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Huang RS, Mihalache A, Lau THA, Popovic MM, Kertes PJ, Muni RH. Pars Plana Vitrectomy With Silicone Oil or Gas Tamponade for Uncomplicated Retinal Detachment: A Systematic Review and Meta-Analysis. Am J Ophthalmol 2024; 266:144-155. [PMID: 38815844 DOI: 10.1016/j.ajo.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE To compare the efficacy and safety of pars plana vitrectomy (PPV) with silicone oil compared to gas tamponade for uncomplicated rhegmatogenous retinal detachment (RRD). DESIGN Systematic review and meta-analysis. METHODS A systematic literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Library from January 2000 to September 2023 for comparative studies evaluating the efficacy and safety of PPV with either silicone oil or gas tamponade in the setting of uncomplicated RRD. Our primary outcome was best-corrected visual acuity at the last study observation. Secondary outcomes included the rates of retinal reattachment, retinal thickness, and the incidence of adverse events. We performed a meta-analysis using a random-effects model. RESULTS Nine observational studies reporting on 491 RRD eyes were included. The mean best-corrected visual acuity at the last study observation was significantly better in the gas tamponade group than in the silicone oil group (weighted mean difference [WMD] = 0.17 logMAR, 95% confidence interval [CI] = [0.06, 0.27], P = .002). Rates of primary retinal reattachment were similar between the silicone oil and gas tamponade groups (P = .89). The ganglion cell layer was significantly thinner in the silicone oil group compared to the gas tamponade group (WMD =-3.70 µm, 95% CI = [-5.87, -1.53, P = .0008), as was the inner plexiform layer (WMD = -2.45, 95% CI = [-4.50, -0.40], P = .02) and outer nuclear layer (WMD = -11.74 µm, 95% CI = [-18.39, -5.10], P = .0005). CONCLUSIONS PPV with gas tamponade was associated with better functional outcomes compared to PPV with silicone oil, although both tamponades yielded comparable primary reattachment rates. The absence of randomized trials and the potential for selection bias underscore the importance of further investigation in diverse patient populations.
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Affiliation(s)
- Ryan S Huang
- Temerty Faculty of Medicine, University of Toronto (RSH, AM), Toronto, Ontario, Canada
| | - Andrew Mihalache
- Temerty Faculty of Medicine, University of Toronto (RSH, AM), Toronto, Ontario, Canada
| | - Tsz Hin Alexander Lau
- Department of Ophthalmology and Visual Sciences, McGill University (THAL), Montreal, Quebec, Canada
| | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto (MMP, PJK, RHM), Toronto, Ontario, Canada
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto (MMP, PJK, RHM), Toronto, Ontario, Canada; John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre (PJK), Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto (MMP, PJK, RHM), Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto (RHM), Toronto, Ontario, Canada.
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Grassi P, Charteris D. Macular changes after primary retinectomy for retinal detachment complicated by proliferative vitreoretinopathy. Clin Exp Optom 2024; 107:434-441. [PMID: 37674262 DOI: 10.1080/08164622.2023.2236098] [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: 09/19/2022] [Accepted: 07/10/2023] [Indexed: 09/08/2023] Open
Abstract
CLINICAL RELEVANCE Primary retinectomy in eyes not previously vitrectomized has been previously rarely performed in a minority of cases, unlike non-primary retinectomies in vitrectomized eyes. BACKGROUND This paper aims to determine anatomical and functional outcomes of primary retinectomy, and to assess structural macular changes among successful cases. METHODS In this retrospective multicentre cohort-study, 35 primary retinectomies in eyes undergoing initial vitrectomy for rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy C or D between 2014 and 2021 were included. The mean follow-up duration was 48 ± 59.24 months among successes and 46.54 ± 20.99 months among unsuccesses (p = 0.483). RESULTS The anatomical success rate was 48.5% after one retinectomy and 60% after two retinectomies. Mean postoperative best corrected visual acuity (BCVA) was 1.85 ± 0.62 logMAR (6/425 Snellen equivalent). The difference from mean preoperative BCVA was not significant (p = 0.312). Final BCVA ≥ 6/60 was achieved in 17% of cases, and no cases gained ≥6/24. Final mean postoperative BCVA of successes was 1.69 ± 0.60 logMAR (6/294 Snellen equivalent) compared with 2.10 ± 0.57 logMAR (6/756 Snellen equivalent) of unsuccessful cases (p = 0.101). Post-operative macular optical coherence tomography was obtained from 95% of successes. Normal macular profile was found in 10% of cases, and the other cases demonstrated exudative maculopathy (60%), tractional maculopathy (20%) and macular atrophy (10%). Final BCVA was significantly higher in eyes with normal macular status compared to eyes with exudative maculopathy (p = 0.045) and macular atrophy (p = 0.025). CONCLUSION Primary retinectomy may be used for rhegmatogenous retinal detachment complicated with advanced proliferative vitreoretinopathy. Anatomical and functional outcome were inferior than non-primary retinectomies for grade C proliferative vitreoretinopathy. Functional outcome was influenced by macular status. Positive prognostic factors include final anatomical success and normal final macular anatomy.
