Retinal Detachment Research Articles

Acute infectious endophthalmitis after chandelier-assisted scleral buckling surgery.

To report a rare case of acute bacterial endophthalmitis that developed after scleral buckling surgery performed with non-contact wide-angle viewing system (WAVS) and chandelier endoillumination. A 63-year-old man underwent scleral buckling surgery using a WAVS with chandelier endoillumination for rhegmatogenous retinal detachment repair in his left eye. Seven days after the surgery, the patient noticed a marked decrease in his vision with ocular pain. No anterior chamber inflammation or exudates were found. No focal congestion or exudates were noted at the sclerotomy site. Posterior segment examination revealed severe vitreous haze and yellowish exudates in the vitreous cavity. Ocular ultrasound revealed dense vitritis, complete posterior vitreous separation, a fully attached retina, and a peripheral scleral buckle indent. Vitreous biopsy combined with pars plana vitrectomy with intravitreal antibiotic injections was done immediately, and Staphylococcus epidermidis was detected in the vitreous fluid. Following surgery, the inflammation and infection subsided and the visual acuity recovered to 6/9 in 6 weeks. Infectious endophthalmitis is a rare occurrence after chandelier-assisted scleral buckling (SB) surgery, characterized by ocular pain and a sudden decline in vision as key symptoms. Clinicians should be cognizant of the possibility of its occurrence following SB surgery, especially when utilizing the WAVS with chandelier endoillumination.

Antiviral therapy for cytomegalovirus retinitis: A systematic review and meta-analysis.

Cytomegalovirus retinitis (CMVR) is a significant cause of blindness in patients with advanced acquired immunodeficiency syndrome (AIDS). There are no established guidelines for its treatment, resulting in varied antiviral approaches. We pooled data from 59 studies (4,501 patients) to evaluate treatment variations and outcomes (CRD42022321088). Overall pooled estimates showed visual acuity improvement at 18% (95% CI: 7-41%), inflammation resolution at 90% (95% CI: 81-95%), retinal detachment at 11% (95% CI: 8-14%), and recurrence at 19% (95% CI: 11-31%). The main antiviral treatment approaches identified were: (1) intravenous antivirals alone in 33 studies, (2) intravitreal antivirals alone in 26 studies, (3) oral antivirals alone in 3 studies, and (4) a combination of systemic (oral or intravenous[IV]) and intravitreal antivirals in 7 studies, with varying schemes and durations. Ganciclovir was the predominant antiviral, with intravenous administration being the most reported (in 23 studies), followed by intravitreal administration (in 20 studies). While visual acuity improvement was comparable, inflammation resolution tended to be higher with intravitreal than with IV antivirals, though not statistically significant (88%, 95% CI: 69-96% vs 75%, 95% CI: 35-94%, p = 0.38). Retinitis progression rate for IV ganciclovir was lower than for those without ganciclovir. Inflammation recurrence was significantly lower in antiretroviral (ART)-treated compared to non-ART-treated HIV/AIDS patients (10% (95% CI: 4-20%) vs 33% (95% CI: 19-50%), p < 0.01). Neutropenia, particularly with ganciclovir, was the most reported adverse effect (up to 50%).

Clinical Profiles of Retinal Vasoproliferative Tumors

Purpose: To describe the clinical features and treatment outcomes of patients with retinal vasoproliferative tumors. Methods: This retrospective case series comprised patients diagnosed with a retinal vasoproliferative tumor. Electronic medical records were reviewed, and patients’ demographic details, clinical presentation, and treatment outcomes were analyzed. Results: Nineteen eyes of 19 patients with vasoproliferative tumors were included. The mean age (±SD) at presentation was 37.0 ± 16.95 years. No eye had bilateral tumors, and 1 eye had multiple tumors. Three eyes (15%) had primary tumors, while 16 (84%) had secondary tumors. Primary tumors mainly affected the inferotemporal quadrant (n = 3). Secondary tumors involved the inferior quadrant (n = 4), inferotemporal quadrant (n = 5), and inferonasal quadrant (n = 5). Secondary tumors were associated with Coats disease (n = 6), intermediate uveitis (n = 3), traumatic chorioretinopathy (n = 2), familial exudative vitreoretinopathy (n = 2), retinal vasculitis (n = 2), and retinal vascular occlusion (n = 1). Retinochoroidal features included intraretinal and subretinal exudates, subretinal fluid, intraretinal hemorrhaging, vitreous hemorrhaging, cystoid macular edema, vitritis, preretinal fibrosis, dilated feeding vessel, epiretinal membranes, and tractional retinal detachment. Treatment modalities included cryotherapy, laser photocoagulation, and local steroids. The mean follow-up was 25.3 months, during which 18 eyes had tumor regression and 1 had a worsening condition. Conclusions: Secondary vasoproliferative tumors were more frequently observed than primary tumors, often presenting as unilateral, unifocal tumors situated posterior to the equator in the inferior fundus. Conventional treatment approaches, such as cryotherapy and laser photocoagulation, were effective at tumor regression and often required multiple sessions.

