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Sample records for buckling retinal detachment

  1. Scleral buckling for retinal detachment in patients with retinoblastoma

    SciTech Connect

    Buzney, S.M.; Pruett, R.C.; Regan, C.D.; Walton, D.S.; Smith, T.R.

    1984-10-15

    Three children (two girls and one boy) with bilateral retinoblastoma each developed a presumed rhegmatogenous retinal detachment in one eye. All three eyes had previously received radiation and cryotherapy. In each case the retinal detachment responded promptly to conventional surgical methods via scleral buckling in the area of treated retinoblastoma and presumed retinal break. All three eyes have retained useful vision for follow-up periods of 3.5 to 12 years.

  2. Sutureless scleral buckle in the management of rhegmatogenous retinal detachment

    PubMed Central

    Shanmugam, P Mahesh; Singh, Tajinder Pal; Ramanjulu, Rajesh; Rodrigues, Gladys; Reddy, Srinivasulu

    2015-01-01

    Purpose: To evaluate the anatomical and functional outcomes of sutureless scleral buckling for the repair of rhegmatogenous retinal detachment (RD). Design: Retrospective interventional case series. Materials and Methods: Retrospective analysis of 50 eyes of 49 patients with rhegmatogenous RD, who underwent sutureless scleral buckling from January 2009 to March 2013. Results: Primary retinal re-attachment rate of 86% was achieved with single surgery, but final anatomical success was 94% with additional interventions in the form of intravitreal gas, buckle revision, and/or pars plana vitrectomy. Best corrected logarithm of minimum angle of resolution visual acuity improved from 1.44 ± 1.01 preoperatively to 0.50 ± 0.40 at a mean follow-up of 6.7 months. Conclusion: Sutureless scleral buckling achieves excellent anatomical and functional success in majority of the patients with rhegmatogenous RD. PMID:26576521

  3. Scleral buckling surgery for rhegmatogenous retinal detachment with subretinal proliferation

    PubMed Central

    Ghasemi Falavarjani, K; Alemzadeh, S A; Modarres, M; Parvaresh, M M; Hashemi, M; Naseripour, M; Nazari Khanamiri, H; Askari, S

    2015-01-01

    Purpose To evaluate the outcome of scleral buckling surgery in patients with rhegmatogenous retinal detachment (RRD) with subretinal proliferation. Methods In this retrospective study, a chart review of all patients with RRD associated with subretinal proliferation who were primarily treated with scleral buckling procedure, from April 2007 to April 2014, was undertaken. Main outcome measures were anatomical retinal reattachment and visual acuity. Results Forty-four eyes of 43 patients including 24 males and 19 females with a mean age of 26.5±13.1 years were evaluated. Immediately after the surgery, retina was reattached in all eyes. However, five eyes (11.3%) needed additional surgery for retinal redetachment. Single surgery anatomical success rate was 88.7%. Four eyes (9.1%), needed pars plana vitrectomy for the treatment of redetachment associated with proliferative vitreoretinopathy and scleral buckle revision surgery was successfully performed in the other eye. Best corrected visual acuity improved from 1.5±0.9 logMAR before surgery to 1.1±0.7 logMAR after surgery (P<0.001). An improvement in BCVA of >2 lines was found in 23 eyes (52.2%) and worsening of best corrected visual acuity of >2 lines was observed in 2 eyes (4.5%). Conclusions Scleral buckling surgery is highly successful in eyes with RRD associated with subretinal proliferation. PMID:25613841

  4. An alternative technique in (1) determining the placement of scleral buckles in (2) retinal detachment surgery.

    PubMed

    Akkin, C; Erakgun, T

    2001-01-01

    We have developed a simple technique to verify the final and exact position of the explant on the retinal break before placing the radial or circumferential scleral buckles during the retinal detachment surgery. For this purpose, we used the back end of a dismantled blade holder which is essentially the same size as a sponge. PMID:12678393

  5. Retinal Detachment

    MedlinePlus

    ... immediately. Treatment How is retinal detachment treated? Small holes and tears are treated with laser surgery or ... laser surgery tiny burns are made around the hole to “weld” the retina back into place. Cryopexy ...

  6. Pneumatic retinopexy versus scleral buckle for repairing simple rhegmatogenous retinal detachments

    PubMed Central

    Hatef, Elham; Sena, Dayse F; Fallano, Katherine A; Crews, Jonathan; Do, Diana V

    2015-01-01

    Background Rhegmatogenous retinal detachment (RRD) is a full-thickness break in the sensory retina, caused by vitreous traction on the retina. While pneumatic retinopexy, scleral buckle, and vitrectomy are the accepted surgical interventions for eyes with RRD, their relative effectiveness has remained controversial. Objectives The objectives of this review were to assess the effectiveness and safety of pneumatic retinopexy versus scleral buckle or pneumatic retinopexy versus a combination treatment of scleral buckle and vitrectomy for people with RRD. The secondary objectives were to summarize any data on economic measures and quality of life. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2015), EMBASE (January 1980 to January 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to January 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 January 2015. Selection criteria We included all randomized or quasi-randomized controlled trials comparing the effectiveness of pneumatic retinopexy versus scleral buckle (with or without vitrectomy) for eyes with RRD. Data collection and analysis After screening for eligibility, two review authors independently extracted study characteristics, methods, and outcomes. We followed systematic review standards as set forth by The Cochrane Collaboration. Main results We included two randomized controlled trials (218 eyes of 216 participants) comparing the effectiveness of

  7. Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling

    PubMed Central

    Fang, Wei; Li, Jiu-Ke; Jin, Xiao-Hong; Dai, Yuan-Min; Li, Yu-Min

    2016-01-01

    AIM To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment (RRD) after sclera buckling (SB). METHODS Totally 48 patients (51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), baseline best corrected visual acuity (BCVA), operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student's t-test, Wilcoxon two-sample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. RESULTS Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR. Primary surgical success rate was 92.16% (47/51). Correlation analyses revealed shorter symptoms duration (r=0.3850, P=0.0053), less detached area (r=0.5489, P<0.0001), fovea (r=0.4605, P=0.0007), no PVR (r=0.3138, P=0.0250), better baseline BCVA (r=0.7291, P<0.0001), shorter operative duration (r=0.3233, P=0.0207) and longer follow up (r=-0.3358, P=0.0160) were related with better final BCVA, while independent predictive factors were better baseline BCVA [partial R-square (PR2)=0.5316, P<0.0001], shorter symptoms duration (PR2=0.0609, P=0.0101), longer follow up duration (PR2=0.0278, P=0.0477) and shorter operative duration (PR2=0.0338, P=0.0350). Patients with vision improvement took up 49.02% (25/51). Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision [odds ratio (OR) =50.369, P=0.0041] and longer follow up duration (OR=1.144, P=0

  8. Retinal detachment

    MedlinePlus

    ... of the first symptoms of new flashes of light and floaters. ... diabetes. See your eye care specialist once a year. You may need more frequent visits if you have risk factors for retinal detachment. Be alert to symptoms of new flashes of light and floaters.

  9. Strabismus following retinal detachment repair: a comparison between scleral buckling and vitrectomy procedures

    PubMed Central

    Kasbekar, S A; Wong, V; Young, J; Stappler, T; Durnian, J M

    2011-01-01

    Purpose We conducted a study to investigate: (1) deviations caused by retinal detachment (RD) repair; (2) correlation between visual acuity and the number of surgeries to deviation size; and (3) differences between deviations following scleral buckling (SB) and pars plana vitrectomy (PPV). Methods A retrospective analysis of patients with persistent binocular diplopia following RD repair. Magnitude of manifest deviation (∣dev∣) in the primary position (PP) and position of greatest deviation (maxDev) was calculated. LogMAR acuity and number of previous vitreoretinal procedures were correlated to ∣dev∣ in both PP and maxDev. Manifest ∣dev∣ were compared between SB and PPV groups. Results Twenty-five patients were identified. The median ∣dev∣ was 7 prism diopters (PD) in PP and 17 PD in maxDev. We found no association between number of surgeries or VA with ∣dev∣ in either the PP (r=−0.18 and r=0.08) or maxDev (r=−0.26 and r=−0.05). Twelve patients underwent PPV: median ∣dev∣ in PP 6 PD and maxDev 9 PD. In the SB group: median ∣dev∣ in PP 8 PD and in maxDev 22 PD. ∣dev∣ in PP showed no significant differences between PPV and SB (U=63, P=0.41); however, ∣dev∣ in maxDev, showed that SB have significantly greater deviations (U=36.0, P=0.02). Conclusion We report the largest cohort of patients with symptomatic ocular motility defects following PPV. We show no association between VA or number of procedures to strabismus magnitude. Ocular deviations in maxDev are significantly greater after SB procedures. PMID:21701526

  10. Retinal Detachment Vision Simulator

    MedlinePlus

    ... Retina Treatment Retinal Detachment Vision Simulator Retinal Detachment Vision Simulator Mar. 01, 2016 How does a detached or torn retina affect your vision? If a retinal tear is occurring, you may ...

  11. Retinal Detachment: Torn or Detached Retina Diagnosis

    MedlinePlus

    ... Eye Health / Eye Health A-Z Detached or Torn Retina Sections Retinal Detachment: What Is a Torn ... Retina Treatment Retinal Detachment Vision Simulator Retinal Detachment: Torn or Detached Retina Diagnosis Written by: Kierstan Boyd ...

  12. Retinal Detachment: Torn or Detached Retina Symptoms

    MedlinePlus

    ... Eye Health / Eye Health A-Z Detached or Torn Retina Sections Retinal Detachment: What Is a Torn ... Retina Treatment Retinal Detachment Vision Simulator Retinal Detachment: Torn or Detached Retina Symptoms Written by: Kierstan Boyd ...

  13. Retinal detachment

    MedlinePlus

    ... separate from the underlying tissues, much like a bubble under wallpaper. This is most often caused by ... small detachment, the doctor may place a gas bubble in the eye. This is called pneumatic retinopexy. ...

  14. Computational Simulation of Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment: On the Effect of the Band Size on the Myopization

    PubMed Central

    Lanchares, Elena; del Buey, María A.; Cristóbal, José A.; Ascaso, Francisco J.

    2016-01-01

    A finite element model (FE) of the eye including cornea, sclera, crystalline lens, and ciliary body was created to analyze the influence of the silicone encircling bandwidth and the tightness degree on the myopia induced by scleral buckling (SB) procedure for rhegmatogenous retinal detachment. Intraocular pressure (IOP) was applied to the reference geometry of the FE model and then SB surgery was simulated with encircling bandwidths of 1, 2, and 2.5 mm. Different levels of tightening and three values of IOP were applied. The anterior segment resulted as unaffected by the surgery. The highest value of Cauchy stress appeared in the surroundings of the implant, whereas no increment of stress was observed either in anterior segment or in the optic nerve head. The initial IOP did not appear to play any role in the induced myopia. The wider the band, the greater the induced myopia: 0.44, 0.88, and 1.07 diopters (D) for the 1, 2, and 2.5 mm bandwidth, respectively. Therefore, patients become more myopic with a wider encircling element. The proposed simulations allow determining the effect of the bandwidth or the tightness degree on the axial lengthening, thus predicting the myopic increment caused by the encircling surgery. PMID:27413542

  15. Computational Simulation of Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment: On the Effect of the Band Size on the Myopization.

    PubMed

    Lanchares, Elena; Del Buey, María A; Cristóbal, José A; Calvo, Begoña; Ascaso, Francisco J; Malvè, Mauro

    2016-01-01

    A finite element model (FE) of the eye including cornea, sclera, crystalline lens, and ciliary body was created to analyze the influence of the silicone encircling bandwidth and the tightness degree on the myopia induced by scleral buckling (SB) procedure for rhegmatogenous retinal detachment. Intraocular pressure (IOP) was applied to the reference geometry of the FE model and then SB surgery was simulated with encircling bandwidths of 1, 2, and 2.5 mm. Different levels of tightening and three values of IOP were applied. The anterior segment resulted as unaffected by the surgery. The highest value of Cauchy stress appeared in the surroundings of the implant, whereas no increment of stress was observed either in anterior segment or in the optic nerve head. The initial IOP did not appear to play any role in the induced myopia. The wider the band, the greater the induced myopia: 0.44, 0.88, and 1.07 diopters (D) for the 1, 2, and 2.5 mm bandwidth, respectively. Therefore, patients become more myopic with a wider encircling element. The proposed simulations allow determining the effect of the bandwidth or the tightness degree on the axial lengthening, thus predicting the myopic increment caused by the encircling surgery. PMID:27413542

  16. Long-term follow-up of vitrectomy, with or without 360° encircling buckle, for rhegmatogenous retinal detachment due to inferior retinal breaks

    PubMed Central

    Ghoraba, Hamouda Hamdy; Zaky, Adel Galal; Ellakwa, Amin Faisal

    2016-01-01

    Objective The aim of this study was to report and compare the anatomic and functional results of primary vitrectomy with and without 360° encircling scleral buckle (SB) for the treatment of rhegmatogenous retinal detachment (RRD) due to inferior retinal break(s). Background A variety of options, including SB, pars plana vitrectomy (PPV) with or without SB, and pneumatic retinopexy have been described as methods to repair RRDs. The use of additional SB with vitrectomy for RRD associated with inferior breaks has been a recent controversy after the introduction of transconjunctival cannula systems. Patients and methods A retrospective, interventional, comparative case study was performed. In this study, we reviewed 105 consecutive patients who underwent vitrectomy for primary RRD with inferior retinal break(s) at the vitreoretinal center, performed by a single surgeon. Ninety four patients (94 eyes) were followed up for at least 4 months after silicon oil removal (SOR), and were analyzed. They were divided into two groups: group I included 50 patients who underwent PPV alone + silicon oil (SO); and group II included 44 patients who underwent PPV with 360° SB + SO. The essential parameters were single-operation success rate (SOSR) before SOR, incidence of retinal redetachment after SOR, and final visual acuity. Results SOSR was obtained in 89 eyes (47 [94%] in group I and 42 [95.5%] in group II). From overall 59 phakic retinal detachments (RDs), SOSR was obtained in 56 eyes (30 in group I [93.8%] and 26 in group II [96.3%]) while from overall 35 aphakic or pseudophakic RDs, SOSR was obtained in 33 eyes (17 in group I [94.4%] and 16 in group II [94.1%]). Retinal redetachments after SOR occurred in three patients in group I and two patients in group II. Visual acuity improvement was greater in group I than in group II before SOR. Conclusion Both surgical procedures had similar reattachment rates. The addition of 360° SB to PPV + SO might not have additional benefits

  17. VANISHING RETINAL DETACHMENT

    PubMed Central

    2015-01-01

    Purpose: The purpose of this report is to describe a case of rhegmatogenous retinal detachment in the setting of chronic kidney disease that exhibited complete retinal reattachment after serial hemodialysis. Methods: Retrospective case report. Results: A 58-year-old woman with acute vision loss was found to have a macula-involving rhegmatogenous retinal detachment. Due to chronic kidney disease, she continued with routinely scheduled hemodialysis for 1 week until surgical clearance was obtained. Preoperative examination revealed complete reattachment of the retina with a persistent retinal tear. Barrier laser was applied to the tear and the retina remained attached until the most recent follow-up 8 months later. The workup of alternate etiologies was unrevealing. Conclusion: This case describes a temporal association between hemodialysis and resolution of subretinal fluid due to rhegmatogenous retinal detachment. A potential causal linkage is suggested based on shifting fluid dynamics associated with hemodialysis. A shift in treatment paradigm is not advised. PMID:26352323

  18. Retinal detachment in pseudophakia.

    PubMed

    Galin, M A; Poole, T A; Obstbaum, S A

    1979-07-01

    In a series of cataract patients excluding myopic individuals, under age 60 years, and cases in which vitreous loss occurred, retinal detachment was no less frequent after intracapsular cataract extraction and Sputnik iris supported lenses than in controls. Both groups were followed up for a minimum of two years. The detachments predominantly occurred from retinal breaks in areas of the retina that looked normal preoperatively. PMID:464014

  19. Scleral buckling for primary rhegmatogenous retinal detachment using noncontact wide-angle viewing system with a cannula-based 25 G chandelier endoilluminator

    PubMed Central

    Imai, Hisanori; Tagami, Mizuki; Azumi, Atsushi

    2015-01-01

    Purpose The aim of this study is to report the result of scleral buckling (SB) using a combination of a noncontact wide-angle viewing system and a cannula-based 25 G chandelier endoilluminator. Methods Retrospective analyses of the medical records of 79 eyes of 79 patients with primary uncomplicated rhegmatogenous retinal detachments who had underwent SB using a combination of a noncontact wide-angle viewing system and a chandelier endoilluminator were performed. Results There were 50 men and 29 women. The mean ± standard deviation age was 43.7±16.0 years. Their preoperative best-corrected visual acuity (BCVA) was 0.31±0.65 logMAR units. The final BCVA was 0.10±0.31 logMAR units, which was significantly better than the preoperative BCVA (P<0.01). The initial and final anatomical success rates were 92.4% and 100%, respectively. Backward logistic multiple regression analysis revealed no relationship between explanatory variables and the primary anatomic success (P=0.104). Conclusion SB using a combination of a noncontact wide-angle viewing system and a chandelier endoilluminator is a modified new technique and may be a valid option for the management of rhegmatogenous retinal detachments. PMID:26635466

  20. Retinal detachment repair - series (image)

    MedlinePlus

    ... scleral buckle is applied. This consists of a silicone patch wrapped around the eye, compressing the globe ... of the eye, and sealing the detachment. The silicone patch is usually left in place permanently, unless ...

  1. PIMASERTIB AND SEROUS RETINAL DETACHMENTS

    PubMed Central

    AlAli, Alaa; Bushehri, Ahmad; Park, Jonathan C.; Krema, Hatem

    2016-01-01

    Purpose: To report a case of multifocal serous retinal detachments associated with pimasertib. Methods: The authors report a 26-year-old patient who developed bilateral multifocal serous retinal detachments appearing 2 days after starting pimasertib (as part of a clinical trial investigating its use in low-grade metastatic ovarian cancer) and rapidly resolving 3 days after stopping it. Conclusion: The mechanism of MEK inhibitor induced visual toxicity remains unclear. The pathophysiology of multifocal serous retinal detachments as a complication of pimasertib is still poorly understood. PMID:26444523

  2. The mechanics of retinal detachment

    NASA Astrophysics Data System (ADS)

    Chou, Tom; Siegel, Michael

    2013-03-01

    We present a model of the mechanical and fluid forces associated with exudative retinal detachments where the retinal photoreceptor cells separate typically from the underlying retinal pigment epithelium (RPE). By computing the total fluid volume flow arising from transretinal, vascular, and retinal pigment epithelium (RPE) pump currents, we determine the conditions under which the subretinal fluid pressure exceeds the maximum yield stress holding the retina and RPE together, giving rise to an irreversible, extended retinal delamination. We also investigate localized, blister-like retinal detachments by balancing mechanical tension in the retina with both the retina-RPE adhesion energy and the hydraulic pressure jump across the retina. For detachments induced by traction forces, we find a critical radius beyond which the blister is unstable to growth. Growth of a detached blister can also be driven by inflamed tissue within which e.g., the hydraulic conductivities of the retina or choroid increase, the RPE pumps fail, or the adhesion properties change. We determine the parameter regimes in which the blister either becomes unstable to growth, remains stable and finite-sized, or shrinks, allowing possible healing. This work supported by the Army Research Office through grant 58386MA

  3. Bilateral Simultaneous Rhegmatogenous Retinal Detachment following Laser in situ Keratomileusis.

    PubMed

    Yumusak, Erhan; Ornek, Kemal; Ozkal, Fatma

    2016-01-01

    A 21-year-old woman developed simultaneous rhegmatogenous retinal detachment after laser in situ keratomileusis (LASIK) in both eyes. She underwent pars plana vitrectomy surgery combined with endolaser photocoagulation and silicone oil tamponade in the right eye. A week later, pneumatic retinopexy was done in the left eye. As the retinal tear did not seal, 360° scleral buckling surgery was performed and retina was attached. Bilateral simultaneous rhegmatogenous retinal detachment after LASIK for correction of myopia can be a serious complication. Patients should be informed about the possibility of this complication. PMID:27462264

  4. Bilateral Simultaneous Rhegmatogenous Retinal Detachment following Laser in situ Keratomileusis

    PubMed Central

    Yumusak, Erhan; Ornek, Kemal; Ozkal, Fatma

    2016-01-01

    A 21-year-old woman developed simultaneous rhegmatogenous retinal detachment after laser in situ keratomileusis (LASIK) in both eyes. She underwent pars plana vitrectomy surgery combined with endolaser photocoagulation and silicone oil tamponade in the right eye. A week later, pneumatic retinopexy was done in the left eye. As the retinal tear did not seal, 360° scleral buckling surgery was performed and retina was attached. Bilateral simultaneous rhegmatogenous retinal detachment after LASIK for correction of myopia can be a serious complication. Patients should be informed about the possibility of this complication. PMID:27462264

  5. Treatment of retinal detachment with an encircling band and buckle implant: A comparative pilot study between poly (styrene-b-isobutylene-b-styrene) (SIBS) and trimethyl terminated polydimethylsiloxane (PDMS)

    NASA Astrophysics Data System (ADS)

    Aguilar, Mariela; Yamamoto, Hideo; Espana, Edgar; Acosta, Ana Carolina; Orozco, Marcia; Aly, Mohamed; Arrieta, Esdras; Hernandez, Eleut; Martin, John; Dubovy, Sander; Smiddy, William; Pinchuk, Leonard; Parel, Jean-Marie

    2006-02-01

    Purpose: To demonstrate the biocompatibility of SIBS implants as compared to PDMS implants in the treatment of retinal detachment in New Zealand White (NZW) rabbit model. 1,2 Introduction: Scleral encircling bands, fixation rings and buckles are utilized for closure of retinal breaks and retina reattachment. The FDA approved PDMS-implant is associated with several post-operative complications, involving thick-fibrotic encapsulations. SIBS, an elastomeric triblock copolymer, was recently FDA approved for use in a cardiovascular drug eluting stent (TAXUS TM, Boston Scientific Corp., MA) and showed excellent biocompatibility and slow drug release capability. Materials and Methods: SIBS (9-mol%-styrene) implants were fabricated (InnFocus LLC, USA) to match PDMS implants (Labtician, Inc, Canada) dimensions. 5 NZW rabbits received SIBS and 4, PDMS-implants. Post-operative exam sequence: day 1 and 2, week 1, 2, 3, 4 and 6, and monthly thereafter for up to 1 year. Anatomohistopathology exams sequence: one SIBS animal at 6 weeks and one animal of each treatment group at 3 and 6-months, and two at 12-months. Results: SIBS compared to PDMS animals exhibited less inflammation and a better buckling effect during the first 6 weeks. At POD 9 months, the conjunctival injection in the SIBS rabbit was none as opposed to the PDMS value and the buckling effect for both groups were equal. There were no visible signs of encapsulation with SIBS. There were no infections in the 9 animals and none of the implants extruded thus far (<10 months). Conclusion: SIBS encircling bands, sleeves, and buckle implants are well tolerated in the rabbit model.

