scholarly journals Effectiveness of intravitreal chemotherapy-assisted endoresection in monocular patients with group D retinoblastoma

2020 ◽  
Author(s):  
Xiling Yu ◽  
Xueke Li ◽  
Yue Xing ◽  
Siduo Lu ◽  
Silvia Tanumiharjo ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Repeated Treatment ◽  
Retrospective Case ◽  
Promising Alternative ◽  
Tumour Control ◽  
Intravitreal Chemotherapy ◽  
Pars Plana ◽  
Group D

Abstract Background: This study aimed to determine the efficacy and complications of intravitreal chemotherapy-assisted endoresection for refractory International Classification of Retinoblastoma (ICRB) group D retinoblastoma in monocular patients.Methods: In this retrospective case series, intravitreal chemotherapy-assisted endoresection by pars plana vitrectomy was performed in 11 eyes with refractory ICRB group D retinoblastoma unresponsive to standard therapies in monocular patients.Results: Across a mean follow-up period of 42.7 months, globe salvage was attained in all 11 eyes (100%). There were no cases of extra-ocular tumour seeding or remote metastasis. In 9 eyes (81.8%), tumour control was achieved with one pars plana vitrectomy; in 2 cases (18.2%), repeated treatment, such as laser therapy, intravitreal chemotherapy or a second pars plana vitrectomy, was needed. Retinal reattachment was achieved in all 4 eyes (100%) with previous retinal detachment. Four eyes (36.4%) required subsequent cataract surgery due to secondary cataract. Ten eyes (90.9%) had improvement in best-corrected visual acuity at the last follow-up.Conclusion: Intravitreal chemotherapy-assisted endoresection appears to be a safe and effective globe-salvaging method for refractory group D retinoblastoma. It is a promising alternative to enucleation and a supplementary therapeutic strategy for those unresponsive to standard therapies, especially for the monocular retinoblastoma patients.

scholarly journals Effectiveness of intravitreal chemotherapy-assisted endoresection in monocular patients with group D retinoblastoma

2020 ◽  
Author(s):  
Xiling Yu ◽  
Xueke Li ◽  
Yue Xing ◽  
Siduo Lu ◽  
Silvia Tanumiharjo ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Repeated Treatment ◽  
Retrospective Case ◽  
Promising Alternative ◽  
Tumour Control ◽  
Intravitreal Chemotherapy ◽  
Pars Plana ◽  
Group D

Abstract Background: This study aimed to determine the efficacy and complications of intravitreal chemotherapy-assisted endoresection for refractory International Classification of Retinoblastoma (ICRB) group D retinoblastoma in monocular patients.Methods: In this retrospective case series, intravitreal chemotherapy-assisted endoresection by pars plana vitrectomy was performed in 11 eyes with refractory ICRB group D retinoblastoma unresponsive to standard therapies in monocular patients.Results: Across a mean follow-up period of 42.7 months, globe salvage was attained in all 11 eyes (100%). There were no cases of extra-ocular tumour seeding or remote metastasis. In 9 eyes (81.8%), tumour control was achieved with one pars plana vitrectomy; in 2 cases (18.2%), repeated treatment, such as laser therapy, intravitreal chemotherapy or a second pars plana vitrectomy, was needed. Retinal reattachment was achieved in all 4 eyes (100%) with previous retinal detachment. Four eyes (36.4%) required subsequent cataract surgery due to secondary cataract. Ten eyes (90.9%) had improvement in best-corrected visual acuity at the last follow-up.Conclusion: Intravitreal chemotherapy-assisted endoresection appears to be a safe and effective globe-salvaging method for refractory group D retinoblastoma. It is a promising alternative to enucleation and a supplementary therapeutic strategy for those unresponsive to standard therapies, especially for the monocular retinoblastoma patients.

scholarly journals Effectiveness of Intravitreal Chemotherapy-Assisted Endoresection in Monocular Patients with Group D Retinoblastoma

2020 ◽  
Author(s):  
Xiling Yu ◽  
Xueke Li ◽  
Yue Xing ◽  
Siduo Lu ◽  
Silvia Tanumiharjo ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Tumor Control ◽  
Repeated Treatment ◽  
Promising Alternative ◽  
Tumor Seeding ◽  
Intravitreal Chemotherapy ◽  
Pars Plana ◽  
Group D