REMOTE FUNCTIONAL RESULTS PATIENTS WITH MACULAR HOLE AND RHEGMATOGENOUS RETINAL DETACHMENT SURGICAL TREATMENT WITH DIFFERENT VOLUMES OF PRESERVATION OF THE INTERNAL LIMITING MEMBRANE ACCORDING TO MICROPERIMETRY DATA

Rationale: Macular hole is a defect of the retina in the foveolar zone. In combination with rhegmatogenous retinal detachment, this disease can lead to irreversible deterioration of visual functions and requires immediate surgical treatment. One of the trends in modern ophthalmic surgery is to increase the area of preservation of the internal limiting membrane during the macular hole blocking. Despite this, microperimetry data indicate the appearance of microscotomas at the point of peeling initiation and a general decrease in the photosensitivity of the retinal tissue in the membrane removal zone.Objective: to analyze the dynamics of changes in the retinal functional parameters of patients with macular hole and rhegmatogenous retinal detachment according to microperimetry data after surgical treatment in the late postoperative period.Methods: Data from 40 patients (40 eyes) diagnosed with macular hole and rhegmatogenous retinal detachment were prospectively studied. Patients in group 1 (20 patients, 20 eyes) underwent surgical treatment, including three-port 25G vitrectomy, perfluoroorganic compound, vitreous body sanitation at the periphery, and silicone tamponade. Membrane peeling was performed during the second operation to remove silicone. Patients in group 2 underwent vitrectomy, membrane staining under the perfluorine layer, membrane peeling with closure of the macular hole with an inverted flap, vitreous body sanitation during the first intervention. The operation was also completed with silicone tamponade. During the second intervention, silicone oil was removed from the vitreous cavity.Results: When comparing the light sensitivity index of the retinal tissue in the foveolar zone between the groups, a reliable difference in the indices by 1.2 times continued to persist up to one and a half years after the final stage of surgical treatment, there was a predominance of values in patients of the 1st group with a completely preserved membrane (p = 0.043 in comparison with the data of patients of the 2nd group). In three peripheral zones of the macula, during the long-term observation period up to one and a half years after surgery, the indices of patients of the 1st group prevailed by 1.5 times (p = 0.041 in comparison with the data of patients of the 2nd group).Conclusion: based on the analysis of the dynamics of the functional indices of the retina of patients after surgical treatment of macular hole in combination with rhegmatogenous retinal detachment, the refusal to perform membrane peeling on the detached retina during the first stage of surgical intervention allows to avoid aggressive mechanical trauma to the retinal tissue.

THE CONNECTION OF LOCAL RETINAL DETACHMENT IN THE MACULAR AREA WITH THE FOSSA OF THE OPTIC DISC. DIFFERENTIAL DIAGNOSIS (CLINICAL CASE)

Relevance. The optic nerve pit is a congenital disease manifested by a depression in the disc of the optic nerve, which affects about 0.9% of the population. Complications occur in 25–75% of patients and may include retinal detachment. The causes of detachment remain unclear, but two theories of the occurrence of this complication have been put forward. Fluorescence angiography and optical coherence tomography are used for diagnosis. The treatment of retinal detachment in ONDP is not standardized and includes laser treatment, vitrectomy and other methods for fluid drainage. It is important to differentiate ONDP from other causes of central retinal detachment.Objective. Based on a clinical case, to demonstrate an approach to the diagnosis and treatment of local retinal detachment in the macular area associated with the fossa of the optic disc.Materials and methods. This article presents a clinical case of retinal detachment in the macular area associated with the fossa of the optic disc. Results and discussions. When comparing two clinical cases, the similarity of the ophthalmoscopic picture and the differences in the OCT and FAG images were revealed.Conclusions. The accumulation of fluid under the neuroepithelium is not a pathognomic sign, therefore it is important to carry out differential diagnosis in central serous retinal detachment associated with the fossa of the optic disc.

