SIGNIFICANCE OF ULTRASONOGRAPHY IN EVALUATION OF VITREORETINAL PATHOLOGY

2021 ◽  
pp. 37-39
Author(s):  
Champa Mandi ◽  
Debashis Dakshit ◽  
Laksmi Kanta Mandal
Keyword(s):  
Retinal Detachment ◽  
Structural Changes ◽  
Posterior Vitreous Detachment ◽  
Anterior Segment ◽  
Sense Organ ◽  
Vitreous Cavity ◽  
Posterior Chamber ◽  
Medical College ◽  
Retinal Pathologies ◽  
Regional Institute

INTRODUCTION:Vitreoretinal pathologies include vitreal haemmorhage and vitreal detachment, retinal detachment, retinoblastoma, diabetic retinopathy, leukocoria, trauma over eye. The eye being an external sense organ lends itself to an easy and rapid examination of anterior segment but structure posterior to the papillary plane i.e lens, vitreous cavity and humor, retina, choroid in an opaque media could not be evaluated by just fundus examination. OBJECTIVES OF RESEARCH: Demographic prole of patient with vitreoretinal pathologies. Diagnose the patient with vitreoretinal pathologies by ultrasonography. Detect and characterize the vitreoretinal pathologies by ultrasonography, clinical ndings and post management conrmatory ndings to establish the diagnostic accuracy of ultrasonography in vitreoretinal pathologies. MATERIALAND METHOD: Study design:Institution based prospective, descriptive study Study setting: USG section at Dept. of Radiodiagnosis, Medical College, Kolkata Place of study: Dept. of Radiodiagnosis, Medical College, Kolkata Period of study:January 2018 to august 2019 Study population:Referred patient from regional institute of opthalmology Sample size: 50 patients. RESULT AND ANALYSIS: We showed that 29(48.3%0 patients had vitreous haemorrhage. 19(31.7%) patients had retinal detachment. 10(16.7%) patients had posterior vitreous detachment. 7(11.7%) patients had endophthalmitis. 9(15.0%) patients had retinoblastoma. 1(1.7%) patients had PHPV. 1(1.7%) patients had asteroid hyalosis. 1(1.7%) patients had retinoschisis. 5(8.3%) patients had normal. SUMMARYAND CONCLUSION: From, the present study it was noted that Ultrasonography is very efcient tool in diagnosing various ocular abnormalities. Ultrasonography can categorize the lesions in the posterior chamber well, depending on the echotexture and anatomy. Even the exact location of the lesion and surrounding structures can be well made out. Ultrasonography can detect structural changes that were missed or could not be detected by clinical examination especially with opaque media as well. Ultrasonography is proved to be very useful diagnostic tool in detection and evaluation of vitreo-retinal pathologies in patients with opacities in the vitreous cavity.

Evaluation and Management

2009 ◽  
Author(s):  
Daniel A. Brinton ◽  
Charles P. Wilkinson
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Anterior Segment ◽  
Careful Examination ◽  
Ocular Motility ◽  
Vitreous Detachment ◽  
Indirect Ophthalmoscopy ◽  
Field Defect

Evaluation of a patient for retinal detachment includes a thorough history and a complete ocular exam, including measurement of visual acuity, external examination, ocular motility testing, testing of pupillary reactions, anterior-segment biomicroscopy, tonometry, and binocular indirect ophthalmoscopy with scleral depression. Posterior-segment biomicroscopy, perimetry, and ultrasonography are also sometimes required. Rhegmatogenous retinal detachment is a diagnosis generally made by clinical examination of the retina alone, but a full history, ocular examination, and sometimes selected ancillary tests are also important parts of the evaluation (Figure 4–1). The symptoms of retinal detachment include fl ashes of light, new floaters, visual Field defect, decreased visual acuity, metamorphopsia, and rarely, defective color vision. The perception of light fl ashes, or photopsia, is due to the production of phosphenes by pathophysiologic stimulation of the retina. The retina is activated by light but is also capable of responding to mechanical disturbances. In fact, the most common cause of light fl ashes is posterior vitreous detachment. As the vitreous separates from the retinal surface, the retina is disturbed mechanically, stimulating a sensation of light. This perception is more marked if there are focal vitreoretinal adhesions. Generally, vitreous separation is benign and may almost be regarded as normal in the senescent eye. In approximately 12% of symptomatic posterior vitreous detachments, however, a careful search of the periphery reveals a tear of the retina. If the fl ashes are associated with floaters, it is wise to assume that a retinal tear exists, until proved otherwise. These symptoms demand a prompt and careful examination of the periphery with binocular indirect ophthalmoscopy and scleral indentation. The patient’s localization of the photopsia is of little value in predicting the location of the vitreoretinal pathology. If no breaks are evident in the first examination after symptomatic vitreous detachment, they rarely appear at a later date. If there is no associated hemorrhage or other pathologic condition, the patient needs counseling only. However, if pigment or blood is detected in the vitreous, a follow-up examination is often required. It is prudent to forewarn patients about the symptoms of retinal detachment. Flashes alone or floaters alone are less significant than if they occur together, in which case they are more likely to be associated with a retinal break.

