Abstract
BackgroundThe literature is scant on the state of the ciliary body, its role in the development of rhegmatogenous retinal detachment (RRD) complicated by choroidal detachment (CD), and on ciliary body changes following the treatment aimed at resolving concomitant inflammation and choroidal attachment. This study assesses the anatomical position and thickness of the ciliary body and investigates the ciliary body changes after anti-inflammatory pre-vitrectomy treatment in RRD complicated by CD.MethodsForty-nine patients (49 eyes) with RRD complicated by CD underwent standard ophthalmological examination (including visual acuity assessment, biomicroscopy, ophthalmoscopy, and ocular tonometry) and ultrasound biomicroscopy of the ciliary body, choroid, and retina both before and following anti-inflammatory pre-vitrectomy treatment.ResultsAt baseline, all subject eyes had ciliary body edema and detachment extending into the choroid. Ultrasonographic ciliary features included ciliary body edema and disorganization of the supraciliary layer of the pars plana, which was evident by the presence of multiple small oblique fibers. In all subject eyes, the treatment resulted in reattachment of the choroid and the ciliary body as well as a reduction in ciliary body edema (total mean ciliary thickness reduced from 0.83 (0.09) to 0.65 (0.09) mm, with a difference of 0.18 (0.07) mm, P < 0.001).ConclusionsPreoperative anti-inflammatory treatment in RRD complicated by CD results in restoration of the anatomical position of the ciliary body and a statistically significant reduction in ciliary body edema.
Highlights
The prognosis for rhegmatogenous retinal detachment (RRD) complicated by choroidal detachment (CD), marked hypotony and intraocular inflammation is rather unfavorable, which is confirmed by poor anatomical and functional outcomes of the treatment and by high redetachment rates [1, 2]
The aim of the study was to assess the anatomical position and thickness of the ciliary body and to investigate the ciliary body changes after anti-inflammatory pre-vitrectomy treatment in RRD complicated by CD, intraocular inflammation, and hypotony
Method for treatment of rhegmatogenous retinal detachment complicated by choroidal detachment
Summary
The prognosis for rhegmatogenous retinal detachment (RRD) complicated by choroidal detachment (CD), marked hypotony and intraocular inflammation is rather unfavorable, which is confirmed by poor anatomical and functional outcomes of the treatment and by high redetachment rates [1, 2]. Patients with this form of retinal detachment are usually excluded in multicenter prospective studies of the efficacy of treatment for RRD [3]. It has been reported that administration of oral steroids (prednisolone, 1 mg per kg) before primary vitrectomy in eyes with the disorder improves reattachment rates [5, 6] Preoperative treatment of such eyes with intravitreal injections of triamcinolone acetonide (TA), either combined with expansile gases in especially severe cases [7], or alone [6, 8] has a number of advantages. Methods Forty-nine patients (49 eyes) with RRD complicated by CD underwent standard ophthalmological examination (including visual acuity assessment, biomicroscopy, ophthalmoscopy, and ocular tonometry) and ultrasound biomicroscopy of the ciliary body, choroid, and retina both before and following anti-inflammatory pre-vitrectomy treatment
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