Foveal bulge as a predictor of high visual function in rhegmatogenous retinal detachment

2021 ◽  
pp. 234-238
Author(s):  
R.R. Fayzrakhmanov ◽  
◽  
A.V. Sukhanova ◽  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Outer Segment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Outer Nuclear Layer ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Outer Segments ◽  
Group 2

Introduction. The integrity of photoreceptor's inner segment/outer segment connection plays great importance in predicting visual acuity in eyes with retinal pathology. However, even optical coherence tomographic study showed the intact of retinal layers, including photoreceptor's inner segment/outer segment line, after surgery due to rhegmatogenous retinal detachment (RRD), low visual acuity is observed. Purpose. to identify predictors of high visual acuity in the foveolar zone in patients after successful RRD repair according to SD-OCT. Material and methods. Group 1 consisted of 20 cases – eyes after successful primary RRD repair performed through pars plana vitrectomy using silicone oil tamponade (1300 cSt), followed by removal of silicone oil with a replacement for sterile air. Group 2 – control, followed eyes without ophthalmopathology and visualisation of foveolar bulge according to OCT. All patients underwent a standard ophthalmological examination and OCT on the 30th day after silicone oil removal. OCT examination was performed by Retina Map and Cross Line modes. The lengths of the outer segments of photoreceptors, inner segments of photoreceptors and the outer nuclear layer of the layer were measured in manual mode. Retina Map was used to measure retinal foveolar thickness. Results. During the study, the data of the foveolar thickness of the retina, the outer nuclear layer and the length of the outer segment of photoreceptors in the main group showed a significant decrease in comparison with the control group (p=0.002, p=0.006, p=0.02, respectively). In this case, a strong correlation was obtained only between the length of the outer segments of photoreceptors and visual acuity (r=0.68). Conclusion. The length of the outer segments of the cones in the central retinal area, or foveolar bulge, should considers a predictor of high visual acuity twostage surgical treatment of primary RRD using silicone oil. Key words: retinal detachment, foveolar bulge, ellipsoid zone, vitrectomy, OCT.

Comparison of the parameters of retinal sensitivity after vitrectomy due to rhegmatogenous retinal detachment

2021 ◽  
pp. 349-354
Author(s):  
R.R. Fayzrakhmanov ◽  
◽  
A.V. Sukhanova ◽  
O.A. Pavlovsky ◽  
E.D. Bosov ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Light Sensitivity ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Gas Tamponade ◽  
Group I ◽  
Silicone Oil Tamponade ◽  
Group Ii

Purpose. To compare the parameters of a light sensitivity (LS) of the central zone of a retina after vitrectomy due to reghmatogenous retinal detachment (RRD) with a silicone oil tamponade (SOT) and gas tamponade (GT). Material and methods. The study included 20 eyes after pars plana vitrectomy due to macula-off rhegmatogenous retinal detachment (RRD) by 25G. All patients were divided in 2 groups depending on the choice of the tamponade. The group I (10 eyes) included cases with the silicone oil tamponade (SOT) (1300 cSt), in the group II (10 eyes) – the gas tamponade (GT) (C2F6). The control group included contralateral eyes without ophthalmic pathology. All patients underwent standard ophthalmological examination and fundus- microperimetry (FMP) on the 30th day after removal of the SOT for the group I, or on the 30th day after the C2F6 tamponade for the group II. Results. According to FMP data, the parameter of average light sensitivity (LS) in the group I was significantly reduced, both in comparison with the group II (p=0.007) and the control group (p=0.003). Differentiation by zones in the group I revealed a decrease in each analyzed parameter in comparison with the control group (p<0.05) and a decrease in the 2nd zone (p=0.031) and the 4th zone (p=0.038) in comparison with the group II. In the 1st zone of the group I the formation of a relative scotoma was revealed in 4 cases out of 10 (40%). The parameters of light sensitivity (LS) in comparison with the control in the group II were significantly reduced when analyzed in each zone (p<0.05). A strong positive correlation was found between the Best Corrected Visual Acuity (BCVA) and the average LS in the group II (r=0.87). Conclusion. There is a decrease in the functional parameters of the retina with SOT compared with GT in the form of a decrease in the LS parameter in the 10° zone according to FMP data. Key words: retinal detachment, photosensitivity, microperimetry, silicone tamponade.

