scholarly journals Diagnosis and Management of Bleeding Vitreous by Trauma Closed Eyeball

2019 ◽  
Vol 2 (2) ◽  
pp. 32-39
Author(s):  
Rika Anggraini ◽  
AK Ansyori ◽  
Ramzi Amin
Keyword(s):  
Pars Plana Vitrectomy ◽  
Posterior Vitreous Detachment ◽  
Vitreous Hemorrhage ◽  
Ophthalmological Examination ◽  
Case Presentation ◽  
Retinal Blood Vessels ◽  
Common Causes ◽  
Pars Plana ◽  
Clinically Significant ◽  
The Right

Introduction. Diagnosis of vitreous bleeding is generally straightforward and  it can be made through history, ophthalmological examination and fundoscopy. However, the management is determined by the underlying etiology. The most common causes as factors that cause opposite vitreous bleeding include retinopathy of proliferative diabetes, posterior vitreous detachment (PVD) and trauma in 59-88.5% of cases. Reported a case of vitreous hemorrhage due to closed eyeball trauma performed by pars plana vitrectomy and endolaser with significant vision improvement. Case Presentation. A male, 21 years old, student, lived in suburban, came to the Polyclinic of RSMH on July 2019. Approximately 1 month ago the patient complained that his right eye vision suddenly felt blurry after being hit by volleyball from the front from a distance of 1 meter while playing volleyball with his friends. Patients complain of the view of the right eye as if it were covered with a red shadow accompanied by pain around the right eye. Ophthalmological examination obtained vision of this patient is a wave of the hand that is 1/300 in the right eye and 6/6 in the left eye that shows the disorder is unilateral with a fairly poor decrease in vision. During intraoperative right eye hemorrhage was found to nearly cover the retina with the source of bleeding in peripheral retinal blood vessels which when found intraoperatively were not found extravasation or active bleeding. Conclusion. The operative action of pars plana vitrectomy gives a clinically significant result that is obtained very good sharp eyesight and from the examination results obtained echofree on vitreous. Proper timing is very important in determining the management of vitreous bleeding in order to get good results and minimize the risk of complications that can occur.

scholarly journals Management of Diabetic Retinopathy

2018 ◽  
Vol 1 (2) ◽  
pp. 45-53
Author(s):  
Nova Herdana ◽  
AK Ansyori ◽  
Ramzi Amin
Keyword(s):  
Diabetic Retinopathy ◽  
Pars Plana Vitrectomy ◽  
Laser Photocoagulation ◽  
Ophthalmological Examination ◽  
Anti Vegf ◽  
History Of ◽  
Grade Ii ◽  
Pars Plana ◽  
The Right ◽  
Photocoagulation Laser

Introduction. Diabetic retinopathy (RD) is one of the most common complications of diabetes mellitus, and is a major cause of blindness in patients aged 20-64 years worldwide. The main principle of the management of RD is to prevent, inhibit and overcome complications that occur. Vitrectomy, laser photocoagulation, intravitreal anti VEGF injection become modalities in RD therapy. If PDR has occurred, vitreous hemorrhage can occur or the retina is attracted by proliferation tissue, vitrectomy should be performed. Case Presentation. The patient is a 52-year-old man who came with the main complaint that both eyes have blurred slowly since ± 6 months ago. Blurred vision is not accompanied by red eyes, there is smoke-like vision. In the past the history of the disease obtained a history of DM 15 years of irregular control and hypertension of 3 years with regular control, a history of spectacles present. The ophthalmological examination of the right eye revealed a vision of 6/30 pH (-), TIOD within normal limits, and a grade II nuclear cataract in the lens. Right eye fundoscopy revealed decreased foveal reflexes and exudates in the macula, dot, blot, flame-shaped bleeding in 4 quadrants of the retina, exudate, venous beading, micro-aneurism. Management in these patients is pars plana vitrectomy, endolaser, and intravenous OS anti-VEGF injection under general anesthesia. Whereas the right eye was intravitreal photocoagulation laser and anti-VEGF laser (done 2 weeks before). Conclusion. A case of advanced left eye PDR with severe NPDR and right eye DME and grade II nuclear cataracts has been described in both eyes. Patients treated with laser photocoagulation in the right eye. In the left eye pars plana vitrectomy, endolaser, and intravitreal bevacizumab injection. Sharp vision of the left eye progressed postoperatively.

scholarly journals Vitrectomy With Peeling the Internal Limiting Membrane for the Treatment of Macular Hole Following Ruptured Retinal Arterial Macroaneurysm: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhigao Liu ◽  
Shuya Wang ◽  
Yu Wang ◽  
Aihua Ma ◽  
Bojun Zhao
Keyword(s):  
Macular Hole ◽  
Posterior Vitreous Detachment ◽  
Internal Limiting Membrane ◽  
Case Presentation ◽  
Surgical Closure ◽  
Retinal Arterial Macroaneurysm ◽  
Corrected Visual Acuity ◽  
Pars Plana ◽  
Sudden Decrease ◽  
The Right

