Brachytherapy for Peripheral Retinal Capillary Haemangioblastoma in von Hippel-Lindau Disease

2021 ◽  
Vol 238 (07) ◽  
pp. 781-787
Author(s):  
Sami Dalbah ◽  
Nikolaos E. Bechrakis ◽  
Henning Thomasen ◽  
Dirk Flühs ◽  
Philipp Rating ◽  
...  
Keyword(s):  
Macular Oedema ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Complication Rates ◽  
Retrospective Case ◽  
Tumour Control ◽  
Von Hippel Lindau ◽  
Retinal Capillary ◽  
Von Hippel Lindau Disease ◽  
Epiretinal Gliosis

Abstract Aim To report our experience with 106ruthenium-brachytherapy of peripheral capillary haemangioblastomas in patients with von Hippel-Lindau disease. Design Retrospective case series. Methods A total of 53 haemangioblastomas, treated with 106ruthenium-brachytherapy, were included in our study. The applied radiation dose, visual outcome, angioma activity, need for vitreoretinal surgery and incidence of secondary complications such as macular oedema, secondary glaucoma, vitreous haemorrhage, and epiretinal gliosis were assessed. Results All treated eyes could be preserved. In 11 patients (20.8%), single brachytherapy did not achieve complete inactivation of the tumour. 31% developed macular oedema postoperatively. Tractional retinal detachment developed in 23.8%, and epiretinal gliosis was observed in 2.4% of patients. Vitreoretinal surgery was necessary in 50% of all treated eyes. At the end of the follow-up, 40.5% of all treated eyes achieved visual acuity (VA) of 0.6 or better, and one third reached a VA of less than 0.1. Mean irradiation dose to the tumour apex was 144 Gy. Higher apex doses correlated with better tumour control of irradiated haemanigoblastomas and lower complication rates. Conclusions Brachytherapy of peripheral retinal capillary haemangioblastomas is an effective treatment modality. Higher irradiation doses seem to lead to more successful treatment.

Vitreoretinal Surgery for Severe Retinal Capillary Hemangiomas in Von Hippel–Lindau Disease

Ophthalmology ◽  
2011 ◽  
Vol 118 (1) ◽  
pp. 142-149 ◽  
Author(s):  
Alain Gaudric ◽  
Valérie Krivosic ◽  
Graham Duguid ◽  
Pascale Massin ◽  
Sophie Giraud ◽  
...  
Keyword(s):  
Vitreoretinal Surgery ◽  
Von Hippel Lindau ◽  
Retinal Capillary ◽  
Von Hippel Lindau Disease

scholarly journals A family with Von Hippel-Lindau disease with different presentations

1970 ◽  
Vol 14 (1) ◽  
pp. 17-24
Author(s):  
Ching-lin Wong ◽  
Ming-Yueh Lee ◽  
R. Sunder ◽  
R. Jamalia ◽  
T.V.N. Karunakar ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Laser Photocoagulation ◽  
Case Series ◽  
Capillary Hemangioma ◽  
Exudative Retinal Detachment ◽  
Fundus Examination ◽  
Von Hippel Lindau ◽  
Retinal Capillary ◽  
Von Hippel Lindau Disease ◽  
Retinal Capillary Hemangioma

Objective: To report three cases of Von Hippel-Lindau (VHL) disease from a family with different presentations.Method: Case series.Results: Case 1, a 14-year-old Malay boy with a history of gradual blurring of vision in both eyes presented with sudden deterioration of right vision. Fundus examination revealed bilateral retinal capillary hemangioma with exudative retinal detachment. His right eye underwent combination therapy of laser photocoagulation, cryotherapy, intravitreal anti-VEGF and photodynamic therapy, but failed to improve vision. His left visiondeteriorated and eventually required surgical intervention. Case 2 was the sister of case 1. She was a 17-year-old Malay girl who presented with sudden onset of left eye pain and redness. Diagnosis of left eye rubeotic glaucoma with closed funnel retinal detachment secondary to a huge retinal hemangioma was made. She underwent left eye external drainage of subretinal fluid plus anterior retinal cryopexy. The rubeotic vessel regressed postoperatively and IOP reduced. Case 3 was the eldest sister of case 1; a 19-year-old Malay girl who came for eye screening after two of her siblings were diagnosed with VHL. She was, however, asymptomatic. Fundus examination revealed right retinal capillary hemangioma. She was treated with laser photocoagulation and her condition remained stable. Systemic investigations identified midline cystic masses in the brain, spine and pancreas. Conclusions: This case series highlight different clinical pictures of Von Hippel-Lindau disease. As marked visual loss is a dreadful sequela of VHL, it is important to screen the family members as early detection and management of ocular and systemic lesions save sight and life.

