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Hoyek S, Kocasarac C, Chhablani J. Anisocoria after vitrectomy and scleral buckle surgery in a patient with undifferentiated connective tissue disease. Indian J Ophthalmol 2024; 72:S161. [PMID: 38271411 DOI: 10.4103/ijo.ijo_2547_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Affiliation(s)
- Sandra Hoyek
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Can Kocasarac
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburg, PA, USA
| | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburg, PA, USA
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Skevas C, Thiwa D, Bartz-Schmidt KU, Katz T, Spitzer M, Dimopoulos S. Pupillotonia after endolaser retinopexy during vitrectomy for retinal detachment: a prospective cohort study comparing circumferential and focal retinopexy. Br J Ophthalmol 2023; 107:1900-1906. [PMID: 36288913 DOI: 10.1136/bjo-2022-321640] [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] [Received: 04/11/2022] [Accepted: 09/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine differences in postoperative pupil diameter in eyes that undergo pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) with endolaser retinopexy (ELR), comparing 360° vs focal ELR. METHODS Patients with uncomplicated RRD who underwent PPV were prospectively analysed regarding the postoperative pupil diameter difference (PDD) between the affected eye and the partner eye. Group 1 underwent 360° ELR and group 2 received focal ELR. Postoperative vision and complications, including redetachment rate, macular oedema and epiretinal membrane formation, were also compared. RESULTS A total of 72 patients, 42 in group 1 and 30 in group 2, were analysed. PDD, as observed at 6 weeks, was significantly greater than the preoperative values in both groups 1 and 2. It increased by a mean of 1±1.11 mm in group 1 and by 0.5±0.78 in group 2. This initial increase in PDD receded over time, but remained statistically significant in both groups, even at 6 months. The top 20% of patients with the largest PDD change comprised 13 out of 15 eyes from group 1, which was a statistically significant overrepresentation (p=0.0435). CONCLUSIONS Moderate pupillotonia was induced post-ELR in vitrectomy and correlated to the extent of ELR. The pupillotonia effect of ELR was significantly less marked in pseudophakic eyes.
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Affiliation(s)
- Christos Skevas
- University Medical Center, Departrment of Ophthalmology, University of Hamburg, Hamburg, Germany
| | - David Thiwa
- University Medical Center, Departrment of Ophthalmology, University of Hamburg, Hamburg, Germany
| | - Karl-Ulrich Bartz-Schmidt
- Department of Ophthalmology, Eberhard Karls University Tübingen Faculty of Medicine, Tubingen, Germany
| | - Toam Katz
- University Medical Center, Departrment of Ophthalmology, University of Hamburg, Hamburg, Germany
| | - Martin Spitzer
- University Medical Center, Departrment of Ophthalmology, University of Hamburg, Hamburg, Germany
| | - Spyridon Dimopoulos
- Department of Ophthalmology, Eberhard Karls University Tübingen Faculty of Medicine, Tubingen, Germany
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Turk HB, Bitirgen G, Satirtav G, Kerimoglu H. Assessment of pupillary light reflex using dynamic pupillometry in laser-treated eyes with retinal vein occlusion. Eur J Ophthalmol 2020; 31:2505-2510. [PMID: 33118385 DOI: 10.1177/1120672120969038] [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: 11/16/2022]
Abstract
PURPOSE This study aims to evaluate the pupillary light reflex measured with dynamic pupillometry in patients who underwent retinal laser photocoagulation due to unilateral retinal vein occlusion (RVO). METHODS A total of 48 patients with unilateral RVO were included in the study. Thirty-four patients had undergone retinal laser photocoagulation while the remaining 14 patients that did not undergo laser treatment were observed for control purposes. Of the laser-treated eyes, 14 eyes (41.2%) had central RVO (CRVO) and 20 eyes (58.8%) had branch RVO (BRVO). Among the 14 patients with RVO without laser treatment, nine eyes (64.3%) had CRVO and five eyes (35.7%) had BRVO. Pupillary light reflexes were assessed with dynamic pupillometry (MonPackOne®; Metrovision, France). The parameters of the eyes with RVO were compared with that of fellow healthy eyes. RESULTS Mean patient age was 65.8 ± 10.4 years and median time after photocoagulation was 25.5 months. Eyes that received laser photocoagulation had lower pupil contraction amplitude (p = 0.037), prolonged contraction latency (p = 0.027), slower contraction velocity (p = 0.043), and slower dilation velocity (p < 0.001) compared to healthy fellow eyes. Subgroup analysis revealed that eyes with CRVO had lower contraction amplitude (p = 0.013) and slower dilation velocity (p = 0.003), and eyes with BRVO had slower dilation velocity (p = 0.003). Non-laser-treated eyes with RVO revealed no significant difference in any of the pupillary light reflex parameters compared to fellow eyes. CONCLUSION Laser-treated eyes with RVO demonstrated changes in pupillary light reflex parameters including reduced contraction amplitude, prolonged contraction latency, and slower contraction and dilation velocities measured with dynamic pupillometry.