Background: This study aimed to report a case of vitrectomy with peeling the internal limiting membrane for the treatment of macular hole (MH) following ruptured retinal arterial macroaneurysm (RAMA).Case Presentation: A 65-year-old woman noticed a sudden decrease in vision in the left eye. She had no other ocular problems apart from a mild cataract in both eyes before. Her best-corrected visual acuity (BCVA) was 20/33 in the right eye, and 6/100 in the left eye. Fluorescein angiography (FFA) showed a retinal arterial macroaneurysm with telangiectatic retinal vascular changes in the inferior temporal macular region. Optical coherence tomography (OCT) examination demonstrated the presence of subretinal hemorrhage extending into the foveal area and incomplete posterior vitreous detachment. Because of the presence of submacular hemorrhage, some medicine was administrated and the patient was followed up. Then, 5 months later, the hemorrhage was absorbed. OCT examination exhibited a full-thickness MH with a macular epiretinal membrane. The size of the MH was 722 μm in diameter. She was then given a standard three-port pars plana vitrectomy (PPV), along with peeling of the internal limiting membrane (ILM) and filling the vitreous cavity with air. Anatomic closure of the MH was achieved after 4 weeks of the surgery by the examination of OCT. The BCVA was improved to 15/100.Conclusions: This case expanded our knowledge of the association of MH secondary to ruptured RAMA. We reported a case with successful surgical closure of the MH and improvement of BCVA.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

Retina Injury After Dexamethasone Injection Into a Vitrectomized Eye

2020 ◽  
Vol 4 (6) ◽  
pp. 538-540
Author(s):  
Michael S. Elliott ◽  
Sandra R. Montezuma
Keyword(s):  
Macular Edema ◽  
Vitreous Hemorrhage ◽  
Signs And Symptoms ◽  
Internal Limiting Membrane ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Patient Reported ◽  
Clinically Significant ◽  
The Right ◽  
Intravitreal Dexamethasone

Purpose: This work reports a case of retinal and vitreous hemorrhage after a dexamethasone (Ozurdex, Allergan) intravitreal implant injection to treat clinically significant macular edema (ME) in a patient with moderate nonproliferative diabetic retinopathy. Methods: A 61-year-old woman who had a vitrectomy 3 years prior in the right eye underwent intravitreal dexamethasone implant injection in the right eye. Immediately after the injection, the patient noted numerous floaters, with visual acuity decline from 20/30 before injection, to counting fingers at 3 feet after injection. Dilated examination revealed the dexamethasone implant resting against the retina, just inferior to the inferior arcade. On 360° fundus examination, the retina was found to be flat and attached. Optical coherence tomography of the macula demonstrated that the dexamethasone implant was preretinal, possibly having lifted the internal limiting membrane. Results: Thirty minutes after the injection, the patient reported that her vision was starting to clear. The patient was informed about what had transpired and warned about signs and symptoms of retinal detachment. She canceled her 1-week follow-up appointment because her vision returned to baseline. By 4 weeks post injection, her vision was 20/20 without macular edema. Conclusions: This case represents the first reported instance in which retinal impact by an Ozurdex implant was observed without treatment and vision recovered to baseline.

A Case of Retinal Detachment in Retinitis Pigmentosa

2007 ◽  
Vol 17 (4) ◽  
pp. 677-679 ◽  
Author(s):  
M.N. Demir ◽  
N. Ünlü ◽  
Z. Yalniz ◽  
M.A. Acar ◽  
F. Örnek
Keyword(s):  
Retinal Detachment ◽  
Retinitis Pigmentosa ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Young Patients ◽  
Scleral Buckling ◽  
Oil Removal ◽  
Pars Plana ◽  
The Right

Purpose To report case of retinitis pigmentosa in association with rhegmatogenous retinal detachment. Methods An eight year old boy complained of a sudden visual loss. The patient had night blindness, bone spicule-like hyperpigmentation, pale optic disc in both eyes, and the retina was totally detached in the right eye. Results He was initially treated with conventional scleral buckling surgery, then pars plana vitrectomy with silicone tamponade was performed and retinal reattachment was established. After the phacoemulsification combined with silicone oil removal the final visual acuity of counting fingers was obtained. Conclusions The association of retinitis pigmentosa and rhegmatogenous retinal detachment is uncommon in young patients.

scholarly journals IMPROVEMENT OF LEUKEMIC RETINOPATHY AFTER LEUKAPHERESIS IN CHRONIC MYELOGENOUS LEUKEMIA WITH LEUKOSTASIS

