Changes in the scotopic electroretinogram (ERG) and oscillatory potentials (Ops) were examined in patients who had rhegmatogenous retinal detachment within 3 days before and also at regular intervals after a successful reattachment operation. Electroretinograms were recorded in 38 patients (age 10 to 62 years) for the recent 5 year period. The amplitudes of the scotopic a-wave and b-wave in the detached eye were significantly decreased compared to the fellow normal eye preoperatively. Statistically significant differences were found between the preoperative and the postoperative recordings of the diseased eye. However, postoperative interocular differences in the amplitude of the a-wave between the reattached and normal fellow eye were not statistically significant. The amplitudes of the a-wave and b-wave were inversely related to the extent of the retinal detachment area, the duration of the detachment, and the extent of the buckles that were applied. Significant interocular differences in the b/a wave amplitude ratio and the Ops amplitude were observed. These results strongly suggest that the retinal function, even after successful reattachment surgery, might be compromised mainly by an inner retinal malfunction rather than from a photoreceptor dysfunction.
Adolescent ; Adult ; Child ; *Electroretinography ; Human ; Middle Age ; Oscillometry ; Postoperative Period ; Retinal Detachment/etiology/*physiopathology/*surgery ; Retinal Perforations/*complications

A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole.
Adult ; Humans ; Male ; Myopia/*surgery ; Photorefractive Keratectomy/*adverse effects ; Retina/*pathology ; Retinal Perforations/diagnosis/*etiology ; Tomography, Optical Coherence ; *Visual Acuity

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

BACKGROUNDIt was well known that tangential vitreoretinal traction and epiretinal membrane play important roles during the formation of macular hole (MH) associated with retinal detachment (RD) in highly myopic eyes. But it was not clear about the correlations between anteroposterior traction, posterior vitreous cortex (PVC) and MH-RD. The vitreous status in highly myopic eyes were analyzed to explore the effect of PVC in the role of MH-RD formation.

METHODSSixteen consecutive highly myopic eyes with RD due to MH were retrospectively analyzed from January 2009 to April 2009. The preoperative examinations for detecting posterior vitreous detachment (PVD) and vitreoretinal traction included B-mode ultrasonography and optical coherence tomography (OCT). The residual PVC and PVD were confirmed intraoperatively during triamcinolone acetonide (TA) assisted vitrectomy.

RESULTSUnder ultrasonography, the preoperative PVD patterns were stratified as: complete PVD in three (19%) eyes, partial PVD in eight (50%) eyes, and no PVD in five (31%) eyes. OCT confirmed vitreoretinal traction and no complete PVD in 10 (63%) eyes, including anteroposterior traction in four eyes and tangential traction in six eyes. During TA-assisted vitrectomy, it was confirmed that no complete PVD existed in 16 eyes, including six eyes (38%) finally diagnosed of partial PVD, and five (31%) eyes with vitreoschisis. Anteroposterior vitreoretinal traction around MH is always in conjunction with partial PVD (67%), and high proportion (80%) of vitreoschisis is associated with tangential vitreoretinal traction. Comparing with the precision of TA staining of PVD diagnosis, the coincidence rate of ultrasonography was 69% (P = 0.02), and that of OCT was 63% (P < 0.01).

CONCLUSIONSThe residual PVC due to partial PVD or vitreoschisis may cause the anteroposterior or tangential traction of macular area, which contributes to the formation of MH and subsequent RD in highly myopic eyes. And it is necessary to realize the vitreoretinal relationship and assess the status of PVC synthetically for surgery by combined ultrasonography and OCT preoperatively and TA staining intraoperatively.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Myopia ; physiopathology ; Retinal Detachment ; physiopathology ; Retinal Perforations ; etiology ; Retrospective Studies ; Vitreous Detachment ; physiopathology

