Full Thickness Macular Hole Closure after Exchanging Silicone-Oil Tamponade with C3F8 without Posturing

Purpose: To report a case of macular hole closure after the exchange of a silicone-oil tamponade with gas C3F8 14%. Method: A 64-year-old female patient with a stage IV macular hole underwent a three-port pars-plana vitrectomy and internal limiting membrane peeling. Due to the patient’s chronic illness (respiratory problems), a silicone-oil tamponade was preferred. However, the macula hole was still flat opened four months postoperatively. Therefore, the patient underwent an exchange of silicone oil with gas C3F8 14%. No face-down position was advised postoperatively due to her health problems. Results: Macular hole closure was confirmed with optical coherence tomography six weeks after exchanging the silicone oil with gas. Conclusions: Macular hole surgery using a silicone-oil tamponade has been proposed as treatment of choice for patients unable to posture. In our case, the use of a long-acting gas (C3F8 14%), even without posturing, proved to be more effective

THE CONTRIBUTION OF VITRECTOMY IN THE COMPREHENSION AND TREATMENT OF ACUTE DIABETIC RETINOPATHY

ONE HUNDRED (100) CASES OF PROLIFERATIVE DIABETIC RETINOPATHY, COMPLICATED BY VITREOUS HEMORRHAGE AND/OR TRACTION RETINAL DETACHMENT, UNDERWENT VITRECTOMY. FROM THESE CASES, 38 WERE ONLY VITREOUS HEMORRHAGE, 26 TRACTION REFINAL DETACHMENT, 31 FRACTION RETINAL DETACHMENT WITH HEMORRHAGE AND FINALLY 5 CASES OF RHEGMATOGENOUS DETACHMENT. DURING VITRECTOMY WE USED 20 G SYSTEM AND SPECIAL MICROSURGICAL INSTRUMENTS FOR PEELING AND REMOVING EPIRETINAL MEMBRANES. IN 48 CASES OUT OF 100 WE APPLIED THREE NEW TECHNIQUES. HORIZONTAL DISSECTION OF MEMBRANES, ASPECIAL TECHNIQUE TO CLEAR EPIRETINAL BLOOD ELEMENTS AND ENDOPHOTOANGULATION ARGON LASER. WE ACHIEVED 66% SUCCESS RATE IMMEDIATE POSTOPERATIVELY AND 53% IN THE LONG TERM. THE FOLLOW UP OF OUR CASES WAS BETWEEN TWO MONTHS AND TWO YEARS. COMPLICATIONS AND RESULTS ARE DISCUSSED IN DETAILS.ΕΚΑΤΟ (100) ΠΕΡΙΣΤΑΤΙΚΑ ΥΠΕΡΠΛΑΣΤΙΚΗΣ ΔΙΑΒΗΤΙΚΗΣ ΑΜΦΙΒΛΗΣΤΡΟΕΙΔΟΠΑΘΕΙΑΣ ΜΕ ΕΠΙΠΛΟΚΗ ΑΙΜΟΡΡΑΓΙΑ ΥΑΛΟΕΙΔΟΥΣ 'Η/ΚΑΙ ΕΛΚΤΙΚΗ ΑΠΟΚΛΗΣΗ ΤΟΥ ΑΜΦΙΒΛΗΣΤΡΟΕΙΔΗ (ΟΞΕΙΑ ΔΙΑΒΗΤΙΚΗ ΑΜΦΙΒΛΗΣΤΡΟΕΙΔΟΠΑΘΕΙΑ ΥΠΟΒΛΗΘΗΚΑΝ ΣΕ ΕΓΧΕΙΡΗΣΗ ΥΑΛΟΕΙΔΕΚΤΟΜΗΣ. ΑΠΟ ΤΑ 100 ΠΕΡΙΣΤΑΤΙΚΑ ΤΑ 38 ΗΤΑΝ ΥΠΕΡΠΛΑΣΤΙΚΗ ΔΙΑΒΗΤΙΚΗ ΑΜΦΙΒΛΗΣΤΡΟΕΙΔΟΠΑΘΕΙΑ (ΥΔΑ) ΚΑΙ ΑΙΜΟΡΡΑΓΙΑ ΥΑΛΟΕΙΔΟΥΣ (ΑΙΜ), ΤΑ 26 ΗΤΑΝ ΥΔΑ ΚΑΙ ΕΛΚΤΙΚΗ ΑΠΟΚΟΛΛΗΣΗ ΩΧΡΑΣ (ΕΛΚΤ), ΤΑ 31 ΗΤΑΝ ΥΔΑ+ΑΙΜ+ΕΛΚΤ ΚΑΙ ΤΕΛΟΣ ΤΑ ΥΠΟΛΟΙΠΑ 5 ΗΤΑΝ ΥΔΑ ΚΑΙ ΡΗΓΜΑΤΟΓΕΝΗΣ ΑΠΟΚΟΛΛΗΣΗ (ΡΗΓΜ) ΕΠΙ ΕΔΑΦΟΥΣ ΕΛΚΤΙΚΗΣ. ΚΑΤΑ ΤΗΝ ΕΓΧΕΙΡΗΣΗ ΧΡΗΣΙΜΟΠΟΙΗΘΗΚΕ ΣΥΣΤΗΜΑ ΥΑΛΟΕΙΔΕΚΤΟΜΗΣ 20 G KAI ΕΙΔΙΚΑ ΜΙΚΡΟΧΕΙΡΟΥΡΓΙΚΑ ΟΡΓΑΝΑ ΓΙΑ ΑΦΑΙΡΕΣΗ ΑΜΦΙΒΛΗΣΤΡΟΕΙΔΙΚΩΝ ΜΕΜΒΡΑΝΩΝ . ΕΠΙ ΠΛΕΟΝ ΣΕ 46 ΠΕΡΙΣΤΑΤΙΚΑ ΕΦΑΡΜΟΣΑΜΕ ΤΡΕΙΣ ΚΑΙΝΟΥΡΓΙΕΣ ΤΕΧΝΙΚΕΣ, ΤΗΝ ΟΡΙΖΟΝΤΙΟ ΔΙΑΤΟΜΗ ΤΩΝ ΜΕΜΒΡΑΝΩΝ, ΕΙΔΙΚΗ ΤΕΧΝΙΚΗ ΕΝΔΟΦΩΤΟΠΗΞΙΑ ARGON LASER. ΑΜΕΣΟ ΚΑΛΟ ΜΕΤΕΓΧΕΙΡΗΤΙΚΟ ΑΠΟΤΕΛΕΣΜΑ ΕΠΕΤΕΥΧΘΗ ΣΕ ΠΟΣΟΣΤΟ 66%, ΕΝΩ ΟΨΙΜΑ ΤΟ ΠΟΣΟΣΤΟ ΕΠΙΤΥΧΙΑΣ ΚΑΤΕΒΗΚΕ ΣΕ 53%. Ο ΧΡΟΝΟΣ ΠΑΡΑΚΟΛΟΥΘΗΣΗΣ ΤΩΝ ΠΕΡΙΣΤΑΤΙΚΩΝ ΗΤΑΝ ΔΥΟ ΜΗΝΕΣ ΕΩΣ ΚΑΙ ΔΥΟ ΧΡΟΝΙΑ. ΣΥΖΗΤΟΥΝΤΑΙ ΟΙ ΕΠΙΠΛΟΚΕΣ, ΕΓΧΕΙΡΗΤΙΚΕΣΚΑΙ ΜΕΤΕΓΧΕΙΡΗΤΙΚΕΣ, ΚΑΘΩΣ ΚΑΙ ΤΑ ΑΠΟΤΕΛΕΣΜΑΤΑ