Pathogenesis, Epidemiology, and Natural Course of Retinal Detachment

2009 ◽  
Author(s):  
Daniel A. Brinton ◽  
Charles P. Wilkinson
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Proliferative Diabetic Retinopathy ◽  
Posterior Vitreous Detachment ◽  
Subretinal Fluid ◽  
Vitreous Cavity ◽  
Subretinal Space ◽  
Retinal Break ◽  
Vitreous Detachment ◽  
Pass Through

Retinal detachment does not result from a single, specific disease; rather, numerous disease processes can result in the presence of subretinal fluid. The three general categories of retinal detachments are termed rhegmatogenous, exudative, and tractional. Rhegmatogenous detachments are sometimes referred to as primary detachments, while both exudative and tractional detachments are called secondary or nonrhegmatogenous detachments. The three types of retinal detachments are not mutually exclusive. For example, detachments associated with proliferative vitreoretinopathy or proliferative diabetic retinopathy may exhibit both rhegmatogenous and tractional features. However, excluding the section on differential diagnosis in Chapter 5, the scope of this book is limited to rhegmatogenous retinal detachments. Accordingly, throughout the book, the term retinal detachment refers to the rhegmatogenous type, unless another type is specifically mentioned. Rhegmatogenous detachments (from the Greek rhegma, meaning rent, rupture, or fissure) are the most common form of retinal detachment. They are caused by a break in the retina through which fluid passes from the vitreous cavity into the subretinal space. The responsible break(s) can be identified preoperatively in more than 90% of cases, but occasionally the presence of a minute, unseen break must be assumed. Exudative detachments, also called serous detachments, are due to an associated problem that produces subretinal fluid without a retinal break. This underlying problem usually involves the choroid as a tumor or an inflammatory disorder. Tractional detachments occur when pathologic vitreoretinal adhesions or membranes mechanically pull the retina away from the pigment epithelium without a retinal break. The most common causes include proliferative diabetic retinopathy, cicatricial retinopathy of prematurity, proliferative sickle retinopathy, and penetrating trauma. Retinal breaks may subsequently develop, resulting in a combined tractional and rhegmatogenous detachment. The essential requirements for a rhegmatogenous retinal detachment include a retinal break and low-viscosity vitreous liquids capable of passing through the break into the subretinal space. Vitreous changes usually precede development of important defects in the retina. The usual pathologic sequence causing retinal detachment is vitreous liquefaction followed by a posterior vitreous detachment (PVD) that causes traction at the site of significant vitreoretinal adhesion with a subsequent retinal tear. Fluids from the vitreous cavity then pass through the tear into the subretinal space (Figure 2–1), augmented by currents within the vitreous cavity caused by rotary eye movements. Although a total PVD is usually seen, many detachments occur with partial vitreous detachment, and evidence of posterior vitreous detachment may not be seen.

scholarly journals Pars plana vitrectomy in management of giant retinal tear and retinal detachment following iris-fixated anterior chamber phakic intraocular lens implantation

2018 ◽  
Vol 11 (1) ◽  
pp. e228052
Author(s):  
Sagnik Sen ◽  
Raghav Dinesh Ravani ◽  
Prateek Kakkar ◽  
Atul Kumar
Keyword(s):  
Retinal Detachment ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Posterior Vitreous Detachment ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Pars Plana

This case report describes a 26-year-old man presenting with a giant retinal tear (GRT) with retinal detachment (RD) following implantation of iris-fixated anterior chamber phakic intraocular lens (AC-PIOL) for high myopia and occurrence of intraoperative aberrations during vitrectomy due to the presence of AC-PIOL in situ. Posterior chamber PIOL have been well reported to be associated with GRT with RD. Very few reports exist of GRT with RD following AC-PIOL. Moreover, the presence of iris-fixated AC-PIOL, in this case, led to the formation of ghost images intraoperatively especially during crucial steps like induction of posterior vitreous detachment which has never been reported.

