To investigate the usefulness of large relaxing retinectomies in the management of selected complicated retinal detachments. The charts of 25 consecutive patients who underwent large relaxing retinectomy during vitrectomy were reviewed. Penetrating injury(10 eyes) and chronic retinal detachment(11 eyes) were the leading etiologic diagnoses. 22 eyes showed extensive PVR, 14 of them had a PVR Grade C P 12 and 3 eyes had extensive vitreoretinal incarceration. Most eyes (22 eyes) had undergone one or more previous ocular procedures and four eyes were early phthisical preoperatively. Extended tamponade was achieved with either silicone oil(23 eyes) or C3F8 gas (2 eyes). Retinectomy size was larger than 180 degrees in 20 eyes, ranging from 90 degrees to 360 degrees. Total retinal reattachment was achieved in 15 eyes(60%) and subtotal attachment including the macula in 6 eyes(24%). 10 eyes(40%) achieved 5/200 or better. The size of retinectomy or etiologic diagnosis did not influence the anatomic results. Hypotony was seen in 3 eyes and corneal decompensation in 8 eyes. Large retinectomy in selected cases of vitreoretinal surgery seemed to be an effective procedure in eyes otherwise unsuccessful.
Diagnosis ; Humans ; Retinal Detachment* ; Retinaldehyde* ; Silicone Oils ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

To investigate the usefulness of large relaxing retinectomies in the management of selected complicated retinal detachments. The charts of 25 consecutive patients who underwent large relaxing retinectomy during vitrectomy were reviewed. Penetrating injury(10 eyes) and chronic retinal detachment(11 eyes) were the leading etiologic diagnoses. 22 eyes showed extensive PVR, 14 of them had a PVR Grade C P 12 and 3 eyes had extensive vitreoretinal incarceration. Most eyes (22 eyes) had undergone one or more previous ocular procedures and four eyes were early phthisical preoperatively. Extended tamponade was achieved with either silicone oil(23 eyes) or C3F8 gas (2 eyes). Retinectomy size was larger than 180 degrees in 20 eyes, ranging from 90 degrees to 360 degrees. Total retinal reattachment was achieved in 15 eyes(60%) and subtotal attachment including the macula in 6 eyes(24%). 10 eyes(40%) achieved 5/200 or better. The size of retinectomy or etiologic diagnosis did not influence the anatomic results. Hypotony was seen in 3 eyes and corneal decompensation in 8 eyes. Large retinectomy in selected cases of vitreoretinal surgery seemed to be an effective procedure in eyes otherwise unsuccessful.
Diagnosis ; Humans ; Retinal Detachment* ; Retinaldehyde* ; Silicone Oils ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

PURPOSE: To analyze retinal tears and to compare the clinical outcomes between retinal tear and rhegmatogenous retinal detachment (RRD) as the cause of dense non-diabetic vitreous hemorrhage in patients who underwent vitreoretinal surgery. METHODS: In a retrospective case series, the medical records of patients who presented dense non-diabetic vitreous hemorrhage and who underwent vitreoretinal surgery between January 2005 and June 2009 were reviewed. Among the 134 patients, 27 patients had dense vitreous hemorrhage caused by retinal tears. The first group had retinal tears only and the second group had accompanying RRD. A comparison of clinical features and postoperative prognoses between the two groups was performed. RESULTS: Among the 27 eyes with non-traumatic retinal tear and RRD, 18 were categorized into the retinal tear group and 9 to the RRD group. The demographic findings between the two studied groups exhibited no significant differences except for time between onset of symptoms and diagnosis. However, the time to diagnosis was significantly delayed in the group with RRD (22.67 +/- 37.47 days) compared to the retinal tear group (5.00 +/- 3.41 days) (p = 0.035). The amount of visual improvement was also greater in the retinal tear group than the RRD group (p = 0.002). CONCLUSIONS: Retinal tears are a major cause of non-diabetic vitreous hemorrhage. Vitreous hemorrhage caused by retinal detachment may result in delayed diagnosis and poor visual recovery. Therefore, early examinations in suspicion of RRD and appropriate treatments are needed in non-diabetic vitreous hemorrhage.
Delayed Diagnosis ; Eye ; Humans ; Medical Records ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Vitreoretinal Surgery ; Vitreous Hemorrhage

OBJECTIVETo explore the diagnosis, classification, and management of uveal effusion syndrome (UES).

