المؤلفون: Teresa Barth, Viola Radeck, Maria-Andreea Gamulescu, Horst Helbig, David Märker

المصدر: BMC Ophthalmology, Vol 24, Iss 1, Pp 1-7 (2024)

مصطلحات موضوعية: Giant retinal tear, Rhegmatogenous retinal detachment, Pars-plana-vitrectomy, Endotamponade, Silicone oil, Gas tamponade, Ophthalmology, RE1-994

الوصف: Abstract Background To compare the outcome of eyes with a macula-on giant retinal tear (GRT) detachment treated with pars-plana-vitrectomy (PPV) depending on the used endotamponade. Methods All consecutive cases with a macula-on GRT-associated rhegmatogenous retinal detachment (RRD) managed with PPV between 2007 and 2022 were retrospectively assessed depending on the selected endotamponade. By reviewing medical charts and surgical protocols the pre- and intraoperative parameters were analysed in detail. The number of vitreoretinal (VR) procedures needed for reattachment, the redetachment rate and the functional outcome were evaluated. Eyes treated with primary silicone oil (SO) tamponade were compared to eyes with primary gas tamponade. Cases with pre-existing conditions affecting outcome e.g. macula-off situation, history of trauma, status after complicated cataract surgery, former VR surgery or proliferative vitreoretinopathy grade C or higher were excluded. Results Overall, 51 eyes of 45 patients with a macula-on GRT detachment were treated with PPV and SO (n = 32; 63%) or gas (n = 19; 37%) endotamponade in the observed period. Eyes with primary SO tamponade underwent on average 2.3 (SD 0.8) VR procedures and had a redetachment rate of 13% (n = 4). Eyes with gas tamponade showed a higher redetachment rate of 32% (n = 6) with a mean number of 1.6 (SD 1.0) PPV procedures. Postoperative best-corrected visual acuity (BCVA) was significantly better in eyes with primary gas tamponade (mean logMAR BCVA 0.32; SD 0.30) compared to eyes with SO (mean logMAR BCVA 0.60; SD 0.42; p = 0.008). Conclusions Surgical management of GRT-associated RRDs is complex. In clinical routine often SO is used as endotamponade. Because of known disadvantages (second procedure necessary for SO removal, unexplained SO-related visual loss, secondary glaucoma, SO emulsification) some VR surgeons prefer a gas tamponade. In our cohort, eyes with a gas compared to SO tamponade showed higher redetachment rates. However, the final postoperative BCVA was significantly better in eyes with gas compared to SO tamponade. Trial registration The trial protocol was approved by the local ethics committee on 25th of November 2022 (Ethikkommission der Universität Regensburg, Votum 22-3166-104).

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2415Test

الوصول الحر: https://doaj.org/article/21d043a53e3840cd944f3cbb0d1eded0Test

المؤلفون: Miguel A. Quiroz-Reyes, Zaheer-Ud-Din Babar, Rabia Hussain, Zhe Chi Loh, Erick A. Quiroz-Gonzalez, Miguel A. Quiroz-Gonzalez, Virgilio Lima-Gomez

المصدر: International Journal of Retina and Vitreous, Vol 10, Iss 1, Pp 1-13 (2024)

مصطلحات موضوعية: Giant retinal tear, Scleral buckling, Primary vitrectomy, High myopia, Proliferative vitreoretinopathy, Rhegmatogenous retinal detachment, Ophthalmology, RE1-994

