1/21. Dome-shaped detachment of premacular vitreous cortex in macular hole development.PURPOSE: To clarify the role of the posterior vitreous cortex in macular hole development, we evaluated the follow-up findings of clinical observations and optical coherence tomography (OCT) images of macular holes in early stage. methods: The vitreoretinal tomography was examined and followed in eyes with stage 1 and 2 macular holes with OCT. RESULTS: The posterior cortical vitreous was identified in 12 of 17 eyes with early-stage macular holes by OCT (71%). In these eyes, the detached posterior vitreous appeared to be merged to the fovea and the disc. The vitreoretinal separations showed typically dome-shaped. A long scan along the papillomacular axis also delineated the posterior vitreous face as dome-shaped perifoveal vitreous detachment with adhesion to the fovea and disc. Repetitive OCT examinations clearly demonstrated the course of development of the macular hole. CONCLUSIONS: The dome-shaped vitreoretinal separation seen with OCT gives rise to an idea that the posterior vitreous cortex may not be taut but slack, and would not cause a continuous tractional force even in early-stage macular holes. This finding brings us an idea that the tangential traction at the fovea may be generated by fluid movements, rather than by contraction of the cortical vitreous.- - - - - - - - - - ranking = 1keywords = detachment (Clic here for more details about this article) |
2/21. Spontaneous closure of macular hole after posterior vitreous detachment.Macular holes can be treated with surgically-induced vitreous detachment and gas tamponade. The authors report a case of a macular hole that closed spontaneously after the development of posterior vitreous detachment (PVD). Optical coherence tomography (OCT) revealed a small full-thickness macular hole with perifoveal cystic changes in a 25-year-old female with a central scotoma at her initial visit. There was no evidence of PVD. Five months later, PVD was observed and the macular hole disappeared. OCT performed three months later showed macular hole closure and resolution of the perifoveal cystic changes. The physiologic pit was restored in the fovea. OCT is useful to detect and monitor the morphologic changes of a macular hole.- - - - - - - - - - ranking = 1.2keywords = detachment (Clic here for more details about this article) |
3/21. Progressive outer retinal necrosis in a patient with nephrotic syndrome.Progressive outer retinal necrosis syndrome (PORN) is a variant of necrotizing herpetic retinopathy and the majority of the described cases were related to acquired immunodeficiency syndrome. We present a patient who is hiv negative with nephrotic syndrome and prednisolone use for 4 months who showed clinical features of PORN. Low CD4 counts and lymphocytopenia suggested immunosuppression. In the left eye, tractional retinal detachment at the posterior pole followed by incomplete posterior vitreous detachment developed. In addition to intravenous administration of acyclovir, vitreous surgeries including stripping of the posterior hyaloid and silicone-oil tamponade were successfully performed to repair the retinal detachment in the left eye and to prevent it in the right eye.- - - - - - - - - - ranking = 0.602847506768keywords = detachment, retinal detachment (Clic here for more details about this article) |
4/21. Biomicroscopic vitreous observation using a 3 CCD video camera and a personal computer for image capture and archiving.The purpose of this study is to evaluate the clinical usefulness of a newly developed biomicroscopic vitreous observation system. Vitreous observation was performed in 300 eyes with age- or disease-related vitreous changes using a 3 CCD video camera mounted on a slit-lamp biomicroscope and connected to a personal computer for real-time observation and especially for the capture and archiving of images. Various types of fundus lenses were used to scan the vitreous status systemically from the posterior pole to the vitreous base. This system allowed us to obtain and immediately review the images of the vitreoretinal relationship. The image quality was sufficient for clinical evaluation of the vitreous status. We were able to identify some variations of posterior vitreous detachments and clarify the changes of the vitreoretinal interface in the study eyes. This system is very useful for the dynamic observation and documentation of vitreous images in order to determine the role of vitreous in many vitreoretinal disorders. Furthermore it is more convenient and affordable than previous methods.- - - - - - - - - - ranking = 0.2keywords = detachment (Clic here for more details about this article) |
5/21. Macular star associated with posterior hyaloid detachment.PURPOSE: To report a patient with a Leber's idiopathic stellate neuroretinitis-like lesion that was caused by vitreous traction accompanying a posterior hyaloid detachment. methods: We present a 49-year-old woman who showed segmental optic disc edema, peripapillary retinal detachment, and a macular star. RESULTS: An incomplete posterior hyaloid detachment was present, and the posterior hyaloid membrane was attached to the nasal margin of the optic disc. fluorescein angiography revealed a bent retinal artery on the upper margin of the optic disc, and leakage of fluorescein was observed from this area. CONCLUSION: Vascular damage to the optic disc due to vitreous traction should also be considered as a mechanism for the ophthalmoscopic appearance of the fundus when lesions suggestive of Leber's idiopathic stellate neuroretinitis are present in an adult.- - - - - - - - - - ranking = 1.401423753384keywords = detachment, retinal detachment (Clic here for more details about this article) |