RESULTS OF TREATMENT OF PATIENTS WITH RHEGMATOGENOUS RETINAL DETACHMENT WITH RUPTURE IN THE LOWER HEMISPHERE DEPENDING ON THE SURGICAL METHOD

Purpose: To evalute the efficacy of short-term tamponade of the vitreal cavity by perfluorinated compound and to analyze the morphological changes after surgical treatment of the patients with rhegmatogenous retinal detachment with rupture in the lower retinal hemisphere.Material and methods: The analysis of surgical treatment of 31 patients with the diagnosis of primary rhegmatogenous retinal detachment in combination with proliferative vitreoretinopathy с type 1–2 with inclusion of the macular zone, with the localization of the rupture in the lower retinal hemisphere. All patients were divided into two groups depending on the tamponade vitreous cavity. I group (n = 15): first stage – vitreoretinal surgery with a tamponade of the vitreous cavity of perfluoroorganic compounds for 14 days, second stage – removal of perfluoroorganic compounds from the vitreous cavity + facoemulsification with implantation of the intraocular lens + tamponade of the natural gas mixture (С2F6). Monitoring for at least 6 months after perfluorinated compound or silicone oil removal.Results: The preliminary results of the study showed a high effectiveness of short-term perfluorinated compound tamponade compared to the silicone oil tamponade in patients with rhegmatogenous retinal detachment with rupture in the lower hemisphere. In all 1st group patients complete retinal reattachment was achieved in all observation periods. In 2nd group, partial retinal reattachment in the lower departments in the long-term postoperative period was detected in 37.5% of cases. There was no cystic macular edema in Group 1 patients, while it occurred in Group 2 patients in 18.7%. Epiretinal fibrosis was detected in Group 1 patients in 14.3% of cases and in Group 2 patients in 31.2% of cases during the whole observation period.Conclusion: The results of the conducted study confirm the effectiveness of the use of short-term tamponade of the vitreous cavity of perfluorinated compound in the treatment of patients with retinal detachment at the localization of a tear in the lower retinal hemisphere. This method improves the anatomical results of vitreoretinal surgery in this category of patients and helps to reduce the number of postoperative complications.

INTERNAL LIMITING MEMBRANE PEELING IN CASE OF RHEGMATOGENOUS RETINAL DETACHMENT AS A PREVENTIVE MEASURE FOR EPIRETINAL MEMBRANE

Rhegmatogenous retinal detachment (RRD) is one of the general determinants of the primary sight disability. However, employable people represent the majority of patients with RRD.Over the past 50 years, retinal detachment surgery had rapid progress, and the rate of success surgery increased up to 90% and higher. However, reducing the risks of reoperations, improving functional outcomes and increasing postoperative visual acuity remain topical issues at present.The main reason for second surgical interventions is progression of the proliferative vitreoretinopathy, which can lead to epiretinal membrane, macular oedema, and to recurrence of the retinal detachment.We reviewed current literature studies that report the results of internal limiting membrane peeling in cases with RRD and other alternative techniques aimed at reducing the risk of mentioned above postoperative complications.

THE METHOD OF DOUBLE CONTRAST IN THE INTRAOPERATIVE DIAGNOSIS OF REGMATOGENIC RETINAL DETACHMENT

Usually, the recurrence rate of regmatogenic retinal detachment (ROS) after surgery ranges from 3% to 30%. In cases where the disease recurs after successful surgery, in 60% of cases the main factor is the progression of proliferative vitreoretinopathy (PVR), which makes it one of the most severe complications that can occur in the postoperative period. In addition, after removal or absorption of a tampon agent (in particular, endotamponade with silicone oil), recurrent retinal detachment may occur due to the inability to detect retinal rupture during surgery.Objective: this study is aimed at evaluating the effectiveness of diagnostic methods used during operations for regmatogenic retinal detachment. After completing the standard stages of central vitrectomy, the group of patients was divided into two equal groups: the first group included patients who received the double contrast method, and the second group (control) – patients who underwent the traditional surgical method.Results and discussion: in patients of the control group, there was a significant increase in the number of relapses of ROS. In addition, it was found that an increase in the number of retinal tears correlated with a greater likelihood of macular involvement; Statistical evaluation has shown that the absence of AST and tight adhesion of the posterior hyaloid membrane to the retina and small retinal tears increase the risk of recurrence of ROS due to the progression of PVR.