METHODSThe clinical data of 10 patients diagnosed with UES in our hospital between 1990-2010 were extracted from hospital records and analyzed, including ophthalmologic examination, ophthalmologic ultrasonography, ultrasound biomicroscopy (UBM), fundus fluorescence angiography (FFA), indocyanine green (ICG) angiography, surgical procedures, and outcomes.

RESULTSThe fundus examination of all impacted eyes showed bullous retinal detachment shifting with head position, confirmed by ultrasonography revealing retinal and choroidal detachment. UBM showed annular peripheral ciliochoroidal detachment in all cases. FFA was performed in 5 patients and revealed leopard spots without leakage from choroid into subretinal space. ICG angiograpy was performed in 3 patients and demonstrated diffused granular marked hyperfluorescence in the choroidal fluorescence in the very early phase, which increased with time and persisted until the late phase. Four eyes of 2 patients underwent full-thickness sclerectomies and 1 eye of 1 patient underwent subscleral sclerectomy, all of whom achieved reattachment of the retina without recurrence during 1-year follow-up.

CONCLUSIONSComprehensive preoperative evaluation, including ophthalmologic ultrasonography, computed tomography, and magnetic resonance imaging, is crucial for accurate classification of UES and selection of proper management strategy. Surgical treatment can achieve optimal clinical outcomes for type 1 and type 2 UES.

Adult ; Choroid Diseases ; diagnosis ; surgery ; Exudates and Transudates ; Female ; Humans ; Male ; Middle Aged ; Retinal Detachment ; diagnosis ; surgery ; Retrospective Studies ; Syndrome

OBJECTIVEThis study aimed to review the available literature on vitreomacular traction (VMT) syndrome and propose the future study prospect in this field.

DATA SOURCESThe data used in this review were mainly obtained from articles listed in Medline and Pubmed (1970-2013). The search terms were "vitreomacular traction", "optical coherence tomography", "vitrectomy", and "ocriplasmin".

STUDY SELECTIONArticles regarding the pathophysiology, diagnosis, and treatments of VMT were selected and reviewed.

RESULTSVMT syndrome is a persistent attachment of vitreous to the macula in eyes with an incomplete posterior vitreous detachment and considered to be an uncommon status which correlated with some other macular disorders. Optical coherence tomography (OCT) can support a new way to examine and classify VMT. Nonoperative and operative intervenes on this disease have been developed recently, especially the intravitreal medical therapy.

CONCLUSIONSVMT syndrome may be associated with various disorders in the macular region, depending in part on the size and strength of the residual vitreomacular adhesion. Regular OCT monitoring is recommended to detect it. Patients with asymptomatic VMT should be observed for at least 2-3 months; nonoperative treatment with ocriplasmin should be considered when disorders persist; surgery is recommended if VMT-related disease is significant.

Eye Diseases ; diagnosis ; epidemiology ; surgery ; Humans ; Retinal Diseases ; diagnosis ; epidemiology ; surgery ; Risk Factors ; Tomography, Optical Coherence ; Vitreous Detachment ; diagnosis ; epidemiology ; surgery

Hereditary vitreous degeneration muddy is rare in clinic. Here we report ten cases (thirteen eyes) of hereditary vitreous degeneration muddy from two families. All patients presented with vitreous opacity, and the textures appeared tough and tensile. Two cases had concurrent detachment of rhegmatogenous retina. HE staining showed red changeableness, and methyl violet staining appeared purple. All patients received vitrectomy with traditional Chinese medicine treatment, and got satisfactory efficacy.
Eye Diseases, Hereditary ; diagnosis ; pathology ; surgery ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Retinal Detachment ; diagnosis ; surgery ; Vitrectomy ; Vitreous Body ; pathology ; surgery

