124 results on '"vitreous traction"'
Search Results
2. Development of traumatic bilateral horseshoe-shaped macular tear without vitreous traction: Case report
- Author
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Tsuyoshi Mito, Takeshi Joko, and Atsushi Shiraishi
- Subjects
blunt ocular trauma ,horseshoe-shaped macular tear ,inverted internal limiting membrane flap technique ,vitreous traction ,Ophthalmology ,RE1-994 - Abstract
To report our findings in a case with bilateral horseshoe-shaped macular tears. Both eyes of a 68-year-old woman developed horseshoe-shaped macular tears in the absence of vitreous traction due to prior vitrectomy in one eye and a posterior vitreous detachment in the other eye. Vitrectomy with the inverted internal limiting membrane flap technique led to a successful closure of the macular tear bilaterally, and an improvement of her visual acuity in both eyes. The cause of horseshoe-shaped macular tear was most likely due to a retinal rupture from a blunt trauma.
- Published
- 2020
- Full Text
- View/download PDF
3. Visualizing Vitreous Traction by Biomicroscopy versus OCT.
- Author
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Vofo BN, Yosef YB, Tiosano L, Levy J, Khateb S, and Chowers I
- Subjects
- Humans, Traction, Vitreous Body diagnostic imaging, Tomography, Optical Coherence, Vitreous Detachment
- Published
- 2023
- Full Text
- View/download PDF
4. Idiopathic horseshoe-like macular tear: a case report
- Author
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Kubota M, Shibata T, Gunji H, and Tsuneoka H
- Subjects
horseshoe-like macular tear ,vitreous surgery ,retinal detachment ,vitreous traction ,Medicine (General) ,R5-920 - Abstract
Masaomi Kubota,1 Tomohiro Shibata,1 Hisato Gunji,1 Hiroshi Tsuneoka2 1Department of Ophthalmology, The Jikei University School of Medicine Kashiwa Hospital, Chiba, 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: Although a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined. Objective: To report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery. Case report: A 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD). Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved. Conclusion: While cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases. Keywords: horseshoe-like macular tear, vitreous surgery, retinal detachment, vitreous traction
- Published
- 2016
5. Development of traumatic bilateral horseshoe-shaped macular tear without vitreous traction: Case report.
- Author
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Mito, Tsuyoshi, Joko, Takeshi, and Shiraishi, Atsushi
- Abstract
To report our findings in a case with bilateral horseshoe-shaped macular tears. Both eyes of a 68-year-old woman developed horseshoe-shaped macular tears in the absence of vitreous traction due to prior vitrectomy in one eye and a posterior vitreous detachment in the other eye. Vitrectomy with the inverted internal limiting membrane flap technique led to a successful closure of the macular tear bilaterally, and an improvement of her visual acuity in both eyes. The cause of horseshoe-shaped macular tear was most likely due to a retinal rupture from a blunt trauma. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
6. Novel probabilistic model of core vitreous traction using microsurgical vitrectomy tools
- Author
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Michael Koss, Jaw-Chyng Lue, Mark S. Humayun, Ramiro Ribeiro, Paulo Falabella, and Rodrigo Brant
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0301 basic medicine ,Pars plana ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Vitrectomy ,Vitreous traction ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Ophthalmology ,Iatrogenic retinal tear ,medicine ,business.industry ,Force gauge ,Traction (orthopedics) ,eye diseases ,Sensory Systems ,Retinal Tear ,surgical procedures, operative ,030104 developmental biology ,medicine.anatomical_structure ,030221 ophthalmology & optometry ,sense organs ,business ,Vitreous base - Abstract
Traction exerted on the vitreous base during vitrectomy poses a risk for retinal tears. We aimed to quantify core vitreous traction during vitrectomy using spring return and pneumatic cutters. Juvenile porcine vitreous was vacuum held in a vitreous bath while traction was measured using precision force gauge during vitrectomy. The parameters included were aspiration rate, cut-rate, cutter size, and machine types. An empirical probabilistic model was developed. The traction was proportional to the aspiration rate but insignificantly dependent on the cut-rate. The traction probability was inversely proportional to the exponential function of the traction (p
- Published
- 2020
7. Foveal cyst: Unknown etiology and unexplained response to treatment
- Author
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B Poornachandra, Chaitra Jayadev, Santosh Gopi Krishna Gadde, Anand Vinekar, and Sherina Thomas
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Adult ,Male ,Fovea Centralis ,medicine.medical_specialty ,genetic structures ,Vitreous traction ,Vitreous Detachment ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Foveal ,Ophthalmology ,medicine ,Humans ,Cyst ,Retinal pathology ,Macular hole ,Retina ,Cysts ,business.industry ,General Medicine ,Retinal Perforations ,medicine.disease ,Response to treatment ,eye diseases ,medicine.anatomical_structure ,030221 ophthalmology & optometry ,Etiology ,sense organs ,business ,Tomography, Optical Coherence ,030217 neurology & neurosurgery - Abstract
Background: Foveal cysts have been associated with vitreous traction due to a taut posterior hyaloid. These eyes may progress to become a full-thickness macular hole, remain stable, or resolve after a posterior vitreous detachment. A foveal cyst in an eye with a complete posterior vitreous detachment and no other obvious pathology is unusual. Case presentation: A 21-year-old male presented with blurred vision in the left eye of 1-month duration. On examination his left-eye vision was 20/60, and anterior segment examination was normal. Fundus examination showed internal limiting membrane folds with a suspected lamellar macular hole. A spectral domain optical coherence scan showed a thin dome-like cyst in the sub foveal region involving the outer retinal layer with a detached posterior hyaloid face. A trial of intravitreal dexamethasone implant was given, following which there was improvement in vision and resolution of the foveal cyst. At the third-month follow-up, the patient presented with a stellate pattern of hyporeflectivity in the macular area both on spectral domain optical coherence scan and multicolor imaging with no change in visual acuity. Conclusion: The presence of a foveal cyst in a young male without any risk factors is peculiar, and the rapid response to intravitreal dexamethasone implant raises questions about the pathogenesis. The stellate pattern of hyporeflectivity on spectral domain optical coherence scan imaging with an intraretinal “filling defect”–like picture on fluorescein angiography suggests a possible ongoing ischemic pathology.
- Published
- 2020
8. Management of peripheral polypoidal choroidal vasculopathy with intravitreal bevacizumab and indocyanine green angiography-guided laser photocoagulation
- Author
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Pukhraj Rishi, Atheeswar Das, Pallavi Sarate, and Ekta Rishi
- Subjects
Band-shaped keratopathy ,corneal dystrophy ,phototherapeutic keratectomy ,phototherapeutic keratectomy with amniotic membrane grafts ,scar ,and Salzmann nodular degeneration ,Kaplan Meier survival analysis ,multivariate Cox Proportional Hazard Regression analysis ,optical penetrating keratoplasties ,Myopia ,phakic refractive intraocular lens ,refractive surgery ,23-Gauge vitrectomy ,rhegmatogenous retinal detachment ,sutureless vitrectomy ,Deep anterior lamellar keratoplasty ,endothelial cell density ,keratoconus ,penetrating keratoplasty ,Anterior chamber contamination ,cataract surgery ,conjunctival flora ,diabetics ,Cardiovascular disease ,diabetes ,diabetic retinopathy ,framingham risk score ,Central macular thickness ,multifocal electroretinogram ,normative database ,optical coherence tomography ,Macular microhole ,microperimetry ,spectral domain optical coherence tomography ,Age-related macular degeneration ,choroidal neovascularization ,photodynamic therapy ,vitreous traction ,Descemet membrane endothelial keratoplasty with a stromal rim ,endothelial keratoplasty ,posterior lamellar keratoplasty ,posterior polymorphous corneal dystrophy ,Indocyanine green angiogram ,intravitreal bevacizumab ,laser photocoagulation ,peripheral hemorrhagic exudative chorioretinopathy ,polypoidal choroidal vasculopathy ,Ophthalmology ,RE1-994 - Abstract
A 69-year-old lady presented with complaints of decreased vision in left eye since one month. Best Corrected Visual Acuity (BCVA) was 6/18 in that eye. Fundus examination revealed non-central geographic atrophy and soft drusens at macula in both eyes. Temporal periphery of left eye revealed subretinal exudates with altered sub-RPE hemorrhage mimicking peripheral exudative hemorrhagic chorioretinopathy (PEHCR). Fundus Fluorescein Angiogram showed window defects at macula and blocked fluorescence at temporal periphery in left eye. However, Indocyanine green angiography (ICGA) revealed active peripheral choroidal polyps. The patient was successfully treated with intravitreal bevacizumab and ICGA-guided laser photocoagulation. 27 months after laser treatment, BCVA improved to 6/9. Rationale of consecutive anti-vascular endothelial growth factor (VEGF) treatment followed by more definitive laser photocoagulation is that anti-VEGF aids in resolution of subretinal fluid, thus making the polyp more amenable to focal laser photocoagulation which stabilizes the choroidal vasculature and prevents further leakage.
- Published
- 2012
- Full Text
- View/download PDF
9. Idiopathic horseshoe-like macular tear: a case report.
- Author
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Masaomi Kubota, Tomohiro Shibata, Hisato Gunji, and Hiroshi Tsuneoka
- Subjects
OPHTHALMIC surgery complications ,VITREOUS body diseases ,VISUAL acuity ,OPHTHALMOSCOPY ,OPTICAL coherence tomography ,RETINAL vein - Abstract
Background: Although a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined. Objective: To report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery. Case report: A 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD). Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved. Conclusion: While cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
10. Abnormal traction of the vitreous detected by swept-source optical coherence tomography is related to the maculopathy associated with optic disc pits.