DYNAMICS OF CHANGES IN THE ANATOMICAL PARAMETERS OF THE ANTERIOR CHAMBER OF THE EYE WITH VARIOUS TYPES OF APHAKIA CORRECTION IN PATIENTS WITH SILICONE TAMPONADE OF THE VITREAL CAVITY

Rationale: In case of combined pathology, in particular aphakia and regmatogenic retinal detachment, an important point is the leveling of changes in the iridocrustal apparatus. When analyzing the morphoanatomic parameters of the angle and depth of the anterior chamber using optical coherence tomography, distinctive features were revealed in patients with various methods of correcting the defect of the iridohrustal barrier.Objective: of the study was to evaluate anatomical changes in the angle and depth of the anterior chamber in patients with various types of intraocular correction of the defect of the capsule-binding apparatus under conditions of tamponade of the vitreal cavity with silicone oil.Methods: Studies were conducted on 74 eyes of patients aged 56 to 75 years with various methods of correction of aphakia and silicone tamponade of the vitreal cavity.Results: There was a significant decrease in the anterior chamber angle in various sectors in patients with aphakia, in contrast to patients with anterior chamber and transclerally fixed intraocular lenses. A similar trend is observed in patients with anterocameral intraocular lenses, relative to the group of patients with artifacia. A decrease in the depth of the anterior chamber was revealed in patients with anterior chamber lenses relative to patients with transcleral fixation and articulation was revealed in the upper sector. In the temporal sector, there is a decrease in this indicator in patients with aphakia relative to patients with artifakia.Conclusion: In the conditions of silicone tamponade of the vitreal cavity, the technique of transcleral fixation of intraocular lenses provides the most physiological indicators of the anterior chamber angle comparable to single-format indicators of patients with artifacia.

Management of persistent exudative retinal detachment: exploring etiology and surgical outcomes.

This report aims to present the causes, clinical features, and surgical outcomes of persistent exudative retinal detachment (ERD) in a single tertiary referral center experience. We retrospectively analyzed 48 patients who underwent vitreoretinal intervention for persistent ERD between 2017 and 2024. The study assessed patient demographics, underlying causes of ERD, the success rate of surgical interventions, and postoperative visual outcomes. Of the 2040 eyes with retinal detachment treated at our center, 48 (2.35%) were diagnosed with ERD. Coats disease was the most frequent underlying cause, identified in 18 (37.5%) of ERD cases. Choroidal hemangioma (n = 6, 12.5%) and nanophthalmos (n = 5, 10.4%) were the next most common etiologies. The study population comprised 48 patients (30 males and 18 females) with a mean age of 37.48 years (range, 4-88 years). The mean best-corrected visual acuity remained stable from baseline to follow-up. The recurrence rate following primary surgery was 29.2%. Patients underwent a mean of 1.75 ± 1.00 surgeries. Globe preservation was achieved in 44 eyes (91.7%), while phthisis bulbi developed in 4 eyes (8.3%). Vitreoretinal surgery may be considered as a salvage procedure in cases where persistent ERD threatens the posterior pole. In our study, Coats' disease, choroidal hemangioma, and nanophthalmos were identified as the most common etiologies associated with persistent ERD. Surgical intervention has the potential to preserve vision, but the high recurrence rate necessitates a cautious approach and the possibility of multiple surgeries.

Subretinal tissue plasminogen activator without vitrectomy for submacular hemorrhage displacement using Nano-vitreoretinal gateway device: A pilot report

Purpose: To evaluate the surgical outcome of subretinal tissue plasminogen activator (tPA) delivered without vitrectomy for the displacement of submacular hemorrhage (SMH). Method: A retrospective interventional cases series of consecutive patients who underwent subretinal tPA and intravitreal expansile gas without vitrectomy for SMH displacement. Concomitant injection of subretinal air and intravitreal ranibizumab and expansile gas was performed per surgeon’s discretion. Results: Seven eyes from 7 patients were included. 6 eyes (85.7%) had polypoidal choroidal vasculopathy (PCV) and 1 (14.3%) had wet age-related macular degeneration (wAMD). The median baseline visual acuity (VA) was 0.014 (range 0.005-50.1) ETDRS letters, which improved to 35 (range 26.3-65.1), 35 (range 31.0-73.9), 35 (range 35-77.3) and 35 (range 5-80.2) ETDRS letters at 1 week, 1 month, 3 months and 6 months, respectively. Visual gain of ≥5 letters was achieved in majority of patients through 6 months. Successful displacement of blood away from fovea was achieved in 100% of eyes. The rate of postoperative vitreous hemorrhage, retinal pigment epithelium tear and macular hole were 14.3% (1 patient) each. Conclusion: This novel, minimally invasive surgical technique is effective in displacing SMH and preserving vision.