  6. Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis

    PubMed Central

    Almeida, David RP; Chin, Eric K; Tarantola, Ryan M; Tegins, Elizabeth O; Lopez, Christopher A; Boldt, Herbert Culver; Gehrs, Karen M; Sohn, Elliott H; Russell, Stephen R; Folk, James C; Mahajan, Vinit B

    2015-01-01

    Purpose To determine the outcomes in patients with rhegmatogenous retinal detachment (RRD) secondary to viral retinitis. Patients and methods This was a retrospective, consecutive, noncomparative, interventional case series of 12 eyes in ten patients with RRD secondary to viral retinitis. Results of vitreous or aqueous biopsy, effect of antiviral therapeutics, time to retinal detachment, course of visual acuity, and anatomic and surgical outcomes were investigated. Results There were 1,259 cases of RRD during the study period, with 12 cases of RRD secondary to viral retinitis (prevalence of 0.95%). Follow-up was available for a mean period of 4.4 years. Varicella zoster virus was detected in six eyes, herpes simplex virus in two eyes, and cytomegalovirus in two eyes. Eight patients were treated with oral valacyclovir and two patients with intravenous acyclovir. Lack of optic nerve involvement correlated with improved final visual acuity of 20/100 or greater. Pars plana vitrectomy (n=12), silicone-oil tamponade (n=11), and scleral buckling (n=10) provided successful anatomic retinal reattachment in all cases, with no recurrent retinal detachment and no cases of hypotony during the follow-up period. Conclusion Varicella zoster virus was the most frequent cause of viral retinitis, and lack of optic nerve involvement was predictive of a favorable visual acuity prognosis. Vitrectomy with silicone-oil tamponade and scleral buckle placement provided stable anatomical outcomes. PMID:26229423

  7. Optimizing the treatment of rhegmatogenous retinal detachment.

    PubMed

    Hajari, Javad Nouri

    2016-03-01

    Surgical approaches for rhegmatogenous retinal detachment (RRD) have evolved rapidly in the past century. This has resulted in an increase in the anatomical success rate from zero per cent in the beginning of the 1900s to now almost 100 per cent. Rhegmatogenous retinal detachment is regarded as an acute eye disease that needs immediate treatment. With the increasing number of cataract surgeries and an increased elderly population, the numbers of RRD occurrences are increasing. The aim of this thesis is to create knowledge on how treatment and care of RRD patients can be optimized. In the first paper, data on the incidence of RRD in Denmark are presented based on data from a nation register the National Patient Registry (NPR). It was discovered that the incidence of RRD in Denmark is similar to previous reported numbers and that the incidence has been increasing due to increasing numbers of cataract surgeries and an increased elderly population. Using data from the NPR, we estimated that the risk of a RRD occurring on the fellow eye is 100 times larger than on the first eye and that middle aged men have the highest risk. Having an increase in the incidence of RRD we need to ensure that the patients are also treated in the most optimal way. To ensure this, an indicator is needed to monitor the quality at the different centres. This indicator presented in the second paper is based in the occurrence of redetachment. We define a detachment to be caused by poor surgery if the retina detaches within one year after initial surgery with pneumatic retinopexy, scleral buckling and VTX with gas, and one and a half years after surgery with VTX with oil. Also lack of oil removal within the first year is a failed operation. It is widely accepted that RRD is an acute disease but when should surgery be performed to attain the most optimal result? In the third paper, we evaluated the progression of posterior RRD with an optical coherence tomography to make an objective assessment of

  8. Retinal Detachment: Torn or Detached Retina Treatment

    MedlinePlus

    ... of these procedures create a scar that helps seal the retina to the back of the eye. ... around the retinal tear. The scarring that results seals the retina to the underlying tissue, helping to ...

  9. Retinal detachment associated with atopic dermatitis.

    PubMed Central

    Takahashi, M; Suzuma, K; Inaba, I; Ogura, Y; Yoneda, K; Okamoto, H

    1996-01-01

    BACKGROUND: Retinal detachment associated with atopic dermatitis, one of the most common forms of dermatitis in Japan, has markedly increased in Japan in the past 10 years. To clarify pathogenic mechanisms of retinal detachment in such cases, we retrospectively studied clinical characteristics of retinal detachment associated with atopic dermatitis. METHODS: We examined the records of 80 patients (89 eyes) who had retinal detachment associated with atopic dermatitis. The patients were classified into three groups according to lens status: group A, eyes with clear lenses (40 eyes); group B, eyes with cataract (38 eyes), and group C, aphakic or pseudophakic eyes (11 eyes). RESULTS: No significant differences were noted in the ratio of males to females, age distribution, refractive error, or characteristic of retinal detachment among the three groups. The types of retinal breaks, however, were different in eyes with and without lens changes. While atrophic holes were dominant in group A, retinal dialysis was mainly seen in groups B and C. CONCLUSION: These findings suggested that anterior vitreoretinal traction may play an important role in the pathogenesis of retinal breaks in eyes with atopic cataract and that the same pathological process may affect the formation of cataract and tractional retinal breaks in patients with atopic dermatitis. PMID:8664234

  10. A mechanical model of retinal detachment

    NASA Astrophysics Data System (ADS)

    Chou, Tom; Siegel, Michael

    2012-08-01

    We present a model of the mechanical and fluid forces associated with exudative retinal detachments where the retinal photoreceptor cells separate, typically from the underlying retinal pigment epithelium (RPE). By computing the total fluid volume flow arising from transretinal, vascular and RPE pump currents, we determine the conditions under which the subretinal fluid pressure exceeds the maximum yield stress holding the retina and RPE together, giving rise to an irreversible, extended retinal delamination. We also investigate localized, blister-like retinal detachments by balancing mechanical tension in the retina with both the retina-RPE adhesion energy and the hydraulic pressure jump across the retina. For detachments induced by traction forces, we find a critical radius beyond which the blister is unstable to growth. Growth of a detached blister can also be driven by inflamed lesions in which the tissue has a higher choroidal hydraulic conductivity, has insufficient RPE pump activity, or has defective adhesion bonds. We determine the parameter regimes in which the blister either becomes unstable to growth, remains stable and finite-sized, or shrinks, allowing possible healing. The corresponding stable blister radius and shape are calculated. Our analysis provides a quantitative description of the physical mechanisms involved in exudative retinal detachments and can help guide the development of retinal reattachment protocols or preventative procedures.

  11. Evaluation and management of pediatric rhegmatogenous retinal detachment

    PubMed Central

    Wenick, Adam S.; Barañano, David E.

    2012-01-01

    Pediatric rhegmatogenous retinal detachments are rare, accounting for less than ten percent of all rhegmatogenous retinal detachments. While most retinal detachments in the adult population are related to posterior vitreous detachment, pediatric retinal detachment are often related to trauma or an underlying congenital abnormalities or genetic syndrome. The anatomy of pediatric eyes, the often late presentation of the disease, and the high incidence of bilateral pathology in children all pose significant challenges in the management of these patients. We discuss the epidemiology of pediatric rhegmatogenous retinal detachment, review the genetic syndromes associated with a high incidence of retinal detachment, and examine other common causes of retinal detachment in this age group. We then outline an approach to evaluation and management and describe the expected outcomes of repair of retinal detachment in the pediatric population. PMID:23961003

  12. Jules Gonin. Pioneer of retinal detachment surgery.

    PubMed

    Wolfensberger, Thomas J

    2003-12-01

    Before the turn of the 20th century, eyes with a retinal detachment were considered doomed. Contrary to other branches of ophthalmology, such as cataract extraction, the surgical treatment of retinal detachment was still in its infancy, and the surgical success rates were less than five percent. From 1902 to 1921 Jules Gonin almost single handedly changed the landscape of retinal detachment surgery forever. He recognised that the retinal break was the cause--and not the consequence as it was largely believed at the time--of the retinal detachment, and that the treatment had at all costs to comprise the closure of the break by cauterisation. He named the procedure ignipuncture, as he cauterised the retina through the sclera with a very hot pointed instrument. Despite rigorously detailed clinical observations and increasing success rates, his discovery was not readily accepted and sometimes openly opposed by a large part of the ophthalmic establishment. It was not until 1929 that he received worldwide acclaim at the International Ophthalmological Congress in Amsterdam for his surgical technique. His legacy lives on in the eye hospital in Lausanne that bears his name, in the Gonin Medal awarded by the International Council of Ophthalmology every four years for the highest achievement in ophthalmology, and in a street named after him, the very street that he used to walk from his home to the hospital every day. PMID:14750617

  13. Shape Change of the Vitreous Chamber Influences Retinal Detachment and Reattachment Processes: Is Mechanical Stress during Eye Rotations a Factor?

    PubMed Central

    Meskauskas, Julia; Repetto, Rodolfo; Siggers, Jennifer H.

    2012-01-01

    Purpose. We aim to understand how mechanical causation influences retinal detachment and reattachment processes. In particular, myopes suffer retinal detachment more frequently than emmetropes, and following a retinal detachment, scleral buckling promotes retinal reattachment. We test the hypothesis that stresses arising from saccadic eye rotations are involved in the processes, and that the alteration in the stress due to the change in the vitreous chamber geometry is sufficient to explain the phenomena. Methods. The vitreous chamber of the eye has an approximately spherical shape and it is filled with vitreous humor. We developed a mathematical model, treating the vitreous chamber in emmetropic and myopic eyes as a spheroid and in eyes subjected to scleral buckling as a sphere with a circumferential indentation. We assume that the eye performs prescribed small-amplitude, periodic, torsional rotations and we solve semi-analytically for the fluid pressure, velocity, and stress distributions. Results. The shape of the vitreous chamber has a large effect on the retinal stress. The vitreous and the retina of a highly myopic eye continuously experience shear stresses significantly higher than those of an emmetropic eye. An eye fitted with a scleral buckle experiences large stress levels localized around the buckle. Conclusions. Our results provide a mechanical explanation for the more frequent occurrence of posterior vitreous detachment and retinal detachment in myopic eyes. To understand how the stress distribution in a buckled eye facilitates reattachment, an additional model of the details of the reattachment process should be coupled to this model. PMID:22899755

  14. [Prediction of postoperative visual acuity in retinal detachment with macular involvement].

    PubMed

    Yasukawa, T; Fukuda, T; Kishimoto, M; Ogura, Y

    1995-03-01

    We used laser interferometry (LI) and a potential acuity meter (PAM) to predict visual acuity after surgery for patients with rhegmatogenous retinal detachment with macular involvement. Thirty one eyes of 31 patients with retinal detachment were treated with scleral buckling procedures. Postoperative visual acuity was correlated with preoperative measurements of the LI and PAM, preoperative visual acuity by Landort's ring, and the estimated duration of macular detachment. The correlation between the duration of macular detachment and the postoperative visual acuity was not good (r = 0.55, p < 0.01). Although the preoperative visual acuity showed a relatively good correlation with postoperative visual acuity (r = 0.62, p < 0.01), the results of the LI and PAM provided a better correlation (LI; r = 0.73, PAM; r = 0.71). Our results suggest that the LI and PAM are useful to predict the visual acuity after retinal reattachment in patients with preoperative macular detachment. PMID:7732924

  15. Intraretinal proliferation induced by retinal detachment

    SciTech Connect

    Fisher, S.K.; Erickson, P.A.; Lewis, G.P.; Anderson, D.H. )

    1991-05-01

    Cellular proliferation after retinal detachment was studied by {sup 3}H-thymidine light microscopic autoradiography in cats that had experimental detachments of 0.5-180 days duration. The animals underwent labeling 2 hr before death with an intraocular injection of 200 microCi of {sup 3}H-thymidine. The number of labeled nuclei were counted in 1-micron thick tissue sections in regions of detachment, in regions of the experimental eyes that remained attached, and in control eyes that had no detachments. In the normal eye, in one that had only the lens and vitreous removed, and in the eyes with 0.5- and 1-day detachments, the number of labeled nuclei ranged from 0/mm (0.5-day detachment) to 0.38/mm (lens and vitreous removed only). By 2 days postdetachment, the number of labeled nuclei increased to 2.09/mm. The highest levels of labeling occurred in two animals with detachments of 3 (7.86/mm) and 4 (7.09/mm) days. Thereafter, the numbers declined steadily until near-baseline counts were obtained at 14 days. The number of labeled nuclei was slightly elevated in the attached regions of two animals with 3-day detachments. Labeled cell types included: Mueller cells, astrocytes, pericytes, and endothelial cells of the retinal vasculature, and both resident (microglial cells) and invading macrophages. In an earlier study RPE cells were also shown to proliferate in response to detachment. Thus, these data show that proliferation is a rapid response to detachment, reaching a maximum within 4 days, and that virtually every nonneuronal cell type in the retina can participate in this response. The data suggest that events leading to such clinical manifestations as proliferative vitreoretinopathy and subretinal fibrosis may have their beginnings in this very early proliferative response.

  16. Retinoschisis transposition following a retinal detachment repair

    PubMed Central

    McVeigh, Katherine; Keller, Johannes; Haynes, Richard J.

    2015-01-01

    Objective: The authors have observed this phenomenon of translocation of the schisis cavity in a few previous cases and aim to report this unusual finding. Method: A patient with known superotemporal retinoschisis developed a distinctly separate inferotemporal retinal detachment in his left eye. This was repaired with a vitrectomy, cryotherapy and C2F6 tamponade under local anaesthetic. Following surgery, the retinoschisis was found in the inferonasal quadrant of the eye and remained stable as the gas dispersed. Result: We hypothesise that the tamponading agent compressed the viscous fluid within the area of schisis, displacing the area of schisis circumferentially. Conclusion: This case emphasises that as long as the retinal breaks are properly sealed, no intervention is required with the schisis during rhegmatogenous retinal detachment surgery.

  17. Surgical challenges and outcomes of rhegmatogenous retinal detachment in albinism.

    PubMed

    Sinha, M K; Chhablani, J; Shah, B S; Narayanan, R; Jalali, S

    2016-03-01

    PurposeTo report the outcomes and surgical difficulties during rhegmatogenous retinal detachment (RRD) repair in patients with albinism.MethodsRetrospective analysis of 10 eyes of 9 patients with albinism that underwent RRD repair was performed. Collected data included demographic details, preoperative examination details, surgical procedure, surgical difficulties, anatomical, and visual outcomes. Outcome measures were retinal reattachment and visual acuity at the last follow-up.ResultsMean preoperative best-corrected visual acuity (BCVA) was logMAR (Logarithm of the Minimum Angle of Resolution) 2.15 (range 0.9-3.0) with preoperative localization of causative break in six eyes. One eye had proliferative vitreoretinopathy grade C1 preoperatively. Four eyes underwent scleral buckling (SB) and six underwent 20G pars plana vitrectomy (PPV) with silicone oil injection. Intraoperative complication as iatrogenic retinal break occurred in four eyes. For retinopexy during vitrectomy, endolaser delivery was possible in three out of six eyes, whereas three eyes had cryopexy. The mean follow-up was 12 months in SB group (range 1-12; median 12 months) and 5.33 months (range 1-12; median 3 months) in PPV group. Among vitrectomized eye, two eyes had recurrence at 3 months with oil in situ. Rest of the eyes had attached retina at last follow-up. Mean BCVA at last follow-up was logMAR -1.46 (range 0.7-2.0) with mean improvement of -0.57 logMAR.ConclusionsIdentification of break, induction of posterior vitreous detachment, and endolaser delivery may be difficult during RRD repair in patients with albinism. The incidence of PVR appeared less in these eyes. Both SB and PPV were efficacious and appear to be good surgical techniques for use in this patient population. PMID:26611845

  18. Rhegmatogenous retinal detachments associated to Stickler syndrome in a tertiary eye care center in Saudi Arabia

    PubMed Central

    Alshahrani, Saeed T; Ghazi, Nicola G; Al-Rashaed, Saba

    2016-01-01

    Purpose To investigate the clinical findings and outcomes of rhegmatogenous retinal detachment (RRD) in Stickler syndrome on affected and fellow eyes that underwent prophylactic retinopexy. Patients and methods Chart review of 70 eyes (62 patients). Incidence of RRD, postoperative visual acuity, and risk factors were evaluated. Results Twenty-two patients (35%) had RRD in the fellow eye, 37% of the eyes had cataract, 93% had macular detachment, 50% had proliferative vitreoretinopathy, and 41% had posterior vitreous detachment. Success rates were: 60% of patients after scleral buckling; 57.1% after pars plana vitrectomy; and 75% after combined scleral buckling and pars plana vitrectomy. Sixty-one (93.8%) of patients had successful surgery (including second surgery). Silicone oil tamponade was significantly associated with final anatomic outcome, with a protective odds ratio of 0.11 (P=0.027). Visual acuity improved in 54% of eyes and decreased in 5%. Statistically significant associations were present for eyes with final visual acuity ≥20/200, and total retinal detachment (P<0.001); preoperative cataract (P=0.023); and proliferative vitreoretinopathy (P<0.001). RRD developed in 16/44 eyes despite laser prophylaxis. Conclusion Prophylactic retinopexy was not beneficial for Stickler syndrome patients. Success of primary surgery for RRD remains low. The primary surgery should be vitrectomy combined with scleral buckling and silicone oil tamponade. PMID:26730175

  19. Rhegmatogenous retinal detachment: a reappraisal of its pathophysiology and treatment.

    PubMed

    Kuhn, Ferenc; Aylward, Bill

    2014-01-01

    This article represents a synthesis of an extensive literature review and the authors' decades-long personal experience with both scleral buckling (SB) and vitrectomy for rhegmatogenous retinal detachment (RD). Presenting a coherent understanding of the pathophysiology and treatment of RD, the authors confirm numerous findings described in earlier publications but also challenge certain long-standing dogmas. The key argument made here is that it is extremely rare for the chain of events leading to an RD to start with a retinal pathology. Rather, the initial pathology is syneresis of the vitreous, which then allows gel movement (intraocular currents). At the point of vitreoretinal adhesion, dynamic traction is exerted on the retina, which may be sufficient to tear it. If the tear is operculated and the dynamic traction overcomes the forces keeping the neuroretina and retinal pigment epithelium (RPE) together, the heretofore virtual subretinal space becomes accessible through the retinal tear. The intraocular currents allow the free (nonbound) intravitreal fluid to enter the subretinal space, and once the amount of the incoming fluid overwhelms the draining capacity of the RPE, an RD ensues. Detachment of the posterior cortical vitreous (PVD) is not a necessary prerequisite to RD development; furthermore, PVD cannot be diagnosed preoperatively with adequate certainty with current technology such as biomicroscopy, ultrasonography or optical coherence tomography. The surgeon should expect no or only partial (anomalous) PVD at the time of surgical repair in over half of eyes. The treatment's primary goal must thus be weakening (pneumatic retinopexy, SB) or eliminating (vitrectomy) this dynamic traction. If vitrectomy is employed, it must be a truly complete vitreous removal. This includes a surgically induced PVD if one is not present, close shaving at the periphery, and removing the vitreous immediately behind the lens. The vitrectomy is followed by the creation of a

  20. Retinal detachment in the Morning Glory syndrome. Pathogenesis and management.

    PubMed

    von Fricken, M A; Dhungel, R

    1984-01-01

    A case of bilateral Morning Glory syndrome is presented, unusual because of a rhegmatogenous posterior pole retinal detachment in the left eye. Posterior pole retinal detachments have been described in association with this syndrome. This case report is the first presentation of a retinal tear located within the excavation surrounding the optic nerve. A surgical management approach is presented wherein vitrectomy and internal gas tamponade are utilized to reattach the retina. PMID:6463401

  1. Retinal Detachment due to CrossFit Training Injury.

    PubMed

    Joondeph, Stephanie A; Joondeph, Brian C

    2013-01-01

    The purpose of this paper is to describe a traumatic retinal detachment occurring as a result of CrossFit training using an elastic exercise band. The patient sustained an ocular injury from an elastic band during CrossFit training, resulting in a giant retinal dialysis and retinal detachment, which were successfully repaired. Trainers and athletes need to be aware of the potential for ocular injury from elastic exercise bands and take appropriate precautions. PMID:24106626

  2. Retinal Detachment due to CrossFit Training Injury

    PubMed Central

    Joondeph, Stephanie A.; Joondeph, Brian C.

    2013-01-01

    The purpose of this paper is to describe a traumatic retinal detachment occurring as a result of CrossFit training using an elastic exercise band. The patient sustained an ocular injury from an elastic band during CrossFit training, resulting in a giant retinal dialysis and retinal detachment, which were successfully repaired. Trainers and athletes need to be aware of the potential for ocular injury from elastic exercise bands and take appropriate precautions. PMID:24106626

  3. An Unusual Case of Extensive Lattice Degeneration and Retinal Detachment

    PubMed Central

    Sarma, Saurabh Kumar; Basaiawmoit, Jennifer V.

    2016-01-01

    Lattice degeneration of the retina is not infrequently encountered on a dilated retinal examination and many of them do not need any intervention. We report a case of atypical lattice degeneration variant with peripheral retinal detachment. An asymptomatic 35-year-old lady with minimal refractive error was found to have extensive lattice degeneration, peripheral retinal detachment and fibrotic changes peripherally with elevation of retinal vessels on dilated retinal examination. There were also areas of white without pressure, chorioretinal scarring and retinal breaks. All the changes were limited to beyond the equator but were found to span 360 degrees. She was treated with barrage laser all around to prevent extension of the retinal detachment posteriorly. She remained stable till her latest follow-up two years after the barrage laser. This case is reported for its rarity with a discussion of the probable differential diagnoses. To the best of our knowledge, this is the first report of such findings in lattice degeneration.