Bilateral Hypertensive Retinopathy Complicated with Retinal Neovascularization: Panretinal Photocoagulation or Intravitreal Anti-VEGF Treatment

Purpose: To present the case of a patient with bilateral hypertensive retinopathy complicated with retinal neovascularization who received anti-VEGF intravitreal injection in one eye and panretinal photocoagulation (PRP) in the fellow eye. Methods: A 33-year-old male patient presented with gradual visual loss in both eyes for the last 5 months. At that time, he was examined by an ophthalmologist and occlusive retinopathy due to malignant systematic hypertension was diagnosed. He was put on antihypertensive treatment but no ophthalmic treatment was undertaken. At presentation, 5 months later, best-corrected visual acuity (BCVA) was 0.1 in the right eye (RE) and 0.9 in the left eye (LE). Fundus examination was compatible with hypertensive retinopathy complicated with retinal neovascularization. Fluorescein angiography (FFA) revealed macular ischemia mainly in the RE and large areas of peripheral retinal ischemia and neovascularization with vascular leakage in both eyes. The patient was treated with two anti-VEGF (ranibizumab) injections with 2 months interval in the RE and PRP laser in the LE. Results: Follow-up examination after 12 months showed mild improvement in BCVA, and FFA documented regression of retinal neovascularization in both eyes. Conclusion: Hypertensive retinopathy can be rarely complicated with retinal neovascularization. Treatment with PRP can be undertaken. In our case, the use of an intravitreal anti-VEGF agent seemed to halt its progression satisfactorily