Abstract Background: To determine the efficacy and complications of intravitreal chemotherapy-assisted endoresection for refractory group D retinoblastoma in monocular patients.Methods: In this retrospective case series, intravitreal chemotherapy-assisted endoresection by pars plana vitrectomy was performed in 11 eyes with refractory ICRB group D retinoblastoma unresponsive to standard therapies in monocular patients.Results: Across a mean follow-up period of 42.7 months, globe salvage was attained in all 11 eyes (100%). There was no case of extra-ocular tumor seeding or remote metastasis. In 9 eyes (81.8%), tumor control was achieved with one-time pars plana vitrectomy, whereas in 2 cases (18.2%), repeated treatment such as laser, intravitreal chemotherapy or second pars plana vitrectomy were needed. Retinal reattachment was achieved in all 4 eyes (100%) with previous retinal detachment. 4 eyes (36.4%) required subsequent cataract surgery due to secondary cataract. 10 eyes (90.9%) had improvement in best-corrected visual acuity at the last follow-up.Conclusion: Intravitreal chemotherapy-assisted endoresection appears to be a safe and effective globe-salvaging method for refractory group D retinoblastoma. It is a promising alternative to enucleation and a supplementary therapeutic strategy for those unresponsive to standard therapies, especially for the monocular retinoblastoma patients.

scholarly journals Combined pars plana glaucoma drainage device placement and vitrectomy using a vitrectomy sclerotomy site for tube placement: a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Glaucoma Drainage Devices ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Purpose The purpose of this study is to report the safety and efficacy of pars plana glaucoma drainage devices with pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma. Methods Retrospective case series of 28 eyes of 28 patients who underwent combined pars plana glaucoma drainage device and pars plana vitrectomy between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity, and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests. Results Mean IOP decreased from 22.8 mmHg to 11.8 mmHg at 1.5 years (p = 0.002), and mean medication burden decreased from 4.3 to 2.1 at 1.5 years (p = 0.004). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 < IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 86.4% at 1 year and 59.8% at 1.5 years. At their last visit, three eyes (10.7%) achieved complete success with IOP reduction as above without medications, and 14 eyes (50.0%) achieved qualified success with medications. Hypotony was observed in 1 eye (3.6%) prior to 3 months postoperatively and 0 eyes after 3 months. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of > 2 lines. Two eyes required subsequent pars plana vitrectomies for tube obstruction, and one eye had transient hypotony. Conclusions The results of pars plana glaucoma drainage device and pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting glaucoma drainage devices into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

scholarly journals Combined Pars Plana Glaucoma Drainage Device Placement and Vitrectomy Using a Vitrectomy Sclerotomy Site for Tube Placement: A Case Series

2020 ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Tests ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Retrospective Case ◽  
Tube Obstruction ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Background: The purpose of this study is to report the safety and efficacy of pars plana (PP) glaucoma drainage devices (GDDs) with pars plana vitrectomy (PPV) using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma.Methods: Retrospective case series of 28 eyes of 28 patients who underwent combined PP GDD and PPV between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity (BCVA), and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests.Results: Mean IOP decreased from 22.8 mmHg to 11.4 mmHg at 1.5 years (p = 0.009), and mean medication burden decreased from 4.3 to 1.7 at 1.5 years (p = 0.009). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 ≤ IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 77.7% at 1 year and 45.8% at 1.5 years. At their last visit, four eyes (14.3%) achieved complete success with IOP reduction as above without medications, and 13 eyes (46.2%) achieved qualified success with medications. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of >2 lines. Two eyes required subsequent PPV for tube obstruction, and one eye had transient hypotony.Conclusions: The results of pars plana GDD and vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting GDDs into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

scholarly journals Outcomes of intravitreal methotrexate to salvage eyes with relapsed primary intraocular lymphoma

2020 ◽  
pp. bjophthalmol-2020-317199
Author(s):  
Mona Mohammad ◽  
Richard M Andrews ◽  
P Nicholas Plowman ◽  
Gordon Hay ◽  
Amit K Arora ◽  
...  
Keyword(s):  
Systemic Chemotherapy ◽  
External Beam Radiotherapy ◽  
Case Series ◽  
Central Nervous System Lymphoma ◽  
Intraocular Lymphoma ◽  
Cystoid Macular Oedema ◽  
Primary Intraocular Lymphoma ◽  
Retrospective Case ◽  
Tumour Control