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Affiliation(s)
- Piergiacomo Grassi
- School of Medical Sciences, the University of Manchester, Manchester, UK
| | - David Charteris
- Vitreoretinal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Vidal-Oliver L, Mataix Boronat J, Palacios Pozo E, López-Prats MJ, Desco Esteban MC. Long-term complications according to silicone oil type. A single center cohort study. Eur J Ophthalmol 2024; 34:541-548. [PMID: 37671421 DOI: 10.1177/11206721231200034] [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: 09/07/2023]
Abstract
PURPOSE To study the incidence of macular edema (ME), ocular hypertension (OHT), emulsification and migration to the anterior chamber (AC) of silicone oil (SO) in patients after complex retina surgery, stratified by SO type. METHODS Retrospective, cohort study. Patients who underwent retina surgery with SO injection and extraction in our center were included. We compared the complication rates of ME, OHT, emulsification and migration to the AS according to SO type (1300cSt, 5700cSt and heavy SO). Data on age, sex, emulsification time, duration of the tamponade, previous retina surgeries and diagnosis were also gathered and included in a multivariate analysis. RESULTS We included 163 patients (mean age of 64.8 years; mean duration of the tamponade: 11 months). Rates of emulsification, ME, OHT and SO migration to the AC were similar in all groups (p = 0.998, 0.668, 0.915 and 0.360). ME was the most frequent complication (33.3-47.8%), which resolved after SO extraction in 77.6% of cases. The majority of cases with OHT persisted (61.7%). Emulsification was related to younger age (OR 0.94) and longer duration of the tamponade (OR 1.04). The odds of SO migration to the AC increased with emulsification (OR 2.78), recurrent retinal detachment (OR 0.99) and aphakia (OR 4.05). CONCLUSIONS We propose SO extraction as the preferred treatment for ME during SO tamponade. SO extraction should be performed sooner in younger patients to avoid emulsification. In selected patients, we suggest a longer duration of the tamponade up to 11 months with a reasonable safety profile, regardless of the SO type.
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Affiliation(s)
| | | | | | | | - M Carmen Desco Esteban
- Fundación Oftalmología Médica de la Comunidad Valenciana, Valencia, Spain
- Department of Medicine and Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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Kontou EP, Karakosta C, Kounas K, Iatropoulos I, Tsinopoulos I, Kozobolis V, Stavrakas P. Macular Edema Following Silicone Oil Tamponade for Retinal Detachment: A Literature Review. Cureus 2023; 15:e51233. [PMID: 38283484 PMCID: PMC10821764 DOI: 10.7759/cureus.51233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
Macular edema (ME) is a major cause of reduced vision following intraocular surgery. Although the pathophysiology of ME is not completely understood, inflammatory mediators play a key role. The incidence of ME following pars plana vitrectomy with silicone oil tamponade varies between 13% and 27%. ME usually resolves spontaneously following silicone oil removal, but treatment may be required for resistant cases. In this review, the mechanisms of ME formation after pars plana vitrectomy, its incidence, and its possible therapeutic approaches are discussed.
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Affiliation(s)
- Evgenia P Kontou
- Department of Ophthalmology, General Hospital of Athens "Korgialeneio-Benakio" Hellenic Red Cross, Athens, GRC
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
| | - Christina Karakosta
- Department of Ophthalmology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Konstantinos Kounas
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
| | - Ioannis Iatropoulos
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
| | - Ioannis Tsinopoulos
- Second Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Vassilios Kozobolis
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
| | - Panagiotis Stavrakas
- Department of Ophthalmology, School of Medicine, University of Patras, Patras, GRC
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Chen J, Guan L, Liu Y, Song Y, Tang Y, Cao Y, Li M, Sheng A, Zhang Z, Liu H. Choroidal vascular changes in silicone oil-filled eyes after vitrectomy for rhegmatogenous retinal detachments. BMC Ophthalmol 2023; 23:442. [PMID: 37919665 PMCID: PMC10621110 DOI: 10.1186/s12886-023-03167-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION The tamponade of silicone oil (SO) can affect both the structure and blood flow of the retina. However, there are few studies on the effect of SO tamponade on choroidal blood flow. Our study aimed to compare the effects of SO tamponade on the choroidal vascular index (CVI) and choroidal thickness (CT) in patients with unilateral rhegmatogenous retinal detachment (RRD) with operated eyes and fellow healthy eyes. METHODS We retrospectively collected demographic and clinical data from 36 patients who underwent 23G pars plana vitrectomy and SO tamponade for unilateral complicated RRD. Enhanced depth imaging-optical coherence tomography (EDI-OCT) scans were performed both within 1 week before SO removal and at the last follow-up visit after SO removal. Using ImageJ software, images were binarized to segment the total choroidal area, luminal area, and stromal area, respectively. The CVI was calculated as CVI=(luminal area)/(total choroidal area), and CT was also evaluated. RESULTS During SO tamponade, the CVI and luminal area in operated eyes were significantly lower compared to fellow eyes (57.616 ± 0.030 vs. 60.042 ± 0.019, P < 0.0001; 0.909 [0.694; 1.185] vs. 1.091 [0.785; 1.296], P = 0.007). Even after SO removal, the CVI remained lower in operated eyes than in fellow eyes (59.530 ± 0.018 vs. 60.319 ± 0.020, P = 0.031). Both CVI and luminal area were lower in operated eyes before SO removal than after SO removal (57.616 ± 0.030 vs. 59.530 ± 0.018, P = 0.0003; 0.909 [0.694; 1.185] vs. 0.994 [0.712; 1.348], P = 0.028). The duration of SO tamponade was positively correlated with the difference in CVI between fellow eyes and operated eyes during SO tamponade (P = 0.035). Total choroidal area, stromal area, and CT did not differ significantly between fellow eyes and operated eyes or between pre- and post-SO removal. CONCLUSIONS SO tamponade reduces CVI and decreases choroidal blood circulation in patients with retinal detachments required vitrectomy combined with SO tamponade. The longer the SO tamponade time, the more CVI reduction. In future work, we will aim to reduce these side effects by shortening the duration of silicone oil filling.