  4. Advantages of diabetic tractional retinal detachment repair

    PubMed Central

    Sternfeld, Amir; Axer-Siegel, Ruth; Stiebel-Kalish, Hadas; Weinberger, Dov; Ehrlich, Rita

    2015-01-01

    Purpose To evaluate the outcomes and complications of patients with diabetic tractional retinal detachment (TRD) treated with pars plana vitrectomy (PPV). Patients and methods We retrospectively studied a case series of 24 eyes of 21 patients at a single tertiary, university-affiliated medical center. A review was carried out on patients who underwent PPV for the management of TRD due to proliferative diabetic retinopathy from October 2011 to November 2013. Preoperative and final visual outcomes, intraoperative and postoperative complications, and medical background were evaluated. Results A 23 G instrumentation was used in 23 eyes (95.8%), and a 25 G instrumentation in one (4.2%). Mean postoperative follow-up time was 13.3 months (4–30 months). Visual acuity significantly improved from logarithm of the minimum angle of resolution (LogMAR) 1.48 to LogMAR 1.05 (P<0.05). Visual acuity improved by ≥3 lines in 75% of patients. Intraoperative complications included iatrogenic retinal breaks in seven eyes (22.9%) and vitreal hemorrhage in nine eyes (37.5%). In two eyes, one sclerotomy was enlarged to 20 G (8.3%). Postoperative complications included reoperation in five eyes (20.8%) due to persistent subretinal fluid (n=3), vitreous hemorrhage (n=1), and dislocated intraocular lens (n=1). Thirteen patients (54.2%) had postoperative vitreous hemorrhage that cleared spontaneously, five patients (20.8%) required antiglaucoma medications for increased intraocular pressure, seven patients (29.2%) developed an epiretinal membrane, and two patients (8.3%) developed a macular hole. Conclusion Patients with diabetic TRD can benefit from PPV surgery. Intraoperative and postoperative complications can be attributed to the complexity of this disease. PMID:26604667

  5. Visual Recovery after Primary Retinal Detachment Surgery: Biofeedback Rehabilitative Strategy.

    PubMed

    Vingolo, Enzo M; Fragiotta, Serena; Domanico, Daniela; Limoli, Paolo G; Nebbioso, Marcella; Spadea, Leopoldo

    2016-01-01

    Purpose. To evaluate possible speeding up recovery time after retinal detachment (RD) surgery using biofeedback strategy. Methods. A total of 52 eyes were selected. After surgery, patients were divided into two groups: group A, including patients submitted to biofeedback with MP-1 strategy; group B, patients who received common care strategy. Biofeedback strategy was started 15 days after the suspension of cycloplegic eye drops in buckling procedure or after silicone oil removal in the vitrectomized eyes. Controls were scheduled at baseline and 6, 12, and 18 weeks. Results. At baseline, there was no significant difference in BCVA between groups (P = 0.4230). At the end of biofeedback treatment (WK 6) BCVA of group A was significantly better (P < 0.001) than group B and BCVA was still better in group A than group B at WK 12 (P = 0.028) and at WK 18 (P = 0.041). Conclusions. Visual recovery after RD surgery is still unclear, and it does not depend on entity of the RD. Our data demonstrate that in biofeedback group there was a significant recovery in visual performances that still remains evident after 3 months from the baseline. PMID:26998353

  6. Visual Recovery after Primary Retinal Detachment Surgery: Biofeedback Rehabilitative Strategy

    PubMed Central

    Vingolo, Enzo M.; Fragiotta, Serena; Domanico, Daniela; Limoli, Paolo G.; Nebbioso, Marcella; Spadea, Leopoldo

    2016-01-01

    Purpose. To evaluate possible speeding up recovery time after retinal detachment (RD) surgery using biofeedback strategy. Methods. A total of 52 eyes were selected. After surgery, patients were divided into two groups: group A, including patients submitted to biofeedback with MP-1 strategy; group B, patients who received common care strategy. Biofeedback strategy was started 15 days after the suspension of cycloplegic eye drops in buckling procedure or after silicone oil removal in the vitrectomized eyes. Controls were scheduled at baseline and 6, 12, and 18 weeks. Results. At baseline, there was no significant difference in BCVA between groups (P = 0.4230). At the end of biofeedback treatment (WK 6) BCVA of group A was significantly better (P < 0.001) than group B and BCVA was still better in group A than group B at WK 12 (P = 0.028) and at WK 18 (P = 0.041). Conclusions. Visual recovery after RD surgery is still unclear, and it does not depend on entity of the RD. Our data demonstrate that in biofeedback group there was a significant recovery in visual performances that still remains evident after 3 months from the baseline. PMID:26998353

  7. Fibrinogen and rhegmatogenous retinal detachment: a pilot prospective study

    PubMed Central

    Theocharis, IP

    2010-01-01

    Purpose: To examine the correlation, if any, between fibrinogen plasma levels (FPL) and the clinical features of rhegmatogenous retinal detachment (RRD). Methods: FPL were measured preoperatively in 33 patients with primary RRD. Patient characteristics and detachment features such as the numbers of breaks and the extent of the detachment were recorded; Results: No statistically significant correlation was found between FPL and the number of breaks. A statistically significant correlation was found between FPL and the extent of the RRD, even if the influence of the number of breaks was excluded. Conclusions: FPL correlate with retinal detachment extent, which implicates an acute inflammatory response to detachment traumatic phenomenon or a role of the fibrinogen molecule in retinal adhesiveness. PMID:20186280

  8. A Chick Model of Retinal Detachment: Cone Rich and Novel

    PubMed Central

    Cebulla, Colleen M.; Zelinka, Chris P.; Scott, Melissa A.; Lubow, Martin; Bingham, Amanda; Rasiah, Stephen; Mahmoud, Ashraf M.; Fischer, Andy J.

    2012-01-01

    Background Development of retinal detachment models in small animals can be difficult and expensive. Here we create and characterize a novel, cone-rich retinal detachment (RD) model in the chick. Methodology/Principal Findings Retinal detachments were created in chicks between postnatal days 7 and 21 by subretinal injections of either saline (SA) or hyaluronic acid (HA). Injections were performed through a dilated pupil with observation via surgical microscope, using the fellow eye as a control. Immunohistochemical analyses were performed at days 1, 3, 7, 10 and 14 after retinal detachment to evaluate the cellular responses of photoreceptors, Müller glia, microglia and nonastrocytic inner retinal glia (NIRG). Cell proliferation was detected with bromodeoxyuridine (BrdU)-incorporation and by the expression of proliferating cell nuclear antigen (PCNA). Cell death was detected with terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). As in mammalian models of RD, there is shortening of photoreceptor outer segments and mis-trafficking of photoreceptor opsins in areas of RD. Photoreceptor cell death was maximal 1 day after RD, but continued until 14 days after RD. Müller glia up-regulated glial fibriliary acidic protein (GFAP), proliferated, showed interkinetic nuclear migration, and migrated to the subretinal space in areas of detachment. Microglia became reactive; they up-regulated CD45, acquired amoeboid morphology, and migrated toward outer retina in areas of RD. Reactive NIRG cells accumulated in detached areas. Conclusions/Significance Subretinal injections of SA or HA in the chick eye successfully produced retinal detachments and cellular responses similar to those seen in standard mammalian models. Given the relatively large eye size, and considering the low cost, the chick model of RD offers advantages for high-throughput studies. PMID:22970190

  9. Risk factors of rhegmatogenous retinal detachment associated with choroidal detachment in Chinese patients

    PubMed Central

    Gu, Yong-Hao; Ke, Gen-Jie; Wang, Lin; Gu, Qi-Hong; Zhou, En-Liang; Pan, Hong-Biao; Wang, Shi-Ying

    2016-01-01

    AIM To comprehensively analyze the risk factors of rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (CD). METHODS A total of 265 eyes of 265 consecutive cases of RRD were retrospectively analyzed. All patients had systemic and ophthalmologic examination. CD was diagnosed by indirect ophthalmoscopy, B-scan ultrasonography, and ultrasound biomicroscope (UBM). Each parameter was compared between patients of RRD and rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD). Logistic regression analysis was used to determine the independent risk factors of CD. RESULTS There were 52 eyes (19.62%) with CD. Pseudophakia was more commonly seen in RRDCD (21.15% vs 6.10%, P=0.002). Intraocular pressure (IOP) was lower (8.60±3.62 vs 12.96±3.55, P<0.001), best-corrected visual acuity was worse [3.00 (2.00 to 3.00) vs 1.92 (1.22 to 3.00), P=0.001], and refractive error was more myopic [-4 (-9 to -2) vs -2 (-6 to 0), P=0.007] in RRDCD. Eyes with RRDCD had larger extent of retinal detachment (P=0.007). In RRDCD, 34.62% of eyes presented with multiple holes (P=0.044) and 25.00% with macular holes (P=0.012), compared with 20.66% and 14.08% in RRD. High myopia (P=0.039), low IOP (P=0.017), and larger extent of retinal detachment (P<0.001) were significant and independent risk factors for developing CD. CONCLUSION For CD in RRD, related factors include BCVA, IOP, lens status, refractive error, extent of retinal detachment, number of holes, and macular hole. Larger extent of retinal detachment, high myopia, and low IOP are significant and independent risk factors. PMID:27500106

  10. Bilateral Rhegmatogenous Retinal Detachment during External Beam Radiotherapy

    PubMed Central

    Hidaka, Takako; Chuman, Hideki; Nao-i, Nobuhisa

    2016-01-01

    Herein, we report a case of nontraumatic bilateral rhegmatogenous retinal detachment (RRD) during external beam radiotherapy for nonocular tumor, presented as an observational case study in conjunction with a review of the relevant literature. A 65-year-old male was referred to our hospital due to bilateral RRD. He underwent a biopsy for a tumor of the left frontal lobe 4 months prior to presentation, and the tumor had been diagnosed as primary central nerve system B-cell type lymphoma. He received chemotherapy and external beam radiotherapy for 1 month. There were no traumatic episodes. Bilateral retinal detachment occurred during a series of radiotherapies. Simultaneous nontraumatic bilateral retinal detachment is rare. The effects of radiotherapy on ocular functionality, particularly in cases involving retinal adhesion and vitreous contraction, may include RRD. Thus, it is necessary to closely monitor the eyes of patients undergoing radiotherapy, particularly those undergoing surgery for retinal detachment and those with a history of photocoagulation for retinal tears, a relevant family history, or risk factors known to be associated with RRD. PMID:27462261

  11. Bilateral Rhegmatogenous Retinal Detachment during External Beam Radiotherapy.

    PubMed

    Hidaka, Takako; Chuman, Hideki; Nao-I, Nobuhisa

    2016-01-01

    Herein, we report a case of nontraumatic bilateral rhegmatogenous retinal detachment (RRD) during external beam radiotherapy for nonocular tumor, presented as an observational case study in conjunction with a review of the relevant literature. A 65-year-old male was referred to our hospital due to bilateral RRD. He underwent a biopsy for a tumor of the left frontal lobe 4 months prior to presentation, and the tumor had been diagnosed as primary central nerve system B-cell type lymphoma. He received chemotherapy and external beam radiotherapy for 1 month. There were no traumatic episodes. Bilateral retinal detachment occurred during a series of radiotherapies. Simultaneous nontraumatic bilateral retinal detachment is rare. The effects of radiotherapy on ocular functionality, particularly in cases involving retinal adhesion and vitreous contraction, may include RRD. Thus, it is necessary to closely monitor the eyes of patients undergoing radiotherapy, particularly those undergoing surgery for retinal detachment and those with a history of photocoagulation for retinal tears, a relevant family history, or risk factors known to be associated with RRD. PMID:27462261

  12. Serous retinal detachment after trabeculectomy in angle recession glaucoma

    PubMed Central

    Roy, Avik Kumar; Padhy, Debananda

    2015-01-01

    An 18-year-old male with 360 degree angle recession after blunt trauma in his right eye developed uncontrolled intraocular pressure (IOP) despite four antiglaucoma medications (AGM) with advancing disc damage. He underwent trabeculectomy with intraoperative mitomycin-c (MMC) application. There was an intraoperative vitreous prolapse which was managed accordingly. On post-surgery day 1, he had shallow choroidal detachment superiorly with non-recordable IOP. This was deteriorated 1 week postoperatively as choroidal detachment proceeded to serous retinal detachment. He was started with systemic steroid in addition to topical route. The serous effusions subsided within 2 weeks time. At the last follow up at 3 months, he was enjoying good visual acuity, deep anterior chamber, diffuse bleb, an IOP in low teens off any AGM and attached retina. This case highlights the rare occurrence of serous retinal detachment after surgical management of angle recession glaucoma.

  13. Unilateral, recurrent exudative retinal detachment in association with pansinusitis

    PubMed Central

    Osman Saatci, Ali; Ozbek Soylemezoglu, Zeynep; Barut Selver, Ozlem; Cenk Ecevit, M.; Ada, Emel

    2012-01-01

    Aim: To report a patient with unilateral exudative retinal detachment due to pansinusitis. Methods: Case report. Results: A 65-year-old woman with a two-month history of blurred vision, red eye and lid swelling in her left eye was referred to us. Her best-corrected visual acuity was 20/20 in the right eye and 20/200 in the left. Conjunctival vessels were engorged in the OS. Funduscopy revealed a 360° exudative detachment in OS and computerized tomography (CT) imaging revealed pansinusitis. Systemic antibiotic treatment was employed and exudative detachment regressed. However, exudative detachment remitted as soon as antibiotic treatment ceased. Finally she underwent sinus surgery and decompression of the orbita. Her visual acuity improved to 20/100 just two days after the surgery, stabilized at 20/30 and no further recurrences occured during the follow-up of 10 months. Conclusion: Since exudative retinal detachment usually accompanies systemic inflammatory or neoplastic diseases, systemic screening and collaboration with other disciplines are mandatory. To the best of our knowledge, this is the first report of a case that developed exudative retinal detachment due to pansinusitis and only recovered after decompression surgery.

  14. Scleral Buckling with Chandelier Illumination

    PubMed Central

    Seider, Michael I.; Nomides, Riikka E. K.; Hahn, Paul; Mruthyunjaya, Prithvi; Mahmoud, Tamer H.

    2016-01-01

    Scleral buckling is a highly successful technique for the repair of rhegmatogenous retinal detachment that requires intra-operative examination of the retina and treatment of retinal breaks via indirect ophthalmoscopy. Data suggest that scleral buckling likely results in improved outcomes for many patients but is declining in popularity, perhaps because of significant advances in vitrectomy instrumentation and visualization systems. Emerging data suggest that chandelier-assisted scleral buckling is safe and has many potential advantages over traditional buckling techniques. By combining traditional scleral buckling with contemporary vitreoretinal visualization techniques, chandelier-assistance may increase the popularity of scleral buckling to treat primary rhegmatogenous retinal detachment for surgeons of the next generation, maintaining buckling as an option for appropriate patients in the future. PMID:27621789

  15. [Treatment of serous macular retinal detachment with antihistamines].

    PubMed

    Kirschfeld, K

    2015-01-01

    The etiology of retinal detachment in central serous retinopathy (CSR) is unknown; however, three facts are generally accepted: (1) the serous exudate which raises the layers of the receptors/pigment epithelium is formed due to hyperpermeability in the choriocapillaries, (2) patients frequently suffer from headaches and (3) stress promotes the incidence of CSR. A high blood plasma histamine concentration can cause the abovementioned symptoms which suggests that histamine might provoke CSR. Within 1 week after administration of the antihistamine loratadin a considerable reduction in the retinal exudate and restoration of vision were observed. This supports the hypothesis that histamine could be involved in the process of retinal detachment. Further investigations and large scale clinical trials should clarify if this hypothesis can be proved or disproved and whether antihistamines can be used for age-related macular degeneration (AMD). PMID:25278347

  16. Spectral domain optical coherence tomography imaging of subretinal bands associated with chronic retinal detachments

    PubMed Central

    Kothari, Nikisha; Kuriyan, Ajay E; Flynn, Harry W

    2016-01-01

    We report three patients with subretinal bands associated with retinal detachment in chronic retinal detachments who underwent successful retinal reattachment. Subretinal bands before and after surgery can be identified on clinical examination and spectral domain optical coherence tomography. Removal of subretinal bands is not mandatory to achieve retinal reattachment. PMID:27099457

  17. Corneal Complications During and After Vitrectomy for Retinal Detachment in Photorefractive Keratectomy Treated Eyes.

    PubMed

    Tosi, Gian Marco; Baiocchi, Stefano; Balestrazzi, Angelo; Martone, Gianluca; Marigliani, Davide; Neri, Giovanni; Caporossi, Tomaso

    2015-12-01

    To evaluate the occurrence of late-onset corneal haze (LOCH) after vitrectomy for rhegmatogenous retinal detachment (RRD) in photorefractive keratectomy (PRK)-treated eyes. This observational cohort study comprised 13 eyes of 13 patients who underwent vitrectomy for RRD and who had been subjected to PRK years earlier. The occurrence of LOCH was evaluated together with all the preoperative, intraoperative, and postoperative factors that could affect final corneal status. LOCH developed in 2 eyes. Both patients had undergone PRK for high myopia--one 3 years and the other 9 years prior to RRD. Both patients presented with RRD due to giant retinal tear and were subjected to scleral buckle, 20-gauge vitrectomy, and silicone oil tamponade. Three months after vitrectomy and 1 month after silicone oil removal they both developed LOCH. During vitreoretinal surgery neither of the 2 patients needed mechanical epithelial debridement. Intraoperative epithelial debridement was performed in 2 of the other patients of the series, who had undergone previous PRK for high myopia and had clear corneas at presentation; in 1 of them this manoeuvre hampered intraoperative visualization. Follow-up after retinal detachment surgery ranged from 6 to 156 months (mean, 37.5 months). Subepithelial corneal scarring may be reactivated many years after PRK. In our series this happened after vitrectomy. PMID:26683931

  18. Retinal Detachment in Down Syndrome: Characteristics and Surgical Outcomes

    PubMed Central

    AlAhmadi, Badr O.; Alsulaiman, Sulaiman M.; Arevalo, J. Fernando

    2016-01-01

    Purpose. To determine the functional and anatomic outcomes of rhegmatogenous retinal detachment (RRD) surgery in patients with Down syndrome. Methods. A retrospective chart review was performed of patients with Down syndrome who had undergone surgery for RRD at King Khalid Eye Specialist Hospital between 1995 and 2014. Results. A total of 245 patients with Down syndrome were evaluated during the study period. Eighteen eyes of 15 patients (6.1%) with RRD were identified. Three out of 15 patients (20%) presented with bilateral retinal detachment. All eyes presented with macula off retinal detachment. The retina was successfully reattached in 16/18 (88.8%) eyes after a mean follow-up of 48 months. The final postoperative visual acuity ranged from light perception to 20/125 (median: hand motion) (11/18 eyes). Conclusions. The anatomic success rate of retinal reattachment surgery in patients with Down syndrome is comparable to the general population. Patients with Down syndrome should undergo regular ophthalmic examinations for early diagnosis. Despite late diagnosis and the presence of proliferative vitreoretinopathy (PVR) in some patients, favorable anatomical outcomes can be achieved. PMID:27123341

  19. Characteristics of rhegmatogenous retinal detachment in pseudophakic and phakic eyes

    PubMed Central

    Mahroo, O AR; Dybowski, R; Wong, R; Williamson, T H

    2012-01-01

    Aims To investigate whether pseudophakic and phakic rhegmatogenous retinal detachment (RRD) patterns differ. Methods Retrospective review of electronic database of patients, aged 50 years or over, presenting to our vitreoretinal service. Data included baseline characteristics, digital drawings, and outcomes. Retinal drawings were analysed in a masked fashion for site, size, and number of retinal breaks. Comparisons were made between the following groups and subgroups: pseudophakic eyes, phakic eyes, phakic eyes with cataract, and phakic eyes without cataract. Results Of 500 eyes included, 146 were pseudophakic; 177 of the phakic eyes had cataract. The following were significant by univariate analysis: pseudophakic patients were older than phakic patients in general, but the same age as patients with cataract; in the pseudophakic group, there were lower proportions of females and of patients presenting with vitreous haemorrhage or with large or superotemporal breaks; higher proportions of pseudophakic eyes had small breaks and inferonasal breaks. Some differences remained significant when comparing pseudophakia eyes with cataract. Multivariate analysis comparing pseudophakia with phakia confirmed a lower chance in pseudophakia of large breaks, vitreous haemorrhage and superotemporal breaks, but higher chance of detached inferior breaks. Some variables were age dependent. Conclusion Differences were found between pseudophakic and phakic RRD patterns. These suggest special pathogenetic mechanisms in pseudophakic retinal detachment, which could help explain increased incidences of RRD after cataract surgery. PMID:22678050

  20. Retinal Detachment in Down Syndrome: Characteristics and Surgical Outcomes.

    PubMed

    AlAhmadi, Badr O; Alsulaiman, Sulaiman M; Arevalo, J Fernando

    2016-01-01

    Purpose. To determine the functional and anatomic outcomes of rhegmatogenous retinal detachment (RRD) surgery in patients with Down syndrome. Methods. A retrospective chart review was performed of patients with Down syndrome who had undergone surgery for RRD at King Khalid Eye Specialist Hospital between 1995 and 2014. Results. A total of 245 patients with Down syndrome were evaluated during the study period. Eighteen eyes of 15 patients (6.1%) with RRD were identified. Three out of 15 patients (20%) presented with bilateral retinal detachment. All eyes presented with macula off retinal detachment. The retina was successfully reattached in 16/18 (88.8%) eyes after a mean follow-up of 48 months. The final postoperative visual acuity ranged from light perception to 20/125 (median: hand motion) (11/18 eyes). Conclusions. The anatomic success rate of retinal reattachment surgery in patients with Down syndrome is comparable to the general population. Patients with Down syndrome should undergo regular ophthalmic examinations for early diagnosis. Despite late diagnosis and the presence of proliferative vitreoretinopathy (PVR) in some patients, favorable anatomical outcomes can be achieved. PMID:27123341

  1. Changes of cone electroretinograms to colour flash stimuli after successful retinal detachment surgery

    PubMed Central

    Hayashi, M; Yamamoto, S

    2001-01-01

    AIM—To examine the changes in the short wavelength (S) and mixed long (L) and middle (M) wavelength sensitive cone (L,M-cone) electroretinograms (ERGs) after successful retinal detachment surgery.
METHODS—Cone ERGs elicited by different colour flashes were recorded from 19 eyes with unilateral rhegmatogenous retinal detachment treated successfully by conventional buckling surgery. Ganzfeld colour flashes on a bright white background were used to elicit S-cone and L,M-cone ERGs. The ratio (operated eye/fellow eye) of the S-cone b-wave elicited by a 450 nm stimulus and the ratio (operated eye/fellow eye) of the L,M-cone b-wave elicited by a 633 nm stimulus were evaluated preoperatively and 1, 3, and 6 months after surgery.
RESULTS—Preoperatively, no significant difference was observed between the ratio of the S-cone ERG amplitudes and the ratio of the L,M-cone ERG amplitudes. Postoperatively, the ratio of the L,M-cone ERGs increased significantly over the preoperative value (p=0.001) but the ratio of the S-cone ERG did not improve. There were significant differences between the ratios of the S-cone and the L,M-cone ERGs at 1, 3, and 6 months after surgery. The postoperative recovery of the S-cone ERG was significantly greater in eyes treated within 4 weeks after the onset of the detachment than in eyes treated later than 4 weeks.
CONCLUSIONS—These results indicate that the impairment of the L,M-cone system caused by retinal detachment may be reversible. However, the S-cone system may have more profound permanent damage.

