1. MENISCUS MICROPYON: An Ophthalmoscopic Sign Possibly Associated With Epiretinal Proliferation After Retinal Surgery With Gas Tamponade.
- Author
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Russell JF, Fowler BJ, Al-Khersan H, Lazzarini TA, Patel NA, Syed NA, and Russell SR
- Subjects
- Humans, Male, Female, Aged, Middle Aged, Visual Acuity, Retinal Perforations surgery, Retinal Perforations diagnosis, Retinal Perforations etiology, Retrospective Studies, Adult, Aged, 80 and over, Endotamponade, Vitrectomy methods, Retinal Detachment surgery, Retinal Detachment diagnosis, Retinal Detachment etiology, Tomography, Optical Coherence methods, Epiretinal Membrane surgery, Epiretinal Membrane diagnosis, Postoperative Complications, Ophthalmoscopy methods, Vitreoretinopathy, Proliferative diagnosis, Vitreoretinopathy, Proliferative surgery, Vitreoretinopathy, Proliferative etiology
- Abstract
Purpose: To describe an ophthalmoscopic sign, termed a meniscus micropyon, and its possible association with proliferative vitreoretinopathy/epiretinal membrane (ERM) formation after retinal surgery with gas tamponade., Methods: Patients with intravitreal gas were examined postoperatively by one of six vitreoretinal surgeons from four institutions. A micropyon was defined as a white-yellow, solid-appearing consolidation along the meniscus (i.e., the fluid-gas interface)., Results: A micropyon was visualized and photographed in 49 patients who received intravitreal gas. Preoperatively, retinal breaks were present in all 49 eyes and rhegmatogenous retinal detachment in 45 (92%). Postoperatively, 39 eyes (80%) developed epiretinal proliferation: 16 eyes (33%) developed recurrent rhegmatogenous retinal detachment from proliferative vitreoretinopathy, 6 eyes (12%) re-detached without frank proliferative vitreoretinopathy, 9 eyes (18%) developed postoperative ERM/worsening, and 8 eyes (16%) had postoperative ERM but no preoperative optical coherence tomography to determine if the postoperative ERM was new or worsening. The single-operation anatomical success in eyes with a micropyon was 51%, which was lower than that of a contemporaneous rhegmatogenous retinal detachment control group (91%) in which no micropyon was detected. In two patients, micropyons were biopsied during pars plana vitrectomy and examined histopathologically; they consist predominantly of white blood cells., Conclusion: The meniscus micropyon is an ophthalmoscopic sign that can occur after retinal surgery with gas tamponade. Features that distinguish a micropyon from postvitrectomy fibrin/fibrinoid syndrome include delayed appearance, hyperautofluorescence, absence of translucent strands or sheets in the anterior chamber or vitreous cavity, and the histopathologic identification of white blood cells. A clinically detectable micropyon may be a biomarker of proliferative vitreoretinopathy/ERM formation.
- Published
- 2024
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