Neuro-Ophthalmological Emergencies. Are They Always Innocent? A Case Report and a Literature Review

2021 ◽  
pp. 1-9
Author(s):  
Anthoula C Tsolaki ◽  
◽  
Thomas Tegos ◽  
Ioannis N Chalkias ◽  
Efthymios Chalkias ◽  
...  
Keyword(s):  
Case Report ◽  
Retinal Detachment ◽  
Literature Review ◽  
Respiratory Distress ◽  
Pars Plana Vitrectomy ◽  
Neurological Complications ◽  
Ophthalmic Surgery ◽  
Tractional Retinal Detachment ◽  
Peribulbar Block ◽  
Pars Plana

Neuro-ophthalmogical complications are rare but can be serious after regional block. We present a case of a 54-year-old diabetic patient who was scheduled for pars plana vitrectomy of his right eye due to tractional retinal detachment, under a peribulbar block with a mixture of lidocaine and ropivacaine. He presented with tachycardia, hypertension, seizures, respiratory distress and apnea. He was intubated for less than 24 hours. He was discharged with no neurological deficit. A review regarding these rare but serious neurological complications of ophthalmic surgery is presented, to raise awareness of neurologists, who are called to evaluate and treat these patients

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

Venous Air Embolism During Pars Plana Vitrectomy: A Case Report and Review of the Literature

2017 ◽  
Vol 1 (5) ◽  
pp. 334-337 ◽  
Author(s):  
Sundeep K. Kasi ◽  
Scott Grant ◽  
Harry W. Flynn ◽  
Thomas A. Albini ◽  
Nidhi Relhan ◽  
...  
Keyword(s):  
Case Report ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Air Embolism ◽  
Choroidal Detachment ◽  
Fatal Complication ◽  
Ocular Surgery ◽  
Venous Air Embolism ◽  
Pars Plana ◽  
Air Exchange

Purpose: Presumed venous air embolism (PVAE) is a rare and potentially fatal complication of pars plana vitrectomy that is poorly described and understood but requires improved awareness among ophthalmologists and vitreoretinal surgeons. Methods: A case report is presented along with a systematic review of published reports of PVAE during ocular surgery. Results: An otherwise healthy adult male undergoing retinal detachment repair under local anesthesia with monitored anesthesia care died from a PVAE. Literature search yielded 2 experimental models, 6 individual case reports, and several editorials. Review of existing reports reveals that PVAE can affect patients of any age or gender with no medical predilection and occurs in cases of trauma, endoresection, or retinal detachment repair. It is typically associated with a drop in end-tidal carbon dioxide during fluid–air exchange and can present similar to a hemorrhagic choroidal detachment. Analysis suggests that venous air embolism can be prevented by ensuring full engagement of the infusion cannula into the vitreous cavity prior to fluid–air exchange. Conclusion: Presumed venous air embolism is a potentially fatal complication of ocular surgery and in some cases may be recognized by ophthalmologists as a choroidal detachment during fluid–air exchange in pars plana vitrectomy. It is imperative to immediately stop the air infusion line if venous air embolism is suspected.

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.

Macular Hole Formation After Pars Plana Vitrectomy for Diabetic Tractional Retinal Detachment

2018 ◽  
Vol 49 (12) ◽  
pp. e256-e262
Author(s):  
Jared T. Sokol ◽  
Kevin Ferenchak ◽  
Darin T. Rosen ◽  
Sidney A. Schechet ◽  
Dimitra Skondra
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Hole Formation ◽  
Tractional Retinal Detachment ◽  
Pars Plana ◽  
Macular Hole Formation

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.

Sign in / Sign up

Export Citation Format

Share Document