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Affiliation(s)
- Jiayu Chen
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Lina Guan
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Yalu Liu
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Yingying Song
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Yu Tang
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Yumei Cao
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Meishuang Li
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Aiqin Sheng
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Zhengpei Zhang
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China.
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China.
| | - Haiyang Liu
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China.
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China.
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Shaheen A, Lai J, Magraner M, Ashkenazy N, Flynn HW, Sridhar J, Yannuzzi NA. Clinical Outcome of Cystoid Macular Edema in Silicone Oil-Filled Eyes. JOURNAL OF VITREORETINAL DISEASES 2023; 7:477-482. [PMID: 37974915 PMCID: PMC10649453 DOI: 10.1177/24741264231200739] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Purpose: To investigate the clinical outcome of cystoid macular edema (CME) in eyes undergoing silicone oil (SO) tamponade with subsequent SO removal (SOR). Methods: A retrospective case series of adult patients with CME treated with SO tamponade and SOR was conducted between January 2015 and January 2021. Exclusion criteria included eyes with a prior SO tamponade, those that did not undergo SOR, or those with infectious/inflammatory diagnoses. The primary outcomes were the incidence and resolution rates of CME in eyes with SO tamponade that had undergone SOR. The secondary outcomes included changes in best-corrected visual acuity (BCVA) and central field thickness (CFT). Results: Nineteen eyes of 19 patients (58% men) aged 52 years (interquartile range [IQR], 45-66 years) met the study inclusion criteria. The median (IQR) follow-up duration post SOR was 22 (8-35) months. The mean CFT decline for the CME-resolved cases was 13.1 µm/mo (P = .257). CME resolved in only 10 eyes (53%), 7 (67%) of which occurred after SOR. The median (IQR) BCVA was 20/400 (20/200 to 20/1262) at CME diagnosis and 20/796 (20/252 to hand motions) after SOR, with 0.184 worsening in logMAR BCVA (P = .340). Medical treatment was not associated with CME resolution compared with observation (50% vs 89%, respectively; P = .069). Eyes with proliferative vitreoretinopathy (PVR) had a higher rate of persistent CME compared with eyes with other diagnoses (78% vs 10%, respectively; P = .005). Conclusions: Nearly half had nonresolution of CME after SO was removed. The VA at the last follow-up was unaffected by CME resolution. Preoperative PVR may be a risk factor for unresolved CME.
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Affiliation(s)
- Abdulla Shaheen
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - James Lai
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Maria Magraner
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Noy Ashkenazy
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Harry W. Flynn
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Nicolas A. Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
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Hsu CR, Hsieh YT, Yang CM, Lin CP. Single-dose Effect of Intravitreal Dexamethasone Implant for Post-vitrectomy Macular Edema under Silicone Oil. Ocul Immunol Inflamm 2023; 31:1587-1593. [PMID: 34477484 DOI: 10.1080/09273948.2021.1970779] [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: 03/04/2021] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the single-dose effect of intravitreal dexamethasone (DEX) implant for patients with post-vitrectomy macular edema (ME) under silicone oil (SO) tamponade. METHODS Twelve eyes diagnosed with ME after undergoing pars plana vitrectomy with SO injections were retrospectively reviewed. Each eye received a single intravitreal DEX implant (0.7-mg, Ozurdex; Allergan Inc) injection as treatment for recalcitrant ME. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were recorded. RESULTS Compared with baseline (1.24 ± 0.34), the mean LogMAR BCVA improved at 1 (1.14 ± 0.27), 3 (1.13 ± 0.22), and 6 (1.22 ± 0.30) months without statistical significance. Maximal CMT resolution was observed at 1 month after intravitreal injection. The CMT value improved significantly at 1 (P = .008), 3 (P = .006), and 6 (P = .009) months. IOP did not show significant elevation during follow-up. No serious adverse events were observed. CONCLUSION Single-dose treatment of DEX implant may have benefit for recalcitrant post-vitrectomy ME under SO tamponade.