PurposeTo report the outcomes of intravitreal methotrexate (MTX) injections to rescue eyes with relapsed primary intraocular lymphoma (PIOL).MethodsRetrospective case series of patients with ocular relapse of PIOL who had initially received systemic chemotherapy (all five cases) and external beam radiotherapy (EBRT) to brain and orbits (two cases). Injections of MTX (400 µg/0.1 mL) were given one time per week for 1 month, every other week for 4 months, followed by a maintenance phase of one injection one time per month for 8 months (total of 20 injections in a year).ResultsFrom April 2008 to February 2016, there were nine eyes of five patients (three men; average age at first presentation 62 years) treated with our rescue protocol of intravitreal MTX injections. Ocular relapse occurred at a mean interval of 15 months (range 5–34 months) after the completion of initial systemic treatment. At mean follow-up of 31 months (range 5–104 months), tumour control was achieved in eight out of nine eyes (89%); one eye failed, with persistent retinal infiltrates despite increasing the frequency of injections, resulting in severe keratopathy. The only other complication occurred in one eye, developing cystoid macular oedema from MTX injections that resolved with topical anti-inflammatory medications and reduced frequency of MTX. There were no cases of reduced vision or ocular relapse, but two patients died (one of central nervous system lymphoma).ConclusionsIntravitreal MTX was a safe and effective treatment modality for relapsed PIOL after systemic chemotherapy and radiotherapy, achieving local tumour control in 89%, and hence represents an optimal choice. However, given the rare nature of PIOL, larger collaborative studies with longer follow-up are needed to corroborate this.

Montgomery and informed consent during Covid-19: Pneumatic retinopexy versus pars plana vitrectomy or scleral buckling for retinal detachment repair

2021 ◽  
pp. 002581722098400
Author(s):  
G Kiew ◽  
AV Poulson ◽  
DK Newman ◽  
P Alexander ◽  
MP Snead
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Scleral Buckling ◽  
Success Rates ◽  
Retrospective Case ◽  
Pneumatic Retinopexy ◽  
Co Morbidity ◽  
Pars Plana ◽  
The Uk

Recent reports suggest that the use of an outpatient-based procedure (pneumatic retinopexy, PR) for retinal detachment repair should be encouraged within the UK, especially in light of Covid-19 and possible restrictions/competing demands on access to operating theatres. It is therefore essential that patients receive comprehensive information about the risks and benefits of this approach compared with a formal surgical repair either by pars plana vitrectomy (PPV) and/or scleral buckling (SB). We report a retrospective case series of retinal detachments (RD) satisfying the strict selection criteria for PR but who were managed with formal surgery. Single-operation success rate for PPV/SB at six months follow-up was 93.8% in our study, higher than published primary success rates for PR (60–80%). When counselling patients for possible PR, the ease, speed and potentially reduced co-morbidity of an outpatient-based procedure needs to be balanced against its significantly higher failure rate in comparison with primary PPV/SB.

scholarly journals Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eun Young Choi ◽  
Chul Hee Lee ◽  
Hyun Goo Kang ◽  
Jae Yong Han ◽  
Suk Ho Byeon ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Retrospective Case ◽  
Iol Implantation ◽  
Intraocular Lens Dislocation ◽  
Post Surgery ◽  
Pars Plana ◽  
Iol Dislocation ◽  
Iris Claw

AbstractWe aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.

scholarly journals Postoperative Endophthalmitis Caused by Cutibacterium (Formerly Propionibacterium) Acnes: Case Series and Review

2021 ◽  
pp. 1-10
Author(s):  
Benjamin J. Fowler ◽  
Darlene Miller ◽  
Xiaohe Yan ◽  
Nicolas A. Yannuzzi ◽  
Harry W. Flynn Jr.
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Clinical Features ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Postoperative Endophthalmitis ◽  
Cutibacterium Acnes ◽  
Pars Plana ◽  
Microbiologic Diagnosis

We report the clinical features, treatment strategies and outcomes in a series of patients with infectious endophthalmitis after cataract surgery caused by <i>Cutibacterium acnes (C. acnes)</i>, formerly known as <i>Propionibacterium acnes (P. acnes)</i>. This retrospective case series includes six eyes of six patients with chronic postoperative endophthalmitis caused by culture-proven <i>C. acnes</i>from December 2010 to July 2019 at a University referral center. All patients underwent prior cataract extraction with intraocular lens (CE/IOL) implantation. The mean time between cataract surgery and the microbiologic diagnosis of endophthalmitis was 7.4 ± 5.2 months (range 1.5–17 months). The average time from obtaining the specimen to culture positivity was 7.7 ± 4.4 days (range 3–15 days). Three eyes (50%) presented with hypopyon and three eyes (50%) presented with prominent keratic precipitates without hypopyon. Presenting visual acuity ranged from 20/25 to 2/200. Initial treatments included intravitreal antibiotics alone (<i>n</i> = 2), pars plana vitrectomy (PPV) with partial capsulectomy and intravitreal antibiotics (<i>n</i> = 3), and pars plana vitrectomy with IOL removal and intravitreal antibiotics (<i>n</i> = 1). Follow-up treatments included IOL removal (<i>n</i> = 2), intravitreal antibiotics (<i>n</i> = 1), and topical antibiotics (<i>n</i> = 1). The best-corrected visual acuity at last follow-up was 20/70 or better in all patients. In a literature review, the clinical features and treatment outcomes for all case series of delayed-onset postoperative endophthalmitis caused by <i>C. acnes</i>(<i>n</i> = 120) are listed<i>.</i> A definitive cure (the absence of recurrent inflammation) was achieved in 100% of patients that underwent IOL removal, in 77% of those that underwent PPV/partial capsulectomy and intravitreal antibiotics, and in 18% of cases treated with intravitreal antibiotics alone. Endophthalmitis after CE/IOL caused by <i>C. acnes</i>is characterized by slowly progressive intraocular inflammation and has a protracted course from surgery to microbiologic diagnosis. Visual outcomes are generally favorable, but IOL explantation may be necessary for definitive cure.