Examination of a 36-year-old man with naked visual acuity of 20/20 revealed a floating, conspicuous cyst of Cysticercus cellulosae in the vitreous cavity of the right eye. A vitreous traction band from the vitreous base and the optic disc was connected to the lodging bulb of the cyst. In the superonasal area, an ovoid retinal break surrounded by a white retinal lesion with two elliptical retinal hemorrhages was found, and this seems to be the previous lodging site of the cyst. A pars plana vitrectomy was performed to remove the parasite, and laser photocoagulation was carried out around the retinal break. Four months after the operation, the patient was satisfied with naked visual acuity of 25/20 without any complication in the affected eye.
Adult ; Animals ; Cysticercosis/*diagnosis/physiopathology/surgery ; Cysticercus/*isolation & purification ; Eye Diseases/diagnosis ; Eye Infections, Parasitic/*diagnosis/physiopathology/surgery ; Humans ; Laser Coagulation ; Male ; Retinal Hemorrhage/etiology/surgery ; Retinal Perforations/etiology/surgery ; Visual Acuity ; Vitrectomy ; Vitreous Body/*parasitology/surgery

PURPOSE: Choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD) is a rare, but serious condition, which makes the prognosis worse. Previously reported risk factors for CD in RRD patients include high myopia, aphakia, pseudophakia, and advanced age. However, macular hole has not been discussed as an important factor in increasing the risk of CD in RRD patients. The purpose of this study was to evaluate macular hole as a risk factor for CD in eyes evidencing RRD. METHODS: The medical records of 480 patients with primary RRD were reviewed. We compared the CD incidence among the RRD patients in accordance with the presence or absence of macular holes. The relationship between gender, age, presence of systemic disease, refractive errors, lens status, intraocular pressure and the development of CD were also analyzed. RESULTS: The incidence (4/21 eyes, 19.0%) of CD in the RRD with macular hole was significantly higher than that (7/459 eyes, 1.5%) observed in the RRD without macular hole (p=0.010). The preoperative intraocular pressure (mean+/-SD; 2.5+/-1.3 mmHg) in the RRD with CD and macular hole was significantly lower than that (7.4+/-4.4 mmHg) observed in the cases of RRD with CD without macular hole (p=0.035). The eyes complicated by CD evidenced a higher prevalence of diabetes mellitus (p=0.024) than was observed in the eyes without CD. CONCLUSIONS: The retinal detachment combined with macular hole creates a predisposition toward the development of profound hypotony and CD.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Choroid Diseases/*etiology ; Female ; Humans ; Incidence ; Intraocular Pressure ; Male ; Middle Aged ; Ocular Hypotension/etiology ; Retinal Detachment/*complications ; Retinal Perforations/*complications ; Risk Factors ; Rupture, Spontaneous

PURPOSE: To report a case of retinal detachment with a macular hole following photodynamic therapy (PDT) using verteporfin and intravtreal bevacizumab injection in the treatment of myopic choroidal neovasclarization (CNV). METHODS: A 58 -year-old woman was diagnosed with myopic CNV and treated with a combination of PDT with verteporfin and intravitreal bevacizumab injection that same day. She received the second injection of intravitreal bevacizumab four weeks after the initial treatment. RESULTS: The patient developed a sudden decline in vision one week after the second injection; and was subsequently diagnosed with retinal detachment associated with a macular hole. She underwent standard three-port pars plana vitrectomy with internal limiting membrane peeling, fluid-air exchange and silicone oil injection. The retina was still firmly attached at the patient's final follow-up visit. CONCLUSIONS: PDT and intravitreal bevacizumab injection used for the treatment of myopic CNV can be associated with retinal detachment with a macular hole. Patients need to be informed about this potential complication, and a higher index of suspicion may be warranted in patients who report sudden vision loss after the treatment.
Angiogenesis Inhibitors/administration & dosage/*adverse effects/therapeutic use ; Antibodies, Monoclonal/administration & dosage/*adverse effects/therapeutic use ; Choroidal Neovascularization/*drug therapy ; Female ; Humans ; Injections ; Middle Aged ; Photochemotherapy/*adverse effects ; Retinal Detachment/*etiology ; Retinal Perforations/*etiology ; Vitreous Body

