Vitreoretinal Disease

The purpose of this study was to analyze the association between plasma metabolite levels and dark adaptation (DA) in age-related macular degeneration (AMD). This was a cross-sectional study including patients with AMD (early, intermediate, and late) and control subjects older than 50 years without any vitreoretinal disease. Fasting blood samples were collected and used for metabolomic profiling with ultra-performance liquid chromatography–mass spectrometry (LC-MS). Patients were also tested with the AdaptDx (MacuLogix, Middletown, PA, USA) DA extended protocol (20 min). Two measures of dark adaptation were calculated and used: rod-intercept time (RIT) and area under the dark adaptation curve (AUDAC). Associations between dark adaption and metabolite levels were tested using multilevel mixed-effects linear modelling, adjusting for age, gender, body mass index (BMI), smoking, race, AMD stage, and Age-Related Eye Disease Study (AREDS) formulation supplementation. We included a total of 71 subjects: 53 with AMD (13 early AMD, 31 intermediate AMD, and 9 late AMD) and 18 controls. Our results revealed that fatty acid-related lipids and amino acids related to glutamate and leucine, isoleucine and valine metabolism were associated with RIT (p < 0.01). Similar results were found when AUDAC was used as the outcome. Fatty acid-related lipids and amino acids are associated with DA, thus suggesting that oxidative stress and mitochondrial dysfunction likely play a role in AMD and visual impairment in this condition.

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Clinical Pathways in Vitreoretinal Disease

Archives of Ophthalmology ◽

10.1001/archopht.122.5.796 ◽

2004 ◽

Vol 122 (5) ◽

pp. 796

Keyword(s):

Clinical Pathways ◽

Vitreoretinal Disease

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Vitreoretinal Disease

Archives of Ophthalmology ◽

10.1001/archopht.1979.01020020297028 ◽

1979 ◽

Vol 97 (9) ◽

pp. 1769-1769

Author(s):

T. A. Weingeist

Keyword(s):

Vitreoretinal Disease

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Impact of Long-Distance Travel on Rhegmatogenous Retinal Detachment Presentation and Outcome in Rural North Dakota

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419854282 ◽

2019 ◽

Vol 3 (4) ◽

pp. 229-234

Author(s):

David Jacobs ◽

Robert Gokey ◽

James R. Beal

Keyword(s):

Retinal Detachment ◽

North Dakota ◽

Rural Areas ◽

Rhegmatogenous Retinal Detachment ◽

Long Distance ◽

Duration Of Symptoms ◽

Vitreoretinal Disease ◽

Distance Travel ◽

Long Distance Travel ◽

Delay In Treatment

Purpose: Long-distance travel in underserved, rural areas could delay treatment of rhegmatogenous retinal detachment (RRD). The purpose of this study was to determine whether patients living remotely experienced a delay in treatment, presented with more-advanced RRD, or had worse visual acuity (VA) outcomes than patients living locally. Methods: A retrospective consecutive case series is presented of patients undergoing RRD repair by pars plana vitrectomy or scleral buckle from August 2011 to September 2014 in Minot, North Dakota, USA. Exclusion criteria were RRD cases presenting with concurrent vitreoretinal disease. Results: Of the 143 total patients, 45 lived locally, 5.2±1.6 miles (8.4±2.6 km), and 98 lived remotely, 122.8±69 miles (197.6±111 km). Duration of symptoms was 14.0±30.2 days for local and 19.2±37.5 days for remote patients ( P = .42). Time from referring provider exam to vitreoretinal surgeon exam was similar for local and remote patients, 1.5±2.9 vs 1.5±2.8 days ( P = .97). The fovea was detached in 51.1% of local and 53.6% of remote patients ( P = .78). Mean clock-hours of RRD were similar in local and remote patients, 5.2±2.3 vs 5.5±2.6 hours ( P = .51). Proliferative vitreoretinopathy was present in 6.7% of local vs 14.4% of remote patients ( P = .19). Time from vitreoretinal surgeon exam to surgical repair was similar for local and remote patients, 1.8±3.4 vs 1.8±3.8 days ( P = .70). The mean logMAR VA change at 6 months was similar in local and remote patients, –0.54±.7 vs –0.52±.8 ( P = .91). Reoperation was required in 4.4% of local vs 6.1% of remote patients ( P = .69). Conclusions: Patients traveling long distances for management of RRD did not experience a significant delay in treatment, present with more-advanced RRD, or have worse VA outcomes than patients who lived locally. Patients with RRD living in remote rural areas can have similar outcomes to patients living locally when referred and treated urgently.