- Author
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Yokoi, Tadashi, Nakayama, Yuri, Nishina, Sachiko, and Azuma, Noriyuki
- Subjects
- *
RETINAL degeneration treatment , *OPTIC disc , *OPTICAL coherence tomography , *GLASS structure , *RETINAL detachment , *VITRECTOMY , *DISEASES - Abstract
Background: Maculopathy associated with optic disc pits (ODP), which sometimes causes severe visual loss, usually appears in late childhood or early adulthood. However, it has long been unclear how the disease begins to develop at these ages. We evaluated the relationship between vitreous structure and maculopathy associated with ODP. Methods: Six patients (seven eyes) with ODP were diagnosed between July 1990 and May 2013. Fundus photographs and swept-source optical coherence tomography (SS-OCT) images were evaluated retrospectively, and the vitreous at the vitreoretinal interface was visualized by reconstructing three-dimensional SS-OCT images. Vitrectomy was performed in the eyes with maculopathy. Results: Among the six patients, five had ODP in one eye each and one patient had bilateral ODP. The pits were mainly located in the temporal quadrant, and maculopathy, including retinoschisis and retinal detachment, was detected in five eyes associated only with the temporal pits. A flat retinal detachment was observed in four eyes and identified within the vascular arcade except in one eye. A posterior precortical vitreous pocket (PPVP) was observed in all eyes except in one eye without maculopathy. Reconstructing images from SS-OCT showed the vitreoretinal interface abnormalities around the optic disc and the macular area in all eyes, which was completely different from the vitreoretinal interface in the normal pediatric eye. Vitrectomy was performed in four eyes with retinal detachment to resect the abnormal vitreous traction. Posterior vitreous detachment was created in two eyes. Retinal reattachment was achieved in three eyes, and subretinal fluid receded in one eye. The visual acuity improved in all four eyes. Conclusions: Abnormal traction of the vitreous due to an abnormality of the vitreoretinal interface, which may be strengthened by the development of a PPVP, generates the maculopathy associated with ODP. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
11. Vitreous and Retinopathy of Prematurity: Vitreous Surgery and Visual Results
- Author
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Trese, Michael T., Hartzer, Michael, Lin, Li-Ren, Mayer, Luisa, Regan, Virginia, Manatrey, Patricia, Flynn, John T., editor, and Tasman, William, editor
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- 1992
- Full Text
- View/download PDF
12. Clinical Characteristics of Eyes Showing a Discrete Margin of Different Retinal Reflectivity
- Author
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Sohee Jeon, Jin Heung Park, Soonil Kwon, and Hyeontak Yang
- Subjects
medicine.medical_specialty ,genetic structures ,Vitreous traction ,Diagnostic Techniques, Ophthalmological ,Retina ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Optical coherence tomography ,Ophthalmology ,medicine ,Humans ,Macula Lutea ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Fundus photography ,Retinal ,Epiretinal Membrane ,medicine.disease ,Reflectivity ,eye diseases ,medicine.anatomical_structure ,chemistry ,030221 ophthalmology & optometry ,sense organs ,Epiretinal membrane ,business ,Tomography, Optical Coherence ,Retinal hole - Abstract
BACKGROUND AND OBJECTIVE: To evaluate the clinical characteristics of discrete margins of different retinal reflectivity (DMDRR) in ultra-widefield fundus photography. PATIENTS AND METHODS: This DMDRR comprises a discrete border, with differing patterns of reflectivity on either side. Spectral-domain optical coherence tomography was performed on both the macula and the margin. The incidences of epiretinal membrane (ERM) and peripheral retinal pathologies of patients with a DMDRR (n = 36) were compared with a control group (n = 41). RESULTS: An ellipsoid zone (EZ) defect at the DMDRR was detected in 34 eyes (92.2%), and vitreous traction was detected in 20 eyes (55.6%). A significantly higher proportion of eyes in the DMDRR group had an ERM, retinal hole, and cystic retinal tuft compared with the control group ( P = .022, P = .010, and P < .001, respectively). CONCLUSIONS: The DMDRR indicates EZ disruption that may originate from vitreous traction. Meticulous observation for vitreoretinal interface diseases is mandatory for these patients. [ Ophthalmic Surg Lasers Imaging Retina . 2021;52:273–280.]
- Published
- 2021
13. Comparison of immersion ultrasonography, ultrasound biomicroscopy and anterior segment optical coherence tomography in the evaluation of traumatic phacoceles
- Author
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Harikrishna Vodapalli, Somasheila I Murthy, Subhadra Jalali, Mohammad Javed Ali, and Padmaja Kumari Rani
- Subjects
Band-shaped keratopathy ,corneal dystrophy ,phototherapeutic keratectomy ,phototherapeutic keratectomy with amniotic membrane grafts ,scar ,and Salzmann nodular degeneration ,Kaplan Meier survival analysis ,multivariate Cox Proportional Hazard Regression analysis ,optical penetrating keratoplasties ,Myopia ,phakic refractive intraocular lens ,refractive surgery ,23-Gauge vitrectomy ,rhegmatogenous retinal detachment ,sutureless vitrectomy ,Deep anterior lamellar keratoplasty ,endothelial cell density ,keratoconus ,penetrating keratoplasty ,Anterior chamber contamination ,cataract surgery ,conjunctival flora ,diabetics ,Cardiovascular disease ,diabetes ,diabetic retinopathy ,framingham risk score ,Central macular thickness ,multifocal electroretinogram ,normative database ,optical coherence tomography ,Macular microhole ,microperimetry ,spectral domain optical coherence tomography ,Age-related macular degeneration ,choroidal neovascularization ,photodynamic therapy ,vitreous traction ,Descemet membrane endothelial keratoplasty with a stromal rim ,endothelial keratoplasty ,posterior lamellar keratoplasty ,posterior polymorphous corneal dystrophy ,Indocyanine green angiogram ,intravitreal bevacizumab ,laser photocoagulation ,peripheral hemorrhagic exudative chorioretinopathy ,polypoidal choroidal vasculopathy ,Anterior segment optical coherence tomography ,B-scan ultrasonography ,phacocele ,ultrasound biomicroscopy ,Ophthalmology ,RE1-994 - Abstract
Blunt ocular trauma in the elderly can result in anterior dislocation of the crystalline lens into the subconjunctival space (phacocele). Although rare, this presentation can be missed, especially if the patient presents several days after the injury and if the lid is not everted on examination. While a careful clinical examination is adequate in the diagnosis, imaging techniques can be put to use for the accurate location of the associated sclera rupture. We report three cases of post-traumatic phacocele wherein ultrasound biomicroscopy (UBM) was compared to the anterior segment optical coherence tomography (AS-OCT) and B-scan ultrasonography (B-scan), in order to establish the best imaging tool for this condition. We concluded, based on image quality, that UBM could be the imaging modality of choice to aid in the diagnosis of phacocele.
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- 2012
- Full Text
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14. Microperimetry and optical coherence tomography in a case of traumatic macular hole and associated macular detachment with spontaneous resolution
- Author
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Lalit Aalok, Rajvardhan Azad, Yog R Sharma, and Swati Phuljhele
- Subjects
Band-shaped keratopathy ,corneal dystrophy ,phototherapeutic keratectomy ,phototherapeutic keratectomy with amniotic membrane grafts ,scar ,and Salzmann nodular degeneration ,Kaplan Meier survival analysis ,multivariate Cox Proportional Hazard Regression analysis ,optical penetrating keratoplasties ,Myopia ,phakic refractive intraocular lens ,refractive surgery ,23-Gauge vitrectomy ,rhegmatogenous retinal detachment ,sutureless vitrectomy ,Deep anterior lamellar keratoplasty ,endothelial cell density ,keratoconus ,penetrating keratoplasty ,Anterior chamber contamination ,cataract surgery ,conjunctival flora ,diabetics ,Cardiovascular disease ,diabetes ,diabetic retinopathy ,framingham risk score ,Central macular thickness ,multifocal electroretinogram ,normative database ,optical coherence tomography ,Macular microhole ,microperimetry ,spectral domain optical coherence tomography ,Age-related macular degeneration ,choroidal neovascularization ,photodynamic therapy ,vitreous traction ,Descemet membrane endothelial keratoplasty with a stromal rim ,endothelial keratoplasty ,posterior lamellar keratoplasty ,posterior polymorphous corneal dystrophy ,Indocyanine green angiogram ,intravitreal bevacizumab ,laser photocoagulation ,peripheral hemorrhagic exudative chorioretinopathy ,polypoidal choroidal vasculopathy ,Anterior segment optical coherence tomography ,B-scan ultrasonography ,phacocele ,ultrasound biomicroscopy ,Microperimetry ,retinal detachment ,spontaneous resolution ,traumatic macular hole ,Ophthalmology ,RE1-994 - Abstract
The association of macular detachment with posttraumatic macular hole is a known but rare occurrence. Spontaneously occurring resolution of the detachment and closure of the macular hole has been reported only once in the literature. We describe a similar rare event in a young male, the documentation of which was done serially by microperimetry (MP) and optical coherence tomography (OCT). A 17-year-old male presented with a decrease in vision following a closed globe injury to the left eye. A coexisting macular hole and macular detachment were detected in the affected eye. Serial follow-up with OCT and MP documented complete resolution of the macular hole and the macular detachment within 1 week of presentation. The case highlights that spontaneous resolution of traumatic macular hole and related macular detachment may occur and a waiting period is advisable before undertaking any corrective surgical procedure. The pathophysiologic mechanisms of causation and the resolution of posttraumatic macular hole-related retinal detachment are discussed.