الوصف: Abstract Background Rhegmatogenous retinal detachment (RRD) is a serious condition that occurs when the retina detaches from its underlying retinal pigment epithelium. RRDs associated with giant retinal tears (GRTs) are caused by retinal tears at least 90° or one-quarter of the circumferential extent. This scoping review systematically identifies and summarizes clinical studies evaluating surgical techniques for the management of GRT-related RRDs, discusses functional and visual outcomes and the risk factors affecting treatment outcomes. Methods This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Google Scholar, and Springer Link databases were searched for relevant papers (from January 2001 to March 2023). Studies that were published in the English language and reported the risk factors, management, and treatment outcomes of GRT-related RRDs were included in the review. The outcome measures included anatomic success rates, changes in BCVA (logMAR) from baseline to the final follow-up, and adverse events. Results A total of 11,982 articles were identified. After the title and abstract review, 71 studies were deemed eligible for full-text review. Thirty-six studies that met the eligibility criteria were included in the final review. Four surgical techniques were identified: pars plana vitrectomy (PPV), combined PPV and scleral buckling, scleral buckling alone, and pneumatic retinopexy. Various types of tamponades, including gas, silicone oil, and air, have been used. PPV was the most commonly used surgical technique in 33.1–100% of patients. Among the 20 studies that used PPV alone, 17 were associated with preoperative PVR. In addition, scleral buckling alone or in combination with PPV was reported as a treatment option in 10 studies, with 2–100% of patients experiencing scleral buckling alone and 13.6–100% experiencing combined PPV and complementary scleral buckling. Primary anatomic success (PAS) was achieved with retinal reattachment via a single operation with no residual tamponade, whereas final anatomic success (FAS) was achieved via more than one operation with no residual tamponade. Reported single surgery anatomic success (SSAS) rates range from 65.51 to 100%. The preoperative best-corrected visual acuity (BCVA) ranged from 0.067 to 2.47 logMAR, whereas the postoperative BCVA ranged from 0.08 to 2.3 logMAR. An improvement in visual acuity was observed in 29 studies. Cataracts (3.9-28.3%) were the most common postoperative complication, followed by high IOP (0.01-51.2%) and PVR (0.8-31.57%). Conclusion PPV is the most common surgical technique, and currently microincision vitrectomy surgery (MIVS) systems are commonly employed. Silicone oil is the most frequently used tamponade in RRD repair. Risk factors for GRT-related RRD include age, sex, lens status, high myopia status, proliferative vitreoretinopathy (PVR), presenting visual acuity, the extent of the GRT and retinal detachment, and macular involvement. Future research areas include guidelines to reduce variability in the reporting of surgical methodology, choice of tamponades, and reporting of functional and visual outcomes to inform the best therapeutic interventions in GRT-related RRD.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2056-9920Test

الوصول الحر: https://doaj.org/article/c2e8bad10a664fcdb93b596a8bc1fcd7Test

المؤلفون: Miguel A. Quiroz-Reyes, Erick A. Quiroz-Gonzalez, Miguel A. Quiroz-Gonzalez, Virgilio Lima-Gomez

المصدر: International Journal of Retina and Vitreous, Vol 9, Iss 1, Pp 1-14 (2023)

مصطلحات موضوعية: Choriocapillaris flow area, Choroidal vascularity index, Giant retinal tear, Rhegmatogenous retinal detachment, Ophthalmology, RE1-994

الوصف: Abstract Purpose Choroidal vascularity index (CVI) and choriocapillaris flow area (CFA) are perfusion biomarkers relevant to retinal disease management. There is limited knowledge regarding these biomarkers in eyes that have been successfully treated for rhegmatogenous retinal detachment (RRD) due to giant retinal tears (GRTs). This study aimed to analyze the relationship between choroidal perfusion biomarkers and functional outcomes in surgically treated eyes with GRT-associated RRD and their fellow eyes. Methods A total of 33 GRT eyes and 29 fellow eyes were included in this study. All RRD-GRT eyes were treated with vitrectomy and categorized into two groups based on whether additional scleral buckles (SB) were placed. Visual and choroidal features were compared between the groups. Results The subjects had an average age of 55.18 years, a mean time of 2.36 weeks before surgery, and a mean follow-up time of 25.9 months. Best-corrected visual acuity (BCVA) was substantially worse in GRT eyes (1.9 logMAR) than in fellow control eyes (0.23 logMAR) but substantially improved after surgery (0.59 logMAR). There were no differences in the presurgical characteristics and BCVA between the eyes that did and did not undergo SB. Long-term CVI and CFA were lower in eyes with GRT than in their fellow eyes. Among eyes with GRT, those with SB had significantly lower CVI and CFA. Correlation analysis revealed that the CVI and CFA were positively correlated with visual outcomes (negative correlation with logMAR). Conclusion Despite successful surgical repair, long-term functional and choroidal evaluations showed permanent changes in eyes with GRT. Positive correlations between perfusion biomarkers and visual function suggest that better choroidal vasculature is associated with better visual outcomes. The results of this study highlight the benefits of analyzing choroidal vasculature biomarkers and the relationship between the choroidal anatomy and vision.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2056-9920Test