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Affiliation(s)
- Huseyin Bugra Turk
- Department of Ophthalmology, Gaziantep Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey
| | - Gulfidan Bitirgen
- Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Gunhal Satirtav
- Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Hurkan Kerimoglu
- Department of Ophthalmology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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Yilmaz I, Perente I, Saracoglu B, Yazici AT, Taskapili M. Changes in pupil size following panretinal retinal photocoagulation: conventional laser vs pattern scan laser (PASCAL). Eye (Lond) 2016; 30:1359-1364. [PMID: 27391936 DOI: 10.1038/eye.2016.135] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/05/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo evaluate and compare the possible changes in pupil size subsequent to panretinal laser photocoagulation (PRP) via conventional laser and pattern scan laser (PASCAL).Patients and methodsForty eyes of 40 patients with diabetic retinopathy were included. 20 eyes had a PRP via conventional laser and formed Group 1. 20 eyes had a PRP via PASCAL laser and formed Group 2. The participants underwent standard ophthalmologic examination at baseline. Automated infrared pupillometry were performed at baseline and month 1.ResultsThe mean pupillary measurements (mm) for Group 1 (in the order photopic, mesopic, and scotopic conditions) were 2.88±0.34, 3.38±0.40, and 3.95±0.38, and changed to 3.64±0.42, 4.18±0.42, and 4.58±0.48, respectively. There was significant increase in pupil size at month 1 (P<0.001, P<0.001, and P<0.00, respectively). For Group 2, they were 2.90±0.38, 3.43±0.36, and 3.90±0.40, and changed to 3.18±0.42, 3.74±0.36, and 4.10±0.38, respectively. There was significant increase in pupil size at month 1 (P=0.018, P=0.014, and P=0.014, respectively). The pupil size increased significantly in both groups in all illumination conditions.ConclusıonWe have demonstrated via automated infrared pupillary measurements that PRP may significantly increase pupil size whether it is performed with conventional laser or PASCAL laser.
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Affiliation(s)
- I Yilmaz
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - I Perente
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - B Saracoglu
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - A T Yazici
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - M Taskapili
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
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Bouheraoua N, Parsa CF. Reply. Ophthalmology 2016; 123:e29-30. [PMID: 27012704 DOI: 10.1016/j.ophtha.2015.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Nacim Bouheraoua
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France.
| | - Cameron F Parsa
- Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France
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Auchère Lavayssiere C, Lux AL, Degoumois A, Stchepinsky Launay M, Denion E. [Neurotrophic keratitis after vitrectomy and circumferential endophotocoagulation for retinal detachment]. J Fr Ophtalmol 2015; 39:195-201. [PMID: 26679387 DOI: 10.1016/j.jfo.2015.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/29/2015] [Accepted: 06/02/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Circumferential (360°) endophotocoagulation is frequently implemented during vitrectomies for retinal detachment. This photocoagulation may result in neurotrophic keratitis by damaging the ciliary nerves in the suprachoroidal space on their way to the pupil. We report a series of 4 cases of neurotrophic keratitis following a circumferential endophotocoagulation. PATIENTS AND METHODS A retrospective observational case series of 4 non-diabetic patients having presented with a neurotrophic keratitis following a retinal detachment treated with vitrectomy and circumferential endophotocoagulation (532 nm) at Caen University Hospital. We report the various forms of corneal lesions and the diagnostic criteria allowing for the diagnosis of neurotrophic keratitis. DISCUSSION Neurotrophic keratitis is caused by lesions occurring at various levels of corneal innervation. Endophotocoagulation may cause a neurotrophic keratitis by damaging the short and long ciliary nerves on their way to the pupil in the suprachoroidal space. The sequelae of this condition can limit visual recovery. Hence, it is probably advisable to screen for corneal anesthesia or severe hypesthesia following a retinal detachment treated with vitrectomy and circumferential endophotocoagulation and to implement prophylactic treatment (intensive lubricant therapy; preservative-free eye drops) if needed. CONCLUSION The risk of neurotrophic keratitis should be weighed against the dose of laser retinopexy necessary and sufficient to obtain a sustained retinal reattachment. If circumferential endophotocoagulation is implemented, it is probably sensible to monitor corneal sensitivity and to adapt postoperative treatment if necessary.
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Affiliation(s)
- C Auchère Lavayssiere
- Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France
| | - A-L Lux
- Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France
| | - A Degoumois
- Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France
| | - M Stchepinsky Launay
- Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France
| | - E Denion
- Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France.
