scholarly journals Macular edema risk factors after vitrectomy for rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy

2021 ◽  
Vol 14 (3) ◽  
pp. 7-16
Author(s):  
Igor V. Khizhnyak ◽  
Ernest V. Boiko ◽  
Yaroslav V Bayborodov
Keyword(s):  
Risk Factors ◽  
Mathematical Model ◽  
Surgical Treatment ◽  
Visual Field ◽  
Retinal Detachment ◽  
Macular Edema ◽  
Postoperative Period ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Significant Information

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.

scholarly journals Macular edema after surgical treatment of rhegmatogenous retinal detachment – the possibilities of its prediction

2021 ◽  
Vol 6 (6-1) ◽  
pp. 56-64
Author(s):  
E. V. Boiko ◽  
I. V. Khizhnyak
Keyword(s):  
Risk Factors ◽  
Mathematical Model ◽  
Regression Analysis ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Macular Edema ◽  
Rhegmatogenous Retinal Detachment ◽  
Internal Limiting Membrane ◽  
Treatment Results ◽  
Preoperative Stage

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.

Rhegmatogenous Retinal Detachment: Pathophysiology and Risk Factors

2019 ◽  
pp. 138-141
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Rhegmatogenous Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Retinal Diseases ◽  
Retinal Tears ◽  
Lattice Degeneration ◽  
Major Factors

Rhegmatogenous retinal detachment is one of the most important retinal diseases requiring urgent surgical treatment. To be aware of the pathophysiology of the disease and to know the risk factors; it is crucial to prevent the development of the disease or overcome the complications that may arise and understand the surgical treatment principles. Major factors in the development of RRD: retinal tears, vitreous liquefaction, and detachment, traction on the retina surface. Myopia, previous cataract surgery, trauma, posterior vitreous detachment, lattice degeneration are the most important risk factors.

scholarly journals Macular edema after rhegmatogenous retinal detachment repair: risk factors, OCT analysis, and treatment responses

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Cameron Pole ◽  
Ismael Chehaibou ◽  
Andrea Govetto ◽  
Sean Garrity ◽  
Steven D. Schwartz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Macular Edema ◽  
Rhegmatogenous Retinal Detachment ◽  
Univariate Analysis ◽  
Subretinal Fluid ◽  
Intravitreal Triamcinolone ◽  
Control Series ◽  
Imaging Characteristics ◽  
Treatment Responses

Abstract Purpose To investigate risk factors, imaging characteristics, and treatment responses of cystoid macular edema (CME) after rhegmatogenous retinal detachment (RRD) repair. Methods Consecutive, retrospective case–control series of patients who underwent pars plana vitrectomy (PPV) and/or scleral buckling (SB) for RRD, with at least six months of follow-up. Clinical and surgical parameters of patients with and without CME (nCME), based on spectral-domain optical coherence tomography (OCT), were compared. Results Of 99 eyes enrolled, 25 had CME while 74 had nCME. Patients with CME underwent greater numbers of surgeries (P < 0.0001). After adjusting for number of surgeries, macula-off RRD (P = 0.06), proliferative vitreoretinopathy (PVR) (P = 0.09), surgical approach (PPV and/or SB, P = 0.21), and tamponade type (P = 0.10) were not statistically significant, although they all achieved significance on univariate analysis (P = 0.001 or less). Intraoperative retinectomy (P = 0.009) and postoperative pseudophakia or aphakia (P = 0.008) were more frequent in the CME group, even after adjustment. Characteristics of cCME on OCT included diffuse distribution, confluent cysts, and absence of subretinal fluid or intraretinal hyperreflective foci. Macular thickness improved significantly with intravitreal triamcinolone (P = 0.016), but not with anti-vascular endothelial growth factor agents (P = 0.828) or dexamethasone implant (P = 0.125). After adjusting for number of surgeries and macular detachment, final visual acuities remained significantly lower in the CME vs nCME group (P = 0.012). Conclusion Risk factors of CME include complex retinal detachment repairs requiring multiple surgeries, and pseudophakic or aphakic lens status. Although this cCME was associated with poor therapeutic response, corticosteroids were the most effective studied treatments.

scholarly journals Shorter Axial Length Is a Risk Factor for Proliferative Vitreoretinopathy Grade C in Eyes Unmodified by Surgical Invasion