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Affiliation(s)
- Cherng-Ru Hsu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chang-Ping Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan
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Moussa G, Tadros M, Ch'ng SW, Ferrara M, Kalogeropoulos D, Sharma A, Lett KS, Mitra A, Tyagi AK, Andreatta W. Unexplained visual loss in retinal detachment repair: comparing gas, silicone oil and heavy silicone oil by multivariable regression. Int J Retina Vitreous 2023; 9:30. [PMID: 37120629 PMCID: PMC10148464 DOI: 10.1186/s40942-023-00466-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/03/2023] [Indexed: 05/01/2023] Open
Abstract
PURPOSE To measure the proportion of unexplained and all causes of visual loss following primary rhegmatogenous-retinal-detachment (RRD) repair, comparing gas tamponade (SF6, C2F6, C3F8), silicone oil (SO, 1000cs and 5000cs) and heavy silicone oil (Densiron). METHODS Retrospective, continuous, comparative study from 01/1/2017-31/5/2021. All primary RRDs were included after successful removal of SO and Densiron. Primary failures were excluded. Visual loss was defined as reduction of ≥0.30 logMAR units. Multivariable binary-logistic and linear regression models to compare tamponade, and all cases of unexplained visual loss and logMAR gain were performed. Covariates included age, ocular co-morbidities, pre-op vision, macula-status, high-myopia, giant-retinal-tear (GRT), perfluorocarbon-use, combined buckle/PPV, PVR-C, retinectomy, tamponade agent and post-operative lens status. RESULTS Of 1,012 primary RRDs, we found an incidence of unexplained visual loss in 15/1012 (1.5%, SF6:1/341[0.3%], C2F6:4/338[1.2%], C3F8:2/239[0.8%], Densiron:0/33[0.0%], SO-1000cs:5/43[11.6%] and SO-5000cs:3/18[16.7%]), and visual loss of all causes in 57/1012 (5.6%, SF6:13/341[3.8%], C2F6:14/338[4.1%], C3F8:15/239[6.3%], Densiron:2/33[6.1%], SO-1000cs:9/43[20.9%] and SO-5000cs:4/18[22.2%]). On multivariable binary-logistic regression, we report that macula-on RRD (Odds-Ratio[OR]5.7,95% Confidence-interval[CI]1.2-28.2, p=0.032), GRT (OR35.0,CI 2.0-617.3, p=0.015), combined buckle/PPV (OR37.7,CI 2.0-711.4, p=0.015), SO1000cs (OR86.6,CI 5.6-1,348.0), p=0.001) and 5000cs (OR37.2,CI 1.3-1,101.5, p=0.036) (Reference-tamponade:SF6) were associated with unexplained visual loss. Duration of oil tamponade was not linked to increase in unexplained visual loss (p=0.569). CONCLUSIONS Correlation between SO in detachment repairs and unexplained visual loss has been established, however incidence with HSO has not been compared to other agents. This study demonstrates that although SO was linked with risk-adjusted increased unexplained visual loss relative to gas tamponade, no such association was found for Densiron, on multivariable analysis.
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Affiliation(s)
- George Moussa
- Birmingham and Midland Eye Centre and Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK.
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK.
| | - Maria Tadros
- Birmingham and Midland Eye Centre and Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK
| | - Soon Wai Ch'ng
- Birmingham and Midland Eye Centre and Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK
| | | | - Dimitrios Kalogeropoulos
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ash Sharma
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Kim Son Lett
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Arijit Mitra
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Ajai K Tyagi
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Walter Andreatta
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
- Kantonsspital Winterthur, Brauerstrasse 15, 8400, Winterthur, Switzerland
- University of Zurich, Rämistrasse 71, 8006, Zurich, Switzerland
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Retinal and Corneal Changes Associated with Intraocular Silicone Oil Tamponade. J Clin Med 2022; 11:jcm11175234. [PMID: 36079165 PMCID: PMC9457190 DOI: 10.3390/jcm11175234] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/13/2022] [Accepted: 09/01/2022] [Indexed: 12/22/2022] Open
Abstract
Silicone oils (SO) are used as long-term intraocular tamponades and have an irreplaceable role in vitreoretinal surgery. They can, however, be associated with multiple and potentially severe complications, involving different ocular tissues, in particular retina and cornea. Recent advances in ophthalmic imaging have allowed the precise characterization of retinal and corneal microstructural changes, at a subclinical level. This detailed analysis of SO-related retinal and corneal changes has improved our understanding of their pathogenesis and offer the potential for optimized monitoring and management of patients with SO-filled eyes. This review aims to provide clinicians and ophthalmic scientists with an updated and comprehensive overview of the corneal and retinal changes associated with SO tamponade.
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Evaluation of long-term outcomes associated with extended heavy-silicone oil use for the treatment of inferior retinal detachment. Sci Rep 2022; 12:11636. [PMID: 35804082 PMCID: PMC9270317 DOI: 10.1038/s41598-022-15896-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/30/2022] [Indexed: 11/08/2022] Open
Abstract
To evaluate macular status with optical coherence tomography (OCT) in eyes that underwent pars plana vitrectomy (PPV) and heavy-silicone oil (HSO) endotamponade for the treatment of rhegmatogenous retinal detachment (RRD) with inferior breaks. Twenty eyes of 20 patients who have RRD with inferior breaks included in the study. Oxane HD was used as an intraocular tamponade for all surgeries. Postoperatively, anatomic reattachment, macular status using OCT imaging, and any long-term complications were evaluated. The mean age was 60.4 ± 11.2 years (range, 37-83). The duration of HSO endotamponade was 15.3 ± 11.0 months (range, 6-48) with some postoperative complications such as HSO emulsification, intraocular pressure elevation, and epiretinal membrane (ERM) formation. Mean follow-up time was 19.5 ± 10.5 months (range, 10-59) after HSO removal or ERM surgery. Primary reattachment was achieved in 90% of eyes and the success rate was 100% with further interventions. Ellipsoid zone (EZ) was continuous in 13 of 20 eyes in which OCT imaging performed as well as the fellow eye. PPV and heavy-silicone oil injection for the treatment of eyes with RRD from inferior break(s) have a good long-term EZ continuity. ERM formation and its removal do not affect EZ.