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- 2012
- Full Text
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15. Ultra-Widefield Optical Coherence Tomographic Imaging of Posterior Vitreous in Eyes With High Myopia
- Author
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Kengo Uramoto, Tae Yokoi, Takeshi Yoshida, Hiroyuki Takahashi, Kyoko Ohno-Matsui, Kosei Shinohara, and Noriko Tanaka
- Subjects
Male ,medicine.medical_specialty ,genetic structures ,Vitreous traction ,Vitreous Detachment ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Aged ,Retrospective Studies ,030304 developmental biology ,Aged, 80 and over ,0303 health sciences ,business.industry ,Reproducibility of Results ,Retinal Vessels ,High myopia ,Retinal ,Axial length ,Middle Aged ,medicine.disease ,eye diseases ,Vitreous Body ,chemistry ,Myopia, Degenerative ,030221 ophthalmology & optometry ,Maculopathy ,Female ,sense organs ,business ,Tomography, Optical Coherence - Abstract
To investigate the morphological changes of posterior vitreous in highly myopic (HM) eyes of patients 50 years of age and older.Retrospective, observational case series.Ultra-widefield swept-source OCT (UWF-OCT) examinations were performed on 768 eyes of 448 HM patients (50-89 years of age) and 54 eyes of 52 non-HM subjects with scan widths of 23 mm and depths of 5 mm. HM was defined as an axial length longer than 26.5 mm. The area and morphology of the posterior vitreous detachments (PVDs) and adhesions onto retinal vessels were examined for in 167 HM eyes and in 11 non-HM eyes in which the vitreal images were clear.Paramacular PVD, perifoveal PVD, peripapillary PVD, and complete PVD were found in 9%, 47%, 41%, and 3% of the 167 HM eyes, respectively, and in 37%, 45%, 18%, and 0% of the 11 non-HM eyes, respectively. In eyes with vitreofoveal adhesions, the PVDs were more commonly asymmetrical relative to the fovea in the HM eyes than in the non-HM eyes (94% vs. 44%, respectively; P.001). The area of the PVD corresponded with the area where the sclera protruded posteriorly. A thickened vitreous was observed to adhere to the retinal vessels at multiple points and was accompanied by paravascular abnormalities including lamellar holes in HM eyes. A total of 54 of the 167 HM eyes had macular retinoschisis, and the eyes commonly had vitreal traction on retinal vessels compared to HM eyes without macular retinoschisis (P = .031).PVD progressed asymmetrically and were associated with scleral curvature in HM eyes. Vitreous traction spanning a wide distance may lead to myopic traction maculopathy.
- Published
- 2019
16. Pathogenesis and Management of Macular Hole: Review of Current Advances
- Author
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Toshiyuki Oshitari, Shuichi Yamamoto, Guzel Bikbova, Keisuke Mori, and Takayuki Baba
- Subjects
medicine.medical_specialty ,genetic structures ,business.industry ,Ocriplasmin ,Inner limiting membrane ,Review Article ,Vitreous traction ,medicine.disease ,eye diseases ,Optimal management ,Closure rate ,Vitreous Detachment ,Ophthalmology ,chemistry.chemical_compound ,medicine.anatomical_structure ,lcsh:Ophthalmology ,chemistry ,lcsh:RE1-994 ,medicine ,sense organs ,business ,Macular hole - Abstract
Macular hole has been believed to be a disorder of vitreomacular interface, which forms as a result of abnormal vitreous traction from incomplete vitreous detachment. However, our recent studies demonstrated that dynamic forces, caused by mobile posterior cortical vitreous with fluid currents, exist already at early stages of macular hole development. Therefore, in eyes with flexible vitreous, the contributions of tractional forces due to vitreous shrinkage are unlikely. These facts indicate that in the development of idiopathic macular holes, there is a greater contribution of dynamic forces than has been previously reported. This review also evaluates the recent findings in the assessment of the idiopathic macular holes and the recent therapeutic strategies for optimal management. Inner limiting membrane is considered to improve anatomical closure rate; however, it is still questionable if peeling is necessary in holes less than 250 µm. There are plenty of publications indicating that in the management of small and medium size hole (less than 400 µm), use of long-lasting gas and face-down position is not always required; however, it may be necessary for the treatment of large holes. Ocriplasmin and expansile gas had been reported to be successful for management of small- and medium-sized holes and vitreomacular attachment.
- Published
- 2019
17. Vitreoretinal Surgery Instruments
- Author
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Diego Ruiz Casas
- Subjects
medicine.medical_specialty ,genetic structures ,business.industry ,Retinal traction ,medicine.medical_treatment ,Vitrectomy ,Vitreous traction ,Vitreoretinal surgery ,eye diseases ,Reduced size ,Ophthalmology ,Medicine ,sense organs ,business - Abstract
The new vitreoretinal surgical devices have better flow control and reduced retinal traction due to new pumps, increased cut per minute rates and reduced size. It is important to understand vitrectomy fluidics to be able to set vitrectomy parameters to perform an efficient and safe vitrectomy. Knowing the volume of the sphere of influence of the vitreous cutter in water and the direction of the vortex of vitreous traction help to engage vitreous tissue without tearing the retina. The most common vitrectomy systems have differential features that make them slightly different.
- Published
- 2021
18. Comparison of modern high-speed vitrectomy systems and the advantages of using dual-bladed probes
- Author
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R. Oravecz, Ralf M Dutescu, Daniel Uthoff, and Norbert Schrage
- Subjects
0301 basic medicine ,Materials science ,medicine.medical_treatment ,Vitrectomy ,Vitreous traction ,20 gauge ,Vitreous ,03 medical and health sciences ,Ophthalmology ,030104 developmental biology ,0302 clinical medicine ,lcsh:Ophthalmology ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,medicine ,Original Article ,Vitreous model ,23 gauge ,Biomedical engineering - Abstract
Purpose This study analyzes the efficiency of different vitrectomy systems and compares single with double-bladed cutters. Methods The systems EVA™ (DORC), Constellation® Vision System (ALCON), megaTRON S4HPS (Geuder) and Stellaris® PC (Bausch and Lomb) were used. We chose 20G and 23G probes, since not all systems had switched to a smaller G at the time the study was conducted in 2016. Cut rates were varied in increments of 1000 cuts/min from 500 cpm to the system’s maximum and vacuum pressures were varied in increments of 100 mmHg, from 100 to 600 mmHg up to the individual system’s maximum. In this study water, egg white, Pluronic®−F127 gel and isolated porcine vitreous were used as models of human vitreous. The vitrectomy efficiency was calculated from the aspirated mass (g) within 30 s. The aperture of the different vitrectomy probes was filmed with a high-speed camera. Results The area under the curve analysis showed differences in efficiency between vitrectomy systems. For water, a reverse relationship between the aspirated mass and cut rate was shown. By contrast, for most systems aspirated egg white and porcine vitreous showed a non-linear increase or decrease for 4000 cpm and above. For all vitreous surrogates, EVA™’s double-bladed probe aspirated significantly (p Conclusion We can demonstrate differences in the efficiency of vitrectomy depending on the vitrectomy system used. Double-bladed probes were more efficient and probably safer than single-bladed probes.
- Published
- 2020
19. Descemet membrane endothelial keratoplasty with a stromal rim in the treatment of posterior polymorphous corneal dystrophy
- Author
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Pavel Studeny, Katerina Jirsova, Pavel Kuchynka, and Petra Liskova
- Subjects
Band-shaped keratopathy ,corneal dystrophy ,phototherapeutic keratectomy ,phototherapeutic keratectomy with amniotic membrane grafts ,scar ,and Salzmann nodular degeneration ,Kaplan Meier survival analysis ,multivariate Cox Proportional Hazard Regression analysis ,optical penetrating keratoplasties ,Myopia ,phakic refractive intraocular lens ,refractive surgery ,23-Gauge vitrectomy ,rhegmatogenous retinal detachment ,sutureless vitrectomy ,Deep anterior lamellar keratoplasty ,endothelial cell density ,keratoconus ,penetrating keratoplasty ,Anterior chamber contamination ,cataract surgery ,conjunctival flora ,diabetics ,Cardiovascular disease ,diabetes ,diabetic retinopathy ,framingham risk score ,Central macular thickness ,multifocal electroretinogram ,normative database ,optical coherence tomography ,Macular microhole ,microperimetry ,spectral domain optical coherence tomography ,Age-related macular degeneration ,choroidal neovascularization ,photodynamic therapy ,vitreous traction ,Descemet membrane endothelial keratoplasty with a stromal rim ,endothelial keratoplasty ,posterior lamellar keratoplasty ,posterior polymorphous corneal dystrophy ,Ophthalmology ,RE1-994 - Abstract
A 20-year-old patient, diagnosed with posterior polymorphous corneal dystrophy, developed corneal edema for which he underwent Descemet membrane endothelial keratoplasty with a stromal rim (DMEK-S) in the right eye. No intra- or postoperative complications were noted. At the last follow-up 2 years and 9 months after the procedure, the best corrected visual acuity was 1.0 and endothelial cell density declined from 3533 cells/mm 2 to 1012 cells/mm 2 . Despite the endothelial cell loss, DMEK-S appears to be a good alternative to other surgical techniques for the treatment of corneal endotheliopathies, and it may be of benefit to young patients.
- Published
- 2012
- Full Text
- View/download PDF
20. Possible vitreous involvement in a case with rapidly progressing choroidal neovascularization
- Author
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Masayuki Hata, Akio Oishi, Michiko Mandai, and Yasuo Kurimoto
- Subjects
Band-shaped keratopathy ,corneal dystrophy ,phototherapeutic keratectomy ,phototherapeutic keratectomy with amniotic membrane grafts ,scar ,and Salzmann nodular degeneration ,Kaplan Meier survival analysis ,multivariate Cox Proportional Hazard Regression analysis ,optical penetrating keratoplasties ,Myopia ,phakic refractive intraocular lens ,refractive surgery ,23-Gauge vitrectomy ,rhegmatogenous retinal detachment ,sutureless vitrectomy ,Deep anterior lamellar keratoplasty ,endothelial cell density ,keratoconus ,penetrating keratoplasty ,Anterior chamber contamination ,cataract surgery ,conjunctival flora ,diabetics ,Cardiovascular disease ,diabetes ,diabetic retinopathy ,framingham risk score ,Central macular thickness ,multifocal electroretinogram ,normative database ,optical coherence tomography ,Macular microhole ,microperimetry ,spectral domain optical coherence tomography ,Age-related macular degeneration ,choroidal neovascularization ,photodynamic therapy ,vitreous traction ,Ophthalmology ,RE1-994 - Abstract
A 65-year-old man with subfoveal choroidal neovascularization (CNV) underwent photodynamic therapy (PDT). Despite the sequential treatments, the CNV grew larger and finally penetrated the retina. Vitreous adhesion was observed at the edge of the supraretinal fibrotic tissue. The case highlighted the possible unexpected side-effect of PDT. The upregulation of the vascular endothelial growth factor or the enhanced vitreous traction was considered to be responsible for the event.
