scholarly journals Effect of deprivation and ethnicity on primary macula-on retinal detachment repair success rate and clinical outcomes: A study of 568 patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259714
Author(s):  
George Moussa ◽  
Dimitrios Kalogeropoulos ◽  
Soon Wai Ch’ng ◽  
Kim Son Lett ◽  
Arijit Mitra ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
South Asians ◽  
Statistical Significance ◽  
Case Series ◽  
Economic Deprivation ◽  
White Ethnicity ◽  
Visual Outcomes ◽  
Detachment Rate ◽  
Deprivation Status

Purpose Socio-economic deprivation and ethnic variation have been frequently linked to poorer health outcomes. We collected a large series of primary macula-on rhegmatogenous retinal detachment (RRD) cases and analysed the effect of socio-economic deprivation and ethnicity on both six-month retinal re-detachment rate and visual outcomes. Materials and methods Retrospective consecutive case series of 568 patients attending Birmingham and Midlands Eye Centre from January 2017–2020. Multiple Indices of Deprivation (IMD) deciles were used for deprivation status and split to two groups: IMD-A (Decile 1–5) and IMD-B (Decile 6–10). The two largest subgroups of ethnicities were compared, White and South Asians (SA). Results We report an overall retinal re-detachment rate of 8.5%. IMD-A re-detached significantly more than IMD-B (11.2% vs 6.0% respectively, p = 0.034). No statistical significance was found between White and SA re-detachment rate (9.1% and 5.6% respectively, p = 0.604). SA median age significantly lower at 49 years (IQR: 37–61) compared to White patients at 57 years (IQR: 50–65) (p = <0.001). IMD-A median age of 55 years (IQR: 46–64) was significantly lower to IMD-B median age of 58 years (IQR: 51–65) (p = 0.011). No differences in final visual outcomes were detected across all groups. Conclusion We demonstrated an increased retinal re-detachment rate in our more deprived patients according to IMD and a younger cohort of SA compared to White ethnicity. Further prospective studies are required to demonstrate the link between socio-economic deprivation and surgical success.

scholarly journals Surgical repair of primary non-complex rhegmatogenous retinal detachment in the modern era of small-gauge vitrectomy

2021 ◽  
Vol 6 (1) ◽  
pp. e000651
Author(s):  
Omar Moinuddin ◽  
Rebhi O Abuzaitoun ◽  
Min W Hwang ◽  
Sanjana K Sathrasala ◽  
Xing D Chen ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Scleral Buckling ◽  
Retrospective Case ◽  
Visual Outcomes ◽  
Small Gauge ◽  
Surgical Treatments ◽  
Modern Era ◽  
Anatomic Success

ObjectiveTo report anatomic and visual outcomes of pars plana vitrectomy (PPV), as well as scleral buckling (SB) and PPV/SB as surgical treatments for the management of primary, non-complex rhegmatogenous retinal detachment (RRD).Methods and analysisData from 751 eyes that underwent PPV, SB or combined PPV/SB as a surgical treatment for primary non-complex RRD with at least 3 months of follow-up were analysed to determine rates of single surgery anatomic success (SSAS) and final anatomic success (FAS). Patients or the public were not involved in the design, conduct or reporting of this research.ResultsPPV accounted for 89.0% (n=668), PPV/SB for 6.8% (n=51) and SB for 4.2% (n=32) cases. Overall SSAS (91.2% PPV, 84.3% PPV/SB, 93.8% SB; p=0.267) and FAS (96.7% PPV, 94.1% PPV/SB and 100.0% SB; p=0.221) were reported for the three surgical groups. SSAS and FAS were similar for lens status, macular detachment status and the presence or absence of inferior retinal breaks for each of the PPV, PPV/SB and SB groups.ConclusionsIn this large, single institution, retrospective case series, we report surgical outcomes for patients with primary non-complex RRD managed with PPV, SB or PPV/SB in the modern era of small-gauge vitrectomy. We demonstrate that primary PPV without adjunct SB provides excellent anatomic and visual outcomes irrespective of lens status, macular involvement or pathology location.