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Dubroux C, Salleron J, Angioi-Duprez K, Berrod JP, Conart JB. Effect of Duration of Silicone Oil Tamponade on Retinal Structure after Rhegmatogenous Retinal Detachment Surgery. Ophthalmologica 2021; 245:144-151. [PMID: 34929691 DOI: 10.1159/000519520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of the study was to investigate the effect of tamponade duration on retinal changes induced by silicone oil (SO) in patients who underwent successful rhegmatogenous retinal detachment (RRD) surgery. METHODS Retrospective comparative case series of 68 patients who underwent SO tamponade for RRD. Patients were divided into 2 groups based on timing of SO removal: <6 months (group 1, n = 34) versus ≥6 months (group 2, n = 34). The main outcome measure was the change in central macular, inner, and outer retinal layer thickness (CMT, IRLT, and ORLT) before and after SO removal (SOR). RESULTS The median tamponade duration was 4 [Clin Ophthalmol. 2016;10:471-6, Zhonghua Yan Ke Za Zhi. 1997 Jan;33(1):39-41] months in group 1 and 8 [Arch Ophthalmol. 1994 Jun;112(6):778-85, Retina. 2004 Dec;24(6):871-7] months in group 2 (p < 0.001). The mean CMT significantly increased from 245.3 ± 22.2 μm and 238.8 ± 41.6 μm under SO to 281.3 ± 60.2 μm and 259.0 ± 43.5 μm after SOR in group 1 (p = 0.009) and in group 2 (p = 0.007), respectively. Automated segmentation measurement revealed a significant increase in mean IRLT (p = 0.014 and p = 0.013) but no change in mean ORLT (p = 0.080 and p = 0.257) in both groups. After adjustment, there was no difference between the 2 groups in terms of mean final CMT, IRLT, and ORLT and mean retinal thickness changes after SOR. There was also no correlation between the tamponade duration and macular microstructural changes or visual recovery. CONCLUSION SO tamponade causes a thinning of all retinal layers, mainly affecting the inner retinal layer. However, these changes resolved following SO extraction and were not affected by longer tamponade duration.
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Affiliation(s)
- Chloé Dubroux
- Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Julia Salleron
- Institut de Cancérologie de Lorraine, Department of Biostatistics and Data Management, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Karine Angioi-Duprez
- Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Jean-Paul Berrod
- Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Jean-Baptiste Conart
- Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
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12
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Lee J, Cho H, Kang M, Hong R, Seong M, Shin Y. Retinal Changes before and after Silicone Oil Removal in Eyes with Rhegmatogenous Retinal Detachment Using Swept-Source Optical Coherence Tomography. J Clin Med 2021; 10:jcm10225436. [PMID: 34830717 PMCID: PMC8619201 DOI: 10.3390/jcm10225436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/04/2021] [Accepted: 11/18/2021] [Indexed: 12/03/2022] Open
Abstract
This study aimed to evaluate and compare the retinal and choroidal thickness and vessel density (VD) changes between silicone oil (SO) tamponade and after SO removal using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Thirty patients who underwent pars plana vitrectomy for retinal detachment (RD) with SO tamponade were included. SS-OCT and OCTA were conducted before RD surgery, during SO tamponade, and after SO removal. A 3-dimensional volumetric wide scan protocol was used for the analysis. The segmented retina, choroidal thickness map, and peripapillary thickness were then measured. For the OCTA analysis, 4.5 × 4.5 mm scans were used. Superficial and deep capillary plexus VDs in unaffected fellow eyes and eyes after SO removal were compared. During the SO tamponade period, the thickness of the parafoveal total retina, ganglion cell-inner plexiform layer, and peripapillary retinal nerve fiber layer (ppRNFL) were significantly thinner than those of unaffected fellow eyes (p < 0.05). The parafoveal layer thickness thinning recovered up to three to six months after SO removal. Moreover, six months after SO removal, the parafoveal thickness was not significantly different compared to that of unaffected fellow eyes (p > 0.05). However, the ppRNFL thickness was significantly decreased during SO tamponade and remained unrecovered six months after SO removal. There was no significant difference in the VD on the OCTA. Thus, SO tamponade and removal for RD resulted in a change in the retinal and peripapillary thickness. This may be due to the mechanical pressure effect of SO.
