1/8. Long-term posterior and anterior segment complications of immune recovery uveitis associated with cytomegalovirus retinitis.PURPOSE: To identify and describe long-term posterior and anterior segment complications of immune recovery uveitis in patients with inactive cytomegalovirus retinitis who are undergoing highly active antiretroviral therapy-mediated recovery of immune function.methods: A prospective cohort study at a university medical center. Twenty-nine eyes of 21 patients with immune recovery uveitis and inactive cytomegalovirus retinitis were followed for 14.5 to 116 weeks (median, 43 weeks) after diagnosis of immune recovery uveitis. RESULTS: Nine eyes of nine patients developed visually important complications involving the posterior segment, anterior segment, or a combination of both. Posterior segment complications included severe proliferative vitreoretinopathy in three eyes and spontaneous vitreous hemorrhage from avulsion of a blood vessel secondary to contraction of the inflamed vitreous in one eye. Proliferative vitreoretinopathy recurred in all cases after surgery, severely compromising the visual outcome. Anterior segment complications included posterior subcapsular cataracts with vision decrease in five eyes and persistent anterior chamber inflammation after cataract extraction, resulting in posterior synechiae and large visually important lens deposits in three eyes.CONCLUSION: Persistent inflammation in immune recovery uveitis may lead to vision-threatening complications, such as proliferative vitreoretinopathy, posterior subcapsular cataracts, and severe postoperative inflammation. Immune recovery uveitis is a chronic inflammatory syndrome that may result in complications months to years after the onset of inflammation.- - - - - - - - - - ranking = 1keywords = vitreoretinopathy (Clic here for more details about this article) |
2/8. Perforating ocular injury by Taser.This report describes the features, treatment and outcome of globe perforation by a Taser dart electrode in a 21-year-old man. The Taser electrode caused mechanical iris, lens and retinal injury and consequent retinal detachment as result of proliferative vitreoretinopathy. The effect of electrical stimulation on ocular tissues is unknown. After the scleral and corneal wounds, traumatic cataract and retinal tear were repaired, the patient regained a visual acuity of 6/18. Nine months later a retinal detachment with proliferative vitreoretinopathy was discovered. The Taser may cause globe perforation and posterior segment injury. Understanding the barbed configuration of the dart electrode is important when extricating this device. Visual recovery is possible despite electric discharge of the Taser and suggests that the mechanism of ocular injury is largely mechanical.- - - - - - - - - - ranking = 0.66666666666667keywords = vitreoretinopathy (Clic here for more details about this article) |
3/8. Inadvertent globe perforation during retrobulbar and peribulbar anesthesia. Patient characteristics, surgical management, and visual outcome.The authors report a series of 20 eyes from 20 patients in whom inadvertent perforation of the globe occurred during local anesthesia for ocular surgery. Perforation resulted from retrobulbar anesthesia in 18 eyes and from peribulbar anesthesia in 2 eyes. Nine (45%) of 20 eyes had an axial length greater than or equal to 26.00 mm. Combining this figure with axial length data for the general population and estimates for the risk of globe perforation during local anesthesia yields an approximate incidence of perforation in eyes with axial length greater than or equal to 26.00 mm of 1 in 140 injections. Proliferative vitreoretinopathy (PVR) developed in 8 of the 20 eyes (40%) in this series. overall, 15 (75%) of the 20 eyes were successfully repaired, and, in five eyes (25%), the final visual acuity was 20/70 or better.- - - - - - - - - - ranking = 0.33333333333333keywords = vitreoretinopathy (Clic here for more details about this article) |
4/8. retinal detachment with severe proliferative vitreoretinopathy in Terson syndrome.BACKGROUND: In several reports, early vitrectomy has been proposed for eyes with vitreous hemorrhage due to Terson syndrome as a means to hasten visual recovery. But the development of nuclear sclerosis and the neurologic problems arising from this disease encourage surgeons to wait for spontaneous resorption, especially with young patients. Although the formation of epiretinal membranes has been described, to the authors' knowledge retinal detachment with proliferative vitreoretinopathy in Terson syndrome never has been observed. methods: The authors report five eyes from four patients with Terson syndrome due to spontaneous aneurysm rupture, in whom retinal detachment with proliferative vitreoretinopathy developed. RESULTS: The early onset and the severe clinical course of proliferative vitreoretinopathy in these eyes showed parallels to traumatic proliferative vitreoretinopathy. The retina in all eyes could be reattached. CONCLUSION: The authors point out the necessity for accurate and close follow-up and early, extensive surgical treatment in Terson syndrome, especially in patients with a reduced general state of health.- - - - - - - - - - ranking = 2.6666666666667keywords = vitreoretinopathy (Clic here for more details about this article) |