 PMID:11264128

  2. Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment

    PubMed Central

    Wilkinson, Charles P

    2015-01-01

    Background Asymptomatic retinal breaks and lattice degeneration are visible lesions that are risk factors for later retinal detachment. Retinal detachments occur when fluid in the vitreous cavity passes through tears or holes in the retina and separates the retina from the underlying retinal pigment epithelium. Creation of an adhesion surrounding retinal breaks and lattice degeneration, with laser photocoagulation or cryotherapy, has been recommended as an effective means of preventing retinal detachment. This therapy is of value in the management of retinal tears associated with the symptoms of flashes and floaters and persistent vitreous traction upon the retina in the region of the retinal break, because such symptomatic retinal tears are associated with a high rate of progression to retinal detachment. Retinal tears and holes unassociated with acute symptoms and lattice degeneration are significantly less likely to be the sites of retinal breaks that are responsible for later retinal detachment. Nevertheless, treatment of these lesions frequently is recommended, in spite of the fact that the effectiveness of this therapy is unproven. Objectives The objective of this review was to assess the effectiveness and safety of techniques used to treat asymptomatic retinal breaks and lattice degeneration for the prevention of retinal detachment. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 2), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to February 2014), EMBASE (January 1980 to February 2014), PubMed (January 1948 to February 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in

  3. Retinal Detachment in Southwest Ethiopia: A Hospital Based Prospective Study

    PubMed Central

    Asaminew, Tsedeke; Gelaw, Yeshigeta; Bekele, Sisay; Solomon, Berhan

    2013-01-01

    Purpose The incidence of retinal detachment in Blacks is generally considered to be low though there are few supporting studies in Africa. This study, thus, aimed at describing the clinical profile of patients with retinal detachment in Southwest Ethiopia. Methods A hospital-based study was done on all consecutive retinal detachment patients who presented to Jimma University Hospital over six months period. A semi-structured questionnaire was used to collect patients’ sociodemographic characteristics and clinical history. Comprehensive anterior and posterior segment eye examinations were done and risk factors were sought for. Statistical tests were considered significant if P < 0.05. Results A total of 94 eyes of 80 patients (1.5%) had retinal detachment (RD) and about 69% of patients were symptomatic for over a month before presentation. The mean age was 41.4 years (SD ±16.5). Fourteen patients (17.5%) had bilateral RD. At presentation, 61 eyes (64.9%) were blind from RD and 11 (13.8%) patients were bilaterally blind from RD. Rhegmatogenous RD was seen in 55 eyes (58.5%) and tractional RD in 22 eyes (23.4%). The most common risk factors were ocular trauma (32 eyes, 34.0%), myopia (23 eyes, 24.5%), posterior uveitis (13 eyes, 13.8%) and diabetic retinopathy (9 eyes, 9.6%). Most retinal breaks (25 eyes, 43.1%) were superotemporal and horse-shoe tear was the most common (19 eyes, 20.2%). Macula was off in 77 eyes (81.9%) and 38 eyes (69.1% of RRD eyes) had grade C proliferative vitreoretinopathy (PVR). Macular status was significantly associated with PVR (P=0.011), and duration of symptoms (RR=1.25, 95%CI: 1.059-1.475, P=0.040). Conclusions A significant numbers of patients with ocular problem had retinal detachment, and nearly two third of the patients presented late. Trauma and myopia were the most important risk factors. People should be educated to improve their health seeking behavior and use eye safety precautions to prevent ocular trauma. PMID:24086614

  4. A rare case of traumatic posterior phacocele with retinal detachment

    PubMed Central

    Sindal, Manavi D; Mourya, Deepesh

    2016-01-01

    Dislocation of crystalline lens into the anterior subconjunctival or subtenon's space is a rare but known complication of blunt trauma. Dislocation into the posterior subtenon's space is even rarer and can be associated with a complication such as occult scleral tear and retinal detachment. We report a case of traumatic posterior subtenon's dislocation of crystalline lens after blunt trauma and its successful surgical management. PMID:26953031

  5. Reactive retinal microglia, neuronal survival and the formation of retinal folds and detachments

    PubMed Central

    Fischer, Andy J.; Zelinka, Christopher; Milani-Nejad, Nima

    2014-01-01

    Reactive microglia and macrophages are prevalent in damaged retinas. Accordingly, we investigate how the activation or ablation of microglia/macrophages influences the survival of neurons in the chick retina in vivo. We applied intraocular injections of interleukin 6 (IL6) to stimulate the reactivity of microglia/macrophages and clodronate-liposomes to ablate microglia/macrophages. Activation of the microglia/macrophages with IL6 delays the death of retinal neurons from N-methyl-D-aspartate (NMDA) -induced excitotoxicity. In addition, activation of microglia/macrophages combined with colchicine-mediated retinal damage diminished the survival of ganglion cells. Application of IL6 after an excitotoxic insult greatly exacerbates the damage, and causes widespread retinal detachments and folds, accompanied by accumulation of microglia/macrophages in the subretinal space. Damage-induced retinal folds and detachments were significantly reduced by the ablation of microglia/macrophages. We conclude that microglial reactivity is detrimental to the survival of ganglion cells in colchicine-damaged retinas and detrimental to the survival of photoreceptors in retinal folds. In addition, we conclude that IL6-treatment transiently protects amacrine and bipolar cells against an excitotoxic insult. We propose that suppressing reactivity of microglia/macrophages may be an effective means to lessen the damage and vision loss resulting from damage, in particular during retinal detachment injuries. PMID:25231952

  6. The genomic response of the retinal pigment epithelium to light damage and retinal detachment

    PubMed Central

    Rattner, Amir; Toulabi, Leila; Williams, John; Yu, Huimin; Nathans, Jeremy

    2008-01-01

    The retinal pigment epithelium (RPE) plays an essential role in maintaining the health of the retina. The RPE is also the site of pathologic processes in a wide variety of retinal disorders including monogenic retinal dystrophies, age-related macular degeneration, and retinal detachment. Despite intense interest in the RPE, little is known about its molecular response to ocular damage or disease. We have conducted a comprehensive analysis of changes in transcript abundance (the “genomic response”) in the murine RPE following light damage. Several dozen transcripts, many related to cell-cell signaling, show significant increases in abundance in response to bright light; transcripts encoding visual cycle proteins show a decrease in abundance. Similar changes are induced by retinal detachment. Environmental and genetic perturbations that modulate the RPE response to bright light suggest that this response is controlled by the retina. In contrast to the response to bright light, the RPE response to retinal detachment over-rides these modulatory affects. PMID:18815272

  7. Retinal Detachment Associated with AIDS-Related Cytomegalovirus Retinitis: Risk Factors in a Resource-Limited Setting

    PubMed Central

    Yen, Michael; Chen, Jenny; Ausayakhun, Somsanguan; Kunavisarut, Paradee; Vichitvejpaisal, Pornpattana; Ausayakhun, Sakarin; Jirawison, Choeng; Shantha, Jessica; Holland, Gary N; Heiden, David; Margolis, Todd P; Keenan, Jeremy D

    2014-01-01

    Purpose To determine risk factors predictive of retinal detachment in patients with cytomegalovirus (CMV) retinitis in a setting with limited access to ophthalmic care. Design Case-control study. Methods Sixty-four patients with CMV retinitis and retinal detachment were identified from the Ocular Infectious Diseases and Retina Clinics at Chiang Mai University. Three control patients with CMV retinitis but no retinal detachment were selected for each case, matched by calendar date. The medical records of each patient were reviewed, with patient-level and eye-level features recorded for the clinic visit used to match cases and controls, and also for the initial clinic visit at which CMV retinitis was diagnosed. Risk factors for retinal detachment were assessed separately for each of these time points using multivariate conditional logistic regression models that included 1 eye from each patient. Results Patients with a retinal detachment were more likely than controls to have low visual acuity (OR, 1.24 per line of worse vision on the logMAR scale; 95%CI, 1.16-1.33) and bilateral disease (OR, 2.12; 95%CI, 0.92-4.90). Features present at the time of the initial diagnosis of CMV retinitis that predicted subsequent retinal detachment included bilateral disease (OR, 2.68; 95%CI, 1.18-6.08) and lesion size (OR, 2.64 per 10% increase in lesion size; 95%CI, 1.41-4.94). Conclusion Bilateral CMV retinitis and larger lesion sizes, each of which is a marker of advanced disease, were associated with subsequent retinal detachment. Earlier detection and treatment may reduce the likelihood that patients with CMV retinitis develop a retinal detachment. PMID:25448999

  8. Retinal tears and rhegmatogenous retinal detachment after intravitreal injections: its prevalence and case reports

    PubMed Central

    Karabag, Revan Yildirim; Parlak, Melih; Cetin, Gölgem; Yaman, Aylin; Osman Saatci, A.

    2015-01-01

    Purpose To report the prevalence of postoperative retinal tear or rhegmatogenous retinal detachment secondary to intravitreal injections. Methods Surgical and medical records of patients who received intravitreal injections at the practice of a single retina specialist from January 2004 to May 2013 and who were followed for at least 6 months were investigated retrospectively. Results During the study period, a total of 3,907 intravitreal injections were performed in 1,049 eyes of 784 patients (416 males [47%]). The mean number of injections per eye was 3.72 ± 3.43 (range, 1–22). The mean age of the participants was 67.03 ± 13.56 (range, 5–94 years). The mean follow-up time was 31.98 ± 22.86 months (range, 6–144 months). Retinal break or rhegmatogenous retinal detachment occurred in 3 injections of 3 eyes, yielding an overall prevalence of 0.077% per injection and 0.29% per eye. Conclusions Retinal tear and rhegmatogenous detachment are rare complications of intravitreal injection. Precautions should be taken especially in patients having predisposing conditions, such as high myopia, or any other vitreoretinal disorders. PMID:27330458

  9. Current Understanding of the Genetic Architecture of Rhegmatogenous Retinal Detachment.

    PubMed

    Johnston, Timothy; Chandra, Aman; Hewitt, Alex W

    2016-06-01

    Rhegmatogenous retinal detachment (RRD) is a common and potentially blinding surgical retinal disease. While the precise molecular mechanisms leading to RRD are poorly understood, there is an increasing body of literature supporting the role of heritable factors in the pathogenesis of the condition. Much work has been undertaken investigating genes important in syndromic forms of RRD (e.g., Stickler, Wagner Syndrome, etc.) and research pertaining to genetic investigations of idiopathic or non-syndromic RRD has also recently been reported. To date, at least 12 genetic loci have been implicated in the development of syndromes of which RRD is a feature. A recent GWAS identified five loci implicated in the development of idiopathic RRD.This article provides an overview of the genetic mechanisms of both syndromic and idiopathic RRD. The genetics of predisposing conditions, such as myopia and lattice degeneration, are also discussed. PMID:26757352

  10. Tamponade in the surgical management of retinal detachment

    PubMed Central

    Vaziri, Kamyar; Schwartz, Stephen G; Kishor, Krishna S; Flynn, Harry W

    2016-01-01

    Despite treatment advances, rhegmatogenous retinal detachment (RD) can have poor visual outcomes even with prompt and appropriate therapy. Pars plana vitrectomy is a leading management modality for the treatment of RD. This procedure is generally accompanied by the use of internal tamponade. Various gases and silicone oils may yield beneficial outcomes. Heavy silicone oils have been approved in some European nations but are not available in the USA. Different tamponade agents have unique benefits and risks, and choice of the agent should be individualized according to the characteristics of the patient and RD, as well as perioperative and postoperative factors. PMID:27041988

  11. Tamponade in the surgical management of retinal detachment.

    PubMed

    Vaziri, Kamyar; Schwartz, Stephen G; Kishor, Krishna S; Flynn, Harry W

    2016-01-01

    Despite treatment advances, rhegmatogenous retinal detachment (RD) can have poor visual outcomes even with prompt and appropriate therapy. Pars plana vitrectomy is a leading management modality for the treatment of RD. This procedure is generally accompanied by the use of internal tamponade. Various gases and silicone oils may yield beneficial outcomes. Heavy silicone oils have been approved in some European nations but are not available in the USA. Different tamponade agents have unique benefits and risks, and choice of the agent should be individualized according to the characteristics of the patient and RD, as well as perioperative and postoperative factors. PMID:27041988

  12. Photoreceptor cell death and rescue in retinal detachment and degenerations

    PubMed Central

    Murakami, Yusuke; Notomi, Shoji; Hisatomi, Toshio; Nakazawa, Toru; Ishibashi, Tatsuro; Miller, Joan W.; Vavvas, Demetrios G.

    2013-01-01

    Photoreceptor cell death is the ultimate cause of vision loss in various retinal disorders, including retinal detachment (RD). Photoreceptor cell death has been thought to occur mainly through apoptosis, which is the most characterized form of programmed cell death. The caspase family of cysteine proteases plays a central role for inducing apoptosis, and in experimental models of RD, dying photoreceptor cells exhibit caspase activation; however, there is a paradox that caspase inhibition alone does not provide a sufficient protection against photoreceptor cell loss, suggesting that other mechanisms of cell death are involved. Recent accumulating evidence demonstrates that non-apoptotic forms of cell death, such as autophagy and necrosis, are also regulated by specific molecular machinery, such as those mediated by autophagy-related proteins and receptor-interacting protein kinases, respectively. Here we summarize the current knowledge of cell death signaling and its roles in photoreceptor cell death after RD and other retinal degenerative diseases. A body of studies indicate that not only apoptotic but also autophagic and necrotic signaling are involved in photoreceptor cell death, and that combined targeting of these pathways may be an effective neuroprotective strategy for retinal diseases associated with photoreceptor cell loss. PMID:23994436

  13. Vision-related quality of life, metamorphopsia, and stereopsis after successful surgery for rhegmatogenous retinal detachment.

    PubMed

    Lina, G; Xuemin, Q; Qinmei, W; Lijun, S

    2016-01-01

    PurposeTo determine the relationship between vision-related quality of life, metamorphopsia, and stereopsis after successful surgery to correct rhegmatogenous retinal detachment (RRD).Patients and methodsData were obtained from 30 patients with RRD who had scleral buckle surgery or vitrectomy. Age, gender, duration of blurred vision, the best-corrected visual acuity (BCVA), extent of detachment, and the location of retinal tears were measured before surgery. Approximately 1 year after surgery, stereopsis was measured with the Randot stereo test, visual acuity (VA) was measured using a Snell VA acuity measurement at a distance of 5 m and was presented as a linear LogMAR value, metamorphopsia was examined using an M-chart, and vision-related quality of life was determined using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25).ResultsAll of the patients achieved anatomical retinal reattachment. There was a significant difference between preoperative BCVA (0.78±0.72) and BCVA 1 year postoperatively (0.25±0.25) (P<0.05). Twenty-three patients had visual distortion postoperatively, including vertical metamorphopsia (0.53±0.52°), and horizontal metamorphopsia (0.48±0.53°). Twenty patients had no stereopsis. The composite score of VFQ-25 was 76.60 postoperatively. Significant differences in postoperative BCVA, metamorphopsia, and VFQ-25 were found between macula-on and macula-off groups (all P<0.05). There was a negative correlation between VFQ-25 composite score and metamorphopsia (P<0.005); there was no significant correlation between VFQ-25 composite score and BCVA or stereopsis.ConclusionVision-related quality of life correlated with metamorphopsia, but did not correlate with VA or stereopsis. PMID:26427988

  14. Structural Recovery of the Detached Macula after Retinal Detachment Repair as Assessed by Optical Coherence Tomography

    PubMed Central

    Joe, Soo Geun; Kim, Yoon Jeon; Chae, Ju Byung; Yang, Sung Jae; Lee, Joo Yong; Kim, June-Gone

    2013-01-01

    Purpose To investigate correlations between preoperative and postoperative foveal microstructures in patients with macula-off rhegmatogenous retinal detachment (RRD). Methods We reviewed the records of 31 eyes from 31 patients with macula-off RRD who had undergone successful re-attachment surgery. We analyzed data obtained from complete ophthalmologic examinations and optical coherence tomography (OCT) before and 9 to 12 months after surgery. All postoperative OCT measurements were taken with spectral-domain OCT, but a subset of preoperative OCT measurements were taken with time-domain OCT. Results The mean duration of macular detachment was 15.5 ± 15.2 days, and mean preoperative best-corrected visual acuity (BCVA, logarithm of the minimum angle of resolution) was 1.03 ± 0.68. Preoperative visual acuity was correlated with retinal detachment height (p < 0.001) and the existence of intraretinal separation (IRS) along with outer layer undulation (OLU) (p = 0.022), but not with macula-off duration. The final BCVA was significantly correlated with integrity of the junction between the photoreceptor inner and outer segments (IS/OS) combined with the continuity of external limiting membrane (ELM) (p = 0.025). The presence of IRS and OLU on a detached macula were highly correlated with the final postoperative integrity of the IS/OS junction and the ELM (p = 0.017). Conclusions Eyes preoperatively exhibiting IRS and OLU showed a higher incidence of disruption to the photoreceptor IS/OS junction and the ELM at final follow-up. Such a close correlation between preoperative and postoperative structural changes may explain why ultimate visual recovery in such eyes is poor. PMID:23730110

  15. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy

    PubMed Central

    Schwartz, Stephen G; Flynn, Harry W; Lee, Wen-Hsiang; Wang, Xue

    2014-01-01

    Background Retinal detachment (RD) with proliferative vitreoretinopathy (PVR) often requires surgery to restore normal anatomy and to stabilize or improve vision. PVR usually occurs in association with recurrent RD (that is, after initial retinal re-attachment surgery) but occasionally may be associated with primary RD. Either way, a tamponade agent (gas or silicone oil) is needed during surgery to reduce the rate of postoperative recurrent RD. Objectives The objective of this review was to assess the relative safety and effectiveness of various tamponade agents used with surgery for retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR). Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2013), EMBASE (January 1980 to June 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 26 June 2013. Selection criteria We included randomized controlled trials (RCTs) of participants undergoing surgery for RD associated with PVR that compared various tamponade agents. Data collection and analysis Two review authors screened the search results independently. We used the standard methodological procedures expected by The Cochrane Collaboration. PMID:24532038

  16. Clinical characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment.

    PubMed

    Gurler, Bulent; Coskun, Erol; Öner, Veysi; Comez, Aysegul; Erbagci, Ibrahim

    2016-08-01

    The objective of this study was to analyze the characteristics and surgical results of pediatric rhegmatogenous retinal detachment (RRD). The medical records of 30 eyes of 29 patients younger than 18 years of age who underwent vitreoretinal surgery due to RRD were analyzed. The gender, age, laterality, duration of presenting symptom, etiology, ocular and systemic co-morbidities, type of breaks, lens status, presence of proliferative vitreoretinopathy (PVR) and its grade, initial and final best-corrected visual acuities (BCVAs), surgical management, number of operations, duration of follow-up, functional and anatomical success, and complications were noted. As the most common predisposing factors were trauma (trauma group) and myopia (myopia group), the data of these patients were further analyzed. The mean age was 12.6 ± 3.0 years. There were 23 male (79.3 %) and 6 female (20.6 %) subjects. The most common etiologic factors were high myopia (40 %) and trauma (36.6 %). Functional success rate was 70 % (n = 21) after the primary surgeries and was 80 % (n = 24) after the secondary surgeries. There were no significant differences between the trauma and myopia groups regarding the presence of total retinal detachment, macula-off status, and the rate of PVR worse than grade C. Although the preoperative mean BCVA and the initial and final retinal reattachment rates of the groups were statistically similar, trauma group had significantly higher postoperative mean BCVA compared to myopia group (p = 0.013). Myopia and trauma were the most common etiologic factors for RRD in children. The visual outcomes of trauma-associated RRD were better than those of myopia-associated RRD. PMID:26627689

  17. Retrospective Review of Ocular Point-of-Care Ultrasound for Detection of Retinal Detachment

    PubMed Central

    Jacobsen, Bradley; Lahham, Sari; Lahham, Shadi; Patel, Amy; Spann, Sophia; Fox, John C.