We report a case of complete surgical resolution of Valsalva retinopathy that manifested as a premacular hemorrhage involving a membrane followed by a macular hole (MH) resulting from the first vitrectomy. A 20-year-old female patient was referred to our hospital due to sudden vision loss in the left eye. Her best-corrected visual acuity (BCVA) in the left eye was hand motion. Fundus photographs and optical coherence tomography (OCT) revealed a premacular hemorrhage. Nine weeks later, the BCVA in the left eye had returned to 20 / 100 and the premacular hemorrhage had completely resolved, but residual sub-internal limiting membrane deposits and a preretinal membrane were present. The preretinal membrane was removed by core vitrectomy and preretinal membrane peeling, but the foveal deposits could not be excised. Two weeks after the first vitrectomy, the deposits resolved spontaneously, but a full-thickness MH was present. Six months after a second vitrectomy with fluid-gas exchange, the BCVA in the left eye had improved to 20 / 25 and OCT showed that the MH had closed. This case illustrates the possibility of MH formation following vitrectomy for Valsalva retinopathy.
Epiretinal Membrane/diagnosis/*surgery ; Female ; Humans ; *Postoperative Complications ; Retinal Perforations/diagnosis/etiology/*surgery ; Tomography, Optical Coherence ; Vitrectomy/*adverse effects ; Young Adult

We report a case of complete surgical resolution of Valsalva retinopathy that manifested as a premacular hemorrhage involving a membrane followed by a macular hole (MH) resulting from the first vitrectomy. A 20-year-old female patient was referred to our hospital due to sudden vision loss in the left eye. Her best-corrected visual acuity (BCVA) in the left eye was hand motion. Fundus photographs and optical coherence tomography (OCT) revealed a premacular hemorrhage. Nine weeks later, the BCVA in the left eye had returned to 20 / 100 and the premacular hemorrhage had completely resolved, but residual sub-internal limiting membrane deposits and a preretinal membrane were present. The preretinal membrane was removed by core vitrectomy and preretinal membrane peeling, but the foveal deposits could not be excised. Two weeks after the first vitrectomy, the deposits resolved spontaneously, but a full-thickness MH was present. Six months after a second vitrectomy with fluid-gas exchange, the BCVA in the left eye had improved to 20 / 25 and OCT showed that the MH had closed. This case illustrates the possibility of MH formation following vitrectomy for Valsalva retinopathy.
Epiretinal Membrane/diagnosis/*surgery ; Female ; Humans ; *Postoperative Complications ; Retinal Perforations/diagnosis/etiology/*surgery ; Tomography, Optical Coherence ; Vitrectomy/*adverse effects ; Young Adult

The purpose of this study was to evaluate the anatomical outcomes of vitrectomy with internal limiting membrane removal in highly myopic eyes with retinal detachment caused by a macular hole. Nineteen, consecutive, highly myopic eyes with full thickness macular hole with retinal detachment were treated by vitrectomy with internal limiting membrane removal, endolaser photocoagulation on the center of the hole and fluid gas exchange. In five eyes with other peripheral breaks, scleral buckling (3 cases), encircling (1 case) and barrier laser (1 case) were combined. In 15 eyes (79.0%) the macular hole was closed after the initial surgery. In 4 eyes (21%) the macular hole was reopened, but these were successfully treated with fluid gas exchange (1 case) or macular buckling (3 cases). The visual acuity was improved in 15 eyes (79.0%). In conclusion, these results suggest that the removal of the perifoveal internal limiting membrane may be an important adjuvant in the treatment of the myopic macular hole with retinal detachment.
Adult ; Aged ; Aged, 80 and over ; Basement Membrane/surgery ; Comparative Study ; Female ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Myopia, Degenerative/*complications ; Retinal Detachment/etiology/*surgery ; Retinal Perforations/*complications ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity ; Vitrectomy/*methods