB for primary retinal detachment (RD) from 2009 to 2013 were reviewed. Optical coherence tomography (OCT) was applied to detect CME. Data pertaining to patient demographics, pre- and postoperative visual acuity, surgical procedures, and postoperative OCT findings were recorded. Factors associated with CME were also analyzed.ResultsThe incidence of CME was 9/130 (6.9%). Risk factors for developing CME were older age (non-CME vs CME: 44.8±14.8 vs 57.3±5.3 years, P<0.05), more extensive RD (RD extent by clock hours; non-CME vs CME: 4.61±1.57 vs 5.78±1.39, P<0.05), macular detachment (non-CME vs CME: 51.2 vs 88.9%, P<0.05), and external drainage (non-CME vs CME: 38.8% vs 77.8%, P<0.05). There was no significant difference between patient with and without CME regarding the use of gas tamponade and the lens status. In patients with more extensive RD (macular detachment plus RD of more than 3 clock hours before surgery), 8 of 68 patients had CME after SB and only older age and external drainage factors were associated with CME.ConclusionsThe risk factors associated with CME after SB were older age, more extended RD, macular detachment, and external drainage. External drainage should be used with caution in older patients with more extensive RD.
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Affiliation(s)
- T-T Lai
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - J-S Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - P-T Yeh
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan
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Terauchi G, Shinoda K, Matsumoto CS, Watanabe E, Matsumoto H, Mizota A. Recovery of photoreceptor inner and outer segment layer thickness after reattachment of rhegmatogenous retinal detachment. Br J Ophthalmol 2015; 99:1323-7. [DOI: 10.1136/bjophthalmol-2014-306252] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/10/2015] [Indexed: 11/03/2022]
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Kovačević I, Radosavljević A, Kalezić B, Potić J, Damjanović G, Stefanović I. Persistent submacular fluid diagnosed with optical coherence tomography after successful scleral buckle surgery for macula-off retinal detachment. Bosn J Basic Med Sci 2013; 12:182-6. [PMID: 22938546 DOI: 10.17305/bjbms.2012.2479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Crataegus species have been widely used in herbal medicine, especially for the hearth diseases. In the present study, the effect of Crataegus aronia var. dentata Browicz extract on partially hepatectomized rats was investigated with biochemical and TUNEL apoptosis assays. The extracts of the plant at the concentrations of 0.5 and 1 ml/100 g body weight/day were administered orally to the two experimental groups including partially hepatectomized rats for 42 days. At the end of the experimental period, animals were sacrificed, blood was collected for the assessment of serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT), and the liver tissue was used for TUNEL assay. In biochemical assay, it was found a significant decrease in the levels of serum ALT and AST in the experimental groups. On the other hand, the plant extract did not cause any significant changes in the level of GGT in these groups. In apoptosis assay, TUNEL positive hepatocytes could not be detected in both experimental groups. The present findings can suggest that Crataegus aronia var. dentata Browicz extract can decrease the levels of serum ALT and AST and play a role in apoptosis of hepatocytes in the liver of partially hepatectomized rats. However, further studies are required to confirm the effects of the plant extract on hepatoprotection and apoptosis in the regenerating liver after partial hepatectomy in animal models.
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Affiliation(s)
- Igor Kovačević
- Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
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Yang CM, Yeh PT, Cheng SF, Yang CH, Chen MS. Macular appearance after diabetic vitrectomy for fibrovascular proliferation: an optical coherence tomography study. Acta Ophthalmol 2010; 88:193-8. [PMID: 19094167 DOI: 10.1111/j.1755-3768.2008.01420.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate morphological variations in the macular area with optical coherence tomography (OCT) after vitrectomy for diabetic fibrovascular proliferation. METHODS We reviewed 108 cases using OCT 7-15 months after vitrectomy. Of these, 32 received OCT within 3 months postoperatively. Morphological variations were categorized and correlated with visual outcome. RESULTS Only 24 cases (21.4%) had no obvious abnormalities. The most frequent findings were epiretinal membrane (52.8%), macular thickening (37.0%) and macular cysts (28.7%). Multivariate regression showed that diffuse macular thickening, loss of foveal depression and diffuse retinal thinning were significantly associated with poor visual acuity. Sequential OCT (< 3 and >or= 7 months) revealed that epiretinal membrane and oedema outside of fovea changed significantly between two examinations. CONCLUSION OCT may identify diverse morphological changes in the macular area after diabetic vitrectomy for fibrovascular proliferation. Macular appearance may change over time, and certain types of morphological changes may be associated with poor visual function.
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Affiliation(s)
- Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan
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Ku M, Sohn HJ, Lee DY, Nam DH. Foveal Reattachment After Scleral Buckling vs Vitrectomy for Macula-Off Retinal Detachment. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.3.399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Myun Ku
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
| | - Hee Jin Sohn
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
| | - Dae Yeong Lee
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
| | - Dong Heun Nam
- Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea
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Koinzer S, Elsner H, Klatt C, Pörksen E, Brinkmann R, Birngruber R, Roider J. Selective retina therapy (SRT) of chronic subfoveal fluid after surgery of rhegmatogenous retinal detachment: three case reports. Graefes Arch Clin Exp Ophthalmol 2008; 246:1373-8. [PMID: 18546010 DOI: 10.1007/s00417-008-0860-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 04/23/2008] [Accepted: 04/28/2008] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Shallow subfoveal fluid accumulation after successful surgery for retinal detachment can be the reason for compromised visual acuity. To date, therapeutical options to tackle this problem have not been established. Selective retina therapy (SRT) is a new laser technology that uses a train of mus-laser pulses to selectively damage retinal pigment epithelial (RPE) cells while sparing retinal structures. METHODS We treated three patients with chronic subfoveal fluid accumulation after retinal detachment surgery. The median period between retinal surgery and SRT treatment was 7 months. For SRT, we used a prototype frequency-doubled, Q-switched Nd:YLF laser (lambda = 527 nm). Each laser exposition contained 30 pulses (t = 1,7 micros, 100 Hz, E = 100-400 microJ). Two of the three patients were treated subfoveally. OCT III (optical coherence tomography) examinations were performed to evaluate changes in subretinal fluid accumulation. RESULTS In all three patients, we observed complete resolution of subfoveal fluid within 1-5 months. Follow-up has been 16 months to 2 years. Visual acuity improved in all patients. In one patient, cystoid macular edema developed 3 months after treatment. Additional SRT treatments were not necessary. CONCLUSION SRT is a safe treatment. Visual acuity improved after SRT, even in subfoveal irradiations. SRT is an option to support subretinal fluid reabsorption. In this situation where no other therapeutical options are established, SRT may be a beneficial treatment for chronic subfoveal fluid accumulation after retinal detachment surgery.
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Affiliation(s)
- Stefan Koinzer
- Department of Ophthalmology, University Hospital of Schleswig-Holstein, Campus Kiel, Hegewischstr.2, 24105 Kiel, Germany.
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