scholarly journals Management of Rhegmatogenous Retinal Detachment during COVID-19 Pandemic

2021 ◽  
Vol 1 (1) ◽  
pp. 77-79
Author(s):  
Adel G. AlAkeely ◽  
Abeer Habeeb
Keyword(s):  
Retinal Detachment ◽  
Conventional Treatment ◽  
Rhegmatogenous Retinal Detachment ◽  
Medical Personnel ◽  
Good Alternative ◽  
Pneumatic Retinopexy ◽  
Visual Outcomes ◽  
Hospital Beds

Patients with primary Rhuegmatougenous Retinal detachment during COVID-19 pandemic were more likely to present late, have macula involving disease secondary and to show poor visual outcomes. Pneumatic Retinopexy (PR) is a procedure that eliminates the need for admission and limits the duration of contact with patients. Hence, more feasible during periods of shortage in hospital beds and medical personnel in the pandemic. In our experience, we successfully performed pneumatic retinopexy on two confirmed COVID-19 cases with favourable visual outcomes. We would recommend retina surgeons be familiar with such procedure as it may be a good alternative to conventional treatment while minimizing the risk of transmitting COVID-19.

Anatomic and Visual Outcomes of 23-G Vitrectomy without Scleral Buckling for Primary Rhegmatogenous Retinal Detachment

2013 ◽  
Vol 23 (3) ◽  
pp. 417-422 ◽  
Author(s):  
Marta S. Figueroa ◽  
Inés Contreras ◽  
Susana Noval ◽  
L. Wu ◽  
J. F. Arevalo ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Visual Outcomes

scholarly journals Internal Limiting Membrane Flap in the Management of Retinal Detachment due to Paracentral Retinal Breaks

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yen-Chih Chen ◽  
Chung-May Yang ◽  
San-Ni Chen
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Structural Changes ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Major Complication ◽  
Internal Limiting Membrane ◽  
Fluid Exchange ◽  
Membrane Peeling ◽  
Retinal Breaks

Purpose. To describe the technique and outcomes of using either inverted or free internal limiting membrane flap in the management of retinal detachment due to paracentral retinal breaks. Methods. This retrospective observational case series includes nine patients who received surgery for retinal detachment due to paracentral retinal breaks developed either from primary rhegmatogenous origin, or secondary iatrogenic retinal breaks after prior membrane peeling, or during surgery for tractional retinal detachment. Either inverted or free internal limiting membrane flaps were inserted in the identified breaks, followed by air fluid exchange and gas tamponade. Visual acuity and structural changes were evaluated. Results. Nine eyes were included. One had primary rhegmatogenous retinal detachment, one had highly myopic eye with peripapillary atrophic hole, three had secondary retinal detachment after membrane peeling for foveoschisis or macular pucker, one had recurrent retinal detachment due to proliferative vitreoretinopathy, one had combination of tractional and rhegmatogenous retinal detachment, and two had iatrogenic breaks during surgery. The retinal breaks of all eyes were sealed with retina attached postoperatively. Visual acuity in logarithm of minimal angle of resolution improved from 1.18 ± 0.55 preoperatively to 0.74 ± 0.47 postoperatively (p=0.04). Conclusion. Internal limiting membrane flap technique can be a surgical approach selectively for retinal detachment due to paracentral retinal breaks with difficulty for laser application. The retina can be attached successfully and achieve good visual outcome without major complication. This trial is registered with NCT03707015.