    2016-01-01

    Introduction Retinal detachment is an ocular emergency that commonly presents to the emergency department (ED). Ophthalmologists are able to accurately make this diagnosis with a dilated fundoscopic exam, scleral depression or ophthalmic ultrasound when a view to the retina is obstructed. Emergency physicians (EPs) are not trained to examine the peripheral retina, and thus ophthalmic ultrasound can be used to aid in diagnosis. We assessed the accuracy of ocular point-of-care ultrasound (POCUS) in diagnosing retinal detachment. Methods We retrospectively reviewed charts of ED patients with suspected retinal detachment who underwent ocular POCUS between July 2012 and May 2015. Charts were reviewed for patients presenting to the ED with ocular complaints and clinical concern for retinal detachment. We compared ocular POCUS performed by EPs against the criterion reference of the consulting ophthalmologist’s diagnosis. Results We enrolled a total of 109 patients. Of the 34 patients diagnosed with retinal detachment by the ophthalmologists, 31 were correctly identified as having retinal detachment by the EP using ocular POCUS. Of the 75 patients who did not have retinal detachment, 72 were ruled out by ocular POCUS by the EP. This resulted in a POCUS sensitivity of 91% (95% CI [76–98]) and specificity of 96% (95% CI [89–99]). Conclusion This retrospective study suggests that ocular POCUS performed by EPs can aid in the diagnosis of retinal detachment in ED. PMID:26973752

  18. Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment

    PubMed Central

    Ono, Kozue; Kinoshita, Hirofumi; Uematsu, Masafumi; Tsuiki, Eiko; Fujikawa, Azusa; Kitaoka, Takashi

    2016-01-01

    Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD). Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA). The primary outcome measures were anatomical (primary and final) and functional success (visual acuity better than 6/60). Results. This study evaluated 422 eyes of 411 patients with a mean age of 57.7 ± 11.2 years. The single-operation reattachment rate (primary anatomical success) was 89.8%. The final anatomical success rate was 100% after 2–6 operations (mean = 3.14 ± 1.03). Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P = 0.002) and the presence of multiple tears (P = 0.01). Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%. PMID:27478632

  19. Bietti crystalline retinal dystrophy with subfoveal neurosensory detachment and congenital tortuosity of retinal vessels: case report.

    PubMed

    Padhi, Tapas Ranjan; Kesarwani, Siddharth; Jalali, Subhadra

    2011-06-01

    A 34-year-old man presented with reduction and distortion of vision in both the eyes. The best-corrected vision was 20/20 parts, N6 in either eye. The external and slit lamp examination of both the eyes was unremarkable. The fundus examination showed multiple intraretinal crystalline deposits at the posterior pole, extending up to midperiphery, tortuous retinal blood vessels with S-shaped deflections, and absent foveal reflex in both the eyes. There were no corneal crystals, and the color vision was defective in both the eyes. Fundus autofluorescence and fundus fluorescein angiogram (FFA) were suggestive of geographic areas of retinal pigment epithelium (RPE) and choriocapillary (CC) loss. OCT revealed subfoveal neurosensory detachment. Flash ERG and EOG were normal except for a slight decrease in amplitude and delay in latency of pattern ERG waveforms. The Humphrey's visual field showed paracentral scotoma with reduction in the amplitude of waveforms from the corresponding area in the multifocal ERG in both the eyes. Systemic evaluation for crystalline retinopathy was unremarkable. He was diagnosed to be a case of Bietti crystalline retinopathy (local/regional variant). The subfoveal neurosensory detachment could represent early RPE dysfunction caused by these crystals and could account for the mild visual disturbance in both the eyes. Retinal vascular tortuosity and neurosensory detachment seen in this case is the first time to be reported in literature. PMID:21611771

  20. Oral fluoroquinolones and the incidence of rhegmatogenous retinal detachment and symptomatic retinal breaks: a population-based study

    PubMed Central

    Kapoor, Kapil G.; Hodge, David O.; St Sauver, Jennifer L.; Barkmeier, Andrew J.

    2016-01-01

    Objective To examine whether oral fluoroquinolone antibiotics are associated with an increase in subsequent rhegmatogenous retinal detachment and symptomatic retinal breaks in a large, population-based cohort. Design Population-based cohort study Participants and Controls Adult residents of Olmsted County, Minnesota who were prescribed oral fluoroquinolone medications from 1/01/03 – 6/30/11. Comparison cohorts consisted of patients prescribed oral macrolide and β-lactam antibiotics during the study period. Methods Procedure codes were used to identify retinal detachment repair and prophylaxis procedures occurring within 1 year of prescription dates. Travel clinic, pro re nata, and self-treatment prescriptions were excluded. Patients with tractional retinal detachment, previous retinal detachment repair, endophthalmitis, and necrotizing retinitis were excluded, as were those with intraocular surgery or severe head/eye trauma ≤ 90 days prior to the procedure. Main Outcome Measures Rates of retinal detachment repair and prophylaxis procedures within 7, 30, 90, and 365 days of the first prescription were calculated and compared between antibiotic prescription cohorts using Chi-square tests. Retinal detachment repair rates were also compared to the expected Olmsted County, Minnesota rates using the one-sample log rank test. Results Oral fluoroquinolones were prescribed for 38,046 patients (macrolide n=48,074, β-lactam n=69,079) during the study period. Retinal detachment repair procedures were performed within 365 days of the first prescription in 0.03% (95% confidence interval [CI] 0.01–0.06%) of the fluoroquinolone, 0.02% (95% CI 0.01–0.03%) of the macrolide, and 0.03% (95% CI 0.02–0.05%) of the β-lactam cohorts (p>0.05). Retinal detachment prophylaxis procedures for symptomatic retinal breaks were performed within 365 days of the first prescription in 0.01% (95% CI 0.00–0.03%) of the fluoroquinolone, 0.02% (95% CI 0.01–0.04%) of the macrolide, and 0

  1. Vitrectomy, lensectomy and silicone oil tamponade in the management of retinal detachment associated with choroidal detachment

    PubMed Central

    Gui, Jun-Min; Jia, Li; Liu, Lei; Liu, Jian-Di

    2013-01-01

    AIM To report the results of combined vitrectomy, lensectomy and silicone oil (SO) tamponade in treating primary rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (CD). METHODS A retrospective, consecutive and case series study of 21 subjects with concurrent RRD associated with CD was conducted. All subjects underwent a standard three-port 20G pars plana vitrectomy (PPV) with lensectomy and silicone oil tamponade. Mean follow-up time was 8 months (rang from 4 to 19 months). The primary and final anatomic success rate, visual acuity and final intraocular pressure(IOP) were recorded and analyzed. RESULTS Of 21 subjects, 8 were women and 13 were men. Age at presentation ranged from 22 to 75 years (mean 57.4 years). The presenting vision ranged from light perception to 0.15. The initial IOP ranged from 3mmHg to 12mmHg (mean 6.2mmHg). All eyes were phakic except one pseudophakic. No intraocular lens was implanted during the primary surgical intervention. Fifteen of 21 (71.4%) eyes had retina reattached after one operation. Six eyes had recurrent inferior retinal detachment due to proliferation. Five of them were successfully reattached after one or more additional operations. Mean IOP at final follow-up was 15.2mmHg (range from 8mmHg to 20mmHg). One case declined for further operation. The final reattachment rate was 95.2%. Visual acuity improved in 19 (90.5%) eyes, was unchanged in 1 (4.8%) eye and decreased in 1 (4.8%) eye. CONCLUSION Combination of vitrectomy, lensectomy and silicone tamponade is an effective method in treating RRD associated with CD, reducing the incidence of postoperative hypotony. PMID:23826529

  2. Amino acid and vascular endothelial growth factor levels in subretinal fluid in rhegmatogenous retinal detachment

    PubMed Central

    Buyukuysal, Rifat Levent; Gelisken, Oner; Buyukuysal, Cagatay; Can, Basak

    2014-01-01

    Purpose To study the concentrations of amino acids and vascular endothelial growth factor (VEGF) in subretinal fluid (SRF) of cases with rhegmatogenous retinal detachment (RRD). The relevance of the results with postoperative anatomic and functional success in RRD was investigated. Methods Fifty-three patients were included in this prospective study. The study group consisted of 46 patients who had scleral buckling surgery with the diagnosis of RRD, and SRF was obtained during the surgery. The control specimens consisted of vitreous samples of seven patients who were diagnosed with pars plana vitrectomy without RRD. Study cases were divided into three groups, corresponding to the duration of retinal detachment. Clinical characteristics, including best corrected visual acuity (BCVA) and anatomic status at month 6, were recorded. Concentrations of 15 selected amino acids were quantified by using high performance liquid chromatography, and VEGF levels were measured with enzyme immunoassay. Results When compared with the control group, SRF concentrations of aspartate, citrulline, glutamate, and glycine increased significantly in the study group (p<0.05). Statistical analysis showed that concentrations of alanine, isoleucine, leucine, methionine, phenylalanine, threonine, tyrosine, and valine decreased (p<0.05). SRF levels of glutamine, taurine, and serine had no significant change. SRF VEGF levels were significantly higher than the vitreous samples of the controls (p<0.001). Time-dependent changes and interactions between VEGF and amino acids were observed. There was no correlation between the concentrations of amino acids or VEGF with the parameters of BCVA and anatomical success. Conclusions Significant changes occur in concentrations of amino acids and VEGF in SRF of cases with RRD. Our results suggest that several mechanisms contribute to the pathophysiology. PMID:25352742

  3. Surgical treatment of retinal detachment owing to macular hole.

    PubMed

    Wolfensberger, T J; Gonvers, M

    2000-06-01

    Retinal detachments owing to macular hole have a low prevalence and occur predominantly in myopic eyes. The choice of surgical technique is primarily based on the axial length of the globe and on the presence or absence of a posterior staphyloma and/or chorioretinal degenerations. Whereas patients with low myopia and no posterior staphyloma are best treated with primary pars plana vitrectomy and air tamponade, patients with marked myopia and large posterior staphylomas should be managed by combining a pars plana vitrectomy with laser photocoagulation of the macular hole rim under perfluorocarbon liquids and a temporary silicone oil tamponade. For the intermediate myopias the surgical technique has to be decided from patient to patient. PMID:11309744

  4. Peripheral Retinal Vascular Patterns in Patients with Rhegmatogenous Retinal Detachment in Taiwan

    PubMed Central

    Chen, San-Ni; Hwang, Jiunn-Feng; Wu, Wen-Chuan

    2016-01-01

    This is an observational study of fluorescein angiography (FA) in consecutive patients with rhegmatogenous retinal detachment (RRD) in Changhua Christian Hospital to investigate the peripheral retinal vascular patterns in those patients. All patients had their age, sex, axial length (AXL), and refraction status (RF) recorded. According to the findings in FA of the peripheral retina, the eyes were divided into 4 groups: in group 1, there was a ramified pattern of peripheral retinal vasculature with gradual tapering; in group 2, there was an abrupt ending of peripheral vasculature with peripheral non-perfusion; in group 3, there was a curving route of peripheral vasculature forming vascular arcades or anastomosis; and in group 4, the same as in group 3, but with one or more wedge-shaped avascular notches. Comparisons of age, sex, AXL, and RF, association of breaks with lattice degeneration and retinal non-perfusion, surgical procedures utilized, and mean numbers of operations were made among the four groups. Of the 73 eyes studied, there were 13 eyes (17.8%) in group 1, 3 eyes (4.1%) in group 2, 40 eyes (54.8%) in group 3 and 17 eyes (23.3%) in group 4. Significant differences in age, AXL and RF, and association of retinal breaks to non-perfusion were noted among the four groups. Patients in group 1 had older ages, while younger ages were noted in groups 3 and 4. Eyes in group 1 had the shortest average AXL and were least myopic in contrast to the eyes in groups 3 and 4. Association of retinal breaks and retinal non-perfusion was significantly higher in groups 2, 3 and 4 than in group 1. In conclusion, peripheral vascular anomalies are common in cases with RRD. Patients with peripheral non-perfusion tend to be younger, with longer axial length and have the breaks associated with retinal non-perfusion. PMID:26909812

  5. Macula-Sparing Rhegmatogenous Retinal Detachment: Is Emergent Surgery Necessary?

    PubMed Central

    Mahmoudi, Sasan; Almony, Arghavan

    2016-01-01

    The status of the macula is a significant factor in determining final visual outcomes in rhegmatogenous retinal detachment (RRD) and should be considered in the timing of surgical repair. Several studies have shown that macula-involving RRDs attain similar visual and anatomic outcomes when surgery is performed within seven days as compared to emergent surgery (within 24 hours). In contrast, surgery prior to macular detachment in macula-sparing RRDs generally yields the best visual outcomes. In the case of macula-sparing RRDs, it is not clear how long the macula may remain attached, therefore, standard practice dictates emergent surgery. Timing of presentation, examination findings, case complexity, co-existing medical conditions, surgeon expertise, and timing and quality of access to operating facilities and staff, however, should all be considered in determining whether a macula-sparing RRD requires immediate intervention or if equivalent visual and possibly better overall outcomes can be achieved with scheduled surgery within an appropriate time frame. PMID:27195093

  6. The Development of a Cat Model of Retinal Detachment and Re-attachment.

    PubMed

    Wassmer, Sarah; Leonard, Brian C; Coupland, Stuart G; Baker, Adam; Hamilton, John; Torlone, Renée; Zacks, David N; Tsilfidis, Catherine

    2016-01-01

    We present an optimized surgical technique for feline retinal detachment which allows for natural re-attachment, reduces retinal scarring and vitreal bands, and allows central placement of the detachment in close proximity to the optic nerve. This enables imaging via Optical Coherence Tomography (OCT) and multifocal electroretinography (mfERG) analysis. Ideal detachment conditions involve a lensectomy followed by a three-port pars plana vitrectomy. A 16-20 % retinal detachment is induced by injecting 8 % C3F8 gas into the subretinal space in the central retina with a 42G cannula. The retinal detachment resolves approximately 6 weeks post-surgery. Imaging is enhanced by using a 7.5 and 20 diopter lens for OCT and mfERG fundus imaging, respectively, to compensate for the removed lens. PMID:26427427

  7. Fibulin 2, a tyrosine O-sulfated protein, is up-regulated following retinal detachment.

    PubMed

    Kanan, Yogita; Brobst, Daniel; Han, Zongchao; Naash, Muna I; Al-Ubaidi, Muayyad R

    2014-05-01

    Retinal detachment is the physical separation of the retina from the retinal pigment epithelium. It occurs during aging, trauma, or during a variety of retinal disorders such as age-related macular degeneration, diabetic retinopathy, retinopathy of prematurity, or as a complication following cataract surgery. This report investigates the role of fibulin 2, an extracellular component, in retinal detachment. A major mechanism for detachment resolution is enhancement of cellular adhesion between the retina and the retinal pigment epithelium and prevention of its cellular migration. This report shows that fibulin 2 is mainly present in the retinal pigment epithelium, Bruch membrane, choriocapillary, and to a lesser degree in the retina. In vitro studies revealed the presence of two isoforms for fibulin 2. The small isoform is located inside the cell, and the large isoform is present inside and outside the cells. Furthermore, fibulin 2 is post-translationally modified by tyrosine sulfation, and the sulfated isoform is present outside the cell, whereas the unsulfated pool is internally located. Interestingly, sulfated fibulin 2 significantly reduced the rate of cellular growth and migration. Finally, levels of fibulin 2 dramatically increased in the retinal pigment epithelium following retinal detachment, suggesting a direct role for fibulin 2 in the re-attachment of the retina to the retinal pigment epithelium. Understanding the role of fibulin 2 in enhancing retinal attachment is likely to help improve the current therapies or allow the development of new strategies for the treatment of this sight-threatening condition. PMID:24692557

  8. An unusual and spontaneous resolution of a total rhegmatogenous retinal detachment.

    PubMed

    Mercanti, Andrea; Renna, Antonio; Prosperi, Raffaele; Lanzetta, Paolo

    2015-04-01

    Spontaneous reattachment of rhegmatogenous retinal detachment is a rare event that involves the relief of vitreoretinal traction, closure of the retinal breaks, and reabsorption of subretinal fluid. Diffuse retinal pigmentary alterations within a sharply demarcated and convex margin are the most common findings within the areas corresponding to the reattached retina in all the cases described in the literature. The authors report the case of a 60-year-old man who experienced spontaneous reattachment of a total rhegmatogenous retinal detachment with gradual recovery of visual function and a completely restored retina. This is the first case reported that does not exhibit the ophthalmoscopic findings commonly described in the literature. PMID:25932730

  9. Atypical Presentation of Ocular Toxoplasmosis: A Case Report of Exudative Retinal Detachment and Choroidal Ischemia.

    PubMed

    Al-Zahrani, Yahya A; Al-Dhibi, Hassan A; Al-Abdullah, Abdulelah A

    2016-01-01

    A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. The patient responded well to anti-toxoplasmosis medications and steroids. Exudative retinal detachment and choroidal ischemia are atypical presentations of ocular toxoplasmosis. However, both conditions responded well to anti.parasitic therapy with steroid. PMID:26957857

  10. Atypical Presentation of Ocular Toxoplasmosis: A Case Report of Exudative Retinal Detachment and Choroidal Ischemia

    PubMed Central

    Al-Zahrani, Yahya A.; Al-Dhibi, Hassan A.; Al-Abdullah, Abdulelah A.

    2016-01-01

    A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. The patient responded well to anti-toxoplasmosis medications and steroids. Exudative retinal detachment and choroidal ischemia are atypical presentations of ocular toxoplasmosis. However, both conditions responded well to anti.parasitic therapy with steroid. PMID:26957857

  11. Retinal pigment epithelial detachments and tears, and progressive retinal degeneration in light chain deposition disease

    PubMed Central

    Spielberg, Leigh H; Heckenlively, John R; Leys, Anita M

    2013-01-01

    Background/purpose Light-chain deposition disease (LCDD) is a rare condition characterised by deposition of monoclonal immunoglobulin light chains (LCs) in tissues, resulting in varying degrees of organ dysfunction. This study reports the characteristic clinical ocular findings seen in advanced LCDD upon development of ocular fundus changes. This is the first report to describe this entity in vivo in a series of patients. Methods A case series of ocular fundus changes in three patients with kidney biopsy-proven LCDD. All patients underwent best corrected visual acuity (BCVA) exam, perimetry, colour fundus photography and fluorescein angiography; two patients underwent indocyanine green angiography, optical coherence tomography, ultrasound and electroretinography; and one patient underwent fundus autofluorescence. Results Three patients, 53–60 years old at initial presentation, were studied. All three presented with night blindness, poor dark adaptation, metamorphopsia and visual loss. Examination revealed serous and serohaemorrhagic detachments, multiple retinal pigment epithelial (RPE) tears, diffuse RPE degeneration and progressive fibrotic changes. Neither choroidal neovascularisation nor other vascular abnormalities were present. Final best corrected visual acuity (BCVA) ranged from 20/40 to 20/300. Conclusions Progressive LC deposition in the fundus seems to damage RPE pump function with flow disturbance between choroid and retina. This pathogenesis can explain the evolution to RPE detachments and subsequent rips and progressive retinal malfunction. PMID:23385633

  12. Proteomic Analysis of the Vitreous following Experimental Retinal Detachment in Rabbits

    PubMed Central

    Mandal, Nakul; Lewis, Geoffrey P.; Fisher, Steven K.; Prause, Jan U.; la Cour, Morten; Vorum, Henrik; Honoré, Bent

    2015-01-01

    Purpose. The pathogenesis of rhegmatogenous retinal detachment (RRD) remains incompletely understood, with no clinically effective treatment for potentially severe complications such as photoreceptor cell death and proliferative vitreoretinopathy. Here we investigate the protein profile of the vitreous following experimental retinal detachment using a comparative proteomic based approach. Materials and Methods. Retinal detachment was created in the right eyes of six New Zealand red pigmented rabbits. Sham surgery was undertaken in five other rabbits that were used as controls. After seven days the eyes were enucleated and the vitreous was removed. The vitreous samples were evaluated with two-dimensional polyacrylamide gel electrophoresis and the differentially expressed proteins were identified with tandem mass spectrometry. Results. Ten protein spots were found to be at least twofold differentially expressed when comparing the vitreous samples of the sham and retinal detachment surgery groups. Protein spots that were upregulated in the vitreous following retinal detachment were identified as albumin fragments, and those downregulated were found to be peroxiredoxin 2, collagen-Iα1 fragment, and α-1-antiproteinase F. Conclusions. Proteomic investigation of the rabbit vitreous has identified a set of proteins that help further our understanding of the pathogenesis of rhegmatogenous retinal detachment and its complications. PMID:26664739

  13. Progressive retinal detachment secondary to juxtapapillary microholes in association with type 3 posterior staphylomas

    PubMed Central

    Dinah, Christiana B; Vaideanu-Collins, Daniela; Steel, David HW

    2014-01-01

    Purpose This study describes a novel subtype of retinal detachment occurring in eyes with pathological myopia associated with type 3 posterior staphyloma and discusses the management options. Methods We retrospectively reviewed the case notes of seven patients who presented with unilateral symptomatic rhegmatogenous retinal detachment secondary to nasal juxtapapillary microholes. Results All seven patients had pathological myopia and an associated peripapillary type 3 posterior staphyloma. They all presented with symptoms of acute posterior vitreous detachment and had progressive retinal detachment. All cases were discovered to have a single juxtapapillary hole less than 1 disc diameter from the optic-nerve head, within areas of nasal chorioretinal atrophy. The microholes were identified intraoperatively in six of seven cases, with one case identified preoperatively on optical coherence tomography. In the four most recent cases, successful retinal reattachment was achieved with vitrectomy and C2F6 gas tamponade. The remaining three cases were managed with vitrectomy and silicone oil. Conclusion Seven patients with pathological myopia, type 3 posterior staphyloma, and progressive retinal detachment secondary to juxtapapillary microholes are presented in this paper. High clinical suspicion is required to identify these breaks. Successful retinal reattachment with pars plana vitrectomy and long-acting gas is possible. PMID:24959066

  14. Prophylactic Circumferential Retinal Cryopexy to Prevent Pseudophakic Retinal Detachment after Posterior Capsule Rupture during Phacoemulsification

    PubMed Central

    Bertelmann, T.; Heun, C.; Paul, C.; Bari-Kacik, E.; Sekundo, W.; Schulze, S.

