1/29. Vitreoretinal findings similar to retinopathy of prematurity in infants with compound heterozygous protein s deficiency.OBJECTIVE: To present previously undescribed vitreoretinal findings similar to severe retinopathy of prematurity (ROP) in two siblings (daughter and son) with a thrombophilic disorder, compound heterozygous protein S (PS) deficiency. DESIGN: family genotype study and literature review. PARTICIPANTS: Two unrelated heterozygous PS-deficient parents and their two children with compound heterozygous PS deficiency were studied. The gestational age and birth weight of the daughter were 40 weeks and 3200 g, respectively, and those of the son were 34 weeks and 2150 g, respectively. Three other neonates with homozygous or compound heterozygous PS deficiency and ophthalmologic findings were identified in the literature. INTERVENTION: The daughter underwent lensectomy-vitrectomy at 48 weeks adjusted age bilaterally. The son underwent therapy developed for severe ROP: laser therapy of the peripheral avascular retina at 39 weeks adjusted age, and bilateral lensectomy-vitrectomy with membrane peel of intravitreous proliferation from the optic disc at 42 weeks adjusted age. MAIN OUTCOME MEASURES: The main clinical outcome measures were retinal appearance and functional vision. Genotypes of the family members were determined. RESULTS: One of the four eyes retained functional vision. A normal-appearing posterior retina, normal scotopic and photopic flash electroretinograms, and a normal flash visual-evoked response were documented from the left eye of the son at 62 weeks adjusted age. The other three eyes had inoperable retinal detachments and no functional vision. The mother had type I PS deficiency and the father had type II PS deficiency. Compound heterozygous PS deficiency was confirmed in both children. CONCLUSION: In both children, normal vasculogenesis was interrupted. At 39 weeks adjusted age, the retinal examination of the son revealed extraretinal fibrovascular proliferation at the optic disc (reactivation of the hyaloid system) and in the peripheral retina (interruption of inner retinal vascularization). patients with homozygous or compound heterozygous PS deficiency may present as infants with severe ROP. The authors' experience suggests that appropriately timed surgical procedures, which are efficacious for ROP, can preserve vision in infants with thrombophilic disorders.- - - - - - - - - - ranking = 1keywords = retinal detachment, detachment (Clic here for more details about this article) |
2/29. Intralenticular candida species abscess in a premature infant.PURPOSE: To report the clinical and histopathologic findings of a premature infant with severe retinopathy of prematurity complicated by the development of an intralenticular fungal abscess. methods: Case report and literature review. RESULTS: A markedly premature infant developed candida septicemia at 29 weeks postconception. Over the ensuing 10 weeks, cataract and intraocular inflammation developed sequentially in each eye, as did progressive retinopathy of prematurity with tractional retinal detachment. Pars plana vitrectomy and lensectomy revealed intralenticular candida species abscess. CONCLUSION: Progressive cataract and intraocular inflammation in a low birth weight infant may be caused by endogenous intraocular infection secondary to systemic candidiasis. cataract secondary to retinopathy of prematurity is rare.- - - - - - - - - - ranking = 1keywords = retinal detachment, detachment (Clic here for more details about this article) |
3/29. Scleral perforation after scleral buckling surgery for retinopathy of prematurity.Scleral perforation occurred as a result of using a silicone band during scleral buckling surgery for subtotal retinal detachment in retinopathy of prematurity (ROP). The patient was initially treated by cryotherapy and scleral buckling surgery for ROP, and was later referred due to a dark bluish mass in the superotemporal quadrant of the eyeball. After removing the overlying whitish membrane, uveal tissue prolapsed through the melted scleral wound (5 mm x 5 mm). A silicone encircling band had passed through the wound and was exposed subconjunctivally around the temporal and the inferior limbus. The band was removed and a scleral allograft was performed. After three years, follow up revealed the eyeball was slightly microphthalmic. Though scleral bucking surgery is helpful for the treatment of advanced ROP, a scleral perforation may develop as a disastrous complication.- - - - - - - - - - ranking = 1keywords = retinal detachment, detachment (Clic here for more details about this article) |
4/29. Diode laser photocoagulation for retinopathy of prematurity: a histopathologic study.Laser photocoagulation has largely supplanted cryotherapy as an effective treatment for retinopathy of prematurity. This case describes the ocular histopathologic findings of a pair of eyes in a severely premature male infant treated with diode laser photocoagulation for bilateral stage 3 retinopathy of prematurity (ROP) for 360 degrees in zone 1 with severe plus disease. The right eye responded to treatment; the left eye developed persistent vitreous hemorrhage and total retinal detachment. The histopathologic examination of laser burns in the right eye disclosed segmental areas of chorioretinal scarring with retinal atrophy and gliosis, loss of RPE and extensive atrophy of the choroid and its vasculature, which involved both the choriocapillaris and larger vessels. The left eye had iris neovascularization, a chronic organized vitreous hemorrhage and a totally detached retina. The histopathologic findings in an eye of a premature infant with threshold ROP treated with diode laser photocoagulation resembled those reported after transsceral cryotherapy. Diode laser photocoagulation may produce less severe chorioretinal damage.- - - - - - - - - - ranking = 1keywords = retinal detachment, detachment (Clic here for more details about this article) |
