Humans ; Panuveitis/etiology* ; Retinal Detachment/etiology* ; Typhoid Fever/diagnosis* ; Visual Acuity

PURPOSE: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) is the first choice of treatment for age-related macular degeneration. However, quite a few eyes treated using conventional dose anti-VEGF (CDAV) have persistent pigment epithelial detachment (PED) on optical coherence tomography. This study investigated the efficacy and safety of high dose anti-VEGF (HDAV) for refractory PED. METHODS: In this retrospective study, 31 eyes of neovascular age-related macular degeneration patients with persistent PED findings despite six or more intravitreal injections of CDAV (bevacizumab 1.25 mg or ranibizumab 2.5 mg) were analyzed. Changes in visual outcome, central foveal thickness, and PED height were compared before and after HDAV (bevacizumab 5.0 mg) for these refractory PED cases. RESULTS: The mean age of patients was 67.7 years. The number of CDAV injections was 12.1. The number of HDAV injections was 3.39. Best-corrected visual acuity in logarithm of the minimum angle of resolution before and after HDAV was 0.49 and 0.41 (p < 0.001), respectively. Central foveal thickness before and after HDAV was 330.06 and 311.10 µm (p = 0.125), respectively. PED height before and after HDAV was 230.28 and 204.07 µm (p = 0.014), respectively. There were no serious adverse reactions in all the eyes. CONCLUSIONS: Increasing the dose of bevacizumab in refractory PED may be a possible treatment option.
Aged ; Angiogenesis Inhibitors/administration & dosage ; Bevacizumab/*administration & dosage ; Dose-Response Relationship, Drug ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Intravitreal Injections ; Macular Degeneration/*complications/diagnosis/drug therapy ; Male ; Middle Aged ; Retinal Detachment/diagnosis/*drug therapy/etiology ; Retinal Pigment Epithelium/*diagnostic imaging/drug effects ; Retrospective Studies ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors

No abstract available.
Choroid/pathology ; Humans ; Male ; Middle Aged ; Ophthalmia, Sympathetic/*etiology/pathology ; Retina/pathology ; Retinal Detachment/surgery ; Vitrectomy/*adverse effects

No abstract available.
Choroid/pathology ; Humans ; Male ; Middle Aged ; Ophthalmia, Sympathetic/*etiology/pathology ; Retina/pathology ; Retinal Detachment/surgery ; Vitrectomy/*adverse effects

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 is very common for professional divers to have damage on the retinas. Severe retinal lesions can profoundly affect athletes' training efficacy and their daily lives. At present, it is not clear if there is effective preventive action. Thus, in our study, we continuously tracked the ocular changes in athletes and closely monitored the risk factors associated with retinal detachment. Also, we analyzed possible interventions, their associated factors, and efficacies for timely preventions to protect the retina from damage in professional divers.

METHODSBetween 2009 and 2012, a total of 39 professional divers enrolled in follow-up management. The conducted examinations included ocular examination, record screening on retinal lesion, monitoring best-corrected visual acuity, and checking intraocular pressure (IOP) and the scope of retinal lesion. The management included optimizing training methods, taking customized follow-up based on different retinal lesions, laser treatments for definite cases of retinal tear, retinal degeneration caused by retinal layer thinning or vitreous traction, and observing the changes in the scope of retinopathy.

RESULTSEvery year, the percentage of divers who have various degrees of retinal lesions is between 43.3% and 56.2%. During the 4 years, there were no statistically significant differences in divers' best-corrected visual acuity and retinal lesions. There were also no statistically significant differences between male and female athletes. However, there were statistically significant differences in IOP during these years. Moreover there were statistically significant differences in IOP and the scope of retinal lesions between platform divers and springboard divers.

CONCLUSIONSOur management of retinal lesions could be effective to prevent severe retinopathy in professional divers. At the same time, platform divers are more likely to have retinal lesions than springboard divers.

Adolescent ; Diving ; injuries ; Female ; Humans ; Male ; Retina ; pathology ; Retinal Detachment ; etiology ; Retinal Diseases ; therapy

No abstract available.
Angiogenesis Inhibitors/*therapeutic use ; Bevacizumab/*therapeutic use ; Choroid/*blood supply ; Ciliary Arteries/pathology ; Fluorescein Angiography ; Humans ; Intravitreal Injections ; Ischemia/*drug therapy/etiology/physiopathology ; Male ; Meningeal Neoplasms/surgery ; Meningioma/surgery ; Neurosurgical Procedures/*adverse effects ; Retinal Detachment/*drug therapy/etiology/physiopathology ; Subretinal Fluid ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology ; Young Adult

This retrospective observational case series on eyes from three patients was done to elucidate the developmental mechanism of spontaneous reattachment of rhegmatogenous retinal detachment (SRRRD). The study eyes of each patients showed evidence of retinal break and diffuse retinal pigmentary change. Ultrasound biomicroscopic examination revealed vitreous fibers attached to the area around the retinal break. Posterior vitreous attachment was confirmed in each eye. A thin fibrovascular membrane incompletely sealing the retinal break was noted in one case. We suggest that the vitreous attachment around the retinal break and the sealing of the break with adjacent vitreous fibers seem to be involved in the developmental mechanism of SRRRD.
Adult ; Atrophy ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Remission, Spontaneous ; Retina/*abnormalities/pathology/*physiopathology ; Retinal Detachment/*etiology/pathology/*physiopathology ; Retinal Pigment Epithelium/abnormalities/pathology/physiopathology ; Retrospective Studies ; Vitreous Body/abnormalities/pathology/physiopathology ; Young Adult

INTRODUCTIONThis study aims to report the safety and effi cacy of the combined use of 70% Densiron®-68 and 30% polydimethysiloxane as a temporary vitreous substitute after pars plana vitrectomy (PPV) in selected cases of retinal detachment with superior and inferior retinal breaks.

MATERIAL AND METHODSFifty consecutive eyes of 50 patients affected by complicated retinal detachment with retinal breaks of the superior and inferior quadrants associated with proliferative vitreoretinopathy (PVR) of grade C2 or more, underwent a pars plana vitrectomy and a combination internal tamponade with 70% Densiron®-68 and 30% silicone oil. The main outcome measures were visual acuity, retinal attachment, intraocular pressure (IOP) and incidence of complications.

RESULTSThe mean best-corrected visual acuity rose from 1.4 logMAR to 0.7 logMAR (P <0.01). Initial retinal reattachment was achieved in 48 (96%) patients. In 15 patients (30%), IOP increased over 21 mmHg. The main complications were redetachment at the 3 month follow-up in 12/48 cases (25%) and cataract formation in 13/21 phakic eyes (62%).

CONCLUSIONThis combination tamponade comprised lighter and heavier oil compounds was well tolerated and effective. It may be a useful tool for the treatment of retinal detachment complicated with breaks and PVR involving the upper and lower quadrants.

Aged ; Aged, 80 and over ; Combined Modality Therapy ; Dimethylpolysiloxanes ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Recurrence ; Retinal Detachment ; etiology ; pathology ; therapy ; Retrospective Studies ; Silicone Oils ; therapeutic use ; Therapeutic Occlusion ; methods ; Treatment Outcome ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative ; complications

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