Macular Changes on Optical Coherence Tomography Before, During, and After Silicone Oil Tamponade for Macula-On Retinal Detachment: A Case Series

2018 ◽  
Vol 2 (5) ◽  
pp. 297-301 ◽  
Author(s):  
Wajiha J. Kheir ◽  
Carl-Joe Mehanna ◽  
Mona Koaik ◽  
Ziad Bashshur
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Ganglion Cell Layer ◽  
Silicone Oil ◽  
Case Series ◽  
Qualitative Assessment ◽  
Optical Coherence ◽  
Time Points ◽  
Silicone Oil Tamponade

Purpose: Assess changes on spectral domain optical coherence tomography (OCT) before, during, and after removal of silicone oil (SO). Methods: Retrospective series of patients who underwent SO tamponade for macula-on rhegmatogenous retinal detachment. OCT scans of the affected eye were taken before, during, and 3 months after SO tamponade. Qualitative assessment of foveal contour and quantitative comparison of OCT parameters (central macular, cube, ganglion cell layer [GCL], and outer retinal thicknesses) were done between 3 time points. Results: Ten eyes of 9 patients were included. Flattening of the foveal contour during SO tamponade was completely reversed after SO removal. Average cube and GCL thicknesses decreased with SO tamponade and increased after SO removal ( P = .01 and P = .02, respectively). Outer retinal thicknesses did not vary among 3 time points ( P = .09). Conclusions: SO tamponade causes foveal flattening and thinning of the inner retinal layers, which is reversible on removal.

Standardized scleral buckling approach in the management of noncomplex primary rhegmatogenous retinal detachment

2020 ◽  
pp. 112067212094020
Author(s):  
Paolo Radice ◽  
Elisa Carini ◽  
Patrizio Seidenari ◽  
Andrea Govetto
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Vision Loss ◽  
Case Series ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Full Thickness Macular Hole ◽  
Air Tamponade ◽  
Subretinal Fluid Drainage ◽  
Anatomical Success

Purpose: To analyze the anatomical and functional outcomes of a standardized scleral buckling approach in patients with noncomplex primary rhegmatogenous retinal detachment (RRD). Methods: Retrospective institutional case series of 135 eyes of 131 patients diagnosed with noncomplex primary RRD. All patients underwent scleral buckling surgery with the placement of an encircling 5 mm oval sponge at 15 ± 2 mm posteriorly from the limbus, cryopexy, subretinal fluid drainage, and air tamponade. Results: Final anatomical success at 12 months was achieved in all 135 eyes (100%). Primary anatomical surgical success was obtained in 127 out of 135 eyes (94%), while re-detachment occurred in eight out of 135 cases (6%). Primary anatomical success was significantly lower in pseudophakic eyes ( p < 0.001). At the end of the follow-up period, no vision loss was observed in any patient and both sphere and cylinder refraction shift was mild. There was a low rate of postoperative complications. Nine out of 135 eyes (6.6%) developed full thickness macular hole, whether in 24 out of 135 eyes (17.8%) epiretinal membrane development was noticed. Conclusion: A standardized scleral buckling approach for primary noncomplex RRD may be effective. The technique is reproducible, easier, and quicker to perform if compared to classic scleral buckling procedures, suggesting that it may represent a valuable surgical option. Special care is needed in the management of pseudophakic RRD due to higher risk of RRD recurrence.

scholarly journals Prognostic Factors and Epidemiology of Open Globe Injuries from Western Sydney: A Twelve-Year Review

2021 ◽  
Author(s):  
Haochi Ho ◽  
Jane Foo ◽  
Yi-Chiao Li ◽  
Samantha Bobba ◽  
Christopher Go ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Prognostic Factors ◽  
Retinal Detachment ◽  
Case Series ◽  
Final Visual Acuity ◽  
Ocular Injury ◽  
Visual Outcomes ◽  
Globe Rupture ◽  
Open Globe ◽  
Open Globe Injuries