Characteristics of ocular-related emergency department visits: Five-years data from a tertiary care center in Riyadh, Saudi Arabia.

Ocular emergencies (OE) include ocular trauma, infections, retinal detachment, and uveitis. Due to the limited number of studies describing ocular emergencies requiring Emergency Department (ED) visits in Saudi Arabia, there is a need for further studies addressing this topic. Therefore, this study aimed to assess and describe the incidence, clinical presentation, and causes of ocular-related ED visits at a tertiary hospital in Riyadh, Saudi Arabia. This was a retrospective cohort study. Medical records were reviewed for all patients (all age groups) patients presenting at the ED from 1 January 2019 to 31 October 2023 where data for patients with any ocular emergency was extracted using an Excel sheet. Data analysis was performed using RStudio (R version 4.3.1). Baseline information was described using frequencies and proportions. Types of Ocular emergencies were described using the International Classification of Diseases, 10th Revision (ICD-10) codes and presented using frequencies and proportions. The distribution of ocular emergencies across months and age groups was expressed using chart figures. A total of 15,321 ocular-related ED visits were included in this study. Almost 51% of patients were males. The mean age at diagnosis was 25.5 ± 22.1 years. More than half of the patients (51.0%) were diagnosed during childhood (<18 years), while proportions of older ages declined gradually. Average presentations of ocular emergencies in a single month ranged from 200 to 400. Conjunctival disorders including conjunctivitis (29.8%) were the most frequent ocular emergencies. The findings of this study showed that ocular emergencies are more prevalent in younger patients (aged <18 years), more commonly due to conjunctivitis. This highlights the need for policymakers to assess the causes of such emergency in this population and implement prevention strategies. Moreover, an average of 200 to 400 emergency visits per month are ocular-related. This finding could help policymakers understand the burden of ocular emergencies on the ED and the pressure that could add to the ED staff to provide appropriate care for these patients.

Rhegmatogenous Retinal Detachment Secondary to Type I Stickler Syndrome: Diagnosis, Treatment and Long-Term Outcomes

Objective: This study aimed to clarify the genetic diagnosis of rhegmatogenous retinal detachment (RRD) secondary to type I Stickler syndrome (STL1) and evaluate the anatomical and functional outcomes of surgical treatment. Methods: This retrospective study included 11 patients with RRD secondary to STL1. Familial and sporadic cases of STL1 were diagnosed at the Eye &amp; ENT Hospital, Fudan University, between 2017 and 2023. To clarify the genetic diagnosis, next-generation sequencing was performed in suspected STL1 cases. Further, standard ocular examinations and surgical treatment were performed. Results: Nine variants of COL2A1, including four novel mutations (c.394G&gt;T, c.2977G&gt;T, c.3003+2dup, and c.3853G&gt;C), were screened and identified. The pathogenicity of all variants was conclusively demonstrated. Among patients who underwent vitrectomy, the mean age at RRD was 11.5 years, and the mean follow-up was 32.9 months. The average number of surgical procedures required during the follow-up was two; 90.9% of eyes achieved final attachment, and best corrected visual acuity (BCVA) significantly improved in 81.8% of the eyes, with a middle postoperative logMAR BCVA of 0.52 compared with the preoperative value (p = 0.0148). High intraocular pressure (81.8%) and cataract (72.7%) were the most common complications. Conclusions: Our study expands the spectrum of COL2A1 mutations and provides a novel diagnostic strategy for STL1. By combining clinical manifestations with genetic testing, STL1 could be accurately diagnosed. With proper surgical treatment and long-term follow-up, the prognosis of RRD in patients with STL1 could be improved.