    2015-01-01

    Purpose. To evaluate whether prophylactic circumferential retinal cryopexy (CRC) can prevent pseudophakic retinal detachment (PRD) development after posterior capsule rupture (PCR) during phacoemulsification. Methods. Retrospective patient chart analysis of eyes experiencing a PCR during phacoemulsification. Comparison of PRD development between eyes receiving CRC (cryo+ group) or not (cryo− group). Results. Overall 106 patients were analyzed, thereof 61 (58%) in the cryo+ and 45 (42%) in the cryo− group. In both clusters a total of 10 PRDs (9.4%) occurred, thereof 3 (30%) in the cryo+ as well as 7 (70%) in the cryo− group (p = 0.087), 79.8 ± 81.58 weeks after PCR. Relative/absolute risk reduction in CRC-treated eyes was calculated to be 68%/11%. Prophylactic CRC reduced PRD development 0.3-fold. Number needed to treat was estimated to be 9.4. Conclusion. Prophylactic CRC might be a useful treatment option in eyes with PCR to hamper PRD development in the further course. Further research is indicated to evaluate this beneficial effect between eyes with and without a rupture of the anterior vitreous cortex and accompanying vitreous loss in an expanding number of eyes. PMID:26697214

  15. Management of retinal detachment in block related globe perforation with pneumatic retinopexy.

    PubMed

    Rishi, Karandeep; Venkatesh, Pradeep; Garg, Satpal P

    2013-03-01

    Retinal detachment after ocular perforation related to local anesthesia is a common complication, which is usually associated with a poor prognosis despite complex vitreoretinal surgical procedures. We report a case of 62-year-old male with cataract surgery done 4 weeks back with nasal retinal detachment with a posterior break. Pneumatic retinopexy was performed and laser barrage of the breaks was done the next day when the retina got attached. A vision of 20/30 was achieved at the end of 2 months. To the best of our knowledge, this is a first case report in literature where pneumatic retinopexy was used to manage a retinal detachment caused by block-related perforation. PMID:23514652

  16. Intraocular SF6 gas applications: treatment of retinal detachments caused by holes at the posterior pole.

    PubMed

    Mester, U; Kroll, P; Völker, B; Kreissig, I

    1983-01-01

    Retinal detachments caused by holes in the posterior pole are rare among rhegmatogenous detachments, but the central position of the holes causes considerable difficulties on surgery. The use of intraocular gas bubbles affords new possibilities for the treatment of these cases. Among 1,800 consecutively treated retinal detachments, we found only 21 which were due exclusively to one or more holes at the posterior pole; of these, only 7 exhibited a hole directly in the macula. The operative treatment of these 21 detachments consisted of an intraocular gas tamponade effected through injection of SF6 combined with cryo- and laser coagulation of the periphery of the holes. Reattachment of the macula and improved visual acuity were achieved in 19 cases. The postoperative follow-up ranges from 4 to 60 months, with a mean of 29 months. PMID:6682535

  17. Retinal detachment as a complication of neodymium: yttrium aluminum garnet laser cyclophotocoagulation.

    PubMed

    Geyer, O; Neudorfer, M; Lazar, M

    1993-05-01

    We report a traction retinal detachment that developed within one month of transscleral neodymium: yttrium aluminum garnet (Nd:YAG) laser cyclophotocoagulation, a previously unreported complication of the new cyclodestructive procedure. A 17-year-old boy was referred to our department with uncontrolled aphakic glaucoma OD after having undergone cyclocryotherapy twice. Three treatments with transscleral Nd:YAG cyclophotocoagulation were done over nine months to lower his intraocular pressure. Hypotony and traction retinal detachment occurred after the third laser treatment and was managed successfully by vitrectomy with a fluid-gas exchange. Thus, the possibility of this additional complication should be remembered when doing transscleral Nd:YAG cyclophotocoagulation. PMID:8517586

  18. Surgical Complications of Primary Rhegmatogenous Retinal Detachment: A Meta-Analysis

    PubMed Central

    Lv, Zhiping; Li, Ying; Wu, Yongzhong; Qu, Yi

    2015-01-01

    Background To investigate the surgical complications of scleral buckling (SB) and pars plana vitrectomy (PPV) performed on primary rhegmatogenous retinal detachment (RRD) and to discover which surgical procedures bring fewer complications. Methods An electronic literature search using the PubMed database, ISI Web of Knowledge and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials and observational studies comparing SB with PPV on primary RRD. Outcome measures included intra-operative complications and early and late post-operative complications. Results During the operation, significantly less subretinal hemorrhage occurred in the PPV group than in the SB group (OR = 4.71; 95%CI, 1.33–16.64; p = 0.02) and the hypotony incidence was significantly higher in the SB group (OR = 18.24; 95%CI, 2.37–140.44; p = 0.005); however, the occurrence of iatrogenic breaks was significantly lower in the SB group (OR = 0.05; 95%CI, 0.01–0.21; p<0.0001). In the early stage of post-operation, significantly higher incidence of choroidal detachment was identified in the SB group than in the PPV group (OR = 10.19; 95%CI, 2.36–44.09; p = 0.002); patients undergoing SB had significantly higher odds of residual subretinal fluid (OR = 14.71; 95%CI, 1.84–117.32; p = 0.01); the occurrence of high intraocular pressure was significantly lower in the SB group (OR = 0.46; 95%CI, 0.23–0.89; p = 0.02); and no significant difference was shown in the incidence of epithelia defect (p = 0.37) between the two groups. In the late stage of post-operation, the incidence of diplopia/extraocular muscle dysfunction was significantly higher in the SB group (OR = 4.04; 95%CI, 1.30–12.52; p = 0.02); and significantly less cataract was observed in the SB group (OR = 0.20; 95%CI, 0.14–0.30; p<0.00001); no significant difference was found in the incidences of cystoid macular edema (p = 0.65), macular pucker (p = 0.52), post-operative proliferative

  19. Macrophage- and RIP3-dependent inflammasome activation exacerbates retinal detachment-induced photoreceptor cell death

    PubMed Central

    Kataoka, K; Matsumoto, H; Kaneko, H; Notomi, S; Takeuchi, K; Sweigard, J H; Atik, A; Murakami, Y; Connor, K M; Terasaki, H; Miller, J W; Vavvas, D G

    2015-01-01

    Detachment of photoreceptors from the retinal pigment epithelium is seen in various retinal disorders, resulting in photoreceptor death and subsequent vision loss. Cell death results in the release of endogenous molecules that activate molecular platforms containing caspase-1, termed inflammasomes. Inflammasome activation in retinal diseases has been reported in some cases to be protective and in others to be detrimental, causing neuronal cell death. Moreover, the cellular source of inflammasomes in retinal disorders is not clear. Here, we demonstrate that patients with photoreceptor injury by retinal detachment (RD) have increased levels of cleaved IL-1β, an end product of inflammasome activation. In an animal model of RD, photoreceptor cell death led to activation of endogenous inflammasomes, and this activation was diminished by Rip3 deletion. The major source of Il1b expression was found to be infiltrating macrophages in the subretinal space, rather than dying photoreceptors. Inflammasome inhibition attenuated photoreceptor death after RD. Our data implicate the infiltrating macrophages as a source of damaging inflammasomes after photoreceptor detachment in a RIP3-dependent manner and suggest a novel therapeutic target for treatment of retinal diseases. PMID:25906154

  20. Controversy over the etiology and therapy of retinal detachment: the struggles of Jules Gonin.

    PubMed

    Gloor, Balder P; Marmor, Michael F

    2013-01-01

    Retinal tears were recognized as soon as ophthalmoscopy became available. They were initially considered to be secondary events, from choroidal exudation and pressure behind the detached retina. This led von Graefe and others to recommend cuts in the retina to drain subretinal fluid into the vitreous cavity. De Wecker (1875, 1879) and Leber (1882) first proposed that intrinsic tears within the retina are the cause of retinal detachment, but they faced extreme and long lasting opposition for this view. Surgical results at this time were uniformly disastrous, and therapeutic nihilism still prevailed when Dufour and Gonin became convinced around 1904-1906 that the retinal tear was indeed the origin of the detachment. It took ten years, however, before Gonin figured out how to close tears by exact placement of heat coagulation ("thermopuncture") and provide therapeutic evidence for his beliefs. When he first presented his results in 1921, colleagues jeered at him, especially Deutschmann and Sourdille who, like the other ophthalmic surgeons, denied the role of the tear (and still made "therapeutic" incisions through the detached retina). Recognition of Gonin's approach finally came at the International Congresses in Amsterdam 1928 and in Madrid in 1933. Sourdille modified his approach when his son Gabriel convinced him to change after 1930, but Deutschmann stuck to his horrific procedure until his death in 1935. Then a new generation of retinal surgeons took over, with subsequent discussion focused on finding the best methods to close the tears. PMID:23257154

  1. Exudative retinal detachment following strabismus surgery in Sturge-Weber syndrome.

    PubMed

    Kim, Yu Cheol; Lee, Se Yeop; Kim, Kwang Soo

    2015-06-01

    A 15-year-old boy with Sturge-Weber syndrome underwent strabismus surgery (oculus sinister [OS]) for the treatment of exotropia. The patient's visual acuity (OS) decreased to hand motion 10 days after the surgery. One month after the surgery, the patient's visual acuity decreased to light perception, and a fundus examination showed total exudative retinal detachment (OS). PMID:26265655

  2. Exudative retinal detachment following strabismus surgery in Sturge–Weber syndrome

    PubMed Central

    Kim, Yu Cheol; Lee, Se Yeop; Kim, Kwang Soo

    2015-01-01

    A 15-year-old boy with Sturge–Weber syndrome underwent strabismus surgery (oculus sinister [OS]) for the treatment of exotropia. The patient's visual acuity (OS) decreased to hand motion 10 days after the surgery. One month after the surgery, the patient's visual acuity decreased to light perception, and a fundus examination showed total exudative retinal detachment (OS). PMID:26265655

  3. Early ultrasonographic diagnosis of retinal detachment: multidisciplinary approach and benefit.

    PubMed

    Cabric, Emir; Salihefendic, Nizama; Zildzic, Muharem; Licanin, Zoran; Smajlovic, Fahrudin

    2010-01-01

    Patients with eye problems are often present in family medicine and emergency wards, whether it is isolated disturbances of vision, or as part of other diseases. A large number of pathological entities of the eye require prompt and accurate diagnosis and appropriate therapy before they get to specialized ophthalmological institutions. Ultrasonography of the eye is a simple, non-invasive, painless method that can be done at the first contact with patients and can provide very important information for accurate diagnosis of pathological changes. Early detection of retinal ablation, intra ocular bleeding and tumors by this method can save sight and lives of patients. Sonography of the eye in 667 patients over two years revealed 27 retinal ablation and hemophthalmos in 36 patients. Every fifth patient with retinal ablation was referred by a doctor of family medicine. Knowing the possibilities of ultrasonography in ophthalmology, teamwork at the level of primary health care can open access to ultrasonography of the eye for other specialty physicians which can improve population health and provide a new quality in the prevention of vision loss. PMID:20422825

  4. Long-term surgical outcomes of retinal detachment in patients with Stickler syndrome

    PubMed Central

    Reddy, Devasis N; Yonekawa, Yoshihiro; Thomas, Benjamin J; Nudleman, Eric D; Williams, George A

    2016-01-01

    Purpose The aim of the study was to present the long-term anatomical and visual outcomes of retinal detachment repair in patients with Stickler syndrome. Patients and methods This study is a retrospective, interventional, consecutive case series of patients with Stickler syndrome undergoing retinal reattachment surgery from 2009 to 2014 at the Associated Retinal Consultants, William Beaumont Hospital. Results Sixteen eyes from 13 patients were identified. Patients underwent a mean of 3.1 surgical interventions (range: 1–13) with a mean postoperative follow-up of 94 months (range: 5–313 months). Twelve eyes (75%) developed proliferative vitreoretinopathy. Retinal reattachment was achieved in 100% of eyes, with ten eyes (63%) requiring silicone oil tamponade at final follow-up. Mean preoperative visual acuity (VA) was 20/914, which improved to 20/796 at final follow-up (P=0.81). There was a significant correlation between presenting and final VA (P<0.001), and patients with poorer presenting VA were more likely to require silicone oil tamponade at final follow-up (P=0.04). Conclusion Repair of retinal detachment in patients with Stickler syndrome often requires multiple surgeries, and visual outcomes are variable. Presenting VA is significantly predictive of long-term VA outcomes. PMID:27574392

  5. Serous retinal detachment and cystoid macular edema in a patient with Wyburn-Mason syndrome.

    PubMed

    Onder, Halil Ibrahim; Alisan, Sibel; Tunc, Murat

    2015-03-01

    Wyburn-Mason syndrome is a rare phacomatosis characterized by unilateral arteriovenous malformations (AVMs) involving the brain, retina, and (rarely) the skin. The diagnosis is concluded with dilated fundus examination and markedly dilated tortuous vascular loops with arteriovenous communications on fluorescent angiography. We present a 14-year-old male patient with Wyburn-Mason syndrome who developed serous macular neuroretinal detachment, cystoid macular edema (CME), and consequent visual deterioration in the left eye. To the best of our knowledge, this is the first report of a patient with Wyburn-Mason syndrome who developed serous retinal detachment and CME. PMID:24171831

  6. Ageing of the vitreous: From acute onset floaters and flashes to retinal detachment.

    PubMed

    Lumi, Xhevat; Hawlina, Marko; Glavač, Damjan; Facskó, Andrea; Moe, Morten C; Kaarniranta, Kai; Petrovski, Goran

    2015-05-01

    Floaters and flashes are most commonly symptoms of age-related degenerative changes in the vitreous body and posterior vitreous detachment. The etiology and pathogenesis of floaters' formation is still not well understood. Patients with acute-onset floaters, flashes and defects in their visual field, represent a medical emergency with the need for same day referral to an ophthalmologist. Indirect ophthalmoscopy with scleral indentation is needed in order to find possible retinal break(s), on-time treatment and prevention of retinal detachment. The molecular and genetic pathogenesis, as well as the epidemiology of the ageing changes of the vitreous is summarized here, with view on the several treatment modalities in relation to their success rate and side-effects. PMID:25841656

  7. Serous retinal detachment following panretinal photocoagulation (PRP) using Pattern Scan Laser (PASCAL) photocoagulator

    PubMed Central

    Azar, Georges; Wolff, Benjamin; Cornut, Pierre-Loïc; Mauget-Faÿsse, Martine

    2012-01-01

    Objective: To report a case of serous retinal detachment after Pattern Scan Laser (PASCAL) treatment in a diabetic woman. Methods: A 34-year-old diabetic woman presented with florid diabetic retinopathy after a miscarriage during the 20th week of pregnancy. Her Best Corrected Visual Acuity (BCVA) was 20/40 right eye (OD) and 20/30 left eye (OS). Fundus exam showed multiple microaneurysms, large blot hemorrhages and venous dilation both eyes (OU). Fundus fluorescein angiography (FFA) revealed large areas of capillary nonperfusion and panretinal neovascularisation in all quadrants OU. Macular Spectral-Domain Optical Coherence Tomography scan (SD-OCT) did not show any foveal thickening. Panretinal photocoagulation (PRP) was immediately performed OU during the same day. Results: Two days after PASCAL treatment, her BCVA decreased to 20/80 OU and worsened to Count Fingers (CF) during the following days. Fundus exam revealed an extensive serous retinal detachment confirmed on SD-OCT. 2 sub-conjunctival injections of 0.1 ml Betamethasone were done OU. One month later, BCVA improved to 20/30 and SD-OCT confirmed regression of retinal detachment. Conclusions: PASCAL is considered to be a safe treatment, but one has to be aware of its potential side effects. It has to be used with caution in pregnant women.

  8. 23-gauge vitrectomy and silicone oil tamponade with and without phacoemulsification in rhegmatogenous retinal detachment

    PubMed Central

    Ozkan, Seyhan Sonar; Citirik, Mehmet; Beyazyildiz, Emrullah; Beyazyildiz, Ozlem

    2015-01-01

    The aim of this study is to assess clinical outcomes of 23-gauge vitrectomy and silicone oil (SO) tamponade combined with and without phacoemulsification (PE) in rhegmatogenous retinal detachment (RRD). The study included forty eyes of 40 patients that underwent 23-gauge vitrectomy and SO tamponade combined with and without PE. Twenty eyes of 20 cases, of whom underwent 23-gauge vitrectomy and SO tamponade combined with PE were allocated to the group 1. Likewise, 20 eyes of 20 cases that underwent 23-gauge vitrectomy and SO tamponade alone were allocated to the group 2. Best corrected visual acuity (BCVA) between two groups was compared. There was no significant difference in BCVA between the two groups during the 6 months (P = 0.3). Recurrent retinal detachments were observed in 2 cases (10%) in both groups. There was no statistically significant difference between two groups as a point of recurrent retinal detachments (P = 1). We have found higher rates of post-vitrectomy cataract progression (45%) in the eyes with RRD who underwent 23-gauge vitrectomy and SO tamponade. Combined vitrectomy and PE is safe and effective for the patients with RRD. PMID:26064338

  9. Retinal detachment and degeneration in response to subretinal perfluorodecalin in rabbit eyes.

    PubMed

    Berglin, L; Ren, J; Algvere, P V

    1993-04-01

    Perfluorocarbon liquids, including perfluorodecalin (PFD), are useful intraoperative tools in complicated vitreoretinal surgery, such as for giant retinal tears, PVR and intraocular foreign bodies. Due to its high specific gravity (1.91 g/cm3) subretinal complications of PFD may occur. The consequences of subretinal PFD were studied in 23 albino rabbits (28 eyes). Using glass micropipettes (outer diameter of tip 100-120 microns), we injected 50-100 microliters PFD subretinally via the vitreous space. The same volume of BSS was injected into 18 control eyes. Eyes were monitored by indirect ophthalmoscopy and examined by light and electron microscopy at 1, 2 and 3 days, and 1, 2, 4 and 12 weeks. Progressive retinal detachments with newly formed retinal breaks in the inferior quadrants developed in 26 of 28 eyes. As early as 1 day postoperatively, subretinal PFD induced loss of outer and inner segments. Local retinal necrosis occurred in 4 eyes 5-7 days after surgery. A marked vacuole formation in retinal layers and PFD emulsification were regularly seen. The control eyes healed spontaneously. Toxic, mechanical and barrier effects may have caused the retinal damage. We advocate that all PFD be removed from the eye at surgery. PMID:8486306

  10. Evaluation of Intravitreal Ranibizumab on the Surgical Outcome for Diabetic Retinopathy With Tractional Retinal Detachment

    PubMed Central

    Dong, Feng; Yu, Chenying; Ding, Haiyuan; Shen, Liping; Lou, Dinghua

    2016-01-01

    Abstract This study aims to investigate intravitreal injection of Ranibizumab on the surgical outcome for diabetic patients who had tractional retinal detachment but did not receive any preoperative retinal photocoagulation. Ninety-seven patients (97 eyes) who had diabetic retinopathy with tractional retinal detachment were enrolled to receive 23-G pars plana vitrectomy (PPV). They were assigned to an experimental group (Group I, n = 47 eyes) and a control group (Group II, n = 50 eyes). The patients in Group I were given 1 injection of intravitreal Ranibizumab (Lucentis 0.5 mg/0.05 mL) 1 week before surgery, whereas those in Group II went down to surgery directly. Follow-ups were performed for 6 months to 3 years (16 ± 6 months), and indicators observed included postoperative best-corrected visual acuity, complications, and retinal thickness in the macula measured by optical coherence tomography. In Group I, BCVA improved from logMAR 1.92 ± 0.49 to logMAR 0.81 ± 0.39 following surgery, whereas in Group II, BCVA improved from logMAR 1.91 ± 0.49 to logMAR 0.85 ± 0.41. There was significant postoperative gain in vision, but there was no significant difference between the 2 groups at postoperative follow-up visits. The mean duration of vitrectomy in Group I and Group II was (40 ± 7) minutes and (53 ± 9) minutes, respectively, with significant difference. Iatrogenic breaks were noted in 5 eyes (11%) in the experimental group and 17 eyes (34%) in the control group; the difference was significant. The retinal thickness in the macula measured by OCT was (256 ± 44) μm and (299 ± 84) μm in Group I and Group II respectively with significant difference. Besides, there were significantly more eyes in Group II that required silicone oil tamponade and postoperative retinal photocoagulation. 23-G PPV combined with intravitreal tamponade and panretinal photocoagulation still remains an effective regimen for the

  11. Evaluation of Intravitreal Ranibizumab on the Surgical Outcome for Diabetic Retinopathy With Tractional Retinal Detachment.

