6 research outputs found
Anatomical and Functional Results Following 23-Gauge Primary Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment: Superior versus Inferior Breaks
Purpose. In this retrospective study, we evaluated the anatomical and functional outcomes of patients with rhegmatogenous retinal detachment primarily treated with pars plana vitrectomy in regard to the location of the breaks. Methods. 160 eyes were enrolled in this study, divided into two groups based on break location: the superior break group (115 eyes) and the inferior break group (45 eyes). The main endpoint of our study was the anatomical success at 3 months following surgery. Results. Primary retinal reattachment was achieved in 96.5% of patients in group A and in 93.3% in group B (no statistically significant difference, OR 1.98, 95% CI: 0.4, 7.7). Mean BCVA change and intraoperative complication rate were also not statistically significantly different between the two groups (p>0.05, OR: 1.0, 95% CI: 0.9, 1.01, resp.). Statistical analyses showed that macula status, age, and preoperative BCVA had a significant effect on mean BCVA change (p=0.0001, p=0.005, and p=0.001, resp.). Conclusion. This study supports that acceptable reattachment rates can be achieved using PPV for uncomplicated RRD irrespective of the breaks location and inferior breaks do not constitute an independent risk factor for worse anatomical or functional outcome
Rhegmatogenous retinal detachment due to a macular hole in a patient with pars planitis: a case report
We report a rare case of rhegmatogenous retinal detachment due to a
full-thickness macular hole in a young patient with pars planitis. This
study was an interventional case report. A 38-year-old Asian man
presented with acute reduction of vision in his left eye. His past
ocular history revealed a precedent of two intravitreal steroid
injections in his left eye, and fundoscopy revealed a total bullous
retinal detachment along with 360 degrees snowbanking at the pars plana.
Precise preoperative visualization of the posterior pole was impossible
due to a dense nuclear cataract. During surgery, an unexpected
full-thickness macular hole with no associated epiretinal membrane was
observed, which resulted in the retinal detachment. This case of chronic
pars planitis complicated with a full-thickness macular hole resulting
in retinal detachment was successfully treated with vitrectomy, internal
limiting membrane peeling, and perfluoropropane tamponade. Visual acuity
improved from hand movements to 6/36 Snellen at 12 months postsurgery.
This case report illustrates the rare but possible association between
pars planitis with macular hole formation and subsequent retinal
detachment, underlying the beneficiary outcome of vitrectomy surgery
both diagnostically and therapeutically
Paracentral Acute Middle Maculopathy following Surgically Induced Branch Retinal Artery Occlusion During Vitrectomy
Paracentral acute middle maculopathy (PAMM) is a spectral-domain OCT
finding of a thickened hyperreflective band at the level of the
intermediate layers of the inner retina, attributed to the acute phase
of intermediate capillary ischemia. The purpose of this paper is to
report a case of PAMM deriving from a surgically induced branch retinal
artery occlusion (BRAO) during vitrectomy for vitreous hemorrhage. A
70-year-old female referred to the posterior segment office with a
1-month history of visual loss in her right eye. Best-corrected visual
acuity (BCVA) was “counting-fingers” (CF) due to a dense vitreous
hemorrhage. She underwent a standard 23-gauge vitrectomy with a
relatively close to the optic disc endodiathermy application to an
avulsed vessel. Follow-up examination revealed a well-demarcated retinal
whitening involving the inferior macula. SD OCT showed a surgically
induced branch retinal artery occlusion exhibiting both a cotton wool
spot and a PAMM lesion. Our case affords an insight into those
pathological processes involved with PAMM, providing angiographic
evidence of the retinal ischemic changes responsible for its
development, by angiographically proving that branch retinal artery
occlusion leads to a prompt formation of both a cotton wool spot and a
PAMM lesion. Our aim is to raise awareness of this potential
complication of vitrectomy surgery, especially when involving multiple
traumatic manipulations onto the retinal surface
The influence of mild posterior capsular opacification on spectral domain optical coherence tomography retinal nerve fiber layer thickness
Purpose tau o investigate whether Yag laser capsulotomy, in addition to
restoring ocular media transparency, may also significantly alter
retinal nerve fiber layer (RNFL) thickness analysis and spectral domain
optical coherence tomography (SD OCT) indices and quality parameters,
such as signal strength (SS), in patients with mild, diffuse posterior
capsular opacification (PCO). Methods Prospective interventional case
series study which enrolled 28 patients with mild PCO and good baseline
best-corrected visual acuity (BCVA). All patients underwent a complete
ophthalmologic examination, including SD OCT RNFL thickness measurement
prior to Yag laser capsulotomy. Following laser intervention, all
patients repeated the same complete ophthalmic examination and results
were recorded and analysed. Results Mean RNFL thickness showed a
significant postoperative increase from 89.6 to 94.1 mu m (p = 0.01),
which was also confirmed for superior (p = 0.041), nasal (p = 0.011) and
inferior quadrants (p = 0.032). SS and BCVA were also significantly
increased after laser treatment (p < 0.01). A significant positive
correlation was observed between SS and mean RNFL thickness
postoperatively (p = 0.043) but not preoperatively (p = 0.059).
Similarly, a significant relationship was found between BCVA and average
RNFL thickness after (p = 0.017) but not before (p = 0.457) laser
intervention. Conclusions Our study suggests that the presence of even
mild PCO may alter the sensitivity of SD-OCT acquisition and lead to
inadvertent RNFL thickness underestimation. Clinicians should be alerted
to this contingency and take it into consideration when evaluating
various optic neuropathies with SD OCT, in pseudophakic eyes
Anatomical and Functional Results Following 23-Gauge Primary Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment: Superior versus Inferior Breaks
Purpose. In this retrospective study, we evaluated the anatomical and
functional outcomes of patients with rhegmatogenous retinal detachment
primarily treated with pars plana vitrectomy in regard to the location
of the breaks. Methods. 160 eyes were enrolled in this study, divided
into two groups based on break location: the superior break group (115
eyes) and the inferior break group (45 eyes). The main endpoint of our
study was the anatomical success at 3 months following surgery. Results.
Primary retinal reattachment was achieved in 96.5% of patients in group
A and in 93.3% in group B (no statistically significant difference, OR
1.98, 95% CI: 0.4, 7.7). Mean BCVA change and intraoperative
complication rate were also not statistically significantly different
between the two groups (p > 0 05, OR: 1.0, 95% CI: 0.9, 1.01, resp.).
Statistical analyses showed that macula status, age, and preoperative
BCVA had a significant effect on mean BCVA change (p = 0 0001, p = 0
005, and p = 0 001, resp.). Conclusion. This study supports that
acceptable reattachment rates can be achieved using PPV for
uncomplicated RRD irrespective of the breaks location and inferior
breaks do not constitute an independent risk factor for worse anatomical
or functional outcome