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Kashani AH, Lebkowski JS, Rahhal FM, Avery RL, Salehi-Had H, Chen S, Chan C, Palejwala N, Ingram A, Dang W, Lin CM, Mitra D, Pennington BO, Hinman C, Faynus MA, Bailey JK, Mohan S, Rao N, Johnson LV, Clegg DO, Hinton DR, Humayun MS. One-Year Follow-Up in a Phase 1/2a Clinical Trial of an Allogeneic RPE Cell Bioengineered Implant for Advanced Dry Age-Related Macular Degeneration. Transl Vis Sci Technol 2021; 10:13. [PMID: 34613357 PMCID: PMC8496407 DOI: 10.1167/tvst.10.10.13] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose To report 1-year follow-up of a phase 1/2a clinical trial testing a composite subretinal implant having polarized human embryonic stem cell (hESC)-derived retinal pigment epithelium (RPE) cells on an ultrathin parylene substrate in subjects with advanced non-neovascular age-related macular degeneration (NNAMD) Methods The phase 1/2a clinical trial included 16 subjects in two cohorts. The main endpoint was safety assessed at 365 days using ophthalmic and systemic exams. Pseudophakic subjects with geographic atrophy (GA) and severe vision loss were eligible. Low-dose tacrolimus immunosuppression was utilized for 68 days in the peri-implantation period. The implant was delivered to the worst seeing eye with a custom subretinal insertion device in an outpatient setting. A data safety monitoring committee reviewed all results. Results The treated eyes of all subjects were legally blind with a baseline best-corrected visual acuity (BCVA) of ≤ 20/200. There were no unexpected serious adverse events. Four subjects in cohort 1 had serious ocular adverse events, including retinal hemorrhage, edema, focal retinal detachment, or RPE detachment, which was mitigated in cohort 2 using improved hemostasis during surgery. Although this study was not powered to assess efficacy, treated eyes from four subjects showed an increased BCVA of >5 letters (6–13 letters). A larger proportion of treated eyes experienced a >5-letter gain when compared with the untreated eye (27% vs. 7%; P = not significant) and a larger proportion of nonimplanted eyes demonstrated a >5-letter loss (47% vs. 33%; P = not significant). Conclusions Outpatient delivery of the implant can be performed routinely. At 1 year, the implant is safe and well tolerated in subjects with advanced dry AMD. Translational Relevance This work describes the first clinical trial, to our knowledge, of a novel implant for advanced dry AMD.
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Affiliation(s)
- Amir H Kashani
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Firas M Rahhal
- Retina-Vitreous Associates Medical Group, Beverly Hills, CA, USA
| | | | | | - Sanford Chen
- Orange County Retina Medical Group, Santa Ana, CA, USA
| | - Clement Chan
- Southern California Desert Retina Consultants, Palm Desert, CA, USA
| | - Neal Palejwala
- Retinal Consultants of Arizona, Retinal Research Institute LLC, Phoenix, AZ, USA
| | - April Ingram
- Regenerative Patch Technologies, Menlo Park, CA, USA
| | - Wei Dang
- Center for Biomedicine and Genetics, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Chih-Min Lin
- Center for Biomedicine and Genetics, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Debbie Mitra
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Britney O Pennington
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Cassidy Hinman
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Mohamed A Faynus
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Jeffrey K Bailey
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Sukriti Mohan
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Narsing Rao
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lincoln V Johnson
- Regenerative Patch Technologies, Menlo Park, CA, USA.,Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - Dennis O Clegg
- Center for Stem Cell Biology and Engineering, Neuroscience Research Institute, University of California, Santa Barbara, CA, USA
| | - David R Hinton
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mark S Humayun
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
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Kim JH, Yoon YS, Woo JM, Min JK. Analysis of the Changes in Retinal Thickness in Eyes Undergoing Vitrectomy with Silicone Oil Tamponade. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.7.969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. Methods: This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. Results: The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. Conclusions: Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.
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Jiang J, Chen S, Jia YD, Li R, Zhou JX, Li RM. Evaluation of macular vessel density changes after vitrectomy with silicone oil tamponade in patients with rhegmatogenous retinal detachment. Int J Ophthalmol 2021; 14:881-886. [PMID: 34150544 DOI: 10.18240/ijo.2021.06.14] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/19/2021] [Indexed: 01/03/2023] Open
Abstract
AIM To evaluate macular microvasculature changes in eyes after pars plana vitrectomy (PPV) and intraocular silicone oil (SO) tamponade for macula-off rhegmatogenous retinal detachment (RRD) using optical coherence tomography angiography (OCTA). METHODS Totally 19 eyes (19 patients) with macula-off RRD who underwent PPV and intraocular SO tamponade were retrospectively reviewed. The parafoveal superficial capillary plexus (SCP) vessel density (VD), deep capillary plexus (DCP) VD, choriocapillaris plexus (CCP) VD, and foveal macular thickness were evaluated using OCTA throughout 16wk postoperatively. The values of healthy fellow eyes were used as control. RESULTS The parafoveal SCP, DCP, and CCP VDs were significant increased over time in RRD eyes during the 12wk postoperatively, then decreased at 16wk postoperatively (all P<0.01). The ratios of RRD eyes and fellow healthy eyes (r/f ratios) of the SCP and DCP VDs were lower than those of the CCP VD postoperatively (all P<0.05). There were not significant differences in the r/f ratios between SCP and DCP VDs postoperatively (all P>0.05). CONCLUSION The parafoveal SCP, DCP, and CCP VDs gradually recover over time after PPV surgery with SO tamponade. Long-time SO tamponade might decrease postoperative macular VDs. Compared to parafoveal CCP VD, the parafoveal SCP and DCP VDs were more vulnerable in RRD eyes postoperatively.