الوصول الحر: https://doaj.org/article/cdd822d8293645d1aa8102b015c90f7cTest

المؤلفون: Pramod S Bhende, Himanshu Kashyap, Ramya R Nadig

المصدر: Indian Journal of Ophthalmology, Vol 72, Iss 5, Pp 765-765 (2024)

مصطلحات موضوعية: bimanual instrumentation, giant retinal tear, pediatric giant retinal tear, Ophthalmology, RE1-994

الوصف: Background: A 7-year-old male child was brought by his parents with a complaint of low vision in both eyes for 2 months. The child had low vision in both the eyes for 1.5 years, but the parents noticed when it worsened further 2 months back, leading to profound vision loss. On ophthalmic evaluation, the child did not perceive light in the right eye. Furthermore, anterior segment examination showed complicated cataract and open funnel retinal detachment with intra-retinal cysts in ultrasound (USG) B scan. In the left eye, he could appreciate light but with poor fixation. Fundus evaluation of the left eye showed total retinal detachment on indirect ophthalmoscopy, which was confirmed on USG B scan. Since the right eye had poor visual potential, no intervention was done. The left eye underwent pars plana vitrectomy with silicone oil tamponade, which led to successful anatomical outcomes. The immediate and late postoperative periods were uneventful, and the child was kept under follow-up and was observed closely. Purpose: To educate regarding the surgical management of giant retinal tears in a pediatric patient. Synopsis: To inform regarding the surgical challenges faced and steps adopted to manage such cases. Highlights: Through this case, we want to highlight the challenges faced, such as delayed presentation, difficult preoperative evaluation, intraoperative difficulties such as mobile retina, absence of posterior vitreous detachment, and tenacious vitreous gel. We also want to emphasize on the steps taken to overcome the challenges. Conclusion: In such challenging situations, effective planning, careful manipulation, and persistence are essential for success. Video Link: https://youtu.be/T0Gy6Wj13zITest

وصف الملف: electronic resource

العلاقة: https://journals.lww.com/10.4103/IJO.IJO_1598_23Test; https://doaj.org/toc/0301-4738Test; https://doaj.org/toc/1998-3689Test

الوصول الحر: https://doaj.org/article/82ec9202c4cb4712a7129ae018567873Test

المؤلفون: Michael J. Morano, MD, M. Ali Khan, MD, Qiang Zhang, PhD, Colleen P. Halfpenny, MD, Douglas M. Wisner, MD, James Sharpe, MS, Alexander Li, MS, Maurizio Tomaiuolo, PhD, Julia A. Haller, MD, Leslie Hyman, PhD, Allen C. Ho, MD, Aaron Y. Lee, MD, MSCI, Cecilia S. Lee, MD, MS, Russ Van Gelder, MD, PhD, Alice Lorch, MD, MPH, Joan W. Miller, MD, Suzann Pershing, MD, MS, Jeffrey Goldberg, MD, PhD

المصدر: Ophthalmology Science, Vol 3, Iss 4, Pp 100314- (2023)

مصطلحات موضوعية: Cataract surgery, High myopia, Lattice degeneration, Rhegmatogenous retinal detachment, Retinal tear, Ophthalmology, RE1-994