scholarly journals Case series of retinal capillary hemangioma in patients with and without von hippel lindau disease

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Nor Syahira Shariffudin ◽  
Azian Adnan ◽  
Hanizasurana Hashim ◽  
Khairy Shamel Sonny Teo
Keyword(s):  
Case Series ◽  
Capillary Hemangioma ◽  
Von Hippel Lindau ◽  
Retinal Capillary ◽  
Von Hippel Lindau Disease ◽  
Retinal Capillary Hemangioma

scholarly journals Complications and Revisions After Spine Surgery in Patients With Skeletal Dysplasia: Have We Improved?

2021 ◽  
pp. 219256822199478
Author(s):  
Karim Shafi ◽  
Francis Lovecchio ◽  
Maria Sava ◽  
Michael Steinhaus ◽  
Andre Samuel ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Skeletal Dysplasia ◽  
Spinal Surgery ◽  
Cardiovascular Health ◽  
Surgical Complication ◽  
Case Series ◽  
Neurologic Complication ◽  
Complication Rates ◽  
Retrospective Case ◽  
Average Patient

Study Design: Retrospective case series. Objective: To report contemporary rates of complications and subsequent surgery after spinal surgery in patients with skeletal dysplasia. Methods: A case series of 25 consecutive patients who underwent spinal surgery between 2007 and 2017 were identified from a single institution’s skeletal dysplasia registry. Patient demographics, medical history, surgical indication, complications, and subsequent surgeries (revisions, extension to adjacent levels, or for pathology at a non-contiguous level) were collected. Charlson comorbidity indices were calculated as a composite measure of overall health. Results: Achondroplasia was the most common skeletal dysplasia (76%) followed by spondyloepiphyseal dysplasia (20%); 1 patient had diastrophic dysplasia (4%). Average patient age was 53.2 ± 14.7 years and most patients were in excellent cardiovascular health (88% Charlson Comorbidity Index 0-4). Mean follow up after the index procedure was 57.4 ± 39.2 months (range). Indications for surgery were mostly for neurologic symptoms. The most commonly performed surgery was a multilevel thoracolumbar decompression without fusion (57%). Complications included durotomy (36%), neurologic complication (12%), and infection requiring irrigation and debridement (8%). Nine patients (36%) underwent a subsequent surgery. Three patients (12%) underwent a procedure at a non-contiguous anatomic zone, 3 (12%) underwent a revision of the previous surgery, and another 3 (12%) required extension of their previous decompression or fusion. Conclusions: Surgical complication rates remain high after spine surgery in patients with skeletal dysplasia, likely attributable to inherent characteristics of the disease. Patients should be counseled on their risk for complication and subsequent surgery.

A Retrospective Case Series of Carbon Fiber Plate Fixation of Ankle Fractures

2017 ◽  
Vol 11 (3) ◽  
pp. 223-229 ◽  
Author(s):  
Zachariah W. Pinter ◽  
Kenneth S. Smith ◽  
Parke W. Hudson ◽  
Caleb W. Jones ◽  
Ryan Hadden ◽  
...  
Keyword(s):  
Carbon Fiber ◽  
Fracture Fixation ◽  
Complication Rate ◽  
Ankle Fracture ◽  
Case Series ◽  
Complication Rates ◽  
Union Rate ◽  
Retrospective Case ◽  
Retrospective Case Series

Distal fibula fractures represent a common problem in orthopaedics. When fibula fractures require operative fixation, implants are typically made from stainless steel or titanium alloys. Carbon fiber implants have been used elsewhere in orthopaedics for years, and their advantages include a modulus of elasticity similar to that of bone, biocompatibility, increased fatigue strength, and radiolucency. This study hypothesized that carbon fiber plates would provide similar outcomes for ankle fracture fixation as titanium and steel implants. A retrospective chart review was performed of 30 patients who underwent fibular open reduction and internal fixation (ORIF). The main outcomes assessed were postoperative union rate and complication rate. The nonunion or failure rate for carbon fiber plates was 4% (1/24), and the union rate was 96% (23/24). The mean follow-up time was 20 months, and the complication rate was 8% (2/24). Carbon fiber plates are a viable alternative to metal plates in ankle fracture fixation, demonstrating union and complication rates comparable to those of traditional fixation techniques. Their theoretical advantages and similar cost make them an attractive implant choice for ORIF of the fibula. However, further studies are needed for extended follow-up and inclusion of larger patient cohorts. Levels of Evidence: Level IV: Retrospective Case series