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- 2012
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21. Descemet′s membrane detachment managed with perfluro-n-octane liquid
- Author
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M Ashok Kumar and Vanaja Vaithianathan
- Subjects
Band-shaped keratopathy ,corneal dystrophy ,phototherapeutic keratectomy ,phototherapeutic keratectomy with amniotic membrane grafts ,scar ,and Salzmann nodular degeneration ,Kaplan Meier survival analysis ,multivariate Cox Proportional Hazard Regression analysis ,optical penetrating keratoplasties ,Myopia ,phakic refractive intraocular lens ,refractive surgery ,23-Gauge vitrectomy ,rhegmatogenous retinal detachment ,sutureless vitrectomy ,Deep anterior lamellar keratoplasty ,endothelial cell density ,keratoconus ,penetrating keratoplasty ,Anterior chamber contamination ,cataract surgery ,conjunctival flora ,diabetics ,Cardiovascular disease ,diabetes ,diabetic retinopathy ,framingham risk score ,Central macular thickness ,multifocal electroretinogram ,normative database ,optical coherence tomography ,Macular microhole ,microperimetry ,spectral domain optical coherence tomography ,Age-related macular degeneration ,choroidal neovascularization ,photodynamic therapy ,vitreous traction ,Descemet membrane endothelial keratoplasty with a stromal rim ,endothelial keratoplasty ,posterior lamellar keratoplasty ,posterior polymorphous corneal dystrophy ,Indocyanine green angiogram ,intravitreal bevacizumab ,laser photocoagulation ,peripheral hemorrhagic exudative chorioretinopathy ,polypoidal choroidal vasculopathy ,Anterior segment optical coherence tomography ,B-scan ultrasonography ,phacocele ,ultrasound biomicroscopy ,Microperimetry ,retinal detachment ,spontaneous resolution ,traumatic macular hole ,Magnetic resonance imaging ,ocular ,orbital ,trauma ,Descemet′s detachment ,perfluro-n-octane ,Perflurocarbon liquid ,Ophthalmology ,RE1-994 - Abstract
We report the case of a 68-year-old male who developed Descemet′s membrane detachment after temporal clear corneal phacoemulsification which did not settle with air or viscoelastic injection. The Descemet′s membrane was successfully reattached with restoration of 20/50 vision with the help of perfluro-n-octane liquid. To our knowledge, this is the first such case to be reported.
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- 2012
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22. Magnetic resonance imaging of intact globe superior subluxation into the intracranium
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Nariman Nezami, Alireza Sadighi, and Babak Rahimi-Ardabili
- Subjects
Band-shaped keratopathy ,corneal dystrophy ,phototherapeutic keratectomy ,phototherapeutic keratectomy with amniotic membrane grafts ,scar ,and Salzmann nodular degeneration ,Kaplan Meier survival analysis ,multivariate Cox Proportional Hazard Regression analysis ,optical penetrating keratoplasties ,Myopia ,phakic refractive intraocular lens ,refractive surgery ,23-Gauge vitrectomy ,rhegmatogenous retinal detachment ,sutureless vitrectomy ,Deep anterior lamellar keratoplasty ,endothelial cell density ,keratoconus ,penetrating keratoplasty ,Anterior chamber contamination ,cataract surgery ,conjunctival flora ,diabetics ,Cardiovascular disease ,diabetes ,diabetic retinopathy ,framingham risk score ,Central macular thickness ,multifocal electroretinogram ,normative database ,optical coherence tomography ,Macular microhole ,microperimetry ,spectral domain optical coherence tomography ,Age-related macular degeneration ,choroidal neovascularization ,photodynamic therapy ,vitreous traction ,Descemet membrane endothelial keratoplasty with a stromal rim ,endothelial keratoplasty ,posterior lamellar keratoplasty ,posterior polymorphous corneal dystrophy ,Indocyanine green angiogram ,intravitreal bevacizumab ,laser photocoagulation ,peripheral hemorrhagic exudative chorioretinopathy ,polypoidal choroidal vasculopathy ,Anterior segment optical coherence tomography ,B-scan ultrasonography ,phacocele ,ultrasound biomicroscopy ,Microperimetry ,retinal detachment ,spontaneous resolution ,traumatic macular hole ,Magnetic resonance imaging ,ocular ,orbital ,trauma ,Ophthalmology ,RE1-994 - Abstract
A 67-year-old man with right-sided blunt ocular trauma is reported here. Despite having received primary medical care, the patient complained of severe headache for 14 days. Initial computed tomography (CT) indicated hematoma in the right frontal lobe. However, magnetic resonance imaging (MRI) indicated that the right globe along with its optic nerve had been intactly dislocated into the intracranium and differentiated from hematoma. In this case, the significance of MRI, in blunt ocular trauma work-up, and also regaining successful ocular function are highlighted.
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- 2012
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23. Local dry vitrectomy combined with segmental scleral buckling for the management of rhegmatogenous retinal detachment with vitreous traction
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Tian T, Zhao P, Fei P, Zhang Q, Lu Z, Peng J, Li J, Jin H, and Lv J
- Subjects
medicine.medical_specialty ,genetic structures ,business.industry ,medicine.medical_treatment ,Retinal detachment ,Vitrectomy ,Vitreous traction ,medicine.disease ,eye diseases ,Ophthalmology ,medicine ,sense organs ,business ,Scleral buckling - Abstract
Purpose: To demonstrate combined local dry vitrectomy and segmental scleral buckling for the treatment of partial rhegmatogenous retinal detachment (RRD) with local vitreous traction in patients at high-risk for proliferative vitreoretinopathy (PVR). Methods: Seven eyes of 7 patients were retrospectively studied, including 3 retinal dialysis, 3 retinal detachment (RD) with peripheral retinal holes and 1 RD with giant tear. All patients exhibited local vitreous traction and a high risk for PVR. Dry local vitrectomy without regular infusion was performed to remove the vitreous traction. Viscoelastic fluid was injected into the vitreous cavity if needed. Segmental scleral buckling was performed accordingly. Demographic information, preoperative and postoperative complications, and outcomes were recorded. Results: The mean age of the patients at presentation was 22.43±14.28 years old. All seven patients obtained retinal reattachment after a single surgical intervention. Postoperative visual acuity was improved in all patients. None of them developed complications, except for temporary mildly increased intraocular pressure in 2 cases. Conclusions: Combined local dry vitrectomy and segmental scleral buckling is effective for patients of RRD with local vitreous traction. The technique avoids many complications associated with regular surgery and was minimally invasive to both the external and internal eye.
- Published
- 2019
24. Idiopathic horseshoe-like macular tear: a case report
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Hiroshi Tsuneoka, Masaomi Kubota, Hisato Gunji, and Tomohiro Shibata
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medicine.medical_specialty ,Visual acuity ,genetic structures ,Adhesion (medicine) ,Case Report ,Ophthalmoscopy ,03 medical and health sciences ,retinal detachment ,0302 clinical medicine ,Ophthalmology ,vitreous traction ,medicine ,Macular hole ,horseshoe-like macular tear ,medicine.diagnostic_test ,business.industry ,Retinal detachment ,General Medicine ,medicine.disease ,eye diseases ,vitreous surgery ,030220 oncology & carcinogenesis ,030221 ophthalmology & optometry ,Physical therapy ,Branch retinal vein occlusion ,Tears ,Tamponade ,sense organs ,medicine.symptom ,business - Abstract
BACKGROUND Although a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined. OBJECTIVE To report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery. CASE REPORT A 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD). Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved. CONCLUSION While cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases.
- Published
- 2016
25. Acquired Nonpigmented Vitreous Cyst Associated With Lattice Degeneration
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Yan Luo, Lin Lu, Guiying Mai, Jing Lu, and Ruyuan Liu
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Male ,medicine.medical_specialty ,Eye Diseases ,genetic structures ,medicine.medical_treatment ,Vitrectomy ,Vitreous traction ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Cyst ,Retina ,Cysts ,business.industry ,Retinal Degeneration ,Retinal ,Middle Aged ,medicine.disease ,eye diseases ,Vitreous Body ,medicine.anatomical_structure ,chemistry ,Lattice degeneration ,030221 ophthalmology & optometry ,sense organs ,business ,Clinical evaluation ,030217 neurology & neurosurgery ,Immunostaining - Abstract
A 63-year-old male presented with a round-shaped floater and visual obscuration in the right eye. Clinical evaluation showed a nonpigmented vitreous cyst connected to a lattice degeneration by a stalk. Immunostaining of the vitreous cyst obtained from vitrectomy showed its origin of retinal neuroepithelium. The cyst was formed by continuous vitreous traction, which might tear up the disrupted retina at the area of lattice degeneration. This report added the lattice degeneration to the list of causes for the acquired vitreous cyst. [ Ophthalmic Surg Lasers Imaging Retina . 2017;48:856–858.]