الوصف: Objective: To report the incidence of and evaluate demographic, ocular comorbidities, and intraoperative factors for rhegmatogenous retinal detachment (RRD) and retinal tear (RT) after cataract surgery in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight). Design: Retrospective cohort study. Participants: Patients aged ≥ 40 years who underwent cataract surgery between 2014 and 2017. Methods: Multivariable logistic regression was used to evaluate demographic, comorbidity, and intraoperative factors associated with RRD and RT after cataract surgery. Main Outcome Measures: Incidence and risk factors for RRD or RT within 1 year of cataract surgery. Results: Of the 3 177 195 eyes of 1 983 712 patients included, 6690 (0.21%) developed RRD and 5489 (0.17%) developed RT without RRD within 1 year after cataract surgery. Multivariable logistic regression odds ratios (ORs) showed increased risk of RRD and RT, respectively, among men (OR 3.15; 95% confidence interval [CI], 2.99–3.32; P < 0.001 and 1.79; 95% CI, 1.70–1.89; P < 0.001), and younger ages compared with patients aged > 70, peaking at age 40 to 50 for RRD (8.61; 95% CI, 7.74–9.58; P < 0.001) and age 50 to 60 for RT (2.74; 95% CI, 2.52–2.98; P < 0.001). Increased odds of RRD were observed for procedure eyes with lattice degeneration (LD) (10.53; 95% CI, 9.82–11.28; P < 0.001), hypermature cataract (1.61; 95% CI, 1.06–2.45; P = 0.03), complex cataract surgery (1.52; 95% CI, 1.4–1.66; P < 0.001), posterior vitreous detachment (PVD) (1.24; 95% CI, 1.15–1.34; P < 0.001), and high myopia (1.2; 95% CI, 1.14–1.27; P < 0.001). Lattice degeneration conferred the highest odds of RT (43.86; 95% CI, 41.39–46.49; P < 0.001). Conclusion: In the IRIS Registry, RRD occurs in approximately 1 in 500 cataract surgeries in patients aged > 40 years within 1 year of surgery. The presence of LD conferred the highest odds for RRD and RT after surgery. Additional risk factors for RRD included male gender, younger age, hypermature cataract, PVD, and high myopia. These data may be useful during the informed consent process for cataract surgery and help identify patients at a higher risk of retinal complications. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2666914523000465Test; https://doaj.org/toc/2666-9145Test

الوصول الحر: https://doaj.org/article/a5cac5fa76324c6a8b6b8fc060a2a21eTest

المؤلفون: Masaki Suzue, Nobuhiko Shiraki, Susumu Sakimoto, Kazuichi Maruyama, Kohji Nishida

المصدر: American Journal of Ophthalmology Case Reports, Vol 32, Iss , Pp 101894- (2023)

مصطلحات موضوعية: Optical coherence tomography angiography, Commotio retinae, Retinal tear, Ophthalmology, RE1-994

الوصف: Purpose: We present a case of traumatic commotio retinae (CR), in which blood flow was evaluated using optical coherence tomography angiography (OCTA). Observations: An 18-year-old Japanese man presented with traumatic retinal detachment and CR in his left eye, which had been hit by a handball. Fundus examination revealed peripheral retinal tear extending from the 1 to 3 o'clock position with retinal detachment, and CR near the area of tear. Fluorescein angiography (FA) confirmed an ischemic area near the retinal tear area at the CR. The patient underwent successful scleral buckling and cryopexy. Sequential OCTA imaging was performed and we were able to determine perfusion in the CR area, with maintained blood flow. Conclusions and importance: In blunt eye trauma, peripheral commotio retinae can be assessed non-invasively over time using OCTA. OCTA is a useful method for evaluating peripheral retinal whitened areas.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2451993623001020Test; https://doaj.org/toc/2451-9936Test

الوصول الحر: https://doaj.org/article/7e09ca2e7e694d568d7de9219a08dd7dTest

المؤلفون: Morris RE, Kuhn F, Richardson C

المصدر: Clinical Ophthalmology, Vol Volume 17, Pp 1505-1513 (2023)