Retrospective Analysis of Complication Rates Associated With Auricular Reconstruction After Skin Cancer Surgery

2019 ◽  
Vol 24 (2) ◽  
pp. 137-143
Author(s):  
Diana Crișan ◽  
Horațiu Alexandru Colosi ◽  
Avram Manea ◽  
Sabine Kastler ◽  
Anna Lipke ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Postoperative Infection ◽  
Tumor Resection ◽  
Case Series ◽  
Skin Tumor ◽  
Complication Rates ◽  
Ear Reconstruction ◽  
Retrospective Case ◽  
Auricular Reconstruction ◽  
Early Postoperative Complications

Background There is limited data regarding postoperative complications after microtia surgery or tympanoplasty; however, complication rates after pinna reconstruction following tumor resection and comorbidities associated with suboptimal outcomes have not been investigated so far. Objective To examine the incidence of postoperative complications after auricular reconstruction surgery following tumor resection and determine the association between postoperative complications and defect size, patients’ comorbidities, and reconstruction type. Methods and Materials In a retrospective case series ( n = 146, January 2014 to October 2018), we examined the surgical outcome and amount of postoperative complications following auricular surgery as well as the association with different comorbidities. SPSS 16.0 was used for statistical analyses. Results The following early postoperative complications were identified: pain (29.5%), hematoma (4.1%), flap congestion (4.8%), infection (3.4%), and flap/graft necrosis (2.7%). Late complications including cartilage step-offs, helical rim sulcus alteration, granulomas, or ear deformities occurred only in 3.6% of subjects. Reconstructions of large defects (>1 cm2) were associated with a higher incidence of early postoperative complications compared to small defects (<1 cm2) ( P < .001). Neither the presence of smoking or diabetes nor immunosuppression was significantly linked to an increased incidence of early complications. Immunosuppression, however, was associated with a higher incidence of postoperative infection ( P < .001) Conclusion The incidence of early and late postoperative complications after skin tumor resection and external ear reconstruction is low. The occurrence of postoperative infection was not linked with smoking or the presence of diabetes, but strongly associated with a state of immunosuppression, which is why a perioperative antibiotic prophylaxis in immune-compromised patients may be considered.

scholarly journals Vitrectomy for endophthalmitis: 5-year study of outcomes and complications

2020 ◽  
Vol 5 (1) ◽  
pp. e000423 ◽  
Author(s):  
Guy Simon Negretti ◽  
WengOnn Chan ◽  
Carlos Pavesio ◽  
Mahiul Muhammed Khan Muqit
Keyword(s):  
Case Series ◽  
Vitreoretinal Surgery ◽  
Endogenous Endophthalmitis ◽  
Final Visit ◽  
Retrospective Case ◽  
Tertiary Centre ◽  
Early Vitrectomy ◽  
Exogenous Endophthalmitis ◽  
Vitrectomy Surgery

Background/AimsTo analyse the complications and outcomes of vitrectomy surgery for endophthalmitis.MethodsThis was a retrospective case series. All cases that underwent 23-gauge vitrectomy surgery for endophthalmitis at a tertiary centre between 1 February 2013 and 1 February 2018 were included. Main outcome measures were as follows: visual acuity (VA) at final visit and post-vitrectomy complications.Results33 patients were included in the study with 20 men and 13 women, average age 63 years. Main post-surgical causes for endophthalmitis included phacoemulsification (n=9), trabeculectomy (n=5), intravitreal injection (n=5), corneal graft (n=4), vitreoretinal surgery (n=3) and endogenous endophthalmitis (n=6). Average follow-up was 18 months (SD 14). 21/33 (64%) patients had baseline perception of light VA. Analysis of exogenous endophthalmitis cases only demonstrated: mean LogMAR VA improved significantly from 2.68 to 1.66 (p=0.001). At final follow-up, 12% had VA of 6/12 or better, and 28% had VA of 6/36 or better. Vitrectomy within 7 days resulted in improved final VA outcomes (1.49 vs 2.16 LogMAR, p=0.032). Complications included retinal detachment (24.2%), macular hole (3%), hypotony (6%), suprachoroidal haemorrhage (3%) and enucleation/evisceration (6%).ConclusionVitrectomy for endophthalmitis leads to VA gains in some cases. Surgical outcomes may be improved with early vitrectomy performed within 7 days of the initial event for exogenous endophthalmitis. Patients should be advised of the potential risk of severe complications with/and without surgery.

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