Abstract BackgroundTo identify prognostic factors determining final visual outcome following open globe injuries.MethodsRetrospective case series of patients presenting to Westmead Hospital, Sydney, Australia with open globe injuries from 1st January 2005 to 31st December 2017. Data collected included demographic information, ocular injury details, management and initial and final visual acuities.ResultsA total of 104 cases were identified. Predictors of poor final visual outcomes included poor presenting visual acuity (p < 0.001), globe rupture (p < 0.001), retinal detachment (p < 0.001), Zone III wounds (p < 0.001), hyphema (p=0.003), lens expulsion (p = 0.003) and vitreous hemorrhage (p < 0.001). Multivariate analysis demonstrated presenting visual acuity (p < 0.001), globe rupture (p = 0.013) and retinal detachment (p = 0.011) as being statistically significant for predicting poor visual outcomes. The presence of lid laceration (p = 0.197) and uveal prolapse (p = 0.667) were not significantly associated with the final visual acuity. ConclusionsPoor presenting visual acuity, globe rupture and retinal detachment are the most important prognostic factors determining final visual acuity following open globe injury.

scholarly journals Peripapillary Vessel Density in Eyes with Rhegmatogenous Retinal Detachment after Pars Plana Vitrectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Bing Lu ◽  
Pengfei Zhang ◽  
Haiyun Liu ◽  
Huixun Jia ◽  
Yang Yu ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Vessel Density ◽  
Flow Density ◽  
Multivariate Linear Regression Analysis ◽  
Visual Outcomes ◽  
Significant Difference ◽  
Pars Plana ◽  
Fellow Eyes

Purpose. To investigate the vascular density of the optic nerve head (ONH) and macula using optical coherence tomography angiography (OCTA) in patients undergoing vitrectomy for rhegmatogenous retinal detachment (RRD) and to evaluate associations with visual outcomes. Methods. Patients with RRD, successfully treated with a pars plana vitrectomy (PPV) and a minimum three-month follow-up were included in this study. The vessel density (VD) of the ONH and peripapillary regions, foveal avascular zone (FAZ), foveal flow density (FFD), and parafoveal flow density (PFD) were evaluated using OCTA and compared to the fellow eye. Multivariate linear regression analysis was performed to determine correlations with visual outcomes. Results. Thirty-one patients with macula-off RRD were included in the study. Compared with the fellow eyes, eyes after RRD surgery had a lower peripapillary VD ( P < 0.01 ). No significant difference in superficial and deep FFD, PFD, and FAZ area was found compared to the fellow eyes. Postoperative peripapillary VD and baseline BCVA were significantly associated with BCVA three months after PPV ( P < 0.05 ). Conclusion. Rhegmatogenous retinal detachment eyes successfully treated with PPV had lower peripapillary vessel density than fellow healthy eyes. Postoperative BCVA was related to postoperative peripapillary VD.

scholarly journals 25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons

2020 ◽  
Author(s):  
Martin Pencak ◽  
Miroslav Veith ◽  
Zbynek Stranak ◽  
Jakub Dite ◽  
Jana Vranova ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Functional Results ◽  
Complication Rates ◽  
Gas Tamponade ◽  
Single Operation ◽  
Case Series Study ◽  
The Mean

Abstract Introduction: To compare the results and complication rates of a 25-gauge pars plana vitrectomy (25g PPV) with gas tamponade for rhegmatogenous retinal detachment (RRD) between experienced and inexperienced surgeons.Materials and Methods: This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25g PPV with gas tamponade. Patients were divided into 2 groups: In Group 1 (ESG) the procedure was performed by an experienced vitreoretinal surgeon and in Group 2 (ISG) the procedure was performed by 2 inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups.Results: 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. The mean best-corrected visual acuity (BCVA) improved from 0.38 decimal to 0.73 decimal. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100.0%. The mean BCVA improved from 0.33 decimal to 0.74 decimal. The differences between groups were not statistically significant. There was no difference in complication rates between groups.Conclusions: A 25g PPV with gas tamponade for treatment of RRD yields excellent anatomical results and improvement in BCVA. With good technique and use of modern vitrectomy machines and instruments, even inexperienced surgeons can achieve high single operation success rate, suggesting a short learning curve. The complication rate is comparable between experienced and inexperienced surgeons.

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