Delayed metastasis in patients with intraocular retinoblastoma: A review of three cases

2020 ◽  
pp. 112067212094628
Author(s):  
Vijitha S Vempuluru ◽  
Saumya Jakati ◽  
Swathi Kaliki
Keyword(s):  
Metastatic Disease ◽  
Tumor Regression ◽  
External Beam Radiotherapy ◽  
Case Series ◽  
Surgical Excision ◽  
Primary Treatment ◽  
Retrospective Case ◽  
Temporal Fossa ◽  
Intravitreal Chemotherapy

Purpose: To discuss the clinical presentation, management, and outcome of delayed metastasis in retinoblastoma (RB). Methods: Retrospective case series of three patients. Results: Mean age at diagnosis of RB was 29 months (median, 28 months; range, 11–48 months). All were males with non-familial bilateral intraocular RB. Primary treatment for RB included intravenous chemotherapy in all three cases. Secondary treatment included transpupillary thermotherapy/cryotherapy ( n = 6 eyes), periocular chemotherapy ( n = 2 eyes), intravitreal chemotherapy ( n = 1 eye), intra-arterial chemotherapy ( n = 1 eye), external beam radiotherapy (EBRT; n = 2 eyes), and enucleation ( n = 2 eyes). Primary tumor regression was achieved in all cases and remained status quo at the time of diagnosis of distant metastasis. Two patients developed bone metastasis (ulna; tibia) and one developed soft tissue metastasis (temporal fossa) over a mean follow-up period of 6 years (median, 7 years; range, 5–8 years) from diagnosis of RB. Mean age of detection of metastatic disease was 8 years (median, 8 years; range, 7–9 years). All the lesions were solitary and the diagnosis of metastatic retinoblastoma was confirmed by tissue biopsy. Metastatic disease was treated with surgical excision ( n = 1), chemotherapy ( n = 2), and EBRT ( n = 2). All patients are alive, with two patients free of disease over a mean follow-up period of 23 months (median, 23 months; range, 12–33 months); and 1 in remission 7 months after completion of EBRT. Conclusion: Long-term follow-up of RB cases is mandatory. In spite of intraocular tumor regression, metastasis can still occur many years after treatment of RB.

scholarly journals Management of Ocular Siderosis: Visual Outcome and Electroretinographic Changes

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Naresh B. Kannan ◽  
Olukorede O. Adenuga ◽  
Renu P. Rajan ◽  
Kim Ramasamy
Keyword(s):  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Visual Outcome ◽  
Ocular Injury ◽  
Retrospective Case ◽  
Common Features ◽  
Radiologic Evaluation ◽  
Pars Plana ◽  
Age Range ◽  
Rule Out

Purpose.Ocular siderosis (OS) is a sight threatening complication of retained iron-containing Intraocular Foreign Body (IOFB). Successful localization of the IOFB and timely removal are crucial to its management. The purpose of this study was to review the presentation, management, and outcome of OS at our institution.Methods. A retrospective case series of eyes with OS that underwent IOFB removal from January 2009 to March 2015 at our institution.Results. OS was seen in 9 eyes of 9 patients during the study period. There were 8 males and 1 female with an age range of 31.6 years. An IOFB was in all the eyes. The most common features of siderosis were cataract and pigmentary retinopathy seen in 6 (67%) and 4 (44%) eyes, respectively. Electroretinogram (ERG) readings were reduced in the 9 eyes. The IOFB was removed by pars plana vitrectomy in all the cases with improvement in ERG amplitudes occurring postoperatively in 7 (78%) eyes.Conclusion.A retained iron-containing IOFB can manifest itself after several years with features of OS. A careful clinical and radiologic evaluation is imperative in patients with history suggestive of penetrating ocular injury to rule out retained or occult IOFB and thus prevent this catastrophic condition.

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