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Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery for the Treatment of Vitreoretinal Disease: A Systematic Review and Meta-Analysis

Journal of Ophthalmology ◽

10.1155/2020/6149692 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Jinlan Ma ◽

Qing Wang ◽

Haoyu Niu

Keyword(s):

Systematic Review ◽

Postoperative Complications ◽

Meta Analysis ◽

Operation Time ◽

Vitreoretinal Disease ◽

Subgroup Analyses ◽

Microincision Vitrectomy Surgery ◽

Anatomical Success ◽

Vitrectomy Surgery ◽

Anatomical Success Rate

Background. We performed a systematic review and meta-analysis to evaluate the safety and effectiveness of 27-gauge (27-G) microincision vitrectomy surgery (MIVS) compared with 25-guage (25-G) MIVS for the treatment of vitreoretinal disease. Methods. A systematic electronic search was conducted in March 2020 in PubMed, Embase, and the Cochrane library. Eligible criteria for including studies were controlled trials comparing 27-G vitrectomy with 25-G vitrectomy in patients with vitreoretinal disease. The main outcomes included operation time; best corrected visual acuity (BCVA) in logMAR; postoperative intraocular pressure (IOP); primary anatomical success rate for rhegmatogenous retinal detachment (RRD) cases and postoperative central macular thickness (CMT) for idiopathic epiretinal membrane (ERM) cases; intraoperative/postoperative complications. Odds ratio (OR) and mean difference (MD) were synthesized under fixed or random effects models. Results. Eleven studies enrolling 940 eyes were identified. Among those 11 studies, six studies were on the treatment of RRD and five studies were on the treatment of ERM, so subgroup analyses were conducted. The total pooled results indicated that 27-G surgery system had obvious advantages in improving BCVA at six months after the vitrectomy (P = 0.004) and reducing intraoperative/postoperative complications (P = 0.03). However, the mean operation time was significantly longer by three minutes for 27-G compared with 25-G vitrectomy (P = 0.002). In subgroup analyses, for the treatment of ERM cases, 27-G group was associated with less complications and longer operation time. However, for the treatment of RRD cases, 27-G groups and 25-G groups were comparable in operation time, postoperative BCVA, postoperative IOP, and primary anatomical success rate. Conclusions. This meta-analysis confirmed that 27-G MIVS was an effective and safe surgical system compared with 25-G MIVS for the treatment of RRD and ERM cases, even though 27-G system needs a longer surgical time.

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Causes of Enucleation: A Clinicopathological Study

European Journal of Ophthalmology ◽

10.1177/112067219700700304 ◽

1997 ◽

Vol 7 (3) ◽

pp. 223-228 ◽

Cited By ~ 11

Author(s):

I. Günalp ◽

K. Gündüz ◽

M. Özkan

Keyword(s):

Malignant Tumors ◽

Vitreoretinal Surgery ◽

Antimicrobial Treatment ◽

Invasive Treatment ◽

Corneal Disease ◽

Non Invasive ◽

Vitreoretinal Disease ◽

Underlying Causes ◽

Vitreoretinal Diseases ◽

End Stage

Background. Enucleation is an approach used for unresponsive end-stage ocular disease often resulting in blind, painful or cosmetically unacceptable eyes. Methods. We reviewed the clinicopathological data on 3506 enucleations performed over a 50-year period, 1945-1995. Histopathological data were divided into eight groups according to the causes leading to enucleation: trauma, phthisis, corneal disease, inflammation, vitreoretinal disease, glaucoma, tumors and infections. Results. The study considered 3506 enucleated eyes of 3482 patients, 2467 (70.8%) males and 1011 (29.1%) females (4 sex unspecified). The z-test showed there were significantly more enucleations in males for phthisis (p<5.05), infections (p<0.01), trauma (p<0.01) and inflammation (p<0.01) and more enucleations for tumors in females (p<0.01). There were no differences between males and females with regard to enucleations for glaucoma, vitreoretinal and corneal diseases (p>0.05). The 0–9 years age group was most frequently affected, accounting for 29.7% of the cases. Patients aged less than 30 years constituted 53.6% of all enucleations. The primary or underlying causes leading to enucleation were tumors (1185 eyes, 33.8%), phthisis (587 eyes, 16.7), glaucoma (561 eyes, 16.0%), vitreoretinal diseases (320 eyes, 9.1%), infections (259 eyes, 7.4%), corneal disease (229 eyes, 6.5%), trauma (209 eyes, 6.0%) and inflammation (156 eyes, 4.4%). Time trends in enucleating eyes with different causes showed the number of enucleations for phthisis, infections, corneal diseases, trauma and inflammations had dropped during the ten-year period 1986–1995 compared to 1976–1985 (z-test, p<0.01). There were no real changes in enucleations for glaucoma and vitreoretinal diseases and there was an increase in the number of enucleations for tumors (p<0.01). Conclusions. Improved diagnostic and therapeutic methods, widespread use of photocoagulation in vascular disorders and vitreoretinal surgery in traumas, effective antimicrobial treatment, increasing use of corticosteroids and immunosuppressants, have contributed to the decreasing frequency of enucleation. Tumor patients generally presented late with advanced tumors totally filling the eye, not salvageable by other non-invasive treatment methods. Prompt diagnosis of intraocular malignant tumors (retinoblastoma and malignant melanoma) may reduce the need for enucleation.

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