5/29. Severe retinopathy in a child with hypoplastic left heart syndrome.PURPOSE: We present the first reported case of a condition similar to retinopathy of prematurity in a full-term patient with hypoplastic left heart syndrome. DESIGN: Interventional case report. methods: We describe the clinical presentation and surgical treatment of a male baby with severe retinopathy and retinal detachments. RESULTS: The clinical course of this baby was similar to retinopathy of prematurity. The patient had areas of avascular retina, significant retinal neovascularization, fibrous proliferation, and tractional detachment. One eye had a totally detached retina; the other had functional vision after the retina was reattached by several vitreoretinal surgeries, including the use of intraocular silicone oil. CONCLUSIONS: This cyanotic condition can cause a retinopathy with chronic retinal neovascularization and retinal detachments. Permanent surgical retinal reattachment is difficult in the presence of neovascular activity that leads to intravitreous cicatrization.- - - - - - - - - - ranking = 2.4956462579968keywords = retinal detachment, detachment (Clic here for more details about this article) |
6/29. scleral buckling surgery for stage 4B retinopathy of prematurity.Results of scleral buckling in 15 consecutive eyes of 13 infants with stage 4B retinopathy of prematurity (ROP) were reviewed. Ten of 15 retinas achieved macular reattachment with a single scleral buckling procedure. Four of 15 retinas unable to be attached by scleral buckling were reattached after the addition of a single vitreous operation. One of 15 retinas was unable to be reattached despite both a scleral buckling and a single vitreous procedure. Despite macular attachment in all except one eye, visual results were disappointing. Fix and follow visual acuity was present in 3 eyes, light perception in 11 eyes, and no light perception in 1 eye. Average follow-up was 10 months. Possible causes for poor visual outcomes despite retinal reattachment include retinal abnormalities as a result of detachment and amblyopia.- - - - - - - - - - ranking = 0.49564625799677keywords = detachment (Clic here for more details about this article) |
7/29. retinal detachment with macular holes in infants with retinopathy of prematurity.OBJECTIVE: To describe retinal detachment with macular holes in infants with retinopathy of prematurity and the methods of surgical repair with their outcomes. methods: A retrospective review of 4 cases of retinopathy of prematurity and 1 case of retinopathy in a full-term infant that resembled retinopathy of prematurity, in which a macular hole and associated retinal detachment developed and surgical repair was attempted. RESULTS: The average gestational age of the 4 infants with retinopathy of prematurity was 26 weeks. All 5 patients had a history of vitreoretinal surgery prior to discovery of the macular hole. All 4 who underwent further surgical correction have partially or completely attached retinas and ambulatory vision. CONCLUSIONS: vitrectomy combined with fluid-air exchange failed to close a macular hole associated with retinal detachment in infants with retinopathy of prematurity. Athermal scleral buckling of the macula can close macular holes and reattach the retina. scleral buckling appears to be the method of choice for repair.- - - - - - - - - - ranking = 4.9825850319871keywords = retinal detachment, detachment (Clic here for more details about this article) |
8/29. Presumed exudative retinal detachment after cryotherapy in retinopathy of prematurity.cryotherapy of the peripheral avascular retina in selected cases of retinopathy of prematurity has been shown to reduce the incidence of posterior retinal detachment, retinal fold involving the macula, and retrolental tissue. Although exudative retinal detachments have been described after cryotherapy during scleral buckling procedures, to our knowledge, this observation has not been reported after cryotherapy in retinopathy of prematurity. We describe such a case.- - - - - - - - - - ranking = 6keywords = retinal detachment, detachment (Clic here for more details about this article) |
9/29. Anterior segment evaluation of infants with retinopathy of prematurity.To understand the mechanisms of glaucoma in retinopathy of prematurity (ROP), anterior segment evaluation is essential. The authors prospectively examined the anterior segment of 27 eyes of 17 premature infants with stages IV and V ROP. Twenty-six eyes received no previous surgery or treatment. Schiotz and applanation tonometry were performed. Structural evaluation of each anterior segment was conducted by biomicroscopy and Koeppe gonioscopy. In the 26 eyes, angle closure of greater than 180 degrees was noted in 3 (12%). The authors noted prominent Schwalbe's line in 4 eyes (15%), high iris convexity in 15 (58%), hypopigmentation of the iris root in 19 (73%), translucent matrix in the angles ("Barkan's-type" membrane) in 18 (69%), posterior synechiae in 16 (62%), visible iris or angle vessels in 12 (46%), and pigment clumping in the angle recess in 12 (46%). This study identified structural abnormalities in the anterior segment of ROP infants, including pathologic changes and anatomic features that could have a developmental origin.- - - - - - - - - - ranking = 0.0016482026331333keywords = pigment (Clic here for more details about this article) |
10/29. Recurrent proliferations in macular pucker, diabetic retinopathy, and retrolental fibroplasialike disease after vitrectomy.The clinical and ultrastructural details of recurrent epiretinal and transvitreal membranes from patients with macular pucker, diabetes mellitus, and a retrolental fibroplasialike disease are presented. The membranes were characterized ultrastructurally by the presence of reactive glia and moderate amounts of collagen in the extracellular matrix. Many of the cells in the recurrent membranes showed myofibroblastlike differentiation. recurrence of transvitreal membranes in a previously vitrectomized eye may be explained by spontaneous detachment of contracting epiretinal membranes.- - - - - - - - - - ranking = 0.49564625799677keywords = detachment (Clic here for more details about this article) |
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