scholarly journals Clinical Analysis of Persistent Subretinal Fluid after Pars Plana Vitrectomy in Macula with Diabetic Tractional Retinal Detachment

2021 ◽  
Vol 10 (24) ◽  
pp. 5929
Author(s):  
Yong-Koo Kang ◽  
Jae-Pil Shin
Keyword(s):  
Retinal Detachment ◽  
Kidney Function ◽  
Pars Plana Vitrectomy ◽  
Univariate Analysis ◽  
Subretinal Fluid ◽  
Clinical Analysis ◽  
Diabetic Patients ◽  
Contributing Factors ◽  
Tractional Retinal Detachment ◽  
Pars Plana

(1) Background: We analyzed the duration of persistent subretinal fluid (PSF) and the contributing factors of PSF after pars plana vitrectomy in patients who had a macula with diabetic tractional retinal detachment (TRD). (2) Methods: Forty eyes of 40 patients who had pars plana vitrectomy due to a macula with diabetic TRD, between 2014 and 2020, were retrospectively reviewed. The duration of PSF, as well as relevant ocular and systemic factors, was analyzed. (3) Results: The mean duration of PSF was 4.4 ± 4.7 months. The prevalence of PSF was 75.0% at 1 month, 50.0% at 3 months, 30.0% at 6 months and 10.0% at 12 months after surgery. Blood urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR) were significantly associated with the duration of PSF in the univariate analysis. In the multivariate analysis, only eGFR was significantly associated with the duration of PSF (β = −0.089, p = 0.030). (4) Conclusion: PSF may persist for more than 12 months in a macula with diabetic TRD after vitrectomy. Moreover, patients with impaired kidney function tended to have a delayed subretinal fluid absorption. Therefore, careful investigation of preoperative systemic conditions, especially kidney function, should be considered before TRD surgery in diabetic patients.

scholarly journals Clinical analysis of persistent subretinal fluid after pars plana vitrectomy in macular involving diabetic tractional retinal detachment

2021 ◽  
Author(s):  
Yong Koo Kang ◽  
Jae Pil Shin
Keyword(s):  
Retinal Detachment ◽  
Kidney Function ◽  
Pars Plana Vitrectomy ◽  
Univariate Analysis ◽  
Subretinal Fluid ◽  
Clinical Analysis ◽  
Final Visit ◽  
Contributing Factors ◽  
Tractional Retinal Detachment ◽  
Pars Plana

Abstract The purpose of this study was to analyze the duration of persistent subretinal fluid (PSF) and contributing factors after pars plana vitrectomy in patients accompanying macular involving diabetic tractional retinal detachment (TRD). We included 33 eyes of 33 patients diagnosed macular involving diabetic TRD and received pars plana vitrectomy between 2014 and 2019 were reviewed retrospectively. PSF was confirmed on optical coherence tomography. The duration of PSF after surgery and relevant ocular and systemic factors according to the duration of PSF were analyzed. The prevalence of PSF was 81.8% a 1 month, 54.5% at 3 months, 36.4% at 6 months and 12.1% at 12 months after surgery and mean duration of PSF was 5.2 ± 4.9 months. The mean best corrected visual acuity was significantly improved after 1 year and the final visit than baseline. Blood urine nitrogen, creatinine, and estimated glomerular filtration rate (eGFR) were significantly associated with duration of PSF in univariate analysis, but only eGFR was significantly associated in the multivariate analysis. Therefore, patients with impaired kidney function tend to have delayed subretinal fluid absorption and it would be necessary to explain in advance that PSF could be long-lasting in patient with impaired kidney function.

scholarly journals Management of Retinal Detachment Associated with Morning Glory Disc Syndrome

2021 ◽  
pp. 457-463
Author(s):  
Tyler Etheridge ◽  
Zackery Oakey ◽  
Michael M. Altaweel
Keyword(s):  
Retinal Detachment ◽  
Gene Mutation ◽  
Pars Plana Vitrectomy ◽  
Subretinal Fluid ◽  
Morning Glory ◽  
Pax6 Gene ◽  
Fluid Exchange ◽  
Tractional Retinal Detachment ◽  
Morning Glory Disc Anomaly ◽  
Pars Plana

We report a case of morning glory disc anomaly in a young patient with tractional retinal detachment successfully repaired with complex pars plana vitrectomy, membrane peel, laser, and oil tamponade. A 19-year-old female with a history of right morning glory disc anomaly associated with PAX6 gene mutation presented with floaters, photopsia, central scotoma, and visual acuity (VA) of 1/200. A complex macula-involving tractional retinal detachment centered around the optic nerve with a morning glory disc anomaly. Retinal detachment was treated with 25-gauge pars plana vitrectomy with difficult separation of the posterior hyaloid. Fibrous preretinal membranes were peeled, a temporal relaxing retinotomy was required, subretinal fluid was drained through a superonasal retinotomy during air-fluid exchange, endolaser was applied, and tamponade was achieved with 1,000-centistoke silicone oil. The retina remained attached at 1-year follow-up, with VA count fingers throughout. Morning glory disc is a rare congenital anomaly associated with PAX6 gene mutation that most often occurs unilaterally. It is rarely associated with tractional retinal detachment. Optimization of visual outcome is imperative despite a poor visual prognosis.

scholarly journals Surgical outcomes of 25-gauge pars plana vitrectomy for diabetic tractional retinal detachment

Eye ◽  
2015 ◽  
Vol 29 (9) ◽  
pp. 1213-1219 ◽  
Author(s):  
M S Dikopf ◽  
K H Patel ◽  
V J Setlur ◽  
J I Lim
Keyword(s):  
Retinal Detachment ◽  
Surgical Outcomes ◽  
Pars Plana Vitrectomy ◽  
Tractional Retinal Detachment ◽  
Pars Plana

scholarly journals Recurrent Retinal Detachment after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

2020 ◽  
Author(s):  
Yan Fu ◽  
Yue-ling Zhang ◽  
Zhaohui Gu ◽  
Ren-Fei Geng ◽  
Xin-Yu Yuan
Keyword(s):  
Visual Acuity ◽  
Risk Factor ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Univariate Analysis ◽  
Visual Outcomes ◽  
Primary Surgery ◽  
Pars Plana

Abstract Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and needs further surgery. The purpose of this study is to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD.Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included the causative factors, visual outcomes of RD recurrence, and the perioperative factors most affecting the recurrence of RD.Results After retinal reattachment, we observed recurrence of RD after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most recurrence (69%) occurred within 6 months after surgery. Univariate analysis showed that the primary risk factor significantly associated with recurrent RD was the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C ( P = 0.003). Logistic regression analysis showed that a PVR ≥ Grade C (odds ration [OR]: 9.421, 95% confidence interval [CI]: 2.432 - 56.39; P =0.020) was a significant predictor for the development of recurrent RD. The recurrence of RD resulted in a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit compared with the reattachment group ( P =0.000). Eyes with PVR prior to primary surgery or at the diagnosis of re-detachment showed a worse final BCVA.Conclusions The presence of PVR ≥ Grade C was the predominant risk factor for the recurrence of RD. PVR prior to primary surgery, or at the diagnosis of re-detachment, limited the recovery of final visual acuity.

Does Pars Plana Vitrectomy Improve Visual Outcomes in Patients with Complications of Proliferative Diabetic Retinopathy

2020 ◽  
pp. 185-190
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Clinical Trial ◽  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Proliferative Diabetic Retinopathy ◽  
Pars Plana Vitrectomy ◽  
Vitreous Hemorrhage ◽  
Diabetic Patients ◽  
Visual Outcomes ◽  
Management Of Complications ◽  
Pars Plana

The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 17) describes the baseline previtrectomy characteristics, initial treatment assignments, indications for vitrectomy, and visual outcomes in the subgroup of patients in the ETDRS who had pars plana vitrectomy (PPV). The study showed that pars plana vitrectomy could improve visual outcomes in patients with complications from proliferative diabetic retinopathy such as vitreous hemorrhage and retinal detachment. PPV continues to play an important role in the management of complications from proliferative diabetic retinopathy.

Posterior Retinotomy vs Perfluorocarbon Liquid to Aid Drainage of Subretinal Fluid During Primary Rhegmatogenous Retinal Detachment Repair (PRO Study Report No. 10)

2020 ◽  
Vol 4 (6) ◽  
pp. 494-498
Author(s):  
Loi V. Vo ◽  
Edwin H. Ryan ◽  
Claire M. Ryan ◽  
Gaurav K. Shah ◽  
Omesh P. Gupta ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Surgical Procedures ◽  
Subgroup Analysis ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Postoperative Outcomes ◽  
Perfluorocarbon Liquid ◽  
Pars Plana ◽  
Retrospective Comparative Study

Purpose: This work compares posterior retinotomy vs perfluorocarbon liquid (PFCL) for subretinal fluid (SRF) drainage during pars plana vitrectomy for primary rhegmatogenous retinal detachment (RRD). Methods: In this large, multicenter, retrospective comparative study, 2620 patients underwent pars plana vitrectomy (with or without scleral buckle) for uncomplicated RRD. Patients for whom SRF was drained via the primary break without retinotomy or PFCL were excluded; those who required both retinotomy and PFCL were similarly excluded. Remaining patients were separated into “retinotomy” and “PFCL” cohorts. Subgroup analysis was conducted for macula-on and macula-off subgroups. Postoperative outcomes were analyzed and compared. Results: A total of 760 eyes (82.7%) had retinotomy and 159 eyes (17.3%) had PFCL for drainage of SRF, and baseline characteristics between the 2 groups were similar. Postoperative analysis showed similar outcomes between the retinotomy and PFCL cohorts, including final visual acuity ( P = .19), redetachment rate ( P = .30), anatomic success ( P = .28), presence of postoperative epiretinal membrane ( P = .75), and other macular pathologies ( P > .99). Subgroup analysis yielded similar outcomes for macula-on and macula-off subgroups. Postoperative presence of retained PFCL was 2.4%, possibly a factor in the slightly higher number of subsequent surgical procedures ( P = .03) in the PFCL cohort. Conclusions: Postoperative outcomes for retinotomy vs PFCL during RRD repair are comparable, aside from slightly greater number of subsequent surgical procedures needed in the PFCL cohort. Our analysis suggests both techniques are reasonable tools in the repair of macula-on or macula-off RRD.

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