مصطلحات موضوعية: retinal tear, retinal detachment, retinal detachment prevention, 360-degree laser retinopexy, encircling laser prophylaxis, ora secunda cerclage, stickler syndrome., Ophthalmology, RE1-994

الوصف: Robert E Morris,1– 3 Ferenc Kuhn,2,4 Cole Richardson1– 3 1Retina Specialists of Alabama, LLC, Birmingham, AL, USA; 2Helen Keller Foundation for Research and Education, Birmingham, AL, USA; 3Department of Ophthalmology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA; 4Department of Ophthalmology, University of Pécs Medical School, Pecs, HungaryCorrespondence: Robert E Morris, Helen Keller Foundation for Research and Education, 2208 University Boulevard, Suite 101, Birmingham, AL, 35233, USA, Tel +1 205 936 0704, Email rmorris@rmeyes.comAbstract: Encircling (360 degree) retinal detachment prophylaxis using indirect ophthalmoscope laser delivery recently achieved strong proof of safety and effectiveness by preventing the development of peripheral retinal tears and detachments in the eyes of patients with Stickler syndrome (syndromic eyes). Untreated, Stickler syndrome patients have a 65% lifetime risk of retinal detachment (half by age 20, 80% bilateral). This report describes an optimal technique of encircling laser retinopexy to also prevent the more common retinal detachments seen in aging (non-syndromic) eyes that share with Stickler syndrome the common pathogenesis of peripheral retinal tears caused by vitreous traction.Keywords: retinal tear, retinal detachment, retinal detachment prevention, 360-degree laser retinopexy, encircling laser prophylaxis, ora secunda cerclage, Stickler syndrome

وصف الملف: electronic resource

العلاقة: https://www.dovepress.com/preventingTest-retinal-detachment-the-encircling-laser-retinopexy-techniqu-peer-reviewed-fulltext-article-OPTH; https://doaj.org/toc/1177-5483Test

الوصول الحر: https://doaj.org/article/1a95c4b1e58b4be3873de86d19edfe37Test

المؤلفون: Ying Zhu, Huizhuo Xu, Xianggui Wang

المصدر: BMC Ophthalmology, Vol 23, Iss 1, Pp 1-5 (2023)

مصطلحات موضوعية: Surgical steps optimization, Iatrogenic retinal tear, Length of operation, Internal limiting membrane flap, Macular hole retinal detachment, Ophthalmology, RE1-994

الوصف: Abstract Background To investigate the effect of surgical steps optimization in pars plana vitrectomy (PPV) with internal limiting membrane (ILM) flap for macular hole retinal detachment (MHRD) in pathological myopia. Methods A retrospective, consecutive, nonrandomized comparative study. High myopic eyes diagnosed with MHRD receiving PPV with ILM flap from March 2019 to June 2020 in Department of Ophthalmology, Xiangya Hospital, Central South University were included in the study. Patients were included into two groups based on different design of surgical steps. In the routine group, extension of posterior vitreous detachment (PVD) towards periphery was performed right after induction of PVD. In the experiment group, the retina was reattached with drainage of subretinal fluid through macular hole before peripheral vitreous was dealt with. Complete ophthalmic examinations were performed before and after surgery. The follow-up time was at least 6 months. The rate of iatrogenic retinal break and length of operation were compared between the two groups. Results Thirty-one eyes from 31 patients were included in the study with 15 in the experiment group and 16 in the routine group. Demographics showed no statistically significant difference between the two groups. Post-op BCVA, rate of macular hole closure and rate of retinal reattachment were similar in the two groups. The rate of iatrogenic retinal break in the experiment group was significantly lower than that in the routine group (6.7% vs. 37.5%, P

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2415Test

الوصول الحر: https://doaj.org/article/a9c75dbeaec54a468f18ac4fb19de25eTest

المؤلفون: Morris RE, Kuhn F, Sipos T

المصدر: Clinical Ophthalmology, Vol Volume 16, Pp 4315-4321 (2022)

