A simple mathematical model of rhegmatogenous retinal detachment

2018 ◽  
Vol 82 ◽  
pp. 245-257 ◽  
Author(s):  
Damiano Natali ◽  
Rodolfo Repetto ◽  
Jennifer H. Tweedy ◽  
Tom H. Williamson ◽  
Jan O. Pralits
2014 ◽  
Vol 695 ◽  
pp. 544-547
Author(s):  
Zuhaila Ismail ◽  
Alistair Fitt ◽  
Colin Please

Scleral buckling is a surgical technique to treat rhegmatogenous retinal detachment (RRD). Vision may be affected by the scleral buckle. Since the buckle is pushed into the sclera towards the detached retina, it may change the shape and the focal length of the eyeball. A paradigm mathematical model of human eyeball is set up to examine how the focal length of the eye is affected under the action of the external force. In particular, this model has been developed using the membrane equations of equilibrium for axisymmetric spherical shells. Using numerical analysis the resulting displacements of the eyeball will be examined. The results of the scleral buckle may prove useful to predict changes in focal length.


2021 ◽  
Vol 14 (3) ◽  
pp. 7-16
Author(s):  
Igor V. Khizhnyak ◽  
Ernest V. Boiko ◽  
Yaroslav V Bayborodov

BACKGROUND: Despite significant advances in the technology of surgical treatment of regmatogenous retinal detachment, a certain proportion of patients with emerging macular edema against the background of silicone oil tamponade remains. AIM: To evaluate the risk factors of macular edema development and to work out a mathematical model for its prediction based on a retrospective analysis of clinical data of patients with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy. MATERIALS AND METHODS: A retrospective case series of 64 patients (64 eyes) with regmatogenous retinal detachment complicated by grade CP proliferative vitreoretinopathy who underwent primary retinal detachment repair. Patients were divided into two groups: with the presence of macular edema in the postoperative period and without it (32 patients in each group). In all cases, at the initial examination, retinal detachment involved the macular area. RESULTS: Using regression analysis, two significant factors were identified: the sum of the 8 meridians of the visual field before surgery (p=0.015) and the number of detached quadrants (p=0.021). Based on the identified factors, a model for predicting macular edema occurrence in the postoperative period in the surgical treatment of regmatogenous retinal detachment was obtained. CONCLUSIONS: The investigation results allowed establishing that the retinal detachment area and the sum of the 8 meridians of the visual field are significant pre-operative factors for macular edema development in retinal detachments with proliferative vitreoretinopathy of CP 1-2 degree. The developed mathematical model based on these indicators is characterized by significant information content and allows predicting macular edema occurrence in the postoperative period. The use of the proposed prognostic model determines a differentiated approach to surgical prevention of macular edema and allows making a decision on the removal of internal limiting membrane at the preoperative stage.


2021 ◽  
Vol 6 (6-1) ◽  
pp. 56-64
Author(s):  
E. V. Boiko ◽  
I. V. Khizhnyak

The aim: to develop a mathematical model for predicting macular edema based on the informativeness of clinical and instrumental predictors of its occurrence.Materials and methods. To determine the risk factors for macular edema 64 patients (64 eyes) with macula-off rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy (grade Cp 1–2) were selected. A retrospective analysis of the surgical treatment results was carried out. The age of the patients ranged from 30 to 81 years (28 women and 36 men).Results. Using regression analysis, two signifi cant factors were identifi ed: the sum of 8 meridians of the visual fi eld before surgery (p = 0.015) and the number of detached quadrants (p = 0.021). Based on the identifi ed factors, a model was obtained for predicting the occurrence of macular edema in the postoperative period for the patients with rhegmatogenous retinal detachment. Conclusion. Based on the analysis of clinical and instrumental indicators in patients with rhegmatogenous retinal detachment, a mathematical model has been developed that allows predicting the occurrence of macular edema in the postoperative period.The application of the proposed prediction model makes it possible to determine the tactics of treatment (peeling of internal limiting membrane) and predict the appearance of macular edema at the preoperative stage.


Author(s):  
А.V. Egorov ◽  
◽  
G.P. Smoliakova ◽  
V.V. Egorov ◽  
А.Y. Khudyakov ◽  
...  

Актуальность. Несмотря на высокую частоту прилегания сетчатки в результате эндовитреальной хирургии, острота зрения в 60% случаев остается низкой или улучшается незначительно. Цель. Оценка эффективности нейропротектора «Цитофлавин» в улучшении остроты зрения после эндовитреальной хирургии регматогенной отслойки сетчатки. Материал и методы. Основная группа наблюдения представлена 20 пациентами с низким зрительным прогнозом, которые получали препарат «Цитофлавин» в послеоперационном периоде (период тампонады силиконом и после удаления силикона). Контрольная группа наблюдения включала 20 человек с низким зрительным прогнозом, получавших стандартное лечение после операции. Критериями оценки эффективности проводимой терапии явились: МКОЗ, амплитуда прироста (АΔ), показателя микроциркуляции (ПМ, перф. ед.), индекса эффективности микроциркуляции (ИЭМ, отн. ед.) относительно исходных, рассчитанная по формуле. Результаты. Результаты исследования показали, что через 6 мес. после операции у пациентов основной группы по сравнению с контрольной МКОЗ выросла более чем в 2 раза (р<0,05). Также при терапии препаратом «Цитофлавин» отмечена более значимая активация хориоретинального кровотока. АΔ, ПМ и ИЭМ у пациентов основной группы исследования к 6 мес. после операции выросла в 2 раза и более (р<0,05), что подтверждает прямую зависимость зрительных функций от состояния и динамики восстановления хориоретинального кровотока. Выводы. При включении нейропротектора «Цитофлавин» в систему медицинской реабилитации пациентов с низким уровнем зрительного прогноза наблюдается повышение МКОЗ в 2 раза и улучшение циркуляторных показателей хориоретинального кровотока более чем в 2 раза.


Author(s):  
V.Y. Markevich ◽  
◽  
T.A. Imshenetskaya ◽  
O.A. Yarmak ◽  
◽  
...  

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.


Author(s):  
V.A. Zaika ◽  
◽  
A.P. Yakimov ◽  
D.V. Shabanov ◽  
A.G. Shchuko ◽  
...  

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