Mechanism Of Retinal Detachment Research Articles

Отслойка сетчатки при цитомегаловирусном увеите у ВИЧ-инфицированных пациентов: исходы лечения

Cytomegalovirus (CMV) uveitis in HIV infection is one of the most dangerous secondary diseases of the visual organ, leading to blindness in the absence of treatment. The aim is to characterize the clinical features of the course of retinal detachment in HIV infection. Materials and methods. The study group included 29 patients, 34 eyes (9 men and 20 women). All patients underwent a standard routine ophthalmological examination. To confirm the diagnosis, an ultrasound of the eyeball was performed. Results. Retinal detachment was detected in 29 patients (34 eyes) out of 72 (94 eyes) and was 40.3% (95% CI=29.3-51.79%). According to the mechanism of retinal detachment, the following forms were identified: acute retinal necrosis, regmatogenic and traction detachment. In 50% of cases, the disease occurred as acute retinal necrosis of CMV-etiology. Visual acuity in the group of patients with operated retinal detachment became significantly lower after complex treatment. Conclusions. CMV-uveitis has a chronic sluggish course, despite multicomponent treatment. Retinal detachment is detected in 40% of HIV-infected patients with CMV-uveitis and in half of cases has the character of acute retinal necrosis. Keywords: cytomegalovirus, uveitis, HIV, HIV-infection, AIDS, retinal detachment.

Structural organization of choroidal colobomas of young and adult patients and mechanism of retinal detachment

In colobomatous eyes, the risk of retinal detachment increases with age. This study elucidates the anatomic conditions and pathologic process of retinal detachment associated with colobomas.The records, including histologic slides, of 14 children (1 day to 17 months old) and 7 adults (17 to 78 years old) with colobomas were examined.In children, colobomas were associated with lethal malformations. The extracolobomatous inner retinal layers extended centrally, forming the intercalary membrane. Duplication of the outer retinal layers and a horizontal shift of Müllerian glia created a triangle and a locus minoris resistentiae adjacent to the laterally displaced pigment epithelium. Part of the locus was an incomplete layer of photoreceptors excluding Müllerian glia. In adults, atrophy of the intercalary membrane, manifested as central schisis, thinning of the neuroepithelium, and hole formation, was related to a paucity of blood vessels within and underneath the intercalary membrane and the size of colobomas. The margins featured blood vessels, pigment epithelial hypertrophy, and choroidal and scleral thickening in a compact, intertwined arrangement.Glial atrophy, schisis, and hole formation in the intercalary membrane and separation of the locus minoris resistentiae from the pigment epithelium can disrupt barriers to fluid flow and set the stage for rhegmatogenous retinal detachment. That process is exacerbated by scleral ectasia, increasing vitreous traction at the margin, and retinovascular ischemia within the intercalary membrane. A vascularized, compact margin resembling a laser barrier, found predominantly in adults, may protect against retinal detachment.

Mechanisms of retinal detachment.

Mechanisms of retinal detachment.

Vitreous Changes and the Mechanism of Retinal Detachment

Vitreous Changes and the Mechanism of Retinal Detachment