- Published
- 2017
26. Development of traumatic bilateral horseshoe-shaped macular tear without vitreous traction: Case report
- Author
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Atsushi Shiraishi, Takeshi Joko, and Tsuyoshi Mito
- Subjects
medicine.medical_specialty ,Visual acuity ,genetic structures ,medicine.medical_treatment ,Vitrectomy ,Case Reports ,Vitreous traction ,Posterior vitreous detachment ,horseshoe-shaped macular tear ,chemistry.chemical_compound ,lcsh:Ophthalmology ,vitreous traction ,Ophthalmology ,medicine ,Blunt ocular trauma ,business.industry ,Internal limiting membrane ,Retinal ,medicine.disease ,eye diseases ,chemistry ,lcsh:RE1-994 ,Blunt trauma ,Tears ,sense organs ,inverted internal limiting membrane flap technique ,medicine.symptom ,business - Abstract
To report our findings in a case with bilateral horseshoe-shaped macular tears. Both eyes of a 68-year-old woman developed horseshoe-shaped macular tears in the absence of vitreous traction due to prior vitrectomy in one eye and a posterior vitreous detachment in the other eye. Vitrectomy with the inverted internal limiting membrane flap technique led to a successful closure of the macular tear bilaterally, and an improvement of her visual acuity in both eyes. The cause of horseshoe-shaped macular tear was most likely due to a retinal rupture from a blunt trauma.
- Published
- 2020
27. Surgical Techniques of Rhegmatogenous Retinal Detachment and Complications After Surgeries
- Author
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Nan Zhou, Wenbin Wei, and Haicheng She
- Subjects
Retinal breaks ,medicine.medical_specialty ,genetic structures ,business.industry ,medicine.medical_treatment ,Retinal detachment ,Vitrectomy ,Vitreous traction ,Surgical procedures ,Balloon ,medicine.disease ,eye diseases ,Ophthalmology ,medicine ,sense organs ,business ,Pneumatic retinopexy ,Scleral buckling - Abstract
The main surgical procedures for the reattachment of rhegmatogenous retinal detachment (RRD) are scleral buckling and vitrectomy. Pneumatic retinopexy and Lincoff balloon are not widely used today. Cryopexy and photocoagulation may sometime be selected for very localized, peripheral RRD. No matter which method is chosen, the key procedures are sealing retinal breaks and relief of vitreous traction. Therefore, a thorough evaluation of the location of the retinal breaks and vitreous status is crucial before the surgery.
- Published
- 2018
28. Comparison of the horizontal diameter to a modeled area of traction in eyes with vitreomacular traction: is the diameter close enough to the truth?
- Author
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Ricarda G. Schumann, S. Müller, Joachim Wachtlin, Hans-Helge Müller, Steffen Schmitz-Valckenberg, Christoph Paul, P. Krug, Thomas Bertelmann, and Stefan Mennel
- Subjects
Male ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Vitreous traction ,Vitreomacular traction ,Vitreous Detachment ,Severity of Illness Index ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Retinal Diseases ,Daily practice ,Ophthalmology ,medicine ,Humans ,In patient ,Macula Lutea ,Mathematics ,Aged ,Retrospective Studies ,Individual difference ,Mean age ,Traction (orthopedics) ,eye diseases ,Sensory Systems ,Vitreous Body ,030221 ophthalmology & optometry ,Female ,sense organs ,030217 neurology & neurosurgery ,Tomography, Optical Coherence ,Horizontal diameter ,Follow-Up Studies - Abstract
In daily practice, vitreomacular traction (VMT) is described by the horizontal diameter of its attachment site implying a regular round shape of VMT. We investigated the deviation from this circular area of vitreous traction in patients with VMT. A retrospective analysis of optical coherence tomography (OCT) scans was performed. The area of vitreomacular attachment was determined using six radial OCT scans (Ameasured). The assumed circular area of traction was calculated based on measuring the maximal horizontal diameter for comparison (Acircular). Thirty-seven eyes of 37 patients with pure VMT were included. Patients’ mean age was 72.8 ± 8.2 years. Mean horizontal VMT diameter was 400.8 ± 230.5 μm (median 361 μm; range 44–991 μm). While there was no difference between mean areas of traction for Acircular and Ameasured (P = 0.93), the individual difference (|Acircular − Ameasured|) was 0.042 (± 0.044) mm2 in mean or relative 73.0% (± 135.8%). A difference of ≥ 30% of Ameasured to Acircular was found in 16 eyes (43.2%) and ≥ 100% in 7 eyes (18.9%), respectively. Vitreous attachment sites possess an irregular non-circular shape in a significant number of eyes with VMT. Consequently, the area of traction appears inaccurately described by its horizontal VMT diameter alone. As the area of traction is important for therapeutic recommendation, our results emphasize the need for a more precise description of the area of traction in eyes with VMT.
- Published
- 2017
29. Intraoperative management of posterior capsular rupture
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Augustine R. Hong, Arsham Sheybani, and Andrew J.W. Huang
- Subjects
Corneal endothelium ,medicine.medical_specialty ,Eye Diseases ,genetic structures ,medicine.medical_treatment ,Vitrectomy ,Cataract Extraction ,Vitreous traction ,Ophthalmology ,medicine ,Humans ,Intraoperative Complications ,business.industry ,General Medicine ,Vitreous loss ,Cataract surgery ,Posterior Capsular Rupture, Ocular ,eye diseases ,Surgery ,Vitreous Body ,Posterior capsular rupture ,Posterior capsule ,Intraoperative management ,sense organs ,business - Abstract
Purpose of review Posterior capsular rupture (PCR) and vitreous loss are inevitable complications encountered in cataract surgery across all levels of surgical experience and in spite of technological advances to improve safety. Thus, cataract surgeons must always be prepared to practice safe and effective intraoperative management strategies for capsular rupture. Recent findings Novel approaches for lens fragment removal, vitrectomy, and lens implantation have expanded the available options for cataract surgery in the setting of an open posterior capsule. Intraoperative PCR management strategies should prioritize safety and strive to minimize vitreous traction, stabilize anterior chamber volume, maintain capsular and zonular integrity, and protect the corneal endothelium and other anterior segment structures. Summary With appropriate management of PCR and vitreous, surgeons may still deliver safe and satisfactory visual outcomes for modern cataract surgery.
- Published
- 2015
30. Structure of the Retinal Margin and Presumed Mechanism of Retinal Detachment in Choroidal Coloboma.
- Author
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Tanaka S, Yokoi T, Katagiri S, Yoshida-Uemura T, Nishina S, and Azuma N
- Subjects
- Adolescent, Adult, Child, Choroid Diseases complications, Coloboma complications, Female, Humans, Male, Retinal Detachment complications, Retrospective Studies, Young Adult, Choroid abnormalities, Choroid Diseases diagnosis, Coloboma diagnosis, Retinal Detachment diagnosis, Tomography, Optical Coherence methods
- Abstract
Purpose: To describe the vitreoretinal structure at the margin of the choroidal coloboma in infants and older patients using swept-source (SS) OCT., Design: Retrospective case series., Participants: Nineteen eyes of 16 patients with choroidal coloboma (7 males, 9 females; average age, 12.3 ± 7.1 years)., Methods: The patients were classified into 2 groups: infants 1 year of age or younger (3 eyes) and older patients (16 eyes). Each finding on SS OCT was documented according to previously defined histopathologic findings., Main Outcome Measures: Description of the SS OCT features of choroidal colobomas., Results: Swept-source OCT showed that the extracolobomatous retina centrally traversed the margin to continue as the marginal intercalary membrane (MICM), whereas the outer layers of the MICM were reversed at the point (point of reversal [POR]). The expected duplication was seen in all infant eyes, but in none of the older eyes whose outer layers of the MICM were ambiguous. However, at the boundary between the layered MICM and monolayered central intercalary membrane (CICM), the POR was detectable in all patients. Further SS OCT analysis showed that the MICM schisis and CICM schisis occurred simultaneously with vitreous traction. Retinal detachments (RDs) seen in 4 eyes were connected to the only MICM schisis, and a MICM break was identified in 1 eye. Swept-source OCT showed that retinal pigment epithelial hyperplasia adhered tightly to the retina and that the glial triangle was adhered tightly to the sclera, indicating barriers to the development of RD after MICM schisis., Conclusions: Swept-source OCT first visualized the POR in infant eyes and showed that the POR was identifiable despite the atrophic changes in the outer layer of the MICM in the older eyes. Based on the POR location, we confirmed that the intercalary membranes reported in previous OCT studies were clearly differentiated between the MICM and CICM. We also showed that the presence of MICM and CICM schisis resulted from vitreous traction at the coloboma margin and that MICM breaks induced RD only if the barrier that prevented the development of RD was broken., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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31. The inner diameter of the optic disc pit decreases with pars plana vitrectomy.