    PubMed

    Dong, Feng; Yu, Chenying; Ding, Haiyuan; Shen, Liping; Lou, Dinghua

    2016-02-01

    This study aims to investigate intravitreal injection of Ranibizumab on the surgical outcome for diabetic patients who had tractional retinal detachment but did not receive any preoperative retinal photocoagulation.Ninety-seven patients (97 eyes) who had diabetic retinopathy with tractional retinal detachment were enrolled to receive 23-G pars plana vitrectomy (PPV). They were assigned to an experimental group (Group I, n = 47 eyes) and a control group (Group II, n = 50 eyes). The patients in Group I were given 1 injection of intravitreal Ranibizumab (Lucentis 0.5 mg/0.05 mL) 1 week before surgery, whereas those in Group II went down to surgery directly. Follow-ups were performed for 6 months to 3 years (16 ± 6 months), and indicators observed included postoperative best-corrected visual acuity, complications, and retinal thickness in the macula measured by optical coherence tomography.In Group I, BCVA improved from logMAR 1.92 ± 0.49 to logMAR 0.81 ± 0.39 following surgery, whereas in Group II, BCVA improved from logMAR 1.91 ± 0.49 to logMAR 0.85 ± 0.41. There was significant postoperative gain in vision, but there was no significant difference between the 2 groups at postoperative follow-up visits. The mean duration of vitrectomy in Group I and Group II was (40 ± 7) minutes and (53 ± 9) minutes, respectively, with significant difference. Iatrogenic breaks were noted in 5 eyes (11%) in the experimental group and 17 eyes (34%) in the control group; the difference was significant. The retinal thickness in the macula measured by OCT was (256 ± 44) μm and (299 ± 84) μm in Group I and Group II respectively with significant difference. Besides, there were significantly more eyes in Group II that required silicone oil tamponade and postoperative retinal photocoagulation.23-G PPV combined with intravitreal tamponade and panretinal photocoagulation still remains an effective regimen for the treatment of

  12. Vitrectomy for Tractional Retinal Detachment with Twin Retinal Capillary Hemangiomas in a Patient with Von Hippel-Lindau Disease: A Case Report

    PubMed Central

    Suzuki, Hiroyuki; Kakurai, Keigo; Morishita, Seita; Kimura, Daisaku; Fukumoto, Masanori; Sato, Takaki; Kida, Teruyo; Ueki, Mari; Sugasawa, Jun; Ikeda, Tsunehiko

    2016-01-01

    Purpose The purpose of this study was to report a case of Von Hippel-Lindau disease (VHL) with twin retinal capillary hemangiomas that was successfully treated by vitreous surgery for tractional retinal detachment following laser photocoagulation. Case A 44-year-old male presented at our university hospital after noticing decreased visual acuity in his right eye. The patient had previously undergone multiple operations for cerebellar, thoracic, and lumbar spine hemangioblastomas when he was approximately 19 years old. Upon initial examination, ocular findings revealed twin connected retinal capillary hemangiomas around the temporal upper area of the patient's right eye. The patient was subsequently diagnosed with VHL based on his medical history and current observations of the ocular fundus. Tractional retinal detachment had occurred as the result of the formation of proliferative membranes following laser photocoagulation. The patient underwent vitreous surgery to treat the tractional retinal detachment, resulting in a successful postoperative outcome. Conclusion The findings of this study show the possibility that proliferative changes and tractional retinal detachment can arise following photocoagulation for retinal capillary hemangiomas in patients with VHL. PMID:27462263

  13. Surgical audit of outcome of rhegmatogenous retinal detachment repair at Vitreoretinal unit JPMC in year 2014

    PubMed Central

    Tareen, Saifullah; Tahir, Muhammad Ali; Cheema, Alyscia Miriam

    2016-01-01

    Objective: To investigate the outcome of rhegmatogenous retinal detachment repair at Vitreoretinal unit of Jinnah Post Graduate Medical Centre Karachi in year 2014. Methods: One hundred and three eyes of one hundred and three patients, who underwent three ports parsplana vitrectomy + band + silicone oil, three ports pars plana vitrectomy + silicone oil, three ports pars plana vitrectomy + C3F8 for rhegmatogenous retinal detachment (RRD) repair, at Jinnah Post Graduate Medical Centre, were included in this observational prospective study. Parsplana vitrectomy was done using 23G vitrectomy system. Duration of study was one year. Removal of silicone oil (ROSO) was done on the basis of completely flat retina at least for eight weeks or because of complications due to silicone oil. Patients were followed up post operatively on day one and after one week and then at four weekly interval till the end of the study. Results: Anatomical success was achieved in 91 eyes (88.3%). However in 12 eyes (11.7%) retina redetached after removal of silicone oil. Functional success achievement of visual acuity of 3/60 or better was achieved in 85 (82.5%) of eyes post operatively after removal of silicone oil or absorption of gas C3F8 as the case may be. Conclusion: Re-detachment is common after removal of silicone oil and incidence of re-detachment is related to the degree of preoperative PVR and location of breaks. Re-detachment occurs more commonly if the breaks are inferiorly located as compared to the superior ones. PMID:27022354

  14. Hypoxia inducible factor 1α contributes to regulation of autophagy in retinal detachment.

    PubMed

    Shelby, Shameka J; Angadi, Pavan S; Zheng, Qiong-Duon; Yao, Jingyu; Jia, Lin; Zacks, David N

    2015-08-01

    Photoreceptor (PR) cells receive oxygen and nutritional support from the underlying retinal pigment epithelium (RPE). Retinal detachment results in PR hypoxia and their time-dependent death. Detachment also activates autophagy within the PR, which serves to reduce the rate of PR apoptosis. In this study, we test the hypothesis that autophagy activation in the PR results, at least in part, from the detachment-induced activation of hypoxia-inducible factors (HIF). Retina-RPE separation was created in Brown-Norway rats and C57BL/6J mice by injection of 1% hyaluronic acid into the subretinal space. Retinas were harvested and assayed for HIF protein levels. Cultured 661W photoreceptor cells were subjected to hypoxic conditions and assayed for induction of HIF and autophagy. The requirement of HIF-1α and HIF-2α in regulating photoreceptor autophagy was tested using siRNA in vitro and in vivo. We observed increased levels of HIF-1α and HIF-2α within 1 day post-detachment, as well as increased levels of BNIP3, a downstream target of HIF-1α that contributes to autophagy activation. Exposing 661W cells to hypoxia resulted in increased HIF-1α and HIF-2α levels and increase in conversion of LC3-I to LC3-II. Silencing of HIF-1α, but not HIF-2α, reduced the hypoxia-induced increase in LC3-II formation and increased cell death in 661W cells. Silencing of HIF-1α in rat retinas prevented the detachment-induced increase in BNIP3 and LC3-II, resulting in increased PR cell death. Our data support the hypothesis that HIF-1α, but not HIF-2α, serves as an early response signal to induce autophagy and reduce photoreceptor cell death. PMID:26093278

  15. [Evaluation of the macula which was not involved in retinal detachment after surgical treatment of retinal detachment using scleral indentation. Summary of a doctoral thesis].

    PubMed

    Boduch-Cieślińska, K

    1992-10-01

    The goal of the study was the evaluation of the influence of the nowadays most frequently used surgical methods in cases of retinal detachment on the macula not involved in the detachment. The study takes into account surgical interventions which have the same indications and principles of action. They are based on an extra-scleral indentation--temporary or permanent one--by means of a Lincoff-Kreissig balloon and a meridional silicone sponge implant. The examinations comprised 54 patients. They were divided into 2 groups: 1st group (24 patients) was treated by cryopexy and a Lincoff-Kreissig balloon, the 2nd group (30 patients) by cryopexy and a meridional silicone sponge implant. In all the patients of both groups the retina reattached. During the 5-years observation of patients of the 1st group no macular changes were detected; one did not observe metamorphopsia or disturbances of the color vision. In the 2nd group instead 17 patients claimed metamorphopsia, 20 patients showed disturbances of the color vision and angiography changes involving the macular region (13 patients). PMID:1306534

  16. Massive Retinal Pigment Epithelial Detachment Following Acute Hypokalemic Quadriparesis in Dengue Fever

    PubMed Central

    Goel, Neha; Bhambhwani, Vishaal; Jain, Pooja; Ghosh, Basudeb

    2016-01-01

    Purpose: To describe an unusual retinal manifestation of dengue fever in an endemic region. Case Report: A 35 year old male presenting with acute onset decreased vision in his right eye, was found to have a massive retinal pigment epithelial detachment (PED) extending up to the vascular arcades. He had been diagnosed with acute hypokalemic quadriparesis in dengue fever in the preceding week, which had resolved following treatment. The patient was managed conservatively. At three months follow up, there was spontaneous flattening of the PEDs with improvement in visual acuity. Conclusion: Dengue fever complicated by acute hypokalemic quadriparesis can be associated with PED, which can be large. The condition resolves spontaneously and bears a good prognosis.

  17. Expression Profiling after Retinal Detachment and Reattachment: A Possible Role for Aquaporin-0

    PubMed Central

    Farjo, Rafal; Peterson, Ward M.; Naash, Muna I.

    2009-01-01

    Purpose Retinal detachment (RD) is associated with acute visual loss caused by anatomic displacement of the photoreceptors and with chronic visual loss/disturbance caused by retinal remodeling and photoreceptor cell death, which may occur even after successful reattachment. The P2Y2 receptor agonist INS37217 improves the rate of retinal reattachment in animal models of induced RD, and has been shown to also significantly enhance the rate of ERG recovery in a mouse model of RD. The identification of genes modulated by INS37217 may allow further drug discovery for treating RD and edema. Methods To identify genes involved in RD and subsequent reattachment, a retinal microarray screen was performed using a mouse model of RD in the presence or absence of INS37217. Results Ninety-two genes were identified as differentially expressed across three time points, most of which were upregulated in the presence of this agonist. Furthermore, it was shown that RD alters the expression of aquaporin-0 (AQP-0), and this modulation is prevented by treatment with INS37217. The presence of AQP-0 in retinal bipolar cells was also demonstrated, whereas it was previously thought to be specific to the lens. Mice lacking functional alleles of AQP-0 had a photo-transduction deficit as assessed by electroretinography; however, their photoreceptor structure was normal, indicative of a problem with signal transmission between neurons. Conclusions This study establishes the genes involved in RD and reattachment, and also demonstrates for the first time a physiologically significant role for AQP-0 in retinal function. PMID:18234993

  18. Panuveitis With Exudative Retinal Detachments After Vaccination Against Human Papilloma Virus.

    PubMed

    Dansingani, Kunal K; Suzuki, Mihoko; Naysan, Jonathan; Samson, C Michael; Spaide, Richard F; Fisher, Yale L

    2015-10-01

    A 20-year-old white woman presented with bilateral acute visual loss (visual acuity: 20/60), panuveitis, and exudative retinal detachments 3 weeks after a second dose of quadrivalent human papillomavirus (HPV4) vaccine. She was treated with oral prednisolone for 6 weeks and responded rapidly. By week 4, vision had normalized and clinical signs resolved. Uveitis after HPV4 vaccination has been reported in two cases. Although the differential diagnosis includes Harada disease, temporal correlation with HPV4 and definitive response to a short course of treatment implicate the vaccine in this case. Vaccine-induced uveitis is rare and difficult to distinguish from coincidental autoimmune disease. PMID:26469238

  19. Biocompatibility of a Synthetic Biopolymer for the Treatment of Rhegmatogenous Retinal Detachment

    PubMed Central

    Sarfare, Shanta; Dacquay, Yann; Askari, Syed; Nusinowitz, Steven; Hubschman, Jean-Pierre

    2015-01-01

    Objective The aim of this study is to evaluate the retinal safety and toxicity of a novel synthetic biopolymer to be used as a patch to treat rhegmatogenous retinal detachment. Methods Thirty one adult wild type albino mice were divided in 2 groups. In Group A (n=9) 0.2 μl balanced salt solution (BSS) and in Group B (n=22), 0.2 μl biopolymer was injected in the subretinal space. Trans-scleral subretinal injection was performed in one eye and the fellow eye was used as control. In both groups, in vivo color fundus photography, electroretinogram (ERG), spectral domain optical coherence tomography (SD-OCT) were performed before injection and at days 7 and 14 post-intervention. Histological analysis was performed following euthanization at days 1, 7 and 21 post-injection. Results The biopolymer was visualized in the subretinal space in vivo by SD-OCT and post-life by histology up to 1 week after the injection. There were no significant differences in ERG parameters between the two groups at 1 and 2 weeks post-injection. Minimal inflammatory response and loss of photoreceptor cells was only observed in the immediate proximity of the site of scleral perforation, which was similar in both groups. Overall integrity of the outer, inner retina and retinal pigment epithelial (RPE) layers was unaffected by the presence of the biopolymer in the subretinal space. Conclusions Functional and histological evaluation suggests that the synthetic biopolymer is non-inflammatory and non-toxic to the eye. It may represent a safe therapeutic agent in the future, for the treatment of rhegmatogenous retinal detachment. PMID:26744635

  20. Retinal Detachment

    MedlinePlus

    ... layer of tissue in the back of your eye that senses light and sends images to your brain. It provides ... about in your field of vision, and/or light flashes in the eye. It may also seem like there is a " ...

  1. Topical difluprednate for treatment of serous retinal detachment and panuveitis associated with Vogt-Koyanagi-Harada disease

    PubMed Central

    Lu, Stacey; Taban, Mehran

    2016-01-01

    Summary Patients with bilateral serous retinal detachments and panuveitis related to Vogt-Koyanagi-Harada disease are commonly managed with oral corticosteroids, immunosuppressive agents, and/or intravitreal injections. We present the case of a 56-year-old Hispanic man with Harada disease whose bilateral serous retinal detachments and panuveitis were treated with topical corticosteroid difluprednate alone. Functional and anatomical recoveries were assessed by fluorescein angiograms and optical coherence tomography studies over a period of 9 months. The patient’s serous retinal detachments resolved, and his vision and panuveitis improved dramatically over a period of 2 weeks, after which he was placed on a drop taper and maintenance therapy for the remainder of the 9 months. PMID:27582676

  2. Topical difluprednate for treatment of serous retinal detachment and panuveitis associated with Vogt-Koyanagi-Harada disease.

    PubMed

    Lu, Stacey; Taban, Mehran

    2016-01-01

    Patients with bilateral serous retinal detachments and panuveitis related to Vogt-Koyanagi-Harada disease are commonly managed with oral corticosteroids, immunosuppressive agents, and/or intravitreal injections. We present the case of a 56-year-old Hispanic man with Harada disease whose bilateral serous retinal detachments and panuveitis were treated with topical corticosteroid difluprednate alone. Functional and anatomical recoveries were assessed by fluorescein angiograms and optical coherence tomography studies over a period of 9 months. The patient's serous retinal detachments resolved, and his vision and panuveitis improved dramatically over a period of 2 weeks, after which he was placed on a drop taper and maintenance therapy for the remainder of the 9 months. PMID:27582676

  3. Vitrectomy with or without encircling band for pseudophakic retinal detachment: a multi-centre, three-arm, randomised clinical trial. VIPER Study Report No. 1—design and enrolment

    PubMed Central

    Mazinani, B; Baumgarten, S; Schiller, P; Agostini, H; Helbig, H; Limburg, E; Hellmich, M; Walter, P

    2016-01-01

    Purpose Scleral buckling is currently used in addition to vitrectomy for the treatment of pseudophakic retinal detachment (PRD) to better support the vitreous base and better visualisation of the periphery. Aims The aims of this study are to evaluate (1) whether the combination of 20 G vitrectomy and scleral buckling is superior to 20 G vitrectomy alone (control) (confirmatory), and (2) whether transconjunctival 23/25 G vitrectomy is non-inferior to 20 G vitrectomy (both without scleral buckling) regarding operation success (exploratory). Methods The VIPER (Vitrectomy Plus Encircling Band Vs. Vitrectomy Alone For The Treatment Of Pseudophakic Retinal Detachment) study is an unmasked, multi-centre, three-arm randomised trial. Patients with PRD were eligible, excluding complicated retinal detachment or otherwise severe ophthalmologic impairment. Patients were randomised to one of three interventions: 20 G vitrectomy alone (control C), combination of 20 G vitrectomy and circumferential scleral buckling (experimental treatment E1) or 23/25 G vitrectomy alone (experimental treatment E2). The primary endpoint is the absence of any indication for a retina re-attaching procedure during 6 months of follow-up. Secondary endpoints include best corrected visual acuity, retina re-attaching procedures, complications and adverse events. Results From June 2011 to August 2013, 257 patients were enrolled in the study. The internet randomisation service assigned 100 patients each to the treatment arms C and E1, and 57 patients to treatment E2. The imbalance is due to the fact that several retinal surgeons did not qualify for performing E2. The random assignment was stratified and balanced (ie, 1:1 or 1:1:1 ratio) by surgeon. Conclusions The described study represents a methodologically rigorous protocol evaluating the benefits of three different vitrectomy approaches to PRD. The projected results will help to establish their overall efficacy and will permit

  4. Scleral Buckle Infection with Aspergillus Flavus

    PubMed Central

    Bouhaimed, Manal; Al-Dhibi, Hassan; Al-Assiri, Abdullah

    2008-01-01

    Purpose: To present a case of scleral buckle infection with Aspergillus flavus in a tertiary eye center in Saudi Arabia. Methods: A retrospective case report of a 28-year-old Saudi male who presented with a six-month history of conjunctival injection and discharge from the left eye which had undergone uncomplicated conventional retinal detachment surgery, at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, in the form of cryopexy, subretinal fluid drainage and scleral buckle (grooved segmental sponge and circumferential band with sleeve) for a macula on retinal detachment four years earlier. A diagnosis of infected extruded scleral buckle was made and the buckle was removed. Results: The infected scleral buckle was removed under local anesthesia with administration of sub-conjunctival irrigation of 50 mg solution of Vancomycin, and sub-conjunctival injection of 25mg of Vancomycin. Post operative microbiological studies revealed infection with silver staining of moderate Aspergillus flavus hyphae. Visual acuity of the left eye improved from 20/200 before surgery to 20/60 in the two years follow-up visit. Conclusion: This case report indicates the importance of considering infection with multiple organisms – including fungal ones – in cases of scleral buckle infections in our population. PMID:20379425

  5. High frequency of latent Chlamydia trachomatis infection in patients with rhegmatogenous retinal detachment

    PubMed Central

    Boiko, Ernest V.; Pozniak, Alexei L.; Maltsev, Dmitrii S.; Suetov, Alexei A.; Nuralova, Irina V.

    2016-01-01

    AIM To determine the frequency of detection of ocular and extraocular Chlamydia trachomatis (CT) infection in non-high myopes with rhegmatogenous retinal detachment (RRD). METHODS This was a single-center, nonrandomized, prospective, case-control study. One hundred and four patients were divided into a study group with RRD (n=63) and a control group with traumatic retinal detachment (n=41). Samples of subretinal fluid (SFR), conjunctival, urethral/cervical swabs, and blood were collected. The frequency of detection of CT infection in SRF samples was determined by polymerase chain reaction (PCR), direct fluorescence assay (DFA) and cell culture, whereas that in conjunctival swabs was determined by PCR and DFA, and those in urethral/cervical swabs and blood were determined by DFA. Yates Chi-square test (with Bonferroni correction) and two-tailed Student's t-test were used for statistical analysis. RESULTS SRF CT infection was detected more frequently in the study group (50.8%-71.4%) than in the control group (9.8%-12.2%) by all the methods used (P<0.01). The frequency of detection of conjunctival CT infection by DFA was higher in the RRD patients compared with the controls (81.0% vs 24.4%, P=0.004). The PCR detected conjunctival CT infection more often in the study group than in the controls (46.0% vs 9.8%, P=0.007). The DFA detected CT in blood specimens almost as frequently as in urogenital specimens, for the RRD patients (61.2% vs 63.5%) and the controls (7.3% vs 9.8%). CONCLUSION CT infection is detected with high frequency in non-high myopes with RRD. PMID:27366689

  6. Five Year Nationwide Incidence of Rhegmatogenous Retinal Detachment Requiring Surgery in Korea

    PubMed Central

    Park, Sang Jun; Choi, Nam-Kyoung; Park, Kyu Hyung; Woo, Se Joon

    2013-01-01

    Purpose To define the incidence and demographic characteristics of rhegmatogenous retinal detachment (RRD) requiring surgery in Korea. Design Nationwide population-based retrospective study. Methods Patients who underwent surgery for RRD from 2007 to 2011 were retrospectively identified using the diagnostic code for RRD and the surgical codes for retinal detachment surgeries in the national claim database. The average incidence rate of RRD during the 5-year period was estimated using the population data of the 2010 Census in Korea. Results A total of 24,928 surgically treated RRD cases were identified. The average incidence of surgery requiring RRD was 10.39 cases per 100,000 person-years [95% confidence interval (CI), 10.26–10.52). The incidence in men (11.32 cases per 100,000 person-years; 95% CI: 11.13–11.51) was significantly higher than that in women (9.47 cases per 100,000 person-years; 95% CI: 9.29–9.64) (p<0.001). The incidence of surgery requiring RRD showed a bimodal distribution across age groups, with one peak (28.55 cases per 100,000 person-years; 95% CI: 27.46–29.67) representing patients between 65 and 69 years of age and the second peak (approximately 8.5 per 100,000 person-years) representing patients between 20 and 29 years of age. The male-to-female ratio was approximately 1.0 for the peak-incidence age groups, whereas the ratio was higher for the other age groups. Conclusions The incidence of RRD in the Korean population was similar to that reported previously, with the peak incidence being lower than that in the Caucasian population. The age-specific RRD incidence pattern in Korea followed a bimodal distribution. PMID:24236173

  7. Outcome of rhegmatogenous retinal detachment repair: Experience of a tertiary center in Oman

    PubMed Central

    Al-Hinai, Ahmed S.; Al-Abri, Mohamed S.

    2013-01-01

    Aim: To study the outcome of repair of rhegmatogenous retinal detachment (RRD) in a tertiary center. Materials and Methods: Review of electronic medical records within a period of 29 months of consecutive patients who underwent surgical repair for RRD in Sultan Qaboos University Hospital (SQUH). Results: We included 33 consecutive patients (36 eyes). Males constituted 70% of them. The average age was 47 years. Seven eyes out of the 36 had macula-on RRD at presentation. The primary success rate with a single procedure was 86%. However, redetachment occurred in five eyes (14%). Visual acuity was either same as preoperative or better in 81% of the eyes. Giant retinal tear was found in three eyes (8%). The average follow-up period for all patients was 10.25 months (range: 3-25 months). Conclusion: Rhegmatogenous RD is not uncommon disorder. It occurs more frequently in males. However, it has a good prognosis if an intervention was performed in early stages. PMID:24379553

  8. Bilateral Serous Retinal Detachment Associated with Inferior Posterior Staphyloma Treated with Scleral Shortening and Vitrectomy

    PubMed Central

    Kasai, Akihito; Kanda, Naotaka; Sekiryu, Tetsuju

    2016-01-01

    Purpose We report a case of bilateral serous retinal detachment (SRD) associated with inferior posterior staphyloma (IPS) treated successfully with scleral shortening. Patient and Methods A 63-year-old woman presented with bilateral visual loss due to an SRD with IPS. The best-corrected visual acuity levels were 0.6 (20/30) and 0.5 (20/40) in the right and left eye, respectively. The patient underwent vitrectomy and scleral shortening in the right eye. The lamellar scleral crescent was resected 4 mm in width from the 5- to 8-o'clock positions. Seven interrupted 5-0 polyester sutures were placed at the edge of the lamellar scleral crescent. After 25-gauge three-port vitrectomy, the sutures were tightened. Optical coherence tomography showed decreased curvature at the staphyloma border. The choroidal thickness decreased in the superior flat portion of the fundus and increased slightly in the staphyloma. The SRD resolved 3 months postoperatively. The best-corrected visual acuity in the right eye improved to 0.8 (20/25) 6 months postoperatively. Angiography 6 months postoperatively showed decreased diffuse dye leakage at the fovea in the right eye; indocyanine green angiography did not show marked changes. Discussion Scleral shortening with vitrectomy changes the eye wall shape, may improve the retinal pigment epithelial integrity, and may be a treatment option for SRD with IPS PMID:27403132

  9. Perfluorocarbon in vitreoretinal surgery and preoperative bevacizumab in diabetic tractional retinal detachment

    PubMed Central

    Arevalo, J Fernando; Serrano, Martin A; Arias, Juan D

    2014-01-01

    AIM: To describe the en bloc perfluorodissection (EBPD) technique and to demonstrate the applicability of using preoperative intravitreal bevacizumab during small-gauge vitreoretinal surgery (23-gauge transconjunctival sutureless vitrectomy) in eyes with advanced proliferative diabetic retinopathy (PDR) with tractional retinal detachment (TRD). METHODS: This is a prospective, interventional case series. Participants included 114 (eyes) with advanced proliferative diabetic retinopathy and TRD. EBPD was performed in 114 eyes (consecutive patients) during 23-gauge vitrectomy with the utilization of preoperative bevacizumab (1.25 mg/0.05 mL). Patients mean age was 45 years (range, 21-85 years). Surgical time had a mean of 55 min (Range, 25-85 min). Mean follow up of this group of patients was 24 mo (range, 12-32 mo). Main outcome measures included best-corrected visual acuity (BCVA), retinal reattachment, and complications. RESULTS: Anatomic success occurred in 100% (114/114) of eyes. Significant visual improvement [≥ 2 Early Treatment Diabetic Retinopathy Study (ETDRS) lines] was obtained in 69.2% (79/114), in 26 eyes (22.8%) BCVA remained stable, and in 8 eyes (7%) BCVA decreased (≥ 2 ETDRS lines). Final BCVA was 20/50 or better in 24% of eyes, between 20/60 and 20/400 in 46% of eyes, and worse than 20/400 in 30% of eyes. Complications included cataract in 32 (28%) eyes, iatrogenic retinal breaks in 9 (7.8%) eyes, vitreous hemorrhage requiring another procedure in 7 (6.1%) eyes, and phthisis bulbi in 1 (0.9%) eye. CONCLUSION: This study demonstrates the usefulness of using preoperative intravitreal bevacizumab and EBPD during small-gauge vitreoretinal surgery in eyes with TRD in PDR. PMID:25317250

  10. Changes of Vision-Related Quality of Life in Retinal Detachment Patients after Cataract Surgery

    PubMed Central

    Zhu, Bijun; Sun, Qian; Xu, Xian; Miao, Yuyu; Zou, Haidong

    2015-01-01

    Rhegmatenous retinal detachment (RRD) is one of the most serious complications after phacoemulsification combined with intraocular lens implantation surgery. It has been reported that vision-related quality of life (VRQoL), as well as visual acuity rapidly decreased when RRD developed. However, little is known of the VRQoL in those RRD patients after anatomical retinal re-attachment, especially whether or not the VRQoL is higher than that before cataract surgery. In this prospective case series study, we use the Chinese-version low vision quality of life questionnaire (CLVQOL) to assess the changes of VRQoL in age-related cataract patients who suffered from RRD after phacoemulsification with intraocular lens (phaco-IOL) implantation. All participants were asked to complete questionnaires in face- to-face interviews one day before and two weeks after cataract surgery, as well as one day before and three months after RRD surgery. A total of 10,127 consecutive age-related cataract patients were followed up to one year after phaco-IOL implantation; among these patients, 17 were diagnosed as RRD. The total CLVQOL scores and subscale scores except “Mobility” decreased significantly when RRD developed. After retinal surgery, only the score of “General vision and lighting” in the CLVQOL questionnaires improved when compared to the scores two weeks after cataract surgery, although the best corrected visual acuity of all patients significantly raised up. However, the mean CLVQOL scores and subscale scores were still considerably higher than the level prior to cataract surgery. Our study suggests that cataract patients at high risk of postoperative RRD should not deny the opportunity to undergo phaco-IOL implantation, even though potential VRQoL impairment induced by RRD exists. PMID:25764367

  11. Surgical outcomes of 25-gauge pars plana vitrectomy for diabetic tractional retinal detachment

    PubMed Central

    Dikopf, M S; Patel, K H; Setlur, V J; Lim, J I

    2015-01-01

    Purpose To evaluate the outcomes and complications of 25-gauge (G) pars plana vitrectomy (PPV) for repair of diabetic tractional retinal detachment (TRD). Methods Retrospective review of consecutive, single-surgeon 25-G PPV cases between July 2007 and July 2014. Seventy eyes from 55 patients were operated on for diabetic TRD; all eyes were tamponaded with sulfur hexafluoride, octofluoropropane, silicone oil, or balanced salt solution. Mean age at surgery was 47.7 years (range 23–76 years), and mean length of follow-up was 713 days (range 90–2368 days; median 671 days). Primary outcomes included best-corrected visual acuity (BCVA), intraocular pressure (IOP), anatomic success, redetachment, and endophthalmitis. Results Preoperatively, 49 eyes (70%) had a concurrent rhegmatogenous component (8 of which also had proliferative vitreoretinopathy (PVR)). Mean BCVA improved from logarithm of the minimal angle of resolution 1.59 (20/800, SD 0.88) to 0.68 postoperatively (20/100, 0.77), P-value<0.001. Mean IOP increased from 15.9 to 20 mm Hg 1 day after surgery. Elevated postoperative IOP (≥22 mm Hg) occurred in 25 eyes, and low IOP (≤5 mm Hg) occurred in 2 eyes. Primary reattachment was achieved in 63 eyes (90%), and final anatomical success occurred in 69 eyes (99%). There were no cases of endophthalmitis. Conclusions Twenty-five-G PPV repair was safe and effective in the repair of diabetic TRD, including eyes with a combined rhegmatogenous detachment or PVR. Gas, silicone oil, and balanced salt solution tamponading agents all proved to be efficacious in this surgical population. PMID:26183284

  12. Diffuse choroidal hemangioma associated with exudative retinal detachment in a Sturge-Weber syndrome case: photodynamic therapy and intravitreous bevacizumab.

    PubMed

    Anaya-Pava, Edwin J; Saenz-Bocanegra, Carlos H; Flores-Trejo, Alejandro; Castro-Santana, Norma A

    2015-03-01

    We report the case of a young female patient with a diffuse choroidal hemangioma (DCH) and glaucoma as part of Sturge-Weber syndrome (SWS) and symptomatic retinal detachment that was treated successfully with photodynamic therapy (PDT) and intravitreal bevacizumab (IVB). The patient was treated with a single session of PDT, a 689-nm laser was used to deliver 50J/cm(2) with a maximum spot size of 6400μm, for 166s. IVB was administered 3 days later. The exudative retinal detachment (ERD), macular edema and visual acuity improved one week after treatment. The patient was followed for 18 months with no recurrence of ERD, and her visual acuity was preserved. PDT followed by IVB may be an effective treatment option for visual deterioration due to ERD in patients with DCHs, as are found in SWS. PMID:25560419

  13. A Comparative Study between Vitrectomy with Internal Tamponade and a New Modified Fiber Optic Illuminated Ando Plombe for Cases of Macular Hole Retinal Detachment in Myopic Eyes

    PubMed Central

    Bedda, Ahmed M.; Abdel Hadi, Ahmed M.; Abd Al Shafy, Muhammad S.

    2015-01-01

    Aim. To compare pars plana vitrectomy (PPV) with silicone tamponade or gas (Groups Ia and Ib) and a new modified Ando plombe equipped with a fiber optic light (Group II) for cases with macular hole retinal detachment (MHRD) in high myopic eyes (axial length > 26 mm). Methods. A prospective interventional randomized case series included 60 eyes (20 in each group). Successful outcome was considered if the retina was completely attached at the end of the follow-up period. Complications were identified for each group. Results. Visual acuity improved by 37.31%, 40.67%, and 49.40% in Groups Ia, Ib, and II, respectively. The success rate was 55%, 60%, and 100% in Groups Ia , Ib, and II, respectively, with a statistically significant difference between Groups Ia, Ib, and II (p < 0.001 in Ia, p: 0.002 in Ib). Complications rates were 60%, 45%, and 20% in Groups Ia, Ib, and II, respectively, with a statistically significant difference between Groups Ia and II (p: 0.01). Conclusion. Fiber optic illuminated Ando plombe allows better positioning under the macula and consequently improves the success rate of epimacular buckling in comparison to PPV with internal tamponade in MMHRD. PMID:26550487

  14. Vitrectomy, argon laser, and gas tamponade for serous retinal detachment associated with an optic disc pit: a case report.

    PubMed Central

    Snead, M P; James, N; Jacobs, P M

    1991-01-01

    We report the case of a 9-year-old boy with a right optic disc pit and associated serous retinal detachment of the macula. This was treated by vitrectomy, endolaser, and gas tamponade as a primary procedure, which resulted in complete resolution. We review the literature and conclude that further reports of the management of this uncommon condition are required so that firmer guidelines on treatment can be established. Images PMID:2043587

  15. Iris retraction associated with rhegmatogenous retinal detachment syndrome and hypotony. A new explanation.

    PubMed

    Campbell, D G

    1984-10-01

    Eyes with rhegmatogenous retinal detachment can occasionally be seen with hypotony and a peculiar retraction of the peripheral iris. Herein I report the following new observations in this syndrome: (1) seclusion of the pupil, (2) resolution of the retraction configuration after disruption of the seclusion, (3) the initial manifestation as angle closure secondary to iris bombé interchangeable with the iris retraction configuration with the addition (to bombé) and the withdrawal (from retraction) of pharmacologic aqueous suppressants, and (4) the rapid cataract formation. The theory that vitreous traction or retraction is the cause of the retrodisplacement of the iris was disproved. A hydrodynamic theory is presented. A lowering of pressure behind the iris, at least partially, due to posterior removal of fluid, presumably from the subretinal space, was shown to be the cause of the iris retraction. The iris retrodisplacement occurred when posterior aqueous removal exceeded aqueous formation. This removal of fluid may be an important factor in the understanding of proliferative vitreoretinopathy as the fluid flow involved may draw cells posteriorly. PMID:6487113

  16. Retinal detachments after Boston Keratoprosthesis: incidence, predisposing factors, and visual outcomes

    PubMed Central

    Jardeleza, Maria Stephanie R.; Rheaume, Marc-Andre; Chodosh, James; Lane, Anne Marie; Dohlman, Claes H.

    2015-01-01

    Purpose To determine the rates, predisposing factors, and visual outcomes of retinal detachment (RD) after Boston Keratoprosthesis (KPro) implantation. Methods In this noncomparative, interventional case series, the medical records of 170 patients (205 eyes) who underwent Boston type 1 and type 2 KPro implantation at the Massachusetts Eye and Ear Infirmary between April 1993 and June 2009 were retrospectively reviewed. Incidence and annual rates of RD were calculated, and the roles of possible predictive factors for RD after KPro were investigated. Main outcome measures were rates of and risk factors for RD, visual acuity after RD, and surgical outcomes after repair. Results Sterile vitritis and autoimmune systemic disease significantly predisposed patients to RD after KPro placement. Of patients who developed RD after implantation, 50% progressed to visual acuity of no light perception despite surgical repair. Conclusions Inflammation plays a major role in RD development after KPro implantation. Patients with predisposing factors should be advised of the high rates of RD and comanaged with a vitreoretinal specialist.

  17. Photoreceptor Inner and Outer Segment Junction Reflectivity after Vitrectomy for Macula-Off Rhegmatogenous Retinal Detachment

    PubMed Central

    Kaluzny, Jakub J.; Sikorski, Bartosz L.; Czajkowski, Grzegorz; Burduk, Mateusz; Kaluzny, Bartlomiej J.; Stafiej, Joanna; Malukiewicz, Grazyna

    2015-01-01

    Purpose. To evaluate the spatial distribution of photoreceptor inner and outer segment junction (IS/OS) reflectivity changes after successful vitrectomy for macula-off retinal detachment (PPV-mOFF) using spectral domain optical coherence tomography (SdOCT). Methods. Twenty eyes after successful PPV-mOFF were included in the study. During a mean follow-up period of 15.3 months, SdOCT was performed four times. To evaluate the IS/OS reflectivity a four-grade scale was used. Results. At the first follow-up visit the IS/OS had very similar reflectivity in entire length of the central scan with total average value of 1,05. At the second visit the most significant increase of the reflectivity was observed in temporal and nasal parafovea with average values of 2,17 and 2,22, respectively. The third region of increased reflectivity of an average value of 2,33 appeared during the third follow-up visit and was located in the foveola. At the last follow-up visit in entire central cross section the IS/OS reflectivity exceeded grade 2 reaching the highest average values in nasal and temporal parafovea and foveola. Conclusions. A gradual increase of the IS/OS reflectivity was observed in eyes after PPV-mOFF. The process is not random and starts independently in the peripheral and central part of the macula which may be attributed to the variable regenerative potential of cones and rods. PMID:26579234

  18. Minimally invasive curved-micro-drainer (CMD) capable of innocuous drainage of subretinal fluid for the treatment of retinal detachment.

    PubMed

    Ma, Yonghao; Lee, ChangYeol; Li, Cheng Guo; You, Yong Sung; Sung, Ho Lee; Jung, Hyungil

    2016-08-01

    Retinal detachment is a serious vision threatening disease. Current consensus for the treatment of retinal detachment is to reattach the retina onto the choroid layer by drainage of accumulated subretinal fluid. Although several surgical methods have been developed, no satisfactory visual outcome has been obtained without surgical complications such as unintended puncture and hemorrhage of the retina and choroid tissue. In this study, we developed a novel Curved-Micro-Drainer (CMD) for the innocuous drainage of subretinal fluid. It is a curved structure with a 15° beveled tip that is 5 mm in length, with an 80 μm inner diameter and a 100 μm outer diameter. This high inner-to-outer diameter ratio of CMD with a 100 μm outer diameter allows efficient drainage of highly viscous subretinal fluid in a minimally invasive manner. In addition, the curved structure precisely matches the spherical ocular structure, which facilitates the CMD insertion into the subretinal space without choroid tissue damage. We demonstrate that the optimized CMD allows for the innocuous drainage of the viscous subretinal fluid from the porcine eye, whereas the traditional hypodermic needle (31-gauge) induces severe retinal and choroid damage. CMD can overcome a critical safety issue and is a potential alternative to conventional surgical interventions for the innocuous drainage of subretinal fluid. PMID:27412289

  19. Concurrent removal of intravitreal lens fragments after phacoemulsification with pars plana vitrectomy prevents development of retinal detachment

    PubMed Central

    Chalam, Kakarla V; Murthy, Ravi K; Priluck, Joshua C; Khetpal, Vijay; Gupta, Shailesh K

    2015-01-01

    AIM To evaluate the outcomes of “concurrent vitrectomy” to retrieve dislocated lens fragment during phacoemulsification. METHODS In a retrospective, observational case series, data of patients who underwent “concurrent” pars plana vitrectomy (PPV) for dislocated lens fragments between the period 2000 and 2008 were reviewed. Data collected included patient demographics, pre-operative visual acuity, intra-operative occurrence of retinal breaks, duration of follow up, post-operative intraocular pressure, final best-corrected visual acuity (BCVA), presence of cystoid macular edema (CME) and occurrence of rhegmatogenous retinal detachment (RRD). RESULTS A total of 58 eyes of 58 patients were included in the study. At 12mo the mean postoperative BCVA was logMAR 0.17 (20/30) with a range of logMAR 0 to 0.69 (20/20 to 20/100), with 96.6% (56/58) of patients showing post-operative improvement in visual acuity (P=0.005). None of the patients developed postoperative retinal detachment, endophthalmitis or non-resolving uveitis at 12mo. CONCLUSION Our study results suggest concurrent PPV for retained lens fragments after cataract surgery is beneficial and may decrease the risk of glaucoma and prevent development of RRD. PMID:25709914

  20. Giant retinal tears.

    PubMed

    Shunmugam, Manoharan; Ang, Ghee Soon; Lois, Noemi

    2014-01-01

    A giant retinal tear (GRT) is a full-thickness neurosensory retinal break that extends circumferentially around the retina for three or more clock hours in the presence of a posteriorly detached vitreous. Its incidence in large population-based studies has been estimated as 1.5% of rhegmatogenous retinal detachments, with a significant male preponderance, and bilaterality in 12.8%. Most GRTs are idiopathic, with trauma, hereditary vitreoretinopathies and high myopia each being causative in decreasing frequency. The vast majority of GRTs are currently managed with a pars plana vitrectomy; the use of adjunctive circumferential scleral buckling is debated, but no studies have shown a clear anatomical or visual advantage with its use. Similarly, silicone oil tamponade does not influence long-term outcomes when compared with gas. Primary and final retinal reattachment rates are achieved in 88% and 95% of patients, respectively. Even when the retina remains attached, however, visual recovery may be limited. Furthermore, fellow eyes of patients with a GRT are at higher risk of developing retinal tears and retinal detachment. Prophylactic treatment under these circumstances may be considered but there is no firm evidence of its efficacy at the present time. PMID:24138895

  1. Optical Coherence Tomography Follow-up of an Unusual Case of Old Rhegmatogenous Retinal Detachment With a Hemorrhagic Macrocyst at the Macula.

    PubMed

    Tripathy, Koushik; Bypareddy, Ravi; Chawla, Rohan; Kumawat, Babulal

    2015-01-01

    A 32-year-old female presented with visual acuity of hand movement close to face, an old inferior rhegmatogenous retinal detachment (RRD), and a large hemorrhagic macular macrocyst (HMM) in the right eye. After 2 weeks of successful vitreoretinal surgery, the HMM started decreasing in height and resolved by 3 months. On optical coherence tomography, a zone of hyperreflectivity in the outer retinal layers was evident on resolution of the cyst. At final follow-up, the visual acuity improved to 1/60 only. Though HMM resolved completely after retinal reattachment, alteration and thickening of microarchitecture of the outer retinal layers ensued. PMID:26599252

  2. Application Of Laser Coagulation In Retinal Detachment And Open - Angle Glaucoma, On The Basis Of Own Experiments

    NASA Astrophysics Data System (ADS)

    Palacz, Olgierd; Karczewicz, Danuta; Owczarska, Wieslawa; Sylwestrzak, Zofia

    1987-10-01

    The first part of the paper presents the results of laser ¬Â¢hotocoaculation treatment involving: 141 patients with retinal detachment , 20 with holes in the macula, and 33 with holes at the eye fundus periphery. At estimating the results, the apposition of retina and the observation time have been taken into account. The second part contains the results of observation of 21 patients, in whom, in 26 eyes laser trabeculoplasty was performed. Normalization of intraocular pressure has been obtained in 76.9% of cases. The outflow coefficient after trabeculoplasty has increased in 57.6% of cases.

  3. Retinal Pigment Epithelium Atrophy 1 (rpea1): A New Mouse Model With Retinal Detachment Caused by a Disruption of Protein Kinase C, θ

    PubMed Central

    Ji, Xiaojie; Liu, Ye; Hurd, Ron; Wang, Jieping; Fitzmaurice, Bernie; Nishina, Patsy M.; Chang, Bo

    2016-01-01

    Purpose Retinal detachments (RDs), a separation of the light-sensitive tissue of the retina from its supporting layers in the posterior eye, isolate retinal cells from their normal supply of nourishment and can lead to their deterioration and death. We identified a new, spontaneous murine model of exudative retinal detachment, nm3342 (new mutant 3342, also referred to as rpea1: retinal pigment epithelium atrophy 1), which we characterize herein. Methods The chromosomal position for the recessive nm3342 mutation was determined by DNA pooling, and the causative mutation was discovered by comparison of whole exome sequences of mutant and wild-type controls. The effects of the mutation were examined in longitudinal studies by clinical evaluation, electroretinography (ERG), light microscopy, and marker and Western blot analyses. Results New mutant 3342, nm3342, also referred to as rpea1, causes an early-onset, complete RD on the ABJ/LeJ strain background, and central exudative RD and late-onset RPE atrophy on the C57BL/6J background. The ERG responses were normal at 2 months of age but deteriorate as mice age, concomitant with progressive pan-retinal photoreceptor loss. Genetic analysis localized rpea1 to mouse chromosome 2. By high-throughput sequencing of a whole exome capture library of an rpea1/rpea1 mutant and subsequent sequence analysis, a splice donor site mutation in the Prkcq (protein kinase C, θ) gene, was identified, leading to a skipping of exon 6, frame shift and premature termination. Homozygotes with a Prkcq-targeted null allele (Prkcqtm1Litt) have similar retinal phenotypes as homozygous rpea1 mice. We determined that the PKCθ protein is abundant in the lateral surfaces of RPE cells and colocalizes with both tight and adherens junction proteins. Phalloidin-stained RPE whole mounts showed abnormal RPE cell morphology with aberrant actin ring formation. Conclusions The homozygous Prkcqrpea1 and the null Prkcqtm1Litt mutants are reliable novel mouse

  4. Change in refraction after lens-sparing vitrectomy for rhegmatogenous retinal detachment and epiretinal membrane

    PubMed Central

    Iwase, Takeshi; Yamamoto, Kentaro; Yanagida, Kosei; Kobayashi, Misato; Ra, Eimei; Murotani, Kenta; Terasaki, Hiroko

    2016-01-01

    Abstract The aim of this study was to compare changes in refraction following lens-sparing vitrectomy between patients with rhegmatogenous retinal detachment (RRD) and epiretinal membrane (ERM) and to investigate factors associated with the change in refraction. We reviewed medical records of 49 eyes of 49 patients with RRD (53.6 ± 7.8 years, mean ± standard deviation) and 24 eyes of 24 patients with ERM (50.9 ± 15.7 years) who underwent lens-sparing vitrectomy. Spherical equivalent refractive power was evaluated before and up to 18 months after surgery. The relationship between the change in refraction and several parameters was evaluated. A significant progressive myopic shift in refractive power was observed after vitrectomy in operated RRD and ERM eyes (P < 0.001, P = 0.016, respectively), with no significant difference in