Vogt-Koyanagi-Harada Disease Presenting as Papillitis vs. Classic Serous Retinal Detachment: A Comparative Analysis of Outcomes

ABSTRACT Background To compare the treatment outcome and visual prognosis of Vogt-Koyanagi-Harada (VKH) disease presenting as papillitis vs. serous retinal detachment (SRD). Methods Retrospective comparative cohort study of 35 patients with previously unknown VKH diagnosis, followed-up for ≥6 months. Outcomes measured: (1) time to achieve inflammatory control; (2) VKH relapse; (3) ocular complications (glaucoma, sunset glow fundus, cataract, and vision loss ≥2 Snellen lines); and (4) chances for developing a chronic-recurrent disease. Results Females predominated in both groups: 12/16 (75%) papillitis and 18/19 (94.7%) SRD. The mean age at presentation was 29 ± 12 years in the papillitis and 36 ± 14 years in the SRD group (p = 0.119), with an overall median follow-up of 26 months (6–180 months). The papillitis-onset VKH group’s mean time elapsed between symptoms onset and initial treatment was shorter (2.9 ± 1.0 vs. 4.6 ± 2.8 weeks, p = 0.024). Anterior segment inflammation was lower (56% vs. 79%, p = 0.018), requiring a shorter corticosteroids treatment duration (12.8 ± 16.1 vs. 32.7 ± 34.1 months, p = 0.040), achieving an earlier inflammatory control (1.9 ± 0.6 vs. 4.1 ± 3.2 months, p <0.001) with fewer ocular complications (13% vs. 74%, p <0.001), including sunset glow fundus (SGF) (0% vs. 63%, p <0.001). Conversely, SRD-onset VKH was a risk factor for developing disease relapse (HR: 4.53; 95% CI: 1.31–15.69, p = 0.017), ocular complications (OR: 19.60, 95% CI: 3.24–118.50, p = 0.001), and chronic-recurrent disease (OR: 20.63; 95% CI: 2.24–189.84, p = 0.008). Conclusion Mexican-mestizo VKH patients with papillitis-onset VKH disease showed earlier inflammatory control, fewer recurrences, and better visual and ocular complication outcomes.

Pachychoroid as a Risk Factor for Exudative Retinal Detachment After Panretinal Photocoagulation: A Report of Two Cases

Pachychoroid as a Risk Factor for Exudative Retinal Detachment After Panretinal Photocoagulation: A Report of Two Cases

Association between ocular diseases and screen time and sedentary time derived from job-exposure matrices

After developing job-exposure matrices (JEMs) for screen and sedentary time, we aimed to assess the associations between the JEM-derived exposures and various ocular diseases. We collected data from patients hospitalized from 2005 to 2021. JEMs were developed from 41,718 patients with occupational information and screen and sedentary times. The adjusted means of screen and sedentary time were calculated for 143 occupational groups and categorized into three classes based on the tertiles. The associations between ocular diseases and these JEM-derived exposures were examined using multivariable conditional logistic regression for 727,589 patients. The odds ratios of the class with highest screen time were 1.05 (95% confidence interval, 1.01–1.09) for cataract, 1.24 (1.06–1.45) for primary open-angle glaucoma (POAG), 1.26 (1.06–1.49) for rhegmatogenous retinal detachment (RRD), 1.49 (1.26–1.76) for ptosis, and 0.39 (0.27–0.57) for pterygium. The odds ratios of the class with highest sedentary time were 1.05 (1.01–1.09) for cataract, 1.24 (1.05–1.46) for RRD, 1.68 (1.42–1.99) for ptosis, and 0.60 (0.42–0.84) for pterygium. Both screen and sedentary time were positively associated with cataract, RRD and ptosis. Interestingly, POAG had a positive association with only screen time. Please check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary."I have confirmed that the content is correct. No amendments are necessary.Please check article title if captured correctly."?>"I have confirmed that the content is correct. No amendments are necessary.