6/21. Postsurgical evaluation of idiopathic vitreomacular traction syndrome by optical coherence tomography.PURPOSE: To report a case of idiopathic vitreomacular traction syndrome with preoperative and postoperative evaluation by optical coherence tomography. DESIGN: Interventional case report. methods: A 62-year-old woman presented with blurred vision in the left eye because of idiopathic vitreomacular traction syndrome, and she underwent a pars plana vitrectomy. Optical coherence tomography was performed before and after surgery. RESULTS: Preoperative optical coherence tomography, right eye, revealed residual adhesion of incomplete posterior vitreous detachment and edematous, thickened outer retina in the macula. A successful vitrectomy relieved vitreoretinal traction with nearly complete resolution of cystoid macular edema within 1 month after surgery, followed in subsequent months by gradual foveal depression resembling a lamellar macular hole. Resolution of subretinal serous fluid was delayed with complete disappearance, some 12 months after surgery, which correlated with a gradual improvement in visual acuity. CONCLUSION: Optical coherence tomography provides a sensitive anatomical evaluation of vitreomacular traction syndrome. Reorganization of retinal tissue after surgical intervention for vitreoretinal traction may be slower than is apparent from conventional examinations.- - - - - - - - - - ranking = 0.2keywords = detachment (Clic here for more details about this article) |
7/21. Optical coherence tomography evaluation of idiopathic macular hole treatment by gas-assisted posterior vitreous detachment.PURPOSE: To report a case of idiopathic macular hole, with vitreoretinal traction confirmed by optical coherence tomography that was successfully treated by a single intravitreous perfluoropropane (C(3)F(8)) gas bubble injection. methods: Case report. A 65-year-old patient with idiopathic macular hole (stage 2, one eye) received an intravitreous gas injection and was prospectively followed with optical coherence tomography. RESULTS: A complete posterior vitreous detachment was achieved within 6 weeks after gas injection. visual acuity improved from 20/80 to 20/25 by 10 months of follow-up. Optical coherence tomography disclosed vitreoretinal traction release and macular hole closure. No complications were related to the procedure. CONCLUSION: This simple procedure can assist a complete posterior vitreous detachment with relief of the hyaloid-foveolar traction, facilitating macular hole closure.- - - - - - - - - - ranking = 1.2keywords = detachment (Clic here for more details about this article) |
8/21. vitrectomy for diabetic macular edema: the role of posterior vitreous detachment and epimacular membrane.PURPOSE: To evaluate the surgical efficacy of pars plana vitrectomy on eyes with diabetic macular edema in the presence or absence of a complete posterior vitreous detachment and with or without an epimacular membrane. methods: Pars plana vitrectomy was performed on 30 eyes of 29 cases with diabetic macular edema. visual acuity was measured, and retinal thickness was determined by optical coherence tomography before and after vitrectomy. To evaluate the relationship between the effects of vitrectomy and the presence or absence of posterior vitreous detachment and/or epimacular membrane, all eyes were placed into one of four groups: group A, eyes with posterior vitreous detachment and epimacular membrane; B, eyes with posterior vitreous detachment and without epimacular membrane; C, eyes without posterior vitreous detachment and with epimacular membrane; and D, eyes without posterior vitreous detachment and without epimacular membrane. The expression of vascular endothelial growth factor and interleukin-6 was investigated immunohistochemically in epimacular membrane specimens obtained from seven eyes with diffuse diabetic macular edema. RESULTS: The postoperative mean visual acuity (0.653 /- 0.350: mean /- SD logarithm of minimal angle of resolution [logMAR]) was significantly better than the mean preoperative visual acuity (0.891 /- 0.319 logMAR; Wilcoxon signed-rank test, P =.0007). The postoperative foveal thickness (264.5 /- 118.6 microm) was significantly thinner than the preoperative foveal thickness (477.8 /- 147.7 microm; Wilcoxon signed-rank test, P <.0001). There were no significant differences in the improvement of visual acuity and decrease of foveal thickness between the four groups (Kruskal-Wallis test, P =.13, P =.65, respectively). All of the epimacular membranes obtained at surgery expressed vascular endothelial growth factor and interleukin-6. CONCLUSIONS: These results demonstrated that vitrectomy with removal of epimacular membrane is generally an effective procedure in reducing diabetic macular edema, and the outcome does not depend on the presence absence of posterior vitreous detachment and epimacular membrane.- - - - - - - - - - ranking = 2.2keywords = detachment (Clic here for more details about this article) |
9/21. A case of Coats' disease with a peeling of premacular fibrosis after photocoagulation.We report a 26-year-old man with Coats' disease associated with premacular fibrosis. As an initial treatment, the peripheral exduative area was treated with argon laser photocoagulation. Six weeks later, the premacular fibrosis was peeled off and the posterior vitreous membrane was also detached. The patient's visual acuity improved to 20/20. We also observed a change of the vitreous component before and after the treatment that was similar to posterior vitreous detachment (PVD). This is the first reported case in which a distinct vitreous change was observed after premacular fibrosis peeling in Coat's disease.- - - - - - - - - - ranking = 0.2keywords = detachment (Clic here for more details about this article) |
10/21. Posterior vitreous findings in cases of spontaneous retinal reattachment.PURPOSE: To describe the posterior vitreous findings in two patients with retinal detachment who experienced spontaneous retinal reattachment. DESIGN: Two observational case reports. TESTING: Biomicroscopic and high-resolution echographic evaluation of the vitreoretinal relationships. MAIN OUTCOME MEASURES: Retinal reattachment and echographic vitreoretinal relationships. RESULTS: Two patients, one with a rhegmatogenous retinal detachment and one with a tractional retinal detachment, were noted to have a partial posterior vitreous detachment with vitreoretinal adherence at the time of presentation. Spontaneous retinal reattachment occurred in both cases, with echography showing complete vitreous separation from the retina. CONCLUSIONS: Complete posterior vitreous detachment may release tractional components in retinal detachment and contribute to spontaneous retinal reattachment.- - - - - - - - - - ranking = 1.205695013536keywords = detachment, retinal detachment (Clic here for more details about this article) |
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