5/8. Surgical management of complications associated with X-linked retinoschisis.OBJECTIVE: To evaluate the role of surgical intervention in cases with severe, vision-threatening complications of X-linked retinoschisis. DESIGN: A retrospective survey of consecutive patients with X-linked retinoschisis who underwent surgery at our institution during a 16-year period. SETTING: A tertiary-care eye hospital. patients: Six eyes of four patients were identified. The mean age of the patients at the time of the first surgical procedure was 4.9 years (range, 18 months to 9 years). INTERVENTION: scleral buckling procedure or pars plana vitrectomy. MAIN OUTCOME MEASURE: Surgical indications and long-term anatomic and visual outcome. RESULTS: patients were initially operated on for rhegmatogenous retinal detachment (three eyes), exudative retinal detachment (one eye), and vitreous hemorrhage (two eyes). The surgical approach was scleral buckling for retinal detachment and vitrectomy for vitreous hemorrhage or proliferative vitreoretinopathy. Anatomic success and ambulatory vision (20/400 or better) was achieved in five of the six eyes with a mean follow-up of 3.8 years (range, 1 to 6 1/2 years). An average of 1.8 procedures per eye were performed. Two of the four eyes approached by primary scleral buckling eventually required vitrectomy. Proliferative vitreoretinopathy with retinal detachment was the major reason for reoperation. CONCLUSIONS: Surgery for X-linked retinoschisis-associated retinal detachment and vitreous hemorrhage can yield favorable anatomic and functional results. Multiple operations and the use of advanced vitreoretinal techniques to manage proliferative vitreoretinopathy-related complications, however, were necessary for ultimate success in certain cases.- - - - - - - - - - ranking = 1keywords = vitreoretinopathy (Clic here for more details about this article) |
6/8. Familial exudative vitreoretinopathy: surgical intervention and visual acuity outcomes.BACKGROUND: Familial exudative vitreoretinopathy (FEVR) is a hereditary condition that may lead to vitreous hemorrhage and traction retinal detachment necessitating surgical intervention. In this paper we review the results of surgery on seven such patients (eight eyes). methods: Seven patients (eight eyes) were followed up after surgery that had been performed because of vitreous hemorrhage and/or traction retinal detachment due to FEVR, in an effort to evaluate outcomes. Parameters that were noted were the current age, gender, age at the time of first surgery, length of follow-up and postoperative retinal status and visual acuity. RESULTS: Seven patients (eight eyes) ranging in age from 6 months to 44 years with a mean of 24.7 and a median of 26 years were followed. There were three females and four males. The lowest age at which surgery was first performed was 6 months and the highest was 28 years, with a mean of 14.7 and a median of 17 years. Six of the 8 eyes were reattached following surgery, although some required multiple procedures. CONCLUSION: vitreoretinal surgery may be of benefit in helping to preserve some degree of vision in eyes of patients with FEVR who develop vitreous hemorrhage and/or retinal detachment.- - - - - - - - - - ranking = 1.6666666666667keywords = vitreoretinopathy (Clic here for more details about this article) |
7/8. Neovascular complications associated with rubeosis iridis and peripheral retinal detachment after retinal detachment surgery.PURPOSE: To report clinical features and surgical management of neovascular complications associated with rubeosis iridis and peripheral retinal detachment after retinal detachment surgery in nondiabetic patients. methods: Seven consecutive eyes of seven nondiabetic patients who developed neovascular complications associated with rubeosis iridis and peripheral retinal detachment after scleral buckling and vitrectomy procedures were retrospectively reviewed. None of the eyes had clinical evidence of anterior segment ischemia or retinal vascular disease, but each eye developed rubeosis iridis and neovascular complications. RESULTS: Of the seven eyes with rubeosis iridis and peripheral retinal detachment, six developed recurrent or progressive vitreous hemorrhage, and three developed progressive neovascular glaucoma. Four eyes underwent a revision procedure to repair the peripheral retinal detachment, and anterior proliferative vitreoretinopathy was found in each of these cases. Rubeosis iridis regressed in all three eyes in which surgery resulted in complete reattachment of the retina. In one eye with persistent peripheral retinal detachment and in the three remaining eyes that did not undergo revision surgery, rubeosis iridis persisted and was associated with long-term neovascular complications. Final corrected visual acuity was 20/70 to 20/400 in three eyes with total retinal reattachment and no light perception to hand motions in four eyes with persistent peripheral retinal detachment and rubeosis iridis. CONCLUSION: Visually significant neovascular complications may occur in eyes that develop rubeosis iridis associated with peripheral retinal detachment after retinal detachment surgery in nondiabetic patients. Successful repair of the peripheral retinal detachment may induce regression of rubeosis iridis, reduce associated complications, and improve the long-term prognosis of these eyes.- - - - - - - - - - ranking = 0.33333333333333keywords = vitreoretinopathy (Clic here for more details about this article) |
8/8. Primary use of silicone oil tamponade in the management of perforating globe injury secondary to inadvertent local anaesthesia injection for ophthalmic surgery.Perforating and penetrating globe injuries secondary to peribulbar and retrobulbar anaesthesia are often complicated by vitreous haemorrhage and retinal detachment. We describe the effectiveness of primary silicone oil tamponade in the repair of three perforated globes secondary to local anaesthesia for ophthalmic surgery. Three patients with axial myopia had peribulbar and retrobulbar anaesthesia for extracapsular cataract extraction (two patients) and cryotherapy (one patient). All eyes sustained a vitreous haemorrhage obscuring the view to the fundus. Retinal detachments were detected by B-scan ultrasound. In all eyes, scleral buckling, pars plana vitrectomy and silicone oil tamponade were performed as a primary surgical procedure. All the patients had complete anatomic reposition. In two patients, after two years follow-up, visual acuity was between 6/12 to 6/36 with the retina attached and no proliferative vitreoretinopathy (PVR). The third patient had blind painful eye and enucleation was performed. Primary use of silicone oil tamponade, in the management of perforated globe with retinal detachment due to local anaesthesia injection, is recommended.- - - - - - - - - - ranking = 0.33333333333333keywords = vitreoretinopathy (Clic here for more details about this article) |