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Affiliation(s)
- Jian Jiang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China.,Tianjin Eye Hospital, Tianjin 300020, China.,Taiyuan Aier Eye Hospital, Taiyuan 030012, Shanxi Province, China
| | - Song Chen
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China.,Tianjin Eye Hospital, Tianjin 300020, China
| | - Ya-Ding Jia
- Taiyuan Aier Eye Hospital, Taiyuan 030012, Shanxi Province, China
| | - Rui Li
- Taiyuan Aier Eye Hospital, Taiyuan 030012, Shanxi Province, China
| | - Jin-Xiu Zhou
- Taiyuan Aier Eye Hospital, Taiyuan 030012, Shanxi Province, China
| | - Rui-Mei Li
- Taiyuan Aier Eye Hospital, Taiyuan 030012, Shanxi Province, China
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Dormegny L, Jeanjean LC, Liu X, Messerlin A, Bourcier T, Sauer A, Speeg-Schatz C, Gaucher D. VISUAL IMPAIRMENT AND MACULAR VASCULAR REMODELING SECONDARY TO RETROGRADE MACULOPATHY IN RETINAL DETACHMENT TREATED WITH SILICON OIL TAMPONADE. Retina 2021; 41:309-316. [PMID: 32404843 DOI: 10.1097/iae.0000000000002812] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the frequency of macular cysts (MCs) in retinal detachment treated with silicone oil and evaluate their impact on visual acuity and macular vascularization using optical coherence tomography-angiography. METHODS Forty-three eyes of 41 patients treated with silicone oil for retinal detachment were retrospectively studied. Best-corrected visual acuity and 6- × 6-mm optical coherence tomography-angiography examination at least 3 months after silicone oil removal were reviewed. In eyes with MCs, cyst area was measured on the en face optical coherence tomography-angiography image using ImageJ. Density of superficial capillary plexus and area of superficial foveal avascular zone were generated by the optical coherence tomography-angiography. Density of deep capillary plexus and deep foveal avascular zone area were measured using ImageJ. RESULTS Twenty-five eyes (58%) presented with MCs. Cysts were exclusively located in the inner nuclear layer in 60% of cases. Mean best-corrected visual acuity in the MC group was lower than that of the non-MC group (P = 0.012). Macular cyst area negatively correlated with best-corrected visual acuity (P = 0.0201). Density of superficial capillary plexus was higher in the MC group (P < 0.0001), whereas area of superficial foveal avascular zone was lower (P < 0.0001). Macular cyst area negatively correlated with density of deep capillary plexus (P < 0.001). CONCLUSION The incidence of INL-MCs after silicone oil removal is high. These are associated with impaired vision and macular vascular remodeling. We highlight their similarity with the "retrograde maculopathy" phenomenon.
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Affiliation(s)
- Lea Dormegny
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Ludovic C Jeanjean
- IIMIS team, Cube-CNRS UMR 7357, Neurophysiology, FMTS, University of Strasbourg, Strasbourg, France. ; and
| | - Xuanli Liu
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France
- Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215000, P.R. China
| | - Arnaud Messerlin
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Tristan Bourcier
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Arnaud Sauer
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Claude Speeg-Schatz
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - David Gaucher
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France
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Hostovsky A, Mandelcorn MS, Mandelcorn ED. Transient Macular Thinning during the Use of Heavy Silicone Oil, Densiron 68. Curr Eye Res 2020; 46:350-354. [PMID: 32700981 DOI: 10.1080/02713683.2020.1795885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND To evaluate the effect of short-term Densiron tamponade on macular thickness. METHODS Retrospective case series. Data were collected from charts of patients who received short-term (less than 90 days) Densiron tamponade. The OCT parameters were compared between Densiron in situ and after Densiron removal and to the fellow eye. RESULTS Twenty eyes were included in the analysis. Although there was a trend toward thinner CRT with Densiron in situ in situ the operated eye when compared to the fellow eye (248 and 264 microns, respectively, p = .066), this difference disappeared after DR. At the final OCT there was a statistically significant recovery in the CRT (from 248 to 277 microns, P = .001) and no statistical difference between operated and the fellow eye (p = .265) with no evidence of ERM or CME. CONCLUSIONS We found transient macular thinning that resolved after Densiron removal with no evidence of long-term macular thinning in eyes treated with Densiron tamponade for retinal detachment.
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Affiliation(s)
- Avner Hostovsky
- Department of Ophthalmology and Vision Sciences, University of Toronto , Toronto, Canada.,Department of Ophthalmology, Toronto Western Hospital, The University Health Network , Toronto, Canda
| | - Mark S Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto , Toronto, Canada.,Department of Ophthalmology, Toronto Western Hospital, The University Health Network , Toronto, Canda
| | - Efrem D Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto , Toronto, Canada.,Department of Ophthalmology, Toronto Western Hospital, The University Health Network , Toronto, Canda
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Evaluation of emulsified silicone oil with spectral domain-optical coherence tomography and fluorescein angiography. Int Ophthalmol 2020; 40:2267-2274. [PMID: 32399773 DOI: 10.1007/s10792-020-01409-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND To report emulsified particles and related complications after removal of silicone oil (SO) by spectral domain-optical coherence tomography (SD-OCT) and fluorescein angiography (FA). METHODS A prospective, single-center investigation was performed using SD-OCT, FA and flare cell photometry measurements to evaluate in a cohort of eyes with emulsified silicone particles after removal of long-term SO tamponade. RESULTS Nineteen eyes of the 19 patients with emulsified silicone particles detected in ophthalmoscopic exam were included in the study: 13 (68%) were male, and 6 (31.6%) were female, and their mean age was 52.75 ± 16.06 years. Preoperative diagnoses were rhegmatogenous retinal detachment in all eyes. The mean duration of the silicone oil's presence in the eye was found as 12.63 ± 4.87 (7-26) months. SD-OCT examination postoperatively showed small, round and hyper-reflective structures compatible with emulsified silicone particles on preretinal surface in 7 (36.8%) eyes, intraretinally in 6 (31.6%) eyes and in the vitreous in 12 (63%) eyes. FA imaging demonstrated pearl-like hyper-fluorescence at early and late phases on the large blood vessels in 9 (47.4%) eyes. Late phase hyper-fluorescence due to leakage on the macula was observed in 17 (89.5%) eyes. Diffuse peripheral leakage and hyper-fluorescence was detected in 11 (57.9%) eyes. Flare levels were higher in eyes with emulsified SO compared to unaffected fellow eyes (p < 0.05). CONCLUSIONS Emulsified silicone particles that remain in the eye may lead to retinal complications and inflammation in addition to their known complications such as keratopathy and glaucoma. The particles that lead to inflammation and presence of inflammation may be examined by imaging methods such as SD-OCT and FA. Removing the SO before emulsification would be suitable for avoiding such complications.