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Yilmaz I, Faiz M, Saracoglu B, Yazici AT. Changes in Pupil Size Following Panretinal and Focal/Grid Retinal Photocoagulation: Automatic Infrared Pupillometry Study. J Ocul Pharmacol Ther 2015; 32:172-7. [PMID: 26580579 DOI: 10.1089/jop.2015.0080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate possible changes in pupil size subsequent to panretinal and focal/grid laser photocoagulation. METHODS Sixty-four eyes of 64 participants were included. Thirty-two eyes with planned panretinal photocoagulation formed Group 1, and 32 eyes with planned focal retinal photocoagulation formed Group 2. The participants underwent full ophthalmologic examination at baseline. Automated infrared pupillometry was performed at baseline and month 1. RESULTS The mean pupillary measurements (in millimeters) for Group 1 (in order photopic, mesopic, scotopic) were 3.09 ± 0.69 mm, 3.66 ± 0.85 mm, and 3.87 ± 1.01 mm and changed to 3.34 ± 0.74 mm, 3.82 ± 0.92 mm, and 4.03 ± 1.02 mm. There was a significant increase in pupil size at month 1 (P = 0.001, P = 0.001, P = 0.003). For Group 2, they were 2.65 ± 0.87 mm, 3.08 ± 1.08 mm, and 3.18 ± 1.19 mm and changed to 2.92 ± 0.72 mm, 3.45 ± 0.76 mm, and 3.57 ± 0.88 mm. There was no significant difference in pupil size at month 1 (P = 0.151, P = 0.106, P = 0.095). CONCLUSION We have demonstrated through automated infrared pupillary measurements that panretinal laser photocoagulation may significantly influence pupil size and focal/grid laser photocoagulation may not.
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Affiliation(s)
- Ihsan Yilmaz
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital , Istanbul, Turkey
| | - Miray Faiz
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital , Istanbul, Turkey
| | - Basak Saracoglu
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital , Istanbul, Turkey
| | - Ahmet Taylan Yazici
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital , Istanbul, Turkey
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Zhang J, Davis AS, Spitze A, Lee AG. Bilateral Adie's Tonic Pupil and Hyperopic Shift in Idiopathic Sclerochoroidal Calcification. Neuroophthalmology 2015; 39:96-99. [PMID: 27928340 DOI: 10.3109/01658107.2015.1004724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 01/03/2015] [Accepted: 01/03/2015] [Indexed: 11/13/2022] Open
Abstract
Sclerochoroidal calcification is a rare but recognised ophthalmic manifestation seen mostly in elderly Caucasian individuals. The lesions, often bilateral, appear as yellow-white irregular subretinal lesions usually found along the mid-peripheral fundus. Though typically asymptomatic, sclerochoroidal calcification has rarely been associated with parafoveal involvement, choroidal neovascularisation, and serous detachment of the calcifications. Visual involvement is typically minimal, and neovascularisation is often visually insignificant. We present a rare case of sclerochoroidal calcification in a 64-year-old Caucasian female who presented with painless progressive bilateral vision loss and a hyperoptic shift with subsequent development of bilateral sequential Adie's tonic pupil. To the best of our knowledge, this is the first such report in the English language literature.
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Affiliation(s)
- Jason Zhang
- Department of Ophthalmology, The Methodist HospitalHoustonTexasUSA; Baylor College of MedicineHoustonTexasUSA
| | - Alexander S Davis
- Baylor College of MedicineHoustonTexasUSA; Department of Ophthalmology, The University of Texas Medical BranchGalvestonTexasUSA
| | | | - Andrew G Lee
- Department of Ophthalmology, The Methodist HospitalHoustonTexasUSA; Baylor College of MedicineHoustonTexasUSA; Department of Ophthalmology, The University of Texas Medical BranchGalvestonTexasUSA; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical CollegeNew YorkNew YorkUSAand; Department of Ophthalmology, The University of Iowa Hospitals and ClinicsIowa CityIowaUSA
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Valldeperas X, Arango A, Blazquez A, Romano M. Tonic Pupil and Corneal Anesthesia after Vitrectomy and Encircling Band for Retinal Detachment in an Ex-Premature Child. Case Rep Ophthalmol 2010; 1:66-70. [PMID: 21103199 PMCID: PMC2988852 DOI: 10.1159/000321250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An 11-year-old boy presented with a total retinal detachment in his right eye. He had a bilateral 360° argon laser treatment for an active retinopathy of prematurity performed after his birth. He underwent an uneventful pars plana vitrectomy, encircling band, 810-nm diode endolaser and heavy silicone oil (Densiron(®)) endotamponade. A tonic pupil and abolition of corneal sensitivity, with a large epithelial defect, were observed during the postoperative period. We discuss the possible etiopathogenic mechanisms of the long and short ciliary nerves damage, and the role that retinopathy of prematurity and retinal detachment laser treatment and the encircling band placement might have played in the development of the tonic pupil and the corneal anesthesia.
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Affiliation(s)
- Xavier Valldeperas
- Department of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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