- Author
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Pinarci, Eylem, Karacal, Humeyra, Oncel, Banu, Bayar, Sezin, and Karakaya, Muharrem
- Abstract
To report a patient with optic disc pit who showed decreased inner diameter of the optic disc pit along with resolution of recurrent macular detachment after pars plana vitrectomy. Pneumatic retinopexy and peripapillary laser photocoagulation was performed in a 28-year-old female with optic disc pit and serous macular detachment. Two months after the initial therapy, serous macular detachment recurred. Then, pars plana vitrectomy with removal of the posterior hyaloid was performed, and intraocular perfluoro-octane (C3F8) tamponade was used. Fundus photography and ocular coherence tomography were obtained at each visit. The patient was followed up for 1 year. Visual acuity was 20/400 (Snellen) at first presentation, improved to 20/40 at 2 weeks after pneumatic retinopexy and peripapillary laser treatment. Then, 2 months later visual acuity decreased to 20/200, improved to 20/40 at 2 weeks after the vitreoretinal surgery, and stayed stable during the 1-year follow-up. It was also noticed on clinical examinations as well as fundus photographs that the inner diameter of the optic disc pit had decreased significantly. Vitreous traction plays an important role in the formation of serous macular detachments with optic disc pits. In these patients, pars plana vitrectomy and posterior hyaloid removal may be an effective treatment for reduction of the inner diameter of the optic pit and resolution of the serous macular detachments. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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32. Photoreceptor Layer Changes Overlying Drusen in Eyes with Age-Related Macular Degeneration Associated with Vitreomacular Traction
- Author
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Polixeni Stamatiou, Panagiotis Theodossiadis, George Theodossiadis, Ioannis Datseris, and Sofia Theodoropoulou
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,genetic structures ,Retinal Drusen ,Tissue Adhesions ,Vitreomacular traction ,Vitreous traction ,Drusen ,Macular Edema ,03 medical and health sciences ,0302 clinical medicine ,Retinal Diseases ,Geographic Atrophy ,Age related ,Ophthalmology ,medicine ,Humans ,Fluorescein Angiography ,Macular edema ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Fundus photography ,General Medicine ,Macular degeneration ,medicine.disease ,Fluorescein angiography ,eye diseases ,Vitreous Body ,030104 developmental biology ,030221 ophthalmology & optometry ,Female ,sense organs ,business ,Tomography, Optical Coherence ,Photoreceptor Cells, Vertebrate - Abstract
Purpose To investigate by spectral-domain optical coherence tomography (SD-OCT) changes of photoreceptor layers over drusen in cases of dry type age-related macular degeneration associated with vitreomacular traction (VMT). Methods Clinical examination, fluorescein angiography, fundus photography, and SD-OCT data were retrospectively studied for a consecutive series of 27 patients with drusen, pseudodrusen, and VMT. Control groups of 32 patients with VMT without drusen and 34 patients with drusen and pseudodrusen without VMT were also studied. Results The examination revealed disruption of the line corresponding to the inner segment ellipsoid (ISel), previously called inner segment/outer segment junction, of photoreceptor layer, and development of cystoid edema in significantly higher incidence in VMT associated with drusen group. 22 out of 32 eyes with VMT and drusen (68.75%) had disrupted ISel, compared to 8 out of 37 (21.6%) control eyes with drusen only and to 12 out of 37 (32.4%) control eyes with VMT only. Chi-square analysis showed significant association between drusen and pseudodrusen on fovea, VMT, and localization of ISel disruption. The changes of the ISel were mainly found in the area that corresponded to VMT. The SD-OCT revealed drusen throughout the macula and discontinuation of ISel only in the fovea in 4 of 32 (12.5%) eyes with VMT, whereas none of 37 control eyes with drusen only had similar appearance. Conclusions The drusen in association with the cystoid macular edema induced by vitreous traction contribute to the photoreceptor layer defect overlying drusen in the fovea. In addition, the number of drusen and pseudodrusen was increased in the area of the vitreous traction compared to the peripheral retina.
- Published
- 2014
33. Dynamic formation of macular microcysts independent of vitreous traction changes
- Author
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Ella Maria Kadas, Alexander U. Brandt, Timm Oberwahrenbrock, Friedemann Paul, and Wolf A. Lagrèze
- Subjects
medicine.medical_specialty ,genetic structures ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Vitreous traction ,Traction (orthopedics) ,eye diseases ,Surgery ,Optical coherence tomography ,Ophthalmology ,medicine ,sense organs ,Neurology (clinical) ,business - Abstract
Objective: To test the assumption of vitreous traction as a cause of macular microcysts in neuroinflammatory diseases and to establish a testable model to quantify vitreous traction changes. Methods: Retrospective cohort study including 9 patients with neuroinflammatory diseases and macular microcysts that were longitudinally analyzed using optical coherence tomography. A mechanical model was developed to test the theory of vitreous traction vs macular swelling. This model was applied to one case presenting with dynamic microcyst evolution over 2 years with 4 visits. Results: None of the patients9 eyes with microcysts showed any signs of vitreous traction upon qualitative meticulous optical coherence tomographic analysis. The longitudinal changes analyzed in one patient were in the opposite direction as predicted by the mechanical model involving vitreous traction. Conclusions: Vitreous traction does not appear to be a causative factor in macular microcyst formation. Quantitative analysis in one case shows even a reduced traction caused by an increase in macular thickness leading to vitreous impingement by the macular wall. The presented model might also serve as a quantification approach in other studies investigating macular microcysts.
- Published
- 2014
34. Treatment of cystic macular lesions in hereditary retinal dystrophies
- Author
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Gerald A. Fishman, Mohamed A. Genead, and Serena Salvatore
- Subjects
medicine.medical_specialty ,genetic structures ,Retinoschisis ,Vision Disorders ,Vitreous traction ,Audiology ,Macular Edema ,Choroideremia ,Pathogenesis ,Ophthalmology ,Retinitis pigmentosa ,Gyrate Atrophy ,Humans ,Medicine ,Carbonic Anhydrase Inhibitors ,Impaired visual acuity ,business.industry ,Retinal Degeneration ,Eye Diseases, Hereditary ,medicine.disease ,eye diseases ,Macular Lesion ,Etiology ,sense organs ,business ,Retinitis Pigmentosa ,Retinal Dystrophies - Abstract
Cystic macular lesions frequently contribute to impaired visual acuity in hereditary retinal dystrophies. Their pathogenesis varies and is not entirely understood. Carbonic anhydrase inhibitors have proven to be potentially efficacious, although not in all cases. We discuss the various factors and mechanisms implicated in the etiology of cystic macular lesions (anatomical abnormalities, impairment of the blood-retinal barrier, tangential vitreous traction, and mutations in retinoschin, etc.) and the various treatments that have been proposed.
- Published
- 2013
35. Posterior Vitreous Detachment Associated with Non-arteritic Ischaemic Optic Neuropathy
- Author
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Peter W. MacIntosh and Bailey Shen
- Subjects
0301 basic medicine ,medicine.medical_specialty ,genetic structures ,business.industry ,Vitreous traction ,Case Reports ,medicine.disease ,Posterior vitreous detachment ,eye diseases ,Visual field ,Surgery ,Ischaemic optic neuropathy ,03 medical and health sciences ,Ophthalmology ,030104 developmental biology ,0302 clinical medicine ,Arteritic ischaemic optic neuropathy ,030221 ophthalmology & optometry ,medicine ,Optic nerve ,Neurology (clinical) ,sense organs ,business - Abstract
It has been hypothesised that non-arteritic ischaemic optic neuropathy is caused by vitreous traction on the optic nerve. The authors recently took care of a patient who developed a posterior vitreous detachment shortly after she was diagnosed with non-arteritic ischaemic optic neuropathy. Her visual field spontaneously improved after the posterior vitreous detachment. This case report provides some evidence that non-arteritic ischaemic optic neuropathy, vitreous traction, and posterior vitreous detachment may be related.
- Published
- 2016
36. Management of peripheral polypoidal choroidal vasculopathy with intravitreal bevacizumab and indocyanine green angiography-guided laser photocoagulation
- Author
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Ekta Rishi, Atheeswar Das, Pukhraj Rishi, and Pallavi Sarate
- Subjects
Vascular Endothelial Growth Factor A ,intravitreal bevacizumab ,genetic structures ,Indocyanine green angiography ,Visual Acuity ,posterior polymorphous corneal dystrophy ,Angiogenesis Inhibitors ,phototherapeutic keratectomy ,Deep anterior lamellar keratoplasty ,Macular microhole ,law.invention ,conjunctival flora ,lcsh:Ophthalmology ,law ,vitreous traction ,Myopia ,Medicine ,posterior lamellar keratoplasty ,Fluorescein Angiography ,phototherapeutic keratectomy with amniotic membrane grafts ,Laser Coagulation ,diabetes ,endothelial cell density ,normative database ,cataract surgery ,Cardiovascular disease ,sutureless vitrectomy ,Peripheral ,Decreased vision ,Bevacizumab ,diabetic retinopathy ,Anterior chamber contamination ,spectral domain optical coherence tomography ,photodynamic therapy ,Intravitreal Injections ,refractive surgery ,microperimetry ,Female ,multivariate Cox Proportional Hazard Regression analysis ,framingham risk score ,Brief Communications ,diabetics ,endothelial keratoplasty ,Tomography, Optical Coherence ,Kaplan Meier survival analysis ,Indocyanine Green ,medicine.medical_specialty ,corneal dystrophy ,laser photocoagulation ,Fundus Oculi ,keratoconus ,Antibodies, Monoclonal, Humanized ,scar ,choroidal neovascularization ,polypoidal choroidal vasculopathy ,Indocyanine green angiogram ,peripheral hemorrhagic exudative chorioretinopathy ,Ophthalmology ,Monitoring, Intraoperative ,Humans ,Intravitreal bevacizumab ,Aged ,Central macular thickness ,optical coherence tomography ,Band-shaped keratopathy ,business.industry ,and Salzmann nodular degeneration ,Laser treatment ,Age-related macular degeneration ,rhegmatogenous retinal detachment ,phakic refractive intraocular lens ,23-Gauge vitrectomy ,Choroid Diseases ,Laser ,penetrating keratoplasty ,eye diseases ,Surgery ,optical penetrating keratoplasties ,Geographic atrophy ,Descemet membrane endothelial keratoplasty with a stromal rim ,lcsh:RE1-994 ,Fluorescein angiogram ,sense organs ,multifocal electroretinogram ,business ,Follow-Up Studies - Abstract
A 69-year-old lady presented with complaints of decreased vision in left eye since one month. Best Corrected Visual Acuity (BCVA) was 6/18 in that eye. Fundus examination revealed non-central geographic atrophy and soft drusens at macula in both eyes. Temporal periphery of left eye revealed subretinal exudates with altered sub-RPE hemorrhage mimicking peripheral exudative hemorrhagic chorioretinopathy (PEHCR). Fundus Fluorescein Angiogram showed window defects at macula and blocked fluorescence at temporal periphery in left eye. However, Indocyanine green angiography (ICGA) revealed active peripheral choroidal polyps. The patient was successfully treated with intravitreal bevacizumab and ICGA-guided laser photocoagulation. 27 months after laser treatment, BCVA improved to 6/9. Rationale of consecutive anti-vascular endothelial growth factor (VEGF) treatment followed by more definitive laser photocoagulation is that anti-VEGF aids in resolution of subretinal fluid, thus making the polyp more amenable to focal laser photocoagulation which stabilizes the choroidal vasculature and prevents further leakage.