2021 ◽  
Vol 10 (17) ◽  
pp. 3944
Author(s):  
Sakiko Minami ◽  
Atsuro Uchida ◽  
Norihiro Nagai ◽  
Hajime Shinoda ◽  
Toshihide Kurihara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retinal Detachment ◽  
Propensity Score ◽  
Confidence Interval ◽  
Axial Length ◽  
Proliferative Vitreoretinopathy ◽  
Odds Ratio ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Failure

Purpose: To investigate the risk factors for the development of proliferative vitreoretinopathy grade C (PVR-C), independent of prior surgical invasion. Methods: Patients who underwent surgery for rhegmatogenous retinal detachment were prospectively registered with the Japan-Retinal Detachment Registry, organized by the Japanese Retina and Vitreous Society, between February 2016 and March 2017. Data obtained from general ophthalmic examinations performed before and at 1, 3, and 6 months after surgery were analyzed. Results: We included 2013 eyes of 2013 patients (men, 1326 (65.9%); mean age, 55.2 ± 15.2 years) from amongst 3446 registered patients. Preoperative PVR-C was observed in 3.6% of patients. Propensity score matching revealed that a shorter axial length (AL) was a risk factor for preoperative PVR-C (OR (Odds Ratio), 0.81; 95%CI (Confidence Interval), 0.69 to 0.96; p = 0.015), which was a risk factor for surgical failure (OR, 4.22; 95%CI, 1.12 to 15.93; p = 0.034); the association was particularly significant for eyes with an AL < 25.0 mm (p = 0.016), while it was insignificant for eyes with an AL ≥ 25.0 mm. Conclusions: A shorter AL was related to the development of PVR-C before surgical invasion. Our results will help elucidate the fundamental pathogenesis of PVR and caution clinicians to meticulously examine eyes with a shorter AL to detect retinal detachment before PVR development.

Rhegmatogenous Retinal Detachment, Pathophysiology and Risk Factors

2019 ◽  
pp. 138-141
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Rhegmatogenous Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Retinal Diseases ◽  
Retinal Tears ◽  
Lattice Degeneration ◽  
Major Factors

Rhegmatogenous retinal detachment is one of the most important retinal diseases requiring urgent surgical treatment. To be aware of the pathophysiology of the disease and to know the risk factors; it is crucial to prevent the development of the disease or overcome the complications that may arise and understand the surgical treatment principles. Major factors in the development of RRD: retinal tears, vitreous liquefaction, and detachment, traction on the retina surface. Myopia, previous cataract surgery, trauma, posterior vitreous detachment, lattice degeneration are the most important risk factors.

scholarly journals Preliminary results of extra-scleral and vitreoretinal procedures for rhegmatogenous retinal detachment

2018 ◽  
Vol 11 (2) ◽  
pp. 36-40
Author(s):  
Andrei D. Shchukin ◽  
Elizaveta A. Saigina ◽  
Yekaterina A. Litvinova
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Treatment Algorithm ◽  
Surgical Care ◽  
Clinical Material ◽  
Preliminary Results ◽  
The City

To date, the problem of rhegmatogenous retinal detachment (RD) relapses due to the proliferative vitreoretinopathy (PVR) progression remains unsolved, there is no single surgical treatment algorithm for retinal detachment, and even more so for its recurrence. The aim is to evaluate the structure of surgical care provided to patients with RD using extensive clinical material, taking into account different methods used, frequency of RD recurrences, frequency of reoperations. Materials and methods. The study was carried out in the vitreoretinal department of the Ophthalmological Center of the City Multifunctional Hospital No. 2 of St. Petersburg. 1502 cases of hospitalization for rhegmatogenous retinal detachment during 2015-2016 have been analyzed, results of surgical treatment have been assessed, number of relapses and frequency of reoperations have been established. Results. RD recurrence after surgical treatment occurs in 20.6% of patients, and vitrectomy is applied twice as often as extrascleral procedures. The use of endovitreal techniques is generally more effective than of extrascleral ones.

Extrascleral Filling Using Endoillumination the First Experiencethe

2020 ◽  
pp. 43-49
Author(s):  
V.Y. Markevich ◽  
◽  
T.A. Imshenetskaya ◽  
O.A. Yarmak ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Crystalline Lens ◽  
Vitreous Cavity ◽  
Macular Area ◽  
General Group ◽  
Anatomical Outcome

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.

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