Different presentations of rhegmatogenous retinal detachments
Thomas H. Williamson in Vitreoretinal Disorders in Primary Care, 2017
Cataract surgery has evolved rapidly in the last 40 years with progression from intracapsular surgery and aphakia, to extracapsular surgery, to phacoemulsification and pseudophakia post-operatively. This has led to a reduction in complications and an improvement in the standard of surgery and post-operative outcome for cataract surgery worldwide. Retinal dialysis is a dehiscence of the anterior retina at the ora serrata. The presence of a full vitreous means that the rhegmatogenous retinal detachments (RRDs) progresses very slowly and often presents by coincidental observation or when the macula finally detaches. A separation of the vitreous base from the retina is sometimes seen as a 'bucket handle' in the inner surface of the dialysis especially in traumatic cases. Blunt trauma has been associated with dialysis. A giant retinal tear (GRT) is defined as a tear of more than 3 clock hours of the retina with posterior vitreous detachment. Retinal detachments are related to posterior paravascular vitreoretinal adhesions or to radially orientated post-equatorial lattice degeneration.
Intravitreal triamcinolone acetonide in macular edema
A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha in Vitreoretinal Surgical Techniques, 2019
Macular edema is one of the most important causes of impaired vision; it can occur in many diseases, including diabetic retinopathy, central retinal vein occlusion, branch retinal vein occlusion, exudative age-related macular degeneration (ARMD), perifoveal telangiectasias, pseudophakia, uveitis, ischemic ophthalmopathy, and chronic prephthisical ocular hypotony. Intravitreal triamcinolone acetonide has increasingly been used as a treatment option for exudative ARMD because of the neovascular and edematous nature of the disease and the possible antiangiogenic, antiproliferative, and antiedematous effects of the drug. Intravitreal triamcinolone acetonide has several side-effects, one of the two most common of which is steroid-induced elevation of intraocular pressure. Eyes with intravitreal triamcinolone acetonide and infectious endophthalmitis show a marked destruction of the whole globe. Triamcinolone acetonide crystals that are washed from the vitreous cavity into the anterior chamber usually settle down in the inferior anterior chamber angle, mimicking a hypopyon.
Comparisons of Clinical Features in Japanese Patients with Behçet’s Uveitis Treated in the 1990s and the 2000s
Published in Ocular Immunology and Inflammation, 2020
Hisae Nakahara, Toshikatsu Kaburaki, Rie Tanaka, Atsushi Yoshida, Mitsuko Takamoto, Mikiko Kawata, Yujiro Fujino, Hidetoshi Kawashima, Makoto Aihara
Purpose: We investigated clinical characteristics of ocular Behçet’s disease (BD) patients treated in the 1990s and the 2000s. Methods: We retrospectively examined records of 68 newly arrived patients with ocular BD followed for more than 4 months during the 2000s and compared to those of 107 patients during the 1990s. Patient profiles, ocular and systemic symptoms, frequency of ocular attacks, BD ocular attack score 24–6 months (BOS24-6M), best-corrected visual acuity (BCVA), and immunomodulatory treatment were noted. Results: Clinical characteristics in the 2000s showed increases in iridocyclitis type, intestinal-, vasculo-, and neuro-BD cases, oral corticosteroid, methotrexate, and infliximab therapy usage, cataract and glaucoma surgery, and pseudophakia, and decreases in BOS24-6M and cyclophosphamide usage. BCVA of 20/30 or better at the final visit was slightly increased in the 2000s. Conclusions: Milder ocular BD tendency was seen in cases in the 2000s, whereas the incidence of special type of BD might be increasing.
Glaucoma Secondary to Uveitis in Children in a Tertiary Care Referral Center
Published in Ocular Immunology and Inflammation, 2019
Natasha Gautam Seth, Sonam Yangzes, Faisal Thattaruthody, Ramandeep Singh, Reema Bansal, Srishti Raj, Sushmita Kaushik, Vishali Gupta, Surinder Singh Pandav, Jagat Ram, Amod Gupta
Purpose: To study outcome of secondary glaucoma in pediatric uveitis patients. Methods: Retrospective analysis of records of uveitis patients ≤16 years. Results: Of 182 pediatric uveitis patients, secondary glaucoma was seen in 48 patients (75 eyes, 26.23%) with female preponderance (F:M-29:19) . JIA was the most common etiology (35.71%). BCVA of ≥20/40 was seen in 22 eyes at presentation and in 38 eyes at final follow up (p
Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment in Pseudophakia
Published in Seminars in Ophthalmology, 2018
Jennifer Ling, Jila Noori, Farhad Safi, Andrew W. Eller
Purpose: To identify the characteristics predictive of unfavorable outcomes for pneumatic retinopexy (PR) in the repair of pseudophakic rhegmatogenous retinal detachments (RD). Methods: A retrospective chart review was performed at a single institution to identify patients who underwent PR in pseudophakic eyes. Pre- and postoperative data were reviewed and analyzed to evaluate predictive factors of failure. Results: Forty-four patients met the study criteria. PR was successful in 23 (52.3%) patients. The failed cases underwent scleral buckles, vitrectomies, or both. A retinal tear located outside the superior four clock hours was a significant predictor of PR failure. At six months post-intervention, the failure and success groups were statistically similar for vision and rate of reattachment. Conclusions: Modified criteria for PR in pseudophakia may include cases with retinal breaks within the superior four clock hours. If further surgery is required, the final vision and anatomic reattachment are not disadvantaged by the initial PR procedure.