- Published
- 2012
37. WIDESPREAD MACULAR NEUROSENSORY DETACHMENT AFTER OCRIPLASMIN INTRAVITREAL INJECTION
- Author
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James E. Neffendorf, Ahmed El-Amir, Irina I. Gout, and Lik Thai Lim
- Subjects
medicine.medical_specialty ,Visual acuity ,genetic structures ,Vision Disorders ,Vitreomacular traction ,Vitreous traction ,Vitreous Detachment ,chemistry.chemical_compound ,Optical coherence tomography ,Fibrinolytic Agents ,Ophthalmology ,Medicine ,Humans ,Fibrinolysin ,Retina ,medicine.diagnostic_test ,business.industry ,Ocriplasmin ,Retinal Detachment ,Retinal ,General Medicine ,Middle Aged ,eye diseases ,Peptide Fragments ,Surgery ,Safety profile ,medicine.anatomical_structure ,chemistry ,Intravitreal Injections ,Female ,sense organs ,medicine.symptom ,business - Abstract
PURPOSE To present the case of a patient with vitreomacular traction who experienced immediate severe acute complications after ocriplasmin intravitreal injection. METHODS Case report. RESULTS A 61-year-old woman with vitreomacular traction underwent ocriplasmin treatment. Within 24 hours after injection, she noticed severe reduction in visual acuity. Spectral domain optical coherence tomography revealed release of vitreous traction, together with widespread subretinal fluid and decreased reflectivity in the outer retina. Ten weeks after treatment, visual acuity improved, although below pretreatment levels, with partial reduction in subretinal fluid. CONCLUSION Intravitreal ocriplasmin can produce acute visual acuity changes with widespread subretinal fluid and outer retinal ellipsoid zone hyporeflectivity on spectral domain optical coherence tomography. The overall acute and long-term safety profile of ocriplasmin remains unknown.
- Published
- 2015
38. Pseudophakic Cystoid Macular Edema Associated with Extrafoveal Vitreoretinal Traction
- Author
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Michael R Martinez and Avinoam Ophir
- Subjects
OCT ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Vitreous traction ,Article ,chemistry.chemical_compound ,extrafoveal traction ,Optical coherence tomography ,vitreous traction ,Ophthalmology ,Edema ,medicine ,Macular edema ,Pseudophakic macular edema ,macular edema ,medicine.diagnostic_test ,business.industry ,Retinal ,Traction (orthopedics) ,Cataract surgery ,medicine.disease ,eye diseases ,Surgery ,chemistry ,Vitreoretinal traction ,sense organs ,medicine.symptom ,business - Abstract
Purpose: To describe an association between extrafoveal vitreoretinal traction and intractable chronic pseudophakic cystoid macular edema (CME) by the use of optical coherence tomography (OCT). Methods: In a retrospective case series study, charts and OCT findings of patients who had postoperative recalcitrant pseudophakic CME for at least 6 months and vitreoretinal traction membranes were analyzed. Excluded were eyes that either had another vitreoretinopathy that could affect the analysis or had undergone an intravitreal intervention. Results: Three eyes (three patients) with macular edema following uneventful cataract surgery were detected to be associated with multifocal extrafoveal vitreoretinal traction sites in each. Retinal edema that was underlying each of the traction sites in all eyes was in continuum in at least one site per eye with the central macular edema, thus manifesting as diffuse macular edema. Conclusion: Chronic pseudophakic macular edema may be related to extrafoveal vitreoretinal traction.
- Published
- 2011
39. A study of macular hole formation by serial spectral optical coherence tomography
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Jerzy Nawrocki, Bartosz L. Sikorski, Janusz Michalewski, Jakub J. Kaluzny, Maciej Wojtkowski, Zofia Michalewska, and Ron A. Adelman
- Subjects
Male ,medicine.medical_specialty ,genetic structures ,Observation period ,Vitreous traction ,Retina ,Older population ,chemistry.chemical_compound ,Optical coherence tomography ,Ophthalmology ,medicine ,Humans ,Cyst ,Prospective Studies ,Macular hole ,Aged ,High prevalence ,medicine.diagnostic_test ,business.industry ,Retinal ,Middle Aged ,Retinal Perforations ,medicine.disease ,eye diseases ,Vitreous Body ,chemistry ,Female ,sense organs ,business ,Tomography, Optical Coherence - Abstract
Background: The purpose of this paper is to evaluate changes of the vitreoretinal interface in fellow eyes of eyes with a macular hole and to study early stages of macular hole formation by spectral optical coherence tomography (SOCT). Methods: A prospective study of 131 consecutive patients with history of macular hole. Serial SOCT examinations were performed on the fellow eyes four times during a 6-month observation period. Progression of foveal changes and formation of macular hole in the fellow eyes were studied. Results: Seven distinct abnormalities in the foveal region were noted in 70 of the fellow eyes (53.4%). Additionally in 18 patients (13.6%) other defects typical for the older population were noted. Gradual evolution to full-thickness macular holes during the 6-month observation period was noted in five eyes. One of these eyes had a previously detected cyst, and four eyes had elevation of the photoreceptor layer. Conclusions: The high prevalence of macular abnormalities in the fellow eyes particularly epiretinal membranes and vitreous traction with schizis as well as the evolution of these abnormalities over time suggest that diseases of the vitreomacular interface may have similar pathogenesis. Macular hole formation often starts as a triangular elevation of the photoreceptor layer. In some cases, a cyst in the inner retinal layers can be an early step in macular hole formation.
- Published
- 2009
40. Asymptomatic Peripapillary Subretinal Hemorrhage: A Study of 10 Cases
- Author
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Patrick A. Sibony, Stuart Fourman, Robert Honkanen, and Fadi El Baba
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,genetic structures ,Retinal Artery ,Optic Disk ,Vitreous traction ,Asymptomatic ,Retina ,White People ,Sex Factors ,Sex factors ,Ophthalmology ,Optic Nerve Diseases ,Subretinal hemorrhage ,Myopia ,medicine ,Humans ,Child ,Retrospective Studies ,Optic Disk Drusen ,business.industry ,Retinal Hemorrhage ,Middle Aged ,medicine.disease ,Optic disc drusen ,eye diseases ,Vitreous Body ,Chronic disease ,medicine.anatomical_structure ,Chronic Disease ,Female ,sense organs ,Neurology (clinical) ,medicine.symptom ,business ,Optic Disc Edema ,Sclera ,Optic disc - Abstract
Peripapillary subretinal hemorrhage (PSH) is often found together with optic disc drusen, optic disc edema, peripapillary subretinal neovascular membranes, vitreous traction, and bleeding diatheses. Previous reports have stated that such optic disc hemorrhages are associated with intrapapillary bleeding largely in patients of Asian origin who are visually symptomatic from this process. We have encountered patients with PSH who have clinical features that differ from those described in these reports.This is a retrospective observational case series. Medical records of 10 patients with isolated peripapillary subretinal hemorrhages were reviewed for clinical characteristics and ancillary testing, including demographics, history, complete eye examination, visual fields, fundus photos, ultrasound, and fluorescein angiography (four patients) at presentation and follow-up. We excluded patients with drusen, neovascular membranes, disc edema, and intrapapillary hemorrhages.There were 10 patients, all white women without visual symptoms, who had isolated, monocular, nasal, or superonasal peripapillary subretinal hemorrhage, a dysplastic crowded-tilted optic disc, myopia, and normal visual function. The hemorrhages resolved without sequelae over 3-6 months. The findings were frequently discovered on routine examination and suspected of representing papilledema.We have described a benign syndrome of isolated PSH in crowded and tilted optic discs in myopic eyes of white women. The PSHs do not cause visual symptoms and resolve spontaneously. We propose that an interplay of ocular motor forces, scleral thinning, and vitreopapillary traction acting on a morphologically vulnerable optic disc explains these hemorrhages.
- Published
- 2008
41. SURGICAL REMOVAL OF THE INTERNAL LIMITING MEMBRANE IN PROGRESSIVE MACULAR CHANGE IN X-LINKED JUVENILE RETINOSCHISIS
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Oh Woong Kwon, Suk Ho Byeon, Hyoung Jun Koh, Sung Soo Kim, and Sung Chul Lee
- Subjects
medicine.medical_specialty ,genetic structures ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Internal limiting membrane ,Vitrectomy ,General Medicine ,Vitreous traction ,eye diseases ,Ophthalmology ,Optical coherence tomography ,Surgical removal ,Deformity ,medicine ,sense organs ,medicine.symptom ,Juvenile retinoschisis ,business - Abstract
PURPOSE To report two cases of progressive macular changes in X-linked juvenile retinoschisis (XLRS) treated with vitrectomy. PATIENTS A 16-year-old boy and a 13-year-old boy with progressive deterioration of vision underwent vitrectomy with internal limiting membrane peeling with or without gas injection for vitreous traction. Optical coherence tomography was performed to monitor morphologic changes of the macula before and after surgery. RESULTS During follow-up (at 6 months and 3 months, respectively), both patients had anatomical improvement and minimal improvement in vision. CONCLUSION We postulate that vitreous tractional force causes the progressive structural deformity of the macula in XLRS.
- Published
- 2007
42. Mechanisms in Traction Retinal Detachment
- Author
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Stephen J. Ryan and Philip E. Cleary
- Subjects
Pathology ,medicine.medical_specialty ,Contraction (grammar) ,genetic structures ,Chemistry ,Vitreous traction ,Traction retinal detachment ,eye diseases ,Pathophysiology ,Membrane ,medicine ,Penetrating Eye Injury ,sense organs ,Wound healing ,Myofibroblast - Abstract
We have developed a reproducible model of traction retinal detachment in the rhesus monkey secondary to a penetrating eye injury. The model is characterized histologically by intravitreal fibroblastic proliferation and by epiretinal and by retroretinal membranes. Cells proliferating within the vitreous and in the epiretinal membranes have the ultrastructural characteristics of myofibroblasts. The presence of these contractile cells suggests that vitreous traction and the contraction of epiretinal membranes may be cell mediated. Our findings suggest that the pathophysiology of traction retinal detachment has many features in common with the normal process of wound healing and in particular with the mechanisms responsible for wound contraction and cicatrization.
