Pharmacologic Retinal Reattachment with INS37217 (Denufosol Tetrasodium), a Nucleotide P2Y2 Receptor Agonist
Glenn J. Jaffe, Paul Ashton, P. Andrew Pearson in Intraocular Drug Delivery, 2006
The purpose of this trial was to assess the tolerability of INS37217 when administered as a single intravitreal injection in subjects with RRD. Only patients with macula-on RRD were enrolled in the study. The secondary objective of this trial was to determine the pharmacologic activity of INS37217 by assessing its ability to clear extraneous fluid from the subretinal space and thereby facilitate retinal reattachment with a single injection. Subjects that responded positively to INS37217 received treatment for repairing the retinal tear, such as laser photocoagulation or cryopexy. Subjects that did not respond to treatment proceeded to rescue therapy of pneumatic retinopexy (PR). The effect of INS37217 or placebo on the extent of retinal detachment was evaluated using two independent, quantitative measures. One measure involved quantifying the extent of retinal detachment using fundus examination, and the second measure involved quantifying extent and height of retinal detachment using B-scan ultrasound images of the eye. Fundus and B-scan evaluations were conducted under conditions in which the identity of the drug versus placebo was masked.
Sensory organs
Aida Lai in Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Myopia Elongated eyeballSymptoms: – blurred distant visionComplications: – retinal detachmentManagement: – concave lens
Clinical specialties
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
An 18-year-old comes into the eye casualty with two police guards after admitting to being in a fight. He complains of painless loss of vision in his right eye. Retinal detachment is at the top of your differential list. State three other causes for sudden painless loss of vision. (3)Retinal detachment is diagnosed, and after visual field testing, he has a loss of the upper half of his visual field in his right eye.State the area of the retina that must be detached. (1)Other than visual field loss, name two other symptoms he may be complaining of. (2)Between people who have myopia and people who have hypermetropia, who are at the greater risk of retinal detachment? Explain your answer. (2)Name two options for treatment for retinal detachment. (2)
Ocular Complications of Intravesicular BCG Treatment for Bladder Carcinoma
Published in Ocular Immunology and Inflammation, 2022
Osman Melih Ceylan, Ali Hakan Durukan, Yusuf Uysal, Gokhan Ozge, Deniz Dogan, Ugur Bozlar
BCG has been proved to be superior over chemotherapy in reducing recurrence rates of the bladder cancer.6 Lamm et al. reported 2.9% incidence of high fever (>39°C), 1.0% major hematuria, 0.9% granulomatous prostatitis, 0.7% granulomatous pneumonitis/hepatitis, 0.5% arthritis or arthralgia, 0.4% epididymo-orchitis, 0.4% sepsis, 0.3% urethral obstruction, 0.2% bladder contracture, 0.1% renal abscess, and 0.1% cytopenia in a study of more than 1,200 patients who received BCG immunotherapy.7 Rare complications such as conjunctivitis, keratitis, sterile corneal dissolution, uveitis, endophthalmitis, and autoimmune retinitis have been reported in previous reports.8–11 Cugati S et al.9 reported a case of choroidal tubercle with tractional retinal detachment who responded well to ATT treatment. In our patient, two mechanisms might be responsible for the retinal detachment. There is a serous component due to choroidal tubercle and a tractional component due to ERM. Main reason for the detachment is serous component and we think that traction due to ERM is a comorbidity. Therefore, PPV was performed in addition to ATT treatment. However, few reports also reported penile involvement following intravesical BCG immunotherapy similar to our study.12
Retinal detachment in a child with Frank-ter Haar syndrome
Published in Ophthalmic Genetics, 2023
Onur Furundaoturan, Mine Esen Baris, Durdugul Ayyıldız Emecen, Elif Demirkilinc Biler
In addition to megalocornea and high astigmatism in the right eye, retinal detachment in the left eye was the major and most serious ophthalmological manifestation in the current case. Retinal detachment is quite rare in children when compared to adults, with only 2% to 6% of all retinal detachments attributed to children. Retinopathy of prematurity, myopia, and trauma are the leading causes of retinal detachment. Interrogation of the family did not reveal any trauma or a predisposing condition for detachment. A history of ophthalmic surgery (especially cataract), hereditary diseases (Marfan syndrome, X-linked juvenile retinoschisis, familial exudative vitreoretinopathy), uveitis, and certain malformations may result in retinal detachment but were ruled out for this patient (15). To the best our knowledge this is the first case of FTHS with retinal detachment. The presence of sensory exotropia in the left eye, in addition to fibrotic membranous changes of the retina, which are suggestive of proliferative vitreoretinopathy, may have promoted chronic retinal detachment. As the VEP test supported a poor prognosis, a decision of no treatment was taken for the patient with the consent of the family. We were unable to rule out avascular peripheral retina by fluorescein angiography in the right eye as the family deferred any further testing under anesthesia, and we continued to monitor this patient in an outpatient setting.
Malpractice Cases Arising From Telephone Based Telemedicine Triage in Ophthalmology
Published in Seminars in Ophthalmology, 2023
Elias H Kahan, Joshua D Shin, Michael E Jansen, Rebecca Hughes Parker, Ravi Parikh
This analysis showed that most medical malpractice lawsuits related to teleophthalmology resulted from delays in evaluation and/or treatment secondary to telephone visits. Although synchronous live audio-visual evaluation and high-resolution images generated through mobile health applications will become more prominent in the coming years, it is unlikely that telephone communication will ever be completely phased out of ophthalmic practice, and these learnings should be leveraged for mitigating future malpractice across all teleophthalmic encounters. Regarding telephone triage in particular, certain steps can be implemented in current practice to avoid the likelihood of malpractice litigation. Based on our findings, certain symptoms that may portend to endophthalmitis or retinal detachment, such as flashes and floaters, especially in the context of previous vitreous hemorrhage, detachment, or retinal repair, should warrant immediate in-person evaluation.
Related Knowledge Centers
- Nervous System
- Optic Nerve
- Posterior Vitreous Detachment
- Retina
- Retinal Pigment Epithelium
- Visual Impairment
- Surgical Emergency
- Floater
- Near-Sightedness
- Lattice Degeneration