PURPOSE: To describe early macular hole (MH) development in rhegmatogenous retinal detachment (RRD) after scleral buckling (SB) based on optical coherence tomography (OCT) findings. METHODS: The medical records and spectral domain OCT images of patients in whom MH developed after RRD repair were evaluated retrospectively. RESULTS: A postoperative MH was detected in five eyes that underwent SB during a 6-year period. All had fovea-off RRD without MH at the time of surgery. OCT showed partial loss of the inner retina with a preserved photoreceptor layer in early postoperative days. On average, 7 days (range,5 to 8 days) after surgery, outer retinal tissues disappeared, resulting in the full-thickness MH. CONCLUSIONS: Serial OCT findings revealed that partial-thickness lamellar holes progressed to full-thickness MHs, which were formed by the degeneration of the outer retina in eyes with preceding loss of the glial cone in the fovea.
Aged ; Humans ; Male ; Middle Aged ; *Postoperative Complications ; Retinal Detachment/*surgery ; Retinal Perforations/diagnosis/*etiology ; Retrospective Studies ; *Scleral Buckling ; Tomography, Optical Coherence

Adolescent ; Adult ; Aged ; Humans ; Middle Aged ; Pupil Disorders ; diagnosis ; etiology ; Refraction, Ocular ; Retina ; physiopathology ; Retinal Detachment ; surgery ; Scleral Buckling ; Visual Acuity ; Vitreoretinopathy, Proliferative ; surgery

We report a rare case of retinal detachment in colobomatous macrophthalmos with microcornea syndrome. A 25-year-old female who had suffered from poor vision in her left eye since early childhood and high myopia in her right eye (-11 D) visited our clinic because of a sudden deterioration of vision. Examination of the anterior segment showed microcornea with coloboma of the inferior pupil margin in the left iris. Fundus examination of the left eye revealed an inferior choroidal coloboma extending from the optic disc and macula. The patient also had total bullous retinal detachment. Pars plana vitrectomy with silicone oil tamponade was performed, and the retina was reattached. In the very rare condition of colobomatous macropthalmos with microcornea, retinal detachment may develop. Pars plana vitrectomy with additional silicone oil tamponade may be performed to treat this condition.
Adult ; Choroid/*abnormalities ; Coloboma/*complications/diagnosis ; Cornea/*abnormalities ; Female ; Follow-Up Studies ; Humans ; Retinal Detachment/diagnosis/*etiology/surgery ; Syndrome ; Vitrectomy/methods

PURPOSE: To report a case of bilateral bullous exudative retinal detachment in central serous chorioretinopathy (CSC) which was attached by vitrectomy and internal drainage of the subretinal fluid. METHODS: A 47-year-old man affected by bilateral atypical CSC with a bullous retinal detachment with subretinal exudate. A fluorescein angiogram (FAG) showed multiple points of leakage and staining of subretinal fibrosis. A tentative diagnosis of Vogt-Koyanagi-Harada (VKH) syndrome was made and the patient was treated with systemic corticosteroids and immunosuppressive agents. However, the subretinal fluid was not absorbed. He was then treated with vitrectomy and internal drainage of subretinal fluid. RESULTS: The retina was attached successfully in both eyes. Visual acuity improved to 20/50 in his left eye but did not improve in the right eye due to subretinal fibrotic scarring and atropic changes on the macula. CONCLUSIONS: Our case suggests that the surgical management of bullous exudative retinal detachment is safe and necessary.
*Vitrectomy ; Retinal Detachment/etiology/pathology/*surgery ; Middle Aged ; Male ; Humans ; Fundus Oculi ; Follow-Up Studies ; Fluorescein Angiography ; Exudates and Transudates ; Drainage/*methods ; Diagnosis, Differential ; Choroid Diseases/*complications/diagnosis