- Published
- 2015
43. Variations in EEG discharges predict ADHD severity within individual Smith-Lemli-Opitz patients
- Author
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Selim R. Benbadis, William H. Trescher, Joshua B. Ewen, and John M. Schreiber
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Male ,medicine.medical_specialty ,genetic structures ,medicine.diagnostic_test ,business.industry ,Electroencephalography ,Vitreous traction ,Audiology ,eye diseases ,Smith-Lemli-Opitz Syndrome ,nervous system ,Attention Deficit Disorder with Hyperactivity ,Medicine ,Humans ,Female ,sense organs ,Neurology (clinical) ,business ,Smith lemli opitz - Abstract
Editors' Note: In reference to “Variations in EEG discharges predict ADHD severity within individual Smith-Lemli-Opitz patients,” Dr. Benbadis cautions against the overinterpretation of benign EEG discharges as epileptiform. Authors Ewen et al. defend their methodology. Drs. Ziemssen and Ziemssen disagree with several terms used in “Dynamic formation of macular microcysts independent of vitreous traction changes” and question the need to include …
- Published
- 2015
44. Utilité du cerclage dans la chirurgie du décollement de rétine rhegmatogène à haut risque: étude rétrospective de 41 cas
- Author
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J. Salzmann, C. J. Pournaras, and N. P. L. Dang Burgener
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medicine.medical_specialty ,Proliferative vitreoretinopathy ,Retinal breaks ,Visual acuity ,genetic structures ,business.industry ,Severe disease ,Retinal detachment ,Vitreous traction ,medicine.disease ,eye diseases ,Surgery ,Ophthalmology ,Scleral abscess ,Male patient ,medicine ,sense organs ,medicine.symptom ,business - Abstract
BACKGROUND 360 degrees encirclement for rhegmatogenous retinal detachment (RD) was introduced over 50 years ago as a method for closing retinal breaks and relieving vitreous traction. In the absence of acknowledged guidelines, current usage varies widely. PATIENTS AND METHODS All 360 degrees encircling bands for RDs performed between 1999 and 2004 were reviewed. Encircling procedures for phakic and recurrent RDs were analysed. RESULTS 41 encircling bands for RD were identified from the records of 875 RD cases. Median follow-up was 6 months (range: 1 - 36). Male patients accounted for 58.5 % of the procedures. Mean age was 51.51 +/- 15.97 years. 37/41 phakic and 18/41 recurrent RDs were encircled. RD recurrence in encircled eyes occurred in 42 % of phakic eyes and in 33 % of eyes re-operated for recurrent RD. At the time of recurrence, proliferative vitreoretinopathy (PVR) was present in 41.6 % of phakic eyes, and 66 % of recurrent RD eyes. Preoperative visual acuity (VA) was 0.26 and post-operative VA 0.34. Post-operative complications due to the encirclement included pain in 4 eyes, scleral abscess in 2 eyes and scleral necrosis in 1 eye. CONCLUSION This small retrospective review highlights the multiple indications for encircling bands including PVR, inferior breaks, multiple breaks and myopia. High overall recurrence rate (34 %) reflects the selection bias of this procedure for severe disease in our series. There is currently no consensus on the use of this technique in the management of RD.
- Published
- 2006
45. Giant retinal tear after pneumatic retinopexy
- Author
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Swati Sinkar, Sumu Simon, and Jagjit S. Gilhotra
- Subjects
medicine.medical_specialty ,genetic structures ,business.industry ,Giant retinal tear ,Retinal detachment ,General Medicine ,Vitreous traction ,medicine.disease ,eye diseases ,Retinal Tear ,Ophthalmology ,medicine ,sense organs ,business ,Pneumatic retinopexy - Abstract
PURPOSE To report a case with giant retinal tear after pneumatic retinopexy. To our knowledge, this is only the second case of a giant retinal tear after pneumatic retinopexy reported. METHODS This is a descriptive case study. RESULTS A 43-year-old myopic man underwent pneumatic retinopexy for right eye rhegmatogenous retinal detachment. Postoperative course was complicated by a giant retinal tear, which was treated successfully. CONCLUSION Though rare, giant retinal tears can occur after pneumatic retinopexy. The likely mechanism is increased vitreous traction because of expansion of gas in a predisposed myopic eye.
- Published
- 2014
46. A HISTOPATHOLOGIC STUDY OF MACULAR CYSTS AND HOLES
- Author
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W R Green, H M Engel, and G T Frangieh
- Subjects
medicine.medical_specialty ,genetic structures ,business.industry ,Ocular surgery ,Internal limiting membrane ,Histopathologic Study ,General Medicine ,Vitreous traction ,medicine.disease ,eye diseases ,Age-related maculopathy ,Ophthalmology ,medicine ,Cyst ,sense organs ,business ,Macular edema - Abstract
Forty-four eyes from 39 patients with either lamellar macular holes (17 eyes), full-thickness macular holes (18 eyes), and/or macular cysts (9 eyes) were studied histopathologically. Lamellar and full-thickness holes were frequently found in eyes with a history of trauma or ocular surgery. Diabetes mellitus was the most common condition associated with macular cysts. Four lamellar holes and four full-thickness holes occurred in eyes with senile macular degeneration. Six lamellar holes, eight full-thickness holes, and one macular cyst developed on an idiopathic basis. Residual cystoid macular edema was the most prevalent accompanying pathologic feature. Cystoid macular edema was also noted in the opposite eye in seven cases of lamellar and full-thickness holes. A preretinal glial membrane, thought to be a secondary change, was found at or near the edges of the lamellar or full-thickness holes or over the macular cyst in the majority of cases. Wrinkling of the internal limiting membrane (ILM) was present in five cases. Vitreous traction, with or without an operculum, was infrequently associated with these entities.
- Published
- 2005
47. Macular Hole and Retinal Detachment
- Author
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Gonvers, M., Blankenship, George W., editor, Binder, Susanne, editor, Gonvers, Michel, editor, and Stirpe, Mario, editor
- Published
- 1986
- Full Text
- View/download PDF
48. Vitreous findings in optic disc pit maculopathy based on optical coherence tomography
- Author
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Theodossiadis, Panagiotis G., Grigoropoulos, Vlassis G., Emfietzoglou, John, and Theodossiadis, George P.
- Published
- 2007
- Full Text
- View/download PDF
49. Dynamic formation of macular microcysts independent of vitreous traction changes
- Author
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Focke Ziemssen, Alexander U. Brandt, Tjalf Ziemssen, and Wolf A. Lagrèze
- Subjects
Male ,medicine.medical_specialty ,Retina ,Materials science ,genetic structures ,medicine.diagnostic_test ,Retinal Detachment ,Vitreous traction ,medicine.disease ,eye diseases ,Vitreous Body ,Optical imaging ,medicine.anatomical_structure ,Optical coherence tomography ,Ophthalmology ,medicine ,Humans ,Female ,Vitreoretinal traction ,Cyst ,sense organs ,Neurology (clinical) - Abstract
Brandt et al.1 addressed transient changes of the inner retina in neuroinflammatory diseases. However, we do not agree with some of the aspects of this study. Optical coherence tomography (OCT), the optical imaging method used, is incapable of providing information content equivalent to real histologic investigations. Pathologists define a cyst as an abnormal membranous sac with distinguishing aspects of some surrounding cells lining the wall of the cyst. Therefore, we recommend using the more careful description of “cystoid” spaces or “pseudocysts.” When explaining transient changes of the inner retina, was it necessary to develop attempts at theoretical explanations of vitreoretinal traction forces? …
- Published
- 2015
50. EFFICACY AND SAFETY OF ENZYMATIC POSTERIOR VITREOUS DETACHMENT BY INTRAVITREAL INJECTION OF HYALURONIDASE
- Author
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Miguel F. Refojo, Mark Harooni, and Tod McMILLAN
- Subjects
medicine.medical_specialty ,Retina ,genetic structures ,medicine.diagnostic_test ,business.industry ,Retinal ,Balanced salt solution ,General Medicine ,Vitreous traction ,medicine.disease ,Fluorescein angiography ,Posterior vitreous detachment ,eye diseases ,Ophthalmology ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Hyaluronidase ,medicine ,sense organs ,business ,medicine.drug ,Electroretinography - Abstract
Purpose To investigate the efficacy and safety of intravitreal injection of hyaluronidase in producing liquefaction resulting in a posterior vitreous detachment. Methods Fifteen young pigmented rabbits were randomized into 3 groups that received 5 (group 1), 10 (group 2), or 20 (group 3) IU of hyaluronidase. The fellow eyes were injected with a volumetric equivalent dose of balanced salt solution as control. The rabbits were followed for 9 weeks and examined for signs of ocular and retinal toxicity. The animals were then euthanized and their eyes were examined histologically. Results Biomicroscopic evaluation in all but one rabbit revealed no evidence of ocular toxicity. One rabbit showed evidence of vitreous traction on the retina with transient retinal elevation. Biomicroscopically and histologically, all rabbits in group 3 and four of five rabbits in group 2 had evidence of a posterior vitreous detachment. Conclusion Intravitreal injection of hyaluronidase in doses of 10 IU or higher induces posterior vitreous detachment in rabbits over a period of 5 weeks. Intravitreal doses of 20 IU or less do not appear to affect the biomicroscopic morphology or function of ocular structures adversely. Injections of hyaluronidase, therefore, could be considered as an alternative or adjunct to conventional mechanical vitrectomy.
- Published
- 1998
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