A study of metamorphopsia following rhegmatogenous retinal detachment surgery

AbstractPurposeOur objective was to quantitatively investigate metamorphopsia in patients who had undergone pars plana vitrectomy for rhegmatogenous retinal detachment at the Department of Ophthalmology of the University of Szeged. We aimed to compare our findings with perioperative clinical data, and in particular the patients' optical coherence tomography (OCT) results.Materials/MethodsOur study is a retrospective analysis of data from 23 patients who had undergone surgery for retinal detachment. We evaluated best corrected visual acuity (BCVA), metamorphopsia (MM) using M-CHARTS, and macular morphological abnormalities using OCT images in patients who attended regular follow-up visits 1–6 months after the surgery.ResultsThe mean preoperative BCVA of the patients was 0.4, while the mean postoperative BCVA was 0.6, indicating a significant improvement (P = 0.03). We observed a negative correlation between preoperative BCVA and postoperative MM (Pearson's r = −0.27), indicating that lower preoperative BCVA was associated with higher postoperative MM. Additionally, we noted a strong trend between disintegration of the ellipsoid zone (EZ), abnormality of the external limiting membrane (ELM), and MM (P = 0.051 and 0.072 respectively).ConclusionsWhile no significant correlation was found between MM and specific perioperative factors, we observed a notable trend between EZ disintegrity and MM, as well as abnormal ELM and MM. This trend is anticipated to become significant with higher numbers of patients.

Unveiling macular displacement: endotamponade variations in retinal detachment repair outcomes.

To compare the rates of macular displacement (MD) in patients with primary macula-off rhegmatogenous retinal detachments (RRD) who underwent pars plana vitrectomy (PPV) with either silicone-oil (SO) or perfluoropropane (C3F8) gas tamponade, and to investigate whether there is a correlation between MD and metamorphopsia. This retrospective comparative study included fifty-three patients with macula-off RRD who underwent a single 25-gauge PPV surgery. The patients were divided into two groups based on the endotamponade used during surgery: 14% C3F8 gas (n=28) or SO (n=25). Demographic information, preoperative, intraoperative, and postoperative characteristics were collected from medical records. Ophthalmological examinations were conducted, and data on various parameters, including perfluorocarbon liquid (PFCL) use, drainage retinotomy, MD rates, and presence of metamorphopsia, were assessed. PFCL was used in all cases, and no patient underwent drainage retinotomy. MD was detected in 18 eyes (64.2%) in the gas tamponade group and 9 eyes (36.0%) in the SO group, and the difference between the two groups was statistically significant (p=0.039). In both groups, 28 patients with suffered from metamorphopsia, but no significant correlation was found between MD and metamorphopsia in the gas group (p= 0.887). The study suggests that MD rates differ significantly between patients who underwent PPV with SO or C3F8 gas tamponade. Furthermore, while MD was observed in both groups, it may not always result in metamorphopsia in most patients after detachment surgery.

Outcomes, efficacy and risk factors of 27-Gauge vitrectomy for diabetic tractional retinal detachment in Japanese patients.

Diabetic retinopathy leads to vision-threatening complications, such as proliferative diabetic retinopathy and tractional retinal detachment (TRD) and is a major global health concern. Despite advancements in vitrectomy techniques, challenges exist in managing postoperative complications and long-term visual acuity. This study aimed to evaluate postoperative outcomes of 27-gauge pars plana vitrectomy (27g PPV) for diabetic TRD and identify associated risk factors. Retrospective study. This study included 94 eyes of 74 patients who underwent 27g PPV for diabetic TRD between July 2017 and September 2022 at Juntendo University Urayasu Hospital, Japan. Patient demographics, preoperative characteristics, intraoperative details, and postoperative outcomes were examined. Statistical analyses were performed to identify factors influencing postoperative visual acuity. Mean follow-up duration was 23.1 ± 14.6 months. Postoperatively, visual acuity (LogMAR) improved significantly from 1.34 ± 0.82 to 0.65 ± 0.79 (P < 0.0001). Postoperative complications included persistent vitreous hemorrhage (15%) and neovascular glaucoma (4%). Final retinal reattachment rate was 97%. Preoperatively, macular detachment (P < 0.0001) and Grade IV TRD (P < 0.0001) severity were significantly associated with poor final best corrected visual acuity (P < 0.0001). Preoperative macular detachment (P < 0.0001), Grade IV TRD (P < 0.0001), intraoperative iatrogenic breaks (P = 0.031), and postoperative neovascular glaucoma (P < 0.0001) were identified as significant predictors of poor postoperative visual outcomes through multivariate analysis. This study highlights the efficacy of 27g PPV in improving visual acuity in patients with diabetic TRD. Despite favorable outcomes, attention to preoperative risk factors and meticulous surgical techniques remain crucial for optimizing long-term visual prognosis in these patients.

Human amniotic membrane overlay grafting for large retinal breaks in eyes with recurrent retinal detachment

Human amniotic membrane overlay grafting for large retinal breaks in eyes with recurrent retinal detachment