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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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Eibenberger K, Sacu S, Rezar-Dreindl S, Schmidt-Erfurth U, Georgopoulos M. Silicone Oil Tamponade in Rhegmatogenous Retinal Detachment: Functional and Morphological Results. Curr Eye Res 2019; 45:38-45. [PMID: 31478404 DOI: 10.1080/02713683.2019.1652917] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To evaluate the functional and morphological outcomes of patients with SO tamponade due to primary rhegmatogenous retinal detachment (primRD) and recurrent rhegmatogenous detachment (recRD).Methods: Seventy-five eyes were enrolled in this prospective study between January 2009 and December 2016. Patients with primRD and recRD were evaluated in a complete ophthalmic examination including best-corrected visual acuity (BCVA) and OCT before and after silicone oil removal (SOR).Results: The primRD group comprised 35 eyes and the recRD group 40 eyes with a duration of SO tamponade of 9 ± 4/12 ± 11 months in the primRD/recRD groups (p = .088). The preoperative OCT revealed a high rate of morphological changes such as ERM (primRD: 24%; recRD: 69%) and CME (primRD: 10%; recRD: 55%) in the recRD compared with the primRD group (ERM: p = .18; CME: p = .04). No such difference was observed postoperatively. Disruption of the ellipsoid zone (EZ) was similar in both groups (primRD: 52%; recRD: 72%) before SOR and was restored in 66%/58% (primRD/recRD) after SOR. No difference was found regarding pre- and postoperative VA (0.91 ± 0.54/0.90 ± 0.54logMAR primRD/recRD preoperative; 0.76 ± 0.56/0.71 ± 0.53logMAR primRD/recRD at the last follow-up; p = .96/p = .70). EZ integrity (0.43 ± 0.31logMAR) was associated with better functional results than an interrupted EZ (0.86 ± 0.43logMAR; p < .001). A significant positive correlation of the duration of SO tamponade and the final VA was found in the primRD (r = 0.396, p = .02) whereas none in the recRD group (r = 0.196; p = .31).Conclusion: Morphological changes including ERM and CME were more pronounced in the recRD group, but only before SOR. Interestingly, the pre- and postoperative BCVA were similar in both groups with EZ integrity being a factor of good functional outcome. The duration of SO tamponade had a statistically significant negative impact on the postoperative VA in the primary detachments.
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Affiliation(s)
| | - Stefan Sacu
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
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Yang JY, Kim HK, Kim SH, Kim SS. Incidence and Risk Factors of Cystoid Macular Edema after Vitrectomy with Silicone Oil Tamponade for Retinal Detachment. KOREAN JOURNAL OF OPHTHALMOLOGY 2017; 32:204-210. [PMID: 29022299 PMCID: PMC5990636 DOI: 10.3341/kjo.2017.0050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 09/13/2017] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the incidence and risk factors of cystoid macular edema (CME) after silicone oil (SO) injection for retinal detachment. METHODS Fifty-eight patients with retinal detachment treated by vitrectomy with SO tamponade during 2011 to 2015 were retrospectively assigned to CME and non-CME groups. Patients underwent complete ophthalmological examination, including color fundus photography and preoperative and postoperative optical coherence tomography. Risk factors for CME during SO tamponade were determined by regression analyses. RESULTS Of the 58 eyes, 21 (36.2%) exhibited CME. The presence of posterior staphyloma in the CME group was significantly more frequent than in the non-CME group (p = 0.026). There were no significant differences in other demographic or clinical characteristics between the CME and non-CME groups. Significant correlations were observed between CME after vitrectomy with SO tamponade and the presence of posterior staphyloma (odds ratio, 4.03; p = 0.031). Of the 21 eyes with CME, 13 underwent SO removal, among which 11 experienced resolution of CME with or without further intervention. CONCLUSIONS The presence of posterior staphyloma is significantly associated with CME after vitrectomy with SO tamponade. Patients with retinal detachment exhibiting posterior staphyloma should be evaluated for potential CME during SO tamponade.
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Affiliation(s)
- Jong Yun Yang
- Siloam Eye Hospital, Seoul, Korea.,Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hong Kyu Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Han Kim
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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