scholarly journals Use of Autologous Conditioned Platelet Rich Plasma in the Surgery of Rhegmatogenous Retinal Detachment with Central and Peripheral Tears

2019 ◽  
Vol 4 (4) ◽  
pp. 61-65
Author(s):  
D. G. Arsiutov
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Platelet Rich Plasma ◽  
Dentate Line ◽  
Retinal Tears ◽  
Retinal Reattachment ◽  
Late Postoperative Period

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.

scholarly journals Effect of Duration of Silicone Oil Tamponade on Retinal Structure after Rhegmatogenous Retinal Detachment Surgery

2021 ◽  
pp. 1-8
Author(s):  
Chloé Dubroux ◽  
Julia Salleron ◽  
Karine Angioi-Duprez ◽  
Jean-Paul Berrod ◽  
Jean-Baptiste Conart
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Case Series ◽  
Retinal Layer ◽  
Before And After ◽  
Silicone Oil Tamponade ◽  
Group 2 ◽  
Change In Mean ◽  
Group 1

<b><i>Purpose:</i></b> The aim of the study was to investigate the effect of tamponade duration on retinal changes induced by silicone oil (SO) in patients who underwent successful rhegmatogenous retinal detachment (RRD) surgery. <b><i>Methods:</i></b> Retrospective comparative case series of 68 patients who underwent SO tamponade for RRD. Patients were divided into 2 groups based on timing of SO removal: &#x3c;6 months (group 1, <i>n</i> = 34) versus ≥6 months (group 2, <i>n</i> = 34). The main outcome measure was the change in central macular, inner, and outer retinal layer thickness (CMT, IRLT, and ORLT) before and after SO removal (SOR). <b><i>Results:</i></b> The median tamponade duration was 4 [Clin Ophthalmol. 2016;10:471–6, Zhonghua Yan Ke Za Zhi. 1997 Jan;33(1):39–41] months in group 1 and 8 [Arch Ophthalmol. 1994 Jun;112(6):778–85, Retina. 2004 Dec;24(6):871–7] months in group 2 (<i>p</i> &#x3c; 0.001). The mean CMT significantly increased from 245.3 ± 22.2 μm and 238.8 ± 41.6 μm under SO to 281.3 ± 60.2 μm and 259.0 ± 43.5 μm after SOR in group 1 (<i>p</i> = 0.009) and in group 2 (<i>p</i> = 0.007), respectively. Automated segmentation measurement revealed a significant increase in mean IRLT (<i>p</i> = 0.014 and <i>p</i> = 0.013) but no change in mean ORLT (<i>p</i> = 0.080 and <i>p</i> = 0.257) in both groups. After adjustment, there was no difference between the 2 groups in terms of mean final CMT, IRLT, and ORLT and mean retinal thickness changes after SOR. There was also no correlation between the tamponade duration and macular microstructural changes or visual recovery. <b><i>Conclusion:</i></b> SO tamponade causes a thinning of all retinal layers, mainly affecting the inner retinal layer. However, these changes resolved following SO extraction and were not affected by longer tamponade duration.

scholarly journals Postoperative Perfluro-N-Octane tamponade for complex retinal detachment surgery

2015 ◽  
Vol 40 (2) ◽  
pp. 63-69
Author(s):  
T Reza Ali
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
T Test ◽  
Short Term ◽  
Vitreous Substitute ◽  
Group 2 ◽  
Paired T Test ◽  
Group 1

Aim: To study outcomes after using perfluoro-n-octane (PFO) as a short-term postoperative vitreous substitute in eyes undergoing primary vitrectomy with or without sclera buckling for complex rhegmatogenous retinal detachments with inferior/multiple breaks or giant retinal tears (GRTs) or retinal detachment with extensive proliferative vitreoretinopathy (PVR). Methods: A prospective study was carried out where in 43 patients (Group 1) PFO was exchanged with silicon oil in the same surgical procedure and in 22 patients (Group 2) PFO was kept for 3 days and then exchanged with silicon oil by a separate surgical procedure. The respective surgeon took the decision whether to exchange PFO on the same day or after 3 days. The patients were followed up for 6 months to analyze the anatomical attachment rates, visual acuity gain, and postoperative complications in both the groups. Results: There were 33 male and 10 female patients in group 1 and 18 male and 4 female patients in group 2. Mean age distribution in group 1 was 38.88 years (SD±21.45) and in group 2 was 38.09 years (SD±16.36). Mean preoperative best corrected visual acuity in group 1 was 2.02±0.58 and in group 2 was 2.01±0.53 logarithm of the minimum angle of resolution (LogMAR). The LogMAR Visual acuity in group 1 improved to 1.76±0.43 after 1 month (P=0.01, paired t test) and to 1.62±0.62 after 6 months (P=0.01, paired T test). This visual acuity in group 2 improved to 1.85±0.42 after 1 month (P=0.24, paired T test) and 1.90±0.72 after 6 months (P=0.49, paired T test). There was no difference regarding visual improvement in between two groups after 1 month and 6 months of follow-up (P=0.125, independent sample T test). The retina was detached in 6 patients (14%) in group 1 and in 7 patients (31%) in group 2 after 6 months of follow-up. There was no statistically significant difference in between two groups regarding final attachment of retina (P= 0.109, Fisher exact test). There was also no significant complication like increased posterior capsular opacification or glaucoma found after retaining PFO for 3 days. Conclusion: Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs or with extensive PVR. But keeping perfluoro-n-octane for 3 days does not significantly reduce the risk of re-detachment with complex rhegmatogenous retinal detachment cases.Bangladesh Med Res Counc Bull 2014; 40 (2): 63-69

scholarly journals The protective effects of erythropoietin on photoreceptor damage by formaldehyde

2016 ◽  
Vol 8 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Mehdi Mard Khoshnood ◽  
Mohammad Zareie ◽  
Ali Amiri ◽  
Ali Zarenezhad ◽  
Elham Zarenezhad ◽  
...  
Keyword(s):  
Outer Segment ◽  
Outer Nuclear Layer ◽  
Control Group ◽  
Ischemic Damage ◽  
Protective Effects ◽  
Adult Rats ◽  
Photoreceptor Layer ◽  
Transmission Electron ◽  
Group 2 ◽  
Group 1

Introduction: The photoreceptor layer of retina has important role for sight. The previous study showed that accidental formaldehyde injection caused ischemia and damage in the retina. On the other hand the erythropoietin prevents neuronal injury of ischemic damage. Objectives: The aim of this study was to survey the effect of erythropoietin on retro bulbar formaldehyde injected photoreceptor layer of rat retina. Materials and methods: 30 adult rats were used and divided into three groups: 1- control group, 2- formaldehyde group (1 ml retro bulbar injected by 10% formaldehyde solution), 3- erythropoietin group (5000 units/kg immediately intraperitoneally injected by erythropoietin after formaldehyde injection for 7 days). The photoreceptor layer of retina studied using a transmission electron microscope. Results: Our observation showed that disorganization and vacuolization in outer segment and inner segment, pyknotic and karyolysis in outer nuclear layer were seen in formaldehyde group. But the minor sign of pathology such as lightly vacuolization in inner segment were obvious in erythropoietin group. Conclusion: We concluded that formaldehyde caused damage in photoreceptor layer and erythropoietin was improvement this injury. Nepal J Ophthalmol 2016; 8(15): 10-17

scholarly journals Preoperative and Postoperative Optical Coherence Tomography Findings in Patients with Rhegmatogenous Retinal Detachment Involving the Macular Region

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Asaki Matsui ◽  
Hiroshi Toshida ◽  
Rio Honda ◽  
Takahiko Seto ◽  
Toshihiko Ohta ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Outer Nuclear Layer ◽  
Optical Coherence ◽  
External Limiting Membrane ◽  
Photoreceptor Layer ◽  
Before And After ◽  
Morphologic Changes

Purpose. To evaluate morphologic changes of the macula, we observed eyes with rhegmatogenous retinal detachment (RRD) involving the macular region by optical coherence tomography (OCT). Subjects and Methods. We studied 26 eyes with RRD before and after surgery, assessing visual acuity, the height of retinal detachment at the fovea (HRD), and morphologic changes of the macular region. The interval between the onset and surgery was also determined. We examined the external limiting membrane (ELM) after surgery and the continuity of the inner segment-outer segment junction (IS/OS junction) of the photoreceptor layer. Results. Impairment of visual acuity was observed when HRD was over 1,000 μm, when there was outer nuclear layer edema before surgery, and when there was IS/OS junction disruption 3 months after surgery. However, 67% of eyes with a continuous ELM and IS/OS junction disruption 3 months after surgery eventually showed restoration of the continuity of IS/OS junction at 6 months. Conclusions. Impairment of visual acuity was observed in eyes with HRD  μm, preoperative outer nuclear layer edema, and IS/OS junction disruption 3 months postoperatively. It is suggested that continuity of ELM might affect restoration of IS/OS junction after surgery for retinal detachment.

scholarly journals Changes of macular vessel density and thickness in gas and silicone oil tamponades after vitrectomy for macula-on rhegmatogenous retinal detachment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Liu ◽  
Boya Lei ◽  
Rui Jiang ◽  
Xin Huang ◽  
Min Zhou ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Retinal Thickness ◽  
Vessel Density ◽  
Gas Tamponade ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose To investigate the macular vessel density and thickness in macular-on rhegmatogenous retinal detachment (RRD) after vitrectomy with gas and silicone oil (SO) tamponade. Methods Patients with macular-on RRD eyes, treated with a single successful vitrectomy with gas or SO tamponade and a minimum 30 months follow-up, were reviewed. Best-corrected visual acuity (BCVA), macular vessel density and retinal thickness by using optical coherence tomography angiography, were compared to the contralateral eyes. Results Sixteen eyes with gas tamponade and 17 eyes with SO tamponade were included in the study. LogMAR best-corrected visual acuity (BCVA) slightly improved from 0.25 ± 0.18 (Snellen 20/36) to 0.17 ± 0.23 (Snellen 20/30) in eyes with gas tamponade, and decreased from 0.30 ± 0.22 (Snellen 20/40) to 0.49 ± 0.28 (Snellen 20/62) in eyes with SO tamponade. The parafoveal vessel densities in superficial vascular complex (SVC) and the corresponding inner retinal thickness (IRT) were similar between the affected eyes and the contralateral eyes in gas tamponade group (P = 0.578, P = 0.943), while significantly reduced in the affected eyes, compared to the contralateral eyes in SO tamponade group (P < 0.001, P < 0.001). Conclusion Eyes in SO tamponade group had worse BCVA, lower SVC vessel densities and thinner corresponding IRT after vitrectomy for macular-on RRD, than those in gas tamponade group.

Use neuroprotection to improve visual acuity after endovitreal surgery of rhegmatogenous retinal detachment

2020 ◽  
pp. 55-56
Author(s):  
А.V. Egorov ◽  
◽  
G.P. Smoliakova ◽  
V.V. Egorov ◽  
А.Y. Khudyakov ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment

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.

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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