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Ruchyta Ranti ◽  
Sauli Ari Widjaja ◽  
Wimbo Sasono ◽  
Muhammad Firmansjah ◽  
Ima Yustiarini ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Chronic Myelogenous Leukemia ◽  
Visual Disturbance ◽  
Myelogenous Leukemia ◽  
Laboratory Examination ◽  
Retinal Hemorrhages ◽  
Case Presentation ◽  
Retinal Blood Vessels ◽  
Wbc Count ◽  
The Right

ABSTRACT Introduction: to report a case of bilateral leukemic retinopathy due to leukostasis that was successfully managed by leukapheresis. Case Presentation: 31-year-old male with mild visual disturbance was referred to ophthalmology department. He suffered from Chronic Myelogenous Leukemia (CML) with white blood cell (WBC) count 533.900/microL. He was started on hydroxyurea, allopurinol, and once leukapheresis. Ophthalmologic evaluation revealed visual acuity of 4/4 in the right eye and 4/6,3 in the left eye. Funduscopy examination showed the presence of bilateral papilledema, venous engorgement, tortuosity, and retinal hemorrhages. Then this patient continued with second leukapheresis. Result: Visual acuity, laboratory examination, and funduscopic finding was evaluated. His visual acuity was improved, papilledema and retinal blood vessels abnormality had markedly reduced concurring with the patient’s hematological remission. Decreasing WBC count after leukapheresis has improved blood flow that reflected from the retinal findings and visual acuity improvement. Conclusion: Leukapheresis treatment is sufficient to improved clinical condition for leukemic retinopathy caused by CML with leukostasis. Keywords: chronic myelogenous leukemia (CML), hyperleukocytosis, leukostasis, leukemic retinopathy

Rhegmatogenous retinal detachment with giant retinal tear in a child with Marfan’s syndrome: a rare ocular emergency

2021 ◽  
Vol 14 (6) ◽  
pp. e241354
Author(s):  
Parrina Sehgal ◽  
Subina Narang ◽  
Deepak Chandra
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Marfan’S Syndrome ◽  
Marfan's Syndrome ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 7-year-old boy with Marfanoid habitus presented with sudden and painless decrease in the vision of the right eye. Ocular examination revealed rhegmatogenous retinal detachment with 360° giant retinal tear in the right eye and small peripheral retinal breaks with lattice degeneration in the left eye. The patient underwent a 23-gauge pars plana vitrectomy with scleral buckling in the right eye and laser around the breaks in the left eye. At 1-week follow-up visit, the child presented with similar complaints in the left eye as were seen in the right eye. This was later managed effectively with 23-gauge pars plana vitrectomy only. So, with our case report, we would like to highlight the need for aggressive screening in children who are diagnosed with Marfan’s syndrome and the need for prophylactic treatment in the unaffected eye.

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.

scholarly journals Surgical timing and presence of a vitreoretinal fellow on postoperative adverse events following pars plana vitrectomy

2018 ◽  
Vol 30 (1) ◽  
pp. 81-87
Author(s):  
Ryan A Shields ◽  
Cassie A Ludwig ◽  
Matthew A Powers ◽  
Jonathan D Tijerina ◽  
Ira H Schachar ◽  
...  
Keyword(s):  
Adverse Event ◽  
Adverse Events ◽  
Pars Plana Vitrectomy ◽  
Vitreous Hemorrhage ◽  
Adverse Event Rate ◽  
Start Time ◽  
School Of Medicine ◽  
Pars Plana ◽  
Independent Risk Factors ◽  
Postoperative Vitreous Hemorrhage

Introduction: To evaluate the adverse event rate following pars plana vitrectomy as a function of surgical start time and the presence of a vitreoretinal fellow. Methods: Single-institution retrospective cohort study of patients undergoing pars plana vitrectomy from 1 January 2016 to 31 December 2016 at Stanford University School of Medicine (Palo Alto, CA, USA). Records were reviewed for surgical start time, the presence of vitreoretinal fellow, and postoperative adverse events defined as any finding deviating from the expected postoperative course requiring observation or intervention. Results: A total of 310 pars plana vitrectomies were performed. There was no statistical difference in the rate of any adverse event when comparing cases starting after 16:01 (9/13, 69.2%) and after 12:01 (42/99, 42.4%) to a morning start time (69/198, 34.9%, adjusted p = 0.083). There was a statistically significant increase in the risk of postoperative vitreous hemorrhage with afternoon and evening cases as compared to morning cases (adjusted p = 0.021). In addition, there was no difference in any adverse event with a fellow present (93/244, 38.1%) compared to without (27/66, 40.9%, adjusted p = 0.163). There was a higher risk of postoperative hypotony when a fellow was involved (6.6% vs 0%, p = 0.028), though this difference disappeared after adjusting for confounders (adjusted p = 0.252). There was no difference in the length of surgery with and without a fellow (49 vs 54 min, respectively; p = 0.990). Discussion: Afternoon start time and the presence of a fellow were not independent risk factors for postoperative adverse events.

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