مصطلحات موضوعية: retinal tear, retinal detachment, retinal detachment prevention, 360-degree laser retinopexy, stickler syndrome, Ophthalmology, RE1-994

الوصف: Robert E Morris,1– 3 Ferenc Kuhn,2,4 Timothy Sipos1– 3 1Retina Specialists of Alabama, LLC, Birmingham, AL, USA; 2Helen Keller Foundation for Research and Education, Birmingham, AL, USA; 3Department of Ophthalmology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA; 4Department of Ophthalmology, University of Pécs Medical School, Pécs, HungaryCorrespondence: Robert E Morris, Helen Keller Foundation for Research and Education, 2208 University Boulevard, Suite 101, Birmingham, AL, USA, 35233, Tel +1 205 936-0704, Email rmorris@rmeyes.comAbstract: Stickler syndrome, a rare inherited disease, carries a lifetime risk of rhegmatogenous retinal detachment (RRD) of up to 65%, higher than any other predisposing condition known. Both syndromic and non-syndromic eyes suffer RRD predominately from the same pathogenesis, vitreous tractional tears in the peripheral retina. Consequently, extraordinary publications in 2021– 2022, each reporting successful prevention of RRD in Stickler syndrome, using 360-degree (encircling) laser retinopexy, provide the first strong evidence upon which similar prophylaxis in non-syndromic eyes at high risk of RRD from peripheral retinal tears can confidently go forward.Keywords: retinal tear, retinal detachment, retinal detachment prevention, 360-degree laser retinopexy, stickler syndrome, encircling laser prophylaxis

وصف الملف: electronic resource

العلاقة: https://www.dovepress.com/preventingTest-retinal-detachment-where-are-we-implications-from-stickler--peer-reviewed-fulltext-article-OPTH; https://doaj.org/toc/1177-5483Test

الوصول الحر: https://doaj.org/article/1fb007729f0b4d688487659ca320e5c5Test

المؤلفون: Jérôme Garneau, Mélanie Hébert, Eunice You, Serge Bourgault, Mathieu Caissie, Éric Tourville, Ali Dirani

المصدر: International Journal of Retina and Vitreous, Vol 8, Iss 1, Pp 1-7 (2022)

مصطلحات موضوعية: Giant retinal tear, Retinal detachment, Pars plana vitrectomy, Scleral buckle, Ophthalmology, RE1-994

الوصف: Abstract Background To compare the functional and anatomical outcomes of primary surgery in patients with giant retinal tear (GRT)-associated retinal detachment (GRT-RD) to patients with simple rhegmatogenous RD (RRD). Methods This is a retrospective study at the CHU de Québec - Université Laval. Medical records of all consecutive patients operated for RD between 2014 and 2018 were reviewed. Patients with GRT-RD and RRD were included. Preoperative, intraoperative, and postoperative data were compared between both groups, including extension of giant tears, number of RD quadrants, preoperative macula and lens status, type of surgery, best corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR) preoperatively and at follow-up, and single surgery anatomical success (SASS). Results There were 39 patients (1.7%) with GRT-RD and 1661 patients (74%) with RRD. Median [Q1, Q3] ages were 59 [52, 62] years and 62 [56, 69] years (p = 0.003), while number of affected quadrants were 2 [2, 3] and 2 [2, 3] (p = 0.96) in GRT-RD and RRD patients, respectively. In GRT-RD patients, GRT size was 120 [90, 150] degrees. Final BCVA was 0.30 [0.10, 0.30] and 0.30 [0.10, 0.40] (p = 0.76) in GRT and RRD patients, respectively. SSAS was 82% (32/39) in the GRT-associated-RD group and 90% (1495/1661) in the RRD group (p = 0.10). After correcting for other preoperative factors, GRT was a risk factor for worse SSAS (odds ratio: 0.422, p = 0.047). Conclusions GRT-RD is still challenging to treat, and our results suggest that it is a risk factor for poorer SSAS.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2056-9920Test

الوصول الحر: https://doaj.org/article/350fa7e9aeac4c99b60002e6ba361660Test