scholarly journals Clinical patterns of rhegmatogenous retinal detachment during the first state of emergency for the COVID-19 pandemic in a Tokyo center

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261779
Author(s):  
Toshiaki Hirakata ◽  
Tianxiang Huang ◽  
Yoshimune Hiratsuka ◽  
Shutaro Yamamoto ◽  
Akira Inoue ◽  
...  

The coronavirus disease 2019 (COVID-19) pandemic is disturbing and overwhelming a regular medical care in the world. We evaluated the clinical characteristics of patients with primary rhegmatogenous retinal detachment (RRD) during the state of emergency for COVID-19 pandemic in Japan. We also reviewed measures against the COVID-19 pandemic in our institute with a focus on RRD treatment. Retrospectively, patients who underwent initial RRD surgery during the state of emergency between April 7, 2020 and May 25, 2020 were included. For comparison, we recruited patients who underwent surgery for initial RRD during the same period in the last 2 years (2018 and 2019). Data related to the number of surgeries, age, gender, macular detachment, proliferative vitreoretinopathy (PVR), preoperative visual acuity, surgical techniques, the time between the onset and hospitalization and/or surgery of the 2020 cohort were analyzed and compared with those of the 2018 and 2019 cohorts. Furthermore, we reviewed measures taken against COVID-19 in our institute. The number of RRD patients during the state of emergency tended to be lower than that within the last 2 years. Relatively lesser female (vs. male) patients were observed in the 2020 cohort than in the last 2 years (P = 0.084). In contrast, among all cohorts, no significant differences were observed in the incidence of macula-off and PVR, preoperative visual acuity, and the time period between symptom onset and hospitalization and/or surgery. This is the first report to show the clinical patterns of RRD during COVID-19 pandemic in Japan. Despite the state of emergency for the COVID-19 pandemic, no delay in the patient’s initial visit to the hospital and surgery was observed. Further studies, including multicenter researches, are important for investigating the influence of COVID-19 on urgent ocular diseases.

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Ritesh Shah ◽  
Raghunandan Byanju ◽  
Sangita Pradhan ◽  
Sudha Ranabhat

Introduction. Scleral buckle surgery retains a special place in treatment of retinal detachment despite development of new and advanced vitreoretinal surgical techniques. The outcome of any retinal detachment surgery depends on correct selection of patient, type and nature of detachment, and the expertise. This study aims to evaluate various other parameters that determine the outcome of scleral buckle surgery. Method. Records of 55 patients with primary rhegmatogenous retinal detachment treated with scleral buckling over a duration of 18 months that had a minimum of 3-month follow-up were retrospectively reviewed. Preoperative and postoperative characteristics were recorded. Parameters that were evaluated to determine the outcome were best-corrected visual acuity (BCVA), anatomical success, and complications. Results. A total of 51 eyes of 50 patients that met the inclusion criteria were included. Mean age was 41 ± 19.9 years (range: 9 to 83). Primary anatomical success was achieved in 80.4%. Parameters significantly associated with the anatomical outcome of surgery were status of lens, preoperative visual acuity, and extent of retinal detachment. There was a significant improvement of visual acuity postoperatively. Conclusion. Scleral buckle surgery is a highly effective surgery in uncomplicated retinal detachment cases, and single surgery success rates are better in cases with good preoperative visual acuity, partial detachment, and clear crystalline lens.


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.


2007 ◽  
Vol 17 (4) ◽  
pp. 627-637 ◽  
Author(s):  
F. Goezinne ◽  
E.C. La Heij ◽  
T.T.J.M. Berendschot ◽  
A.T.A. Liem ◽  
F. Hendrikse

Purpose The goal of this study was to identify risk factors for redetachment and/or a worse visual outcome after silicone oil removal (SOR) for complicated retinal detachment. Methods The authors retrospectively analyzed 287 consecutive eyes with SOR between January 1999 and December 2003. Results Anatomic success after SOR was achieved in 81% of the eyes. The overall anatomic success at the end of follow-up was 94%. Postoperative ocular hypertension was found in 8% of the eyes, hypotony in 6% of the eyes, and keratopathy in 29% of the eyes. After SOR 43% of the eyes had an improvement in visual acuity of at least two Snellen lines. After multivariate analysis, male sex, the presence of preoperative rubeosis, and proliferative diabetic retinopathy (PDR) were found to be risk factors for recurrent retinal detachment. Male sex, preoperative visual acuity of <0.1 Snellen lines, PDR, the performance of three more operations, any size of retinectomy, and hypotony were found to be associated with a poor visual outcome of Snellen visual acuity <0.1. Conclusions Retinal detachment after SOR in the current unselected series of eyes occurred in approximately 20%, which is comparable to the Silicone Oil Study reports, published approximately 20 years ago. However, preoperative selection was then made, and less than 50% of the silicone oil-filled eyes had SOR. The higher overall anatomic success in the current study may be due to improved vitreoretinal surgical techniques.


2016 ◽  
Vol 57 (3) ◽  
pp. 889 ◽  
Author(s):  
Misato Kobayashi ◽  
Takeshi Iwase ◽  
Kentaro Yamamoto ◽  
Eimei Ra ◽  
Kenta Murotani ◽  
...  

2022 ◽  
Author(s):  
P. Barrett Paulk ◽  
Dala Eloubeidi ◽  
John O. Mason III ◽  
Christine A. Curcio ◽  
Jason N. Crosson ◽  
...  

Abstract Background Patients presenting with macula-off rhegmatogenous retinal detachment (RRD) with concomitant age-related macular degeneration (AMD) and their treating physicians would benefit from knowledge regarding the visual prognosis after repair. The prognosis for such patients is not well known. The purpose of this study is to compare visual outcomes in macula-off RRD in eyes with AMD versus a group of comparison eyes without AMD. Methods This was a retrospective chart review of 1,149 patients. A total of 191 eyes met study criteria, 162 non-AMD eyes (controls) and 29 AMD eyes. The main outcome measure was postoperative visual acuity in control eyes versus AMD eyes, and this was compared using Fisher’s exact test. Results There was a statistically significant difference in postoperative visual acuity by AMD status, with those without AMD having a higher frequency of Count Fingers (CF), Hand Motion (HM), Light Perception (LP), or No Light Perception (NLP) vision (p = 0.023). More specifically 5.56% of non-AMD eyes and 3.45% of AMD eyes were 20/40 or better, 77.16% of non-AMD and 55.17% of AMD eyes were worse than 20/40 and better than 20/200, 10.49% of non-AMD eyes and 37.93% of AMD eyes were 20/200 or worse, and there were 11 eyes in the non-AMD group with CF, HM, LP, or NLP vision while there was only 1 eye in the AMD group with CF vision. Conclusions Though postoperative visual acuity was worse in the non-AMD group with a higher frequency of patients having final vision of CF, HM, LP, or NLP, this is not likely a clinically significant finding. Rather, it is a function of the difference in sample size and composition between the two groups. Importantly, this study suggests AMD patients can expect similar outcomes to non-AMD patients after RRD repair. Our study suggests that approximately 58% of patients with AMD can expect to maintain functional vision better than 20/200. We conclude that AMD patients can achieve functional vision after RRD surgery, similar to those without AMD. These findings may be helpful in guiding realistic expectations of AMD patients with RRD.


2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yen-Chih Chen ◽  
Chung-May Yang ◽  
San-Ni Chen

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.


Eye ◽  
2012 ◽  
Vol 26 (10) ◽  
pp. 1329-1336 ◽  
Author(s):  
M Roldán-Pallarés ◽  
C Bravo-Llatas ◽  
A-S Musa ◽  
J Hernandez-Montero ◽  
R Fernández-Durango

2019 ◽  
Vol 4 (4) ◽  
pp. 61-65
Author(s):  
D. G. Arsiutov

Background. The method of the use of autologous conditioned platelet rich plasma is a promising method in the surgery of retinal pathology, particularly in the surgery of rhegmatogenous retinal detachment without the use of additional endolaser photocoagulation, but requires the foundation of its efficiency.Aim: to evaluate the effectiveness of the surgery of rhegmatogenous retinal detachment with central (macular) and peripheral retinal tears, including retinal abruption from the dentate line, with the use of 25, 27-gauge subtotal vitrectomy, pneumoretinopexy and silicone oil tamponade with blocking of retinal defect with the use of autologous conditioned plasma without the use of endolaser photocoagulation around retinal defects.Materials and methods. The surgery included 25, 27-gauge vitrectomy, posterior hyaloid membrane removal, internal limiting membrane removal in case of macular hole, pneumoretinopexy, instiilation in 2–3 layers of autologous conditioned platelet rich plasma, devoid of leukocytes and containing 1.5–3 times more thrombocytes than in whole blood into the area of retinal detachment or along the edge of retinotomy till the retinal defect and nearby intact retina are totally covered. A total of 29 patients with visual acuity from 0.03 to 1.0 underwent the surgery.Results. In the early postoperative period (up to 1 month) 96.6 % of patients showed total retinal reattachment, retinal detachment was blocked, in one patient with multiple retinal tears recurrent retinal detachment was detected; in the early delayed postoperative period (1–3 months) 82.8 % of patients showed total retinal reattachment, in 5 patient retinal reattachment was partial.In the late postoperative period (4–12 months) 86.2 % of patients showed total retinal reattachment, there were 4 recurrent retinal detachments. Patients with recurrent retinal detachment were successfully reoperated. Autologous conditioned plasma was not used during reoperations. Visual acuity of the patients, which underwent surgery in the late postoperative period, was 0.1–1.0.Conclusions. 25, 27-gauge vitreoretinal surgery of rhegmatogenous retinal detachment with central and peripheral retinal tears, including tears with abruption from the dentate line and retinal defects blocking with the use of autologous conditioned plasma rich with thrombocytes without the use of endolaser photocoagulation around retinal defects – is a method which allows to achieve in most cases total retinal reattachment, better functioning of the operated eye.


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