A novel approach for scleral fixation using Carlevale lens

2021 ◽  
pp. 112067212199135
Author(s):  
Tito Fiore ◽  
Marco Messina ◽  
Alessio Muzi ◽  
Marco Lupidi ◽  
Michele Reibaldi ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Axial Length ◽  
Anterior Segment ◽  
Posterior Chamber ◽  
Topical Steroids ◽  
Minimal Risk ◽  
Scleral Fixation ◽  
Novel Approach ◽  
Ophthalmologic Examination

Purpose: To evaluate the surgical outcomes and feasibility of a novel approach for scleral-fixation using a single-piece acrylic foldable Carlevale lens (Soleko). Methods: Eighteen eyes of 18 patients with aphakia, dislocated IOL, subluxated lens, anisometropia, perforated trauma, and retinal detachment who underwent IOL implantation with a Carlevale lens were evaluated. All the patients underwent a standard ophthalmologic examination. Anterior segment (AS)-OCT was used postoperatively to check plugs positioning and IOL tilt. Results: Mean patients age was 73 ± 19 years. Mean follow-up was 11.2 ± 4.1 months. Mean axial length was 23.7 ± 1.65 mm, white-to-white distance was 11.74 ± 0.40 mm, and axial length was 23.67 ± 1.65 mm. Refractive spherical equivalent prediction error was −0.31 ± 0.71D. Mean IOL tilt was 2.2° ± 1.6° and plugs were placed within the sclera. Five patients had aphakia, five in-the-bag IOL subluxation, three in-the-bag IOL luxation, one high residual myopia after previous verisyse implant, one Uveitis-Glaucoma-Hyphema syndrome, one perforating trauma with phacodonesis, one intraocular foreign body and retinal detachment, two lens subluxation. One eye developed cystoid macular edema which disappeared with topical steroids and FANS. No other complications were observed throughout the follow-up. Conclusion: Carlevale lens (Soleko) appears to be a viable option for both anterior and posterior segment surgeons in the management of complex cases providing less challenging maneuvers which lead to a good lens self-centration and minimal risk of haptic rupture and/or dislocation. The lens seems to offer a good compartmentalization between the anterior and posterior chamber reducing the risk of an inflammatory response.

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.

scholarly journals Microperimetry-Assessed Functional Alterations and OCT-Changes in Patients after Retinal Detachment Surgery Using Pars Plana Vitrectomy and SF6 Tamponade

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1157
Author(s):  
María D. Díaz-Barreda ◽  
Isabel Bartolomé-Sesé ◽  
Ana Boned-Murillo ◽  
Antonio Ferreras ◽  
Elvira Orduna-Hospital ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Structural Changes ◽  
Cross Sectional Study ◽  
Retinal Sensitivity ◽  
Cross Sectional ◽  
Swept Source ◽  
Integrity Assessment ◽  
Integrity Index ◽  
Pars Plana

Background: We study the retinal function measured by macular integrity assessment microperimetry (MAIA) and structural changes assessed by scanning swept source optical coherence tomography (SS-OCT) between healthy individuals and patients undergoing pars plana vitrectomy (PPV) after rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study. Early Treatment Diabetic Retinopathy Study (ETDRS) grids were measured by SS-OCT and compared with the MAIA parameters. Results: Thirty-eight eyes with RRD (19 macula-on and 19 macula-off) were compared with 113 healthy eyes. The retinal sensitivity and average total threshold were reduced in all sectors in the RRD group; macular integrity index was increased. Macular thicknesses in total retina and ganglion cell layer (GCL)++ protocols were higher in the RRD group in nasal outer (NO) and central (C) sectors and only in C sector for GCL+ protocol. Thicknesses were lower in total retina, GCL++ protocols in the temporal outer (TO) sector and in the GCL+ protocol in NO sector. Best-corrected visual acuity (BCVA) correlated moderately with retinal sensitivity in all sectors and in just several sectors with time between the date of surgery and the test. The central nasal (CN) sector thickness and the average total threshold were higher in the macula-on subgroup. Conclusions: RRD and subsequent surgery results in functional and structural changes, especially in individuals with macular detachment.

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