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Dou R, Li R, Li RC, Yu YR, Zhou JX, Li RM, Wang XP, Zhang DC, Jiang J, Chen S. Evaluation of retinal structural and functional changes after silicone oil removal in patients with rhegmatogenous retinal detachment: a retrospective study. Int J Retina Vitreous 2024; 10:1. [PMID: 38167553 PMCID: PMC10759386 DOI: 10.1186/s40942-023-00519-z] [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: 11/10/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND To evaluate retinal structural and functional changes after silicone oil (SO) removal in eyes with macula-off rhegmatogenous retinal detachment (RRD). METHODS Best-corrected visual acuity (BCVA) testing, microperimetry, and optical coherence tomography angiography were performed in 48 eyes with macula-off RRD before and 3 months after SO removal. The values of healthy contralateral eyes were used as control data. Correlations between retinal vessel density (VD), retinal nerve fiber layer thickness (RNFLT), the interval between retinal detachment and surgery, the duration of SO tamponade, the follow-up time after SO removal, and visual function were analyzed. RESULTS Significant increases in 2˚ fixation rate (FR), 4˚ FR, 2˚ mean retinal sensitivity (MRS), 6˚ MRS, parafoveal superficial capillary plexus VD and RNFLT were observed after SO removal (all P < 0.05). The increase of 2˚ MRS and 6˚ MRS were correlated with the duration of SO tamponade and the follow-up time after SO removal respectively (all P < 0.05). The last 2˚ MRS and 6˚ MRS were correlated with the duration of SO tamponade, the interval between retinal detachment and surgery, and the follow-up time after SO removal (all P < 0.01). The last FR in RRD eyes was close to that of contralateral eyes (P > 0.05). CONCLUSION Retinal structure and function improved to different degrees after SO removal. Fixation stability and retinal sensitivity increased more than BCVA postoperatively. Retinal sensitivity, which was affected by the interval between retinal detachment and surgery and the duration of SO tamponade, gradually recovered after SO removal.
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Affiliation(s)
- Ran Dou
- Department of Ophthalmology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, China
| | - Rui Li
- Shanxi Aier Eye Hospital, Taiyuan, 030000, Shanxi Province, China
| | - Rui-Chan Li
- Shanxi Aier Eye Hospital, Taiyuan, 030000, Shanxi Province, China
| | - Yan-Ru Yu
- Shanxi Aier Eye Hospital, Taiyuan, 030000, Shanxi Province, China
| | - Jin-Xiu Zhou
- Shanxi Aier Eye Hospital, Taiyuan, 030000, Shanxi Province, China
| | - Rui-Mei Li
- Shanxi Aier Eye Hospital, Taiyuan, 030000, Shanxi Province, China
| | - Xia-Ping Wang
- Shanxi Aier Eye Hospital, Taiyuan, 030000, Shanxi Province, China
| | - Dong-Chang Zhang
- Shanxi Aier Eye Hospital, Taiyuan, 030000, Shanxi Province, China
| | - Jian Jiang
- Department of Ophthalmology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, China.
| | - Song Chen
- Clinical College of Ophthalmology, Tianjin Eye Hospital, Tianjin Medical University, No.4 Gansu Road, Heping District, Tianjin, 300020, China.
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Pakravan P, Shaheen A, Patel V, Villalba MF, Dib B, Lai J, Rohowetz L, Chau V, Patel NA, Tzu JH, Wang AL, Alhoyek S, Scott N, Samara WA, Goduni L, Jung JJ, Russell JF, Mantopoulos D, Hajrasouliha AR, Savoie BT, Haddock LJ, Berrocal AM, Sridhar J, West MR, Yannuzzi NA. Unexplained Vision Loss Associated With Intraocular Silicone Oil Tamponade in Rhegmatogenous Retinal Detachment Repair. JOURNAL OF VITREORETINAL DISEASES 2023; 7:299-304. [PMID: 37927311 PMCID: PMC10621697 DOI: 10.1177/24741264231161121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Purpose: To evaluate the visual outcomes with unexplained vision loss during or after silicone oil (SO) tamponade. Methods: This multicenter retrospective case series comprised patients with unexplained vision loss associated with SO tamponade or its removal. Eyes with other clear secondary identifiable causes of vision loss were excluded. Results: Twenty-nine eyes of 28 patients (64% male) were identified. The mean age was 50 ± 13 years (range, 13-78 years). The mean duration of SO tamponade was 148 ± 38 days. Eighteen eyes (62%) developed unexplained vision loss while under SO; 11 (38%) had vision loss after SO removal. The most common optical coherence tomography (OCT) finding was ganglion cell layer (GCL) thinning (55%). Eyes with vision loss after SO removal had a mean logMAR best-corrected visual acuity (BCVA) of 0.6 ± 0.7 (Snellen 20/85) before SO tamponade and 1.2 ± 0.4 (20/340) before SO removal. By the last follow-up after SO removal, the BCVA had improved to 1.1 ± 0.4 (20/235). In eyes with vision loss after SO removal, the BCVA before SO removal was 0.7 ± 0.7 (20/104), which deteriorated to 1.4 ± 0.4 (20/458) 1 month after SO removal. By the last follow-up, the BCVA had improved to 1.0 ± 0.5 (20/219). Conclusions: Unexplained vision loss can occur during SO tamponade or after SO removal. Vision loss was associated with 1000-centistoke and 5000-centistoke oil and occurred in macula-off and macula-on retinal detachments. The duration of tamponade was 3 months or longer in the majority of eyes. Most eyes had GCL thinning on OCT. Gradual visual recovery can occur yet is often incomplete.
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Affiliation(s)
- Parastou Pakravan
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abdulla Shaheen
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Veshesh Patel
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Maria F. Villalba
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bernard Dib
- Department of Ophthalmology, University of Alabama, Birmingham, AL, USA
| | - James Lai
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Landon Rohowetz
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Viet Chau
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nimesh A. Patel
- Department of Ophthalmology, Massachusetts Eye and Ear infirmary, Harvard University, Boston, MA, USA
| | | | - Angeline L. Wang
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sandra Alhoyek
- Department of Ophthalmology, Massachusetts Eye and Ear infirmary, Harvard University, Boston, MA, USA
| | - Nathan Scott
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Wasim A. Samara
- Department of Ophthalmology, University of Alabama, Birmingham, AL, USA
| | - Lediana Goduni
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jesse J. Jung
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Jonathan F. Russell
- Institute for Vision Research and Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
| | - Dimosthenis Mantopoulos
- Diseases of the Retina and Vitreous, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Amir R. Hajrasouliha
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brian T. Savoie
- Department of Ophthalmology at Brown University, Providence, RI, USA
| | - Luis J. Haddock
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Audina M. Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Matthew R. West
- Department of Ophthalmology, University of Alabama, Birmingham, AL, USA
| | - Nicolas A. Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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3
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Barth T, Helbig H, Maerker D, Gamulescu MA, Radeck V, Barth T. Unexplained visual loss after primary pars-plana-vitrectomy with silicone oil tamponade in fovea-sparing retinal detachment. BMC Ophthalmol 2023; 23:75. [PMID: 36829157 PMCID: PMC9951486 DOI: 10.1186/s12886-023-02823-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/17/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND To investigate the incidence and clinical characteristics of unexplained visual loss in patients with fovea-sparing rhegmatogenous retinal detachment (RRD) during or after silicone oil (SO) tamponade. METHODS The medical charts of all patients with macula-on RRDs, who underwent pars-plana-vitrectomy (ppV) with SO tamponade were retrospectively assessed regarding unexplained visual loss (UVL) of ≥ 3 Snellen lines and alterations on optical coherence tomography (OCT) during or after SO tamponade. The clinical data analysed included visual acuity, surgical parameters, OCT images, duration of SO tamponade and the time point of visual decline. Cases with re-detachment or secondary causes of visual loss such as SO emulsification, epiretinal membranes or macular edema were excluded. RESULTS Over a 15-year-period, 22 cases with macula-on RRD, which had primarily been treated with ppV and SO tamponade, met the inclusion criteria. In most eyes (n = 20; 91%), the RRD was caused by a giant retinal tear (GRT). In 11 of these 22 cases (50%), best-corrected visual acuity (BCVA) had dropped by at least 3 lines for no apparent reason. In these 11 cases, mean preoperative logMAR BCVA was 0.2 (SD 0.13; range 0-0.5), equal to Snellen's VA of 0.63, and mean postoperative logMAR BCVA 1.0 (SD 0.24; range 0.5-1.3), equal to Snellen's VA of 0.10. Visual decline occurred about 12 weeks postoperatively (SD 6.2; range 3-20 ) and comprised 8 lines (SD 2.3; range -11 to -4). SO was removed on average 139 (SD 50.0; range 88-271) days after the first ppV. In 9 cases visual decline occurred while the SO was in-situ. In 2 patients, BCVA decline was noted 2 weeks after SO removal. In all eyes, preoperative central foveal thickness (CFT) was 254 μm (SD 24.2), which decreased to 224 μm (SD 29.6) during SO tamponade and increased to 247 μm (SD 29.2) after SO removal, irrespective of the presence of UVL. The mean follow-up time was 20 months (SD 30.6) after SO removal. CONCLUSION UVL after SO tamponade for macula-on RRD is more frequent than expected. The incidence in our case series was 50%. The mechanism of this phenomenon is still unknown. In general, vitreoretinal surgeons should thoroughly question the need for SO tamponade, inform their patients of possible UVL and remove SO as early as possible. TRIAL REGISTRATION The study was approved by the local ethics committee on 6th of May 2022 (Ethikkommission der Universität Regensburg, Votum 22-2925-104) and was conducted in accordance with the ethical standards of the Declaration of Helsinki.
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Affiliation(s)
- T Barth
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - H Helbig
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - D Maerker
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - M-A Gamulescu
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - V Radeck
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Teresa Barth
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
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4
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Application of moving particle semi-implicit (MPS) method on retro-oil fluid using three-dimensional vitreous cavity models from magnetic resonance imaging. Sci Rep 2022; 12:1735. [PMID: 35110656 PMCID: PMC8810992 DOI: 10.1038/s41598-022-05886-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/20/2022] [Indexed: 11/09/2022] Open
Abstract
Silicone oil (SO) is a safe and widely used intraocular tamponade agent for treating complicated vitreoretinal diseases, such as retinal detachments (RRDs) with inferior proliferative vitreoretinopathy (PVR). However, as the human vitreous cavity is irregularly shaped, it is difficult to predict the area of the inferior retina covered with SO and the retro-oil fluid currents in each patient. Here, we performed fluid simulation analysis using the moving particle semi-implicit method on the oil cover rates and absolute velocity gradient of retro-oil fluid to the retina using vitreous cavity models derived from magnetic resonance imaging of patients to determine the appropriate amount of SO and postoperative position to achieve a sufficient tamponade effect on the inferior retina. In all seven vitreous cavity models tested, the inferior quadrant of the retina was completely covered by SO in more positions and the absolute velocity gradient of the retro-oil fluid in contact with the retinal wall caused by eye and head movements was lower when the vitreous cavity was filled with 95% SO and 5% retro-oil fluid versus 80% SO and 20% retro-oil fluid. Taken together, these findings have clinical implications for the treatment of complicated RRDs with inferior PVR requiring SO tamponade.
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5
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Shu Y, Gao M, Zhou Y, Liu H, Sun X. DIA Comparative Proteomic Analysis of Retro-oil Fluid and Vitreous Fluid From Retinal Detachment Patients. Front Mol Biosci 2021; 8:763002. [PMID: 34926578 PMCID: PMC8678117 DOI: 10.3389/fmolb.2021.763002] [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: 08/23/2021] [Accepted: 11/03/2021] [Indexed: 01/13/2023] Open
Abstract
Objectives: There have been reports of unexplained visual loss following intra-ocular silicone oil (SiO) tamponade in retinal detachment patients, yet the underlying mechanism is unknown. The aim of this study was to investigate the mechanisms behind retinal toxicity following intra-ocular SiO tamponade in retinal detachment patients. Methods and Results: Vitreous fluid samples were acquired from 27 patients (27 eyes). Twelve eyes for data-independent acquisition (DIA) were divided into four groups: pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RD group), SiO removal after successful retinal reattachment (SO group), cataract surgery after successful retinal reattachment with sterilized air tamponade (FA group), and PPV for epiretinal membrane (ERM group). The remaining 15 eyes were used for enzyme-linked immunosorbent assay analysis. DIA was combined with two-dimensional liquid chromatography-tandem mass spectrometry to find expression changes in the proteome of vitreous. Mean number mass spectra, statistically differentially expressed proteins, gene ontology (GO), pathway representations, and protein interactions were analyzed. GO analysis showed that the protein categories of synapse organization, cell adhesion, and regulation of cell migration in the SO group were differentially expressed compared to the control or FA groups (p < 0.05). Through Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, lysosome and cell adhesion were found to be significantly enriched in the SO group compared to the FA and control groups (p < 0.05). Cadherin 2, transferrin, and lysosome function may partially contribute to silicone oil-related vision loss. Conclusion: Vision loss-inducing novel molecular signatures and pathways that may be associated with SiO toxicity were identified. Transferrin may be a potential visual outcome biomarker for SiO tamponade.
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Affiliation(s)
- Yiyang Shu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Min Gao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Yifan Zhou
- Putuo People's Hospital, Tongji University, Shanghai, China
| | - Haiyun Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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6
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Liu Y, Lei B, Jiang R, Huang X, Zhou M, Xu G. Changes of macular vessel density and thickness in gas and silicone oil tamponades after vitrectomy for macula-on rhegmatogenous retinal detachment. BMC Ophthalmol 2021; 21:392. [PMID: 34781932 PMCID: PMC8591799 DOI: 10.1186/s12886-021-02160-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/30/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose To investigate the macular vessel density and thickness in macular-on rhegmatogenous retinal detachment (RRD) after vitrectomy with gas and silicone oil (SO) tamponade. Methods Patients with macular-on RRD eyes, treated with a single successful vitrectomy with gas or SO tamponade and a minimum 30 months follow-up, were reviewed. Best-corrected visual acuity (BCVA), macular vessel density and retinal thickness by using optical coherence tomography angiography, were compared to the contralateral eyes. Results Sixteen eyes with gas tamponade and 17 eyes with SO tamponade were included in the study. LogMAR best-corrected visual acuity (BCVA) slightly improved from 0.25 ± 0.18 (Snellen 20/36) to 0.17 ± 0.23 (Snellen 20/30) in eyes with gas tamponade, and decreased from 0.30 ± 0.22 (Snellen 20/40) to 0.49 ± 0.28 (Snellen 20/62) in eyes with SO tamponade. The parafoveal vessel densities in superficial vascular complex (SVC) and the corresponding inner retinal thickness (IRT) were similar between the affected eyes and the contralateral eyes in gas tamponade group (P = 0.578, P = 0.943), while significantly reduced in the affected eyes, compared to the contralateral eyes in SO tamponade group (P < 0.001, P < 0.001). Conclusion Eyes in SO tamponade group had worse BCVA, lower SVC vessel densities and thinner corresponding IRT after vitrectomy for macular-on RRD, than those in gas tamponade group.
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Affiliation(s)
- Yang Liu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, No.83, Fen Yang Road, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, Fudan University, Shanghai, China
| | - Boya Lei
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, No.83, Fen Yang Road, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, Fudan University, Shanghai, China
| | - Rui Jiang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, No.83, Fen Yang Road, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, Fudan University, Shanghai, China
| | - Xin Huang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, No.83, Fen Yang Road, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, Fudan University, Shanghai, China
| | - Min Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, No.83, Fen Yang Road, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, Fudan University, Shanghai, China
| | - Gezhi Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, No.83, Fen Yang Road, Shanghai, 200031, China. .,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. .,Key Laboratory of Myopia of State Health Ministry, Fudan University, Shanghai, China.
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Iuliano L, Corbelli E, Ramoni A, Bandello F, Codenotti M. UNEXPLAINED VISUAL LOSS AFTER GAS TAMPONADE FOR MACULA-ON RETINAL DETACHMENT: Incidence and Clinical Characterization. Retina 2021; 41:957-964. [PMID: 33149095 DOI: 10.1097/iae.0000000000003007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To identify the incidence rate and the clinical characteristics of unexplained visual loss after gas tamponade for primary macula-sparing rhegmatogenous retinal detachment. METHODS Retrospective longitudinal analysis of all subjects undergoing vitrectomy with gas for primary macula-on rhegmatogenous retinal detachment from 2010 to 2019. Outcome was the unexplained visual loss evaluated after gas absorption, defined as a loss of vision to less than 20/200 without evident causes. The diagnostic workup was reviewed. RESULTS Nine eyes with unexplained visual loss of 357 surgeries were found. The incidence proportion was 2.52 new cases every 1,000 eyes affected by macula-on rhegmatogenous retinal detachment treated with gas per year. All subjects had an absolute central scotoma, with a median postoperative visual acuity of 20/1,600 (counting fingers). Structural findings were consistent with an axonal damage; all eyes had microcystoid macular edema and reduced thickness of both macular ganglion cell and retinal nerve fiber layers. No photoreceptor structural damages were noted. CONCLUSION The incidence of unexplained visual loss after gas tamponade for primary macula-on rhegmatogenous retinal detachment is 2.52 new cases every 1,000 eyes per year. This rare complication, which findings are suggestive of an axonal damage within retinal ganglion cells, remains a serious and unexplained concern for vitreoretinal surgeons.
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Affiliation(s)
- Lorenzo Iuliano
- Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
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8
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Zhou Y, Zhang S, Zhou H, Gao M, Liu H, Sun X. Comparison of fundus changes following silicone oil and sterilized air tamponade for macular-on retinal detachment patients. BMC Ophthalmol 2020; 20:249. [PMID: 32571251 PMCID: PMC7310510 DOI: 10.1186/s12886-020-01523-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/17/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To investigate different tamponade effects of intravitreal silicone oil (SO) and sterilized air on macular vasculature and structure after successful retinal repair for macular-on rhegmatogenous retinal detachment (RRD) patients. METHOD 21 eyes (21 patients) with macular-on RRD underwent single pars plana vitrectomy following intravitreal SO or sterilized air (Gas) tamponade. Optical Coherence Tomography (OCT) and angiography were used to evaluate retinal layer thickness and flow density (FD) changes throughout the observation period of 12 weeks. Retinal layers were segmented into 7 sets: NFL, GCL + IPL, INL, OPL, ONL + IS, OS+RPE and BRM. Macular perfusion system was segmented into superficial and deep capillary plexus flow density (SCPFD, DCPFD), and choriocapillaries plexus flow density (CCPFD). RESULT Compared to Gas tamponade, SO tamponade led to more decrease in both superficial and deep retinal blood flow during observation. NFL thickness was found to decrease in both Gas tamponade and SO tamponade eyes. SO tamponade resulted in more pronounced decrease which led to significant intergroup difference. Opposite changing trends were found in GCL + IPL and ONL + IS thicknesses due to different means of tamponade. SO tamponade caused thicknesses of these two segmented layers to decrease, which led to significant intergroup differences. SO tamponade also led to more decrease in INL, OPL thicknesses. No significant intergroup difference of choroidal thickness was observed. CONCLUSION Compared to gas, silicone oil could have more negative tamponade effects on both fundus vasculature and structure.
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Affiliation(s)
- Yifan Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Siqi Zhang
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Min Gao
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Haiyun Liu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China.
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China.
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
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9
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Kars ME, Toklu Y, Arıkan Yorgun M, Neşelioğlu S, Eren F. Electrolyte, Nitric Oxide and Oxidative Stress Levels of Aqueous Humor in Patients with Retinal Detachment and Silicone Oil Tamponade. Curr Eye Res 2020; 45:1443-1450. [PMID: 32228105 DOI: 10.1080/02713683.2020.1749668] [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: 10/24/2022]
Abstract
Purpose: To enlighten the pathogenesis of silicone oil (SiO)-related complications via measuring aqueous humor levels of electrolytes, nitric oxide (NO), and oxidative stress in SiO, retinal detachment (RD), and control groups. Materials and Methods: In this prospective study, 56 patients were grouped as SiO (n = 29), RD (n = 12), and control (n = 15). The results of pre- and post-operative ophthalmological examinations, aqueous humor electrolyte and NO levels, total antioxidant and oxidant status (TAS, TOS) and oxidative stress index (OSI) were analyzed. Results: SiO group had a higher mean Na+ level compared to controls (144.77 ± 11.48 vs 137.56 ± 6.57 mmol/kg, p = .02). Also, the mean Na+ and Cl- levels of RD group were higher than controls (149.04 ± 12.05 vs. 137.56 ± 6.57 mmol/kg, p = .02, 115.2 ± 7.79 vs 106.23 ± 8.99 mmol/kg, p = .031 for Na+ and Cl-, respectively). The mean NO level of RD group was higher than that of SiO group (51.07 ± 19.56 vs. 34.07 ± 13.84 μM, p = .009). The mean TAS and TOS were lower in SiO group compared to controls (1.92 ± 0.64 vs. 2.49 ± 0.56 μmolTroloxEqv./L, p = .021, 34.98 ± 26.55 vs. 61.46 ± 22.69 μmolH2O2Eqv./L, p = .004 for TAS and TOS, respectively). Intraocular retention time of SiO demonstrated positive correlation with post-operative visual acuity (logMAR) and negative correlation with TOS. Conclusions: Elevated aqueous humor Na+ and Cl- in RD patients might reflect abolished function of ion channels on detached retina. Increased Na+ and lack of NO response to elevated intraocular pressure in SiO-filled eyes might contribute to secondary cataract and glaucoma formation. SiO is associated with low levels of oxidative stress in aqueous humor; however, increased intraocular retention time of SiO is related to a poor visual outcome.
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Affiliation(s)
- Meltem Ece Kars
- Department of Ophthalmology, Yıldırım Beyazıt University, Ankara Atatürk Training and Research Hospital , Ankara, Turkey
| | - Yasin Toklu
- Department of Ophthalmology, Yıldırım Beyazıt University, Ankara Atatürk Training and Research Hospital , Ankara, Turkey
| | - Mücella Arıkan Yorgun
- Department of Ophthalmology, Ankara Atatürk Training and Research Hospital , Ankara, Turkey
| | - Salim Neşelioğlu
- Department of Biochemistry, Yıldırım Beyazıt University, Ankara Atatürk Training and Research Hospital , Ankara, Turkey
| | - Funda Eren
- Department of Biochemistry, Ankara Atatürk Training and Research Hospital , Ankara, Turkey
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10
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Yamada K, Kaneko H, Tsunekawa T, Shimizu H, Suzumura A, Namba R, Takeuchi J, Kataoka K, Takayama K, Inoue M, Ito Y, Terasaki H. Silicone oil-associated retinal light exposure under a surgical microscope. Acta Ophthalmol 2019; 97:e742-e746. [PMID: 30698352 DOI: 10.1111/aos.14038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 01/08/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE Based on the hypothesis that silicone oil (SO) with a higher refractive index than water induces unexpected vignetting effects during surgeries, we aimed to investigate the relationship between the volume of SO and light intensity using a surgical microscope. METHODS Using a light-sensitive paper and model eye filled with varying volumes (0%, 50%, 62.5%, 75%, 87.5% and 100%) of SO, the light intensity of intraocular lens (IOL) with various refractive powers (0, 10 and 20 dioptres) illuminated by a surgical microscope was measured. RESULTS Light exposure density with 1.0% coaxial and oblique light was approximately 22-fold higher than that with 0.1% coaxial and oblique light. Further, it was approximately 34-fold higher in eyes with +20 D IOL than in those with no IOL. The density in eyes with 75% SO was the highest among all groups followed by that with 0% SO. Light exposure densities in the eyes with 75% and 0% SO were significantly higher than those with other volumes of SO. In SO-filled eyes, a microscope set with only an oblique light and a filter successfully reduced light exposure. CONCLUSION Silicone oil-related vision loss (SORVL) during SO removal surgeries might be due to increased light exposure on the macular retina caused by the SO-associated vignetting effect. SORVL could be prevented by placing a filter in the microscope during SO removal surgeries.
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Affiliation(s)
- Kazuhisa Yamada
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Hiroki Kaneko
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Taichi Tsunekawa
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Hideyuki Shimizu
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Ayana Suzumura
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Rina Namba
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Jun Takeuchi
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Keiko Kataoka
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Kei Takayama
- Department of Ophthalmology National Defense Medical College Saitama Japan
| | - Makoto Inoue
- Kyorin Eye Center Kyorin University School of Medicine Tokyo Japan
| | - Yasuki Ito
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Hiroko Terasaki
- Department of Ophthalmology Nagoya University Graduate School of Medicine Nagoya Japan
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11
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Lee JYX, Sawant R, Jonas A, Lochhead J. The incidence of silicone oil-related visual loss following the removal of heavy silicone oil. Eye (Lond) 2019; 33:1969-1970. [PMID: 31267085 DOI: 10.1038/s41433-019-0504-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/20/2019] [Accepted: 05/16/2019] [Indexed: 11/09/2022] Open
Affiliation(s)
- J Y X Lee
- Ophthalmology Department, St. Mary's Hospital, Isle of Wight NHS Trust, Parkhurst Road, Isle of Wight, PO30 5TG, UK.
| | - R Sawant
- Ophthalmology Department, St. Mary's Hospital, Isle of Wight NHS Trust, Parkhurst Road, Isle of Wight, PO30 5TG, UK
| | - A Jonas
- Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J Lochhead
- Ophthalmology Department, St. Mary's Hospital, Isle of Wight NHS Trust, Parkhurst Road, Isle of Wight, PO30 5TG, UK
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12
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Wenzel DA, Kunzmann BC, Druchkiv V, Hellwinkel O, Spitzer MS, Schultheiss M. Effects of Perfluorobutylpentane (F4H5) on Corneal Endothelial Cells. Curr Eye Res 2019; 44:823-831. [PMID: 30892089 DOI: 10.1080/02713683.2019.1597891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To evaluate the effects of perfluorobutylpentane (F4H5) on corneal endothelial cell density (ECD) and morphology using a porcine corneal endothelial organ culture model. Materials and methods: "Split corneal buttons" were cultivated for 15 days (d) after incubation in F4H5 (15, 30, 60, and 120 min) or BSS (controls). ECD was assessed manually on d1, d8, and d15. After histological staining (trypan blue, alizarin red S) on d15 morphological changes (reformation figures, rosette formations, and alizarin red cells) were evaluated. Results: ECD was significantly reduced after incubation in F4H5 for 120 min (median ± 25%/75%-quartile; 3281 ± 43/222 cells/mm2; p = 0.046) on d15 compared to controls (3658 ± 129/296 cells/mm2), but not after shorter incubation times (15, 30, and 60 min). Morphological assessment supports these findings as reformation figures (F4H5 120 min: 10.5 ± 9.3/13.9/mm2 vs. controls: 5.2 ± 2.8/7.2/mm2; p = 0.010), rosette formations (F4H5 120 min 25.566 ± 17.044/36.219/mm2 vs. controls: 8.333 ± 0.000/15.667/mm2; p = 0.002), and alizarin red cells (F4H5 120 min: 38.350 ± 29.827/51.333/mm2 vs. controls: 20.833 ± 10.417/25.000/mm2; p = 0.049) were significantly more prevalent after incubation in F4H5 for 120 min compared to controls. Also, F4H5 60 min showed significantly more rosette formations (25.452 ± 16.968/36.057/mm2; p = 0.006) and alizarin red cells (46.662 ± 42.420/50.903/mm2; p = 0.007), but not reformation figures (7.0 ± 2.2/1.6 %; p = 0.953). Conclusion: Short exposure (≤30 min) of porcine corneal endothelial cells to F4H5 does not have significant effects on ECD or morphological characteristics. Longer exposure times (≥60-120 min) may cause ECD decline and/or induce morphological changes.
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Affiliation(s)
- Daniel A Wenzel
- a Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| | - Berenike C Kunzmann
- b Center of Ophthalmology, University Eye Hospital Tübingen , Tübingen , Germany
| | - Vasyl Druchkiv
- a Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| | - Olaf Hellwinkel
- c Center for Diagnostics, Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| | - Martin S Spitzer
- a Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| | - Maximilian Schultheiss
- a Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
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13
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Shimizu H, Kaneko H, Suzumura A, Takayama K, Namba R, Funahashi Y, Kataoka K, Iwase T, Hwang SJ, Ito S, Yamada K, Ueno S, Ito Y, Terasaki H. Biological Characteristics of Subsilicone Oil Fluid and Differences With Other Ocular Humors. Transl Vis Sci Technol 2019; 8:28. [PMID: 30842889 PMCID: PMC6398349 DOI: 10.1167/tvst.8.1.28] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/26/2018] [Indexed: 01/29/2023] Open
Abstract
Purpose Subsilicone oil fluid (SOF) in eyes with silicone oil (SO) endotamponade possibly has a role in complications (e.g., vision loss); thus, we aimed to examine inflammatory cytokine and electrolyte levels and retinal glial cell viability in SOF. Methods We measured major inflammatory cytokine levels and electrolytes in SOF and compared them with those in vitreous fluid (VF) and anterior chamber fluid (ACF). We analyzed the correlation between inflammatory cytokines and retinal thickness in SO-filled eyes. Further, we measured the MIO-M1 cell viability in medium with SOF and compared it with that containing VF. Results We collected and examined 57 SOF, 22 ACF, and 21 VF samples from eyes with PVR, PDR, RD, and MH. Interleukin (IL)-8 and monocyte chemoattractant protein (MCP)-1 levels in SOF were significantly higher than those in ACF. There was no significant difference for all cytokines between SOF and VF. Retinal thickness changes during SO endotamponade were not correlated with the presence of any inflammatory cytokines. Levels of ferrous iron, but not of potassium, showed a significant decrease in SOF compared with VF. The WST-1 assay showed that SOF-added medium induced higher MIO-M1 cell viability than VF-added medium. Conclusions We found no significant correlation between the change in the retinal thickness and cytokine levels, but SOF contains higher concentrations of cytokines and lower concentrations of ferrous iron and can be biologically distinguished from ACF and VF. Translational Relevance Novel knowledge of inflammatory cytokine levels and electrolytes in SOF provides better understanding of pathology of SO-filled eyes.
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Affiliation(s)
- Hideyuki Shimizu
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroki Kaneko
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayana Suzumura
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kei Takayama
- Department of Ophthalmology, National Defense Medical College, Nagoya, Japan
| | - Rina Namba
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keiko Kataoka
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shiang-Jyi Hwang
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Laboratory of Bell Research Center-Department of Obstetrics and Gynecology Collaborative Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seina Ito
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhisa Yamada
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuki Ito
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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14
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Scheerlinck LM, Schellekens PA, Liem AT, Steijns D, van Leeuwen R. Retinal sensitivity following intraocular silicone oil and gas tamponade for rhegmatogenous retinal detachment. Acta Ophthalmol 2018; 96:641-647. [PMID: 29498239 DOI: 10.1111/aos.13685] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 12/01/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate whether intraocular silicone oil (SO) tamponade is associated with functional changes in patients with both macula-on and macula-off rhegmatogenous retinal detachments (RRDs). METHODS Prospective observational cohort study of patients with RRD treated by vitrectomy with gas or SO tamponade at the University Medical Center Utrecht. Outcome was best-corrected visual acuity (BCVA) and retinal sensitivity on microperimetry 2 months after surgery. RESULTS In total, 40 eyes were included. There are 10 eyes in each of the following groups: macula-on RRD and gas, macula-on RRD and SO, macula-off RRD and gas, and macula-off RRD and SO. Median retinal sensitivity on microperimetry was decreased following SO tamponade compared to gas tamponade for both macula-on and macula-off RRD (p < 0.037). CONCLUSION Foveal sensitivity was decreased in eyes after SO tamponade compared to gas tamponade. These effects were observed in patients with macula-on as well as macula-off RRD. Although further investigation is warranted to validate our results and to study underlying mechanisms, retinal surgeons need to be aware of these findings after the use of SO tamponade.
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Affiliation(s)
- Laura M. Scheerlinck
- Department of Ophthalmology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Peter A. Schellekens
- Department of Ophthalmology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Albert T. Liem
- Department of Ophthalmology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Daan Steijns
- Department of Ophthalmology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Redmer van Leeuwen
- Department of Ophthalmology; University Medical Center Utrecht; Utrecht The Netherlands
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15
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Roca JA, Wu L, Berrocal M, Rodriguez F, Alezzandrini A, Alvira G, Velez-Montoya R, Quiroz-Mercado H, Fernando Arevalo J, Serrano M, Lima LH, Figueroa M, Farah M, Chico G. Un-explained visual loss following silicone oil removal: results of the Pan American Collaborative Retina Study (PACORES) Group. Int J Retina Vitreous 2017; 3:26. [PMID: 28748109 PMCID: PMC5523152 DOI: 10.1186/s40942-017-0079-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 05/03/2017] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To report the incidence and clinical features of patients that experienced un-explained visual loss following silicone oil (SO) removal. METHODS Multicenter retrospective study of patients that underwent SO removal during 2000-2012. Visual loss of ≥2 lines was considered significant. RESULTS A total of 324 eyes of 324 patients underwent SO removal during the study period. Forty two (13%) eyes suffered a significant visual loss following SO removal. Twenty three (7.1%) of these eyes lost vision secondary to known causes. In the remaining 19 (5.9%) eyes, the loss of vision was not explained by any other pathology. Eleven of these 19 patients (57.9%) were male. The mean age of this group was 49.2 ± 16.4 years. Eyes that had an un-explained visual loss had a mean IOP while the eye was filled with SO of 19.6 ± 6.9 mm Hg. The length of time that the eye was filled with SO was 14.8 ± 4.4 months. In comparison, eyes that did not experience visual loss had a mean IOP of 14 ± 7.3 mm Hg (p < 0.0002) and a mean tamponade duration of 9.3 ± 10.9 months (p < 0.0001). CONCLUSIONS An un-explained visual loss after SO removal was observed in 5.9% of eyes. Factors associated with this phenomenon included a higher IOP and longer SO tamponade duration.
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Affiliation(s)
| | - Lihteh Wu
- Asociados de Macula Vitreo y Retina de Costa Rica, Apdo 144-1225 Plaza Mayor, San José, Costa Rica
| | | | | | - Arturo Alezzandrini
- OFTALMOS, Catedra de Oftalmologia, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Raul Velez-Montoya
- Asociación Para Evitar la Ceguera, Hospital Luis Sanchez Bulnes, Mexico, DF Mexico
| | - Hugo Quiroz-Mercado
- Asociación Para Evitar la Ceguera, Hospital Luis Sanchez Bulnes, Mexico, DF Mexico
| | | | - Martín Serrano
- Clinica Oftalmologica Centro Caracas, Arevalo-Coutinho Foundation for Research in Ophthalmology, Caracas, Venezuela
| | - Luiz H Lima
- Departamento de Oftalmologia, Instituto da Visão, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Marta Figueroa
- Departamento de Retina, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Michel Farah
- Departamento de Oftalmologia, Instituto da Visão, Universidade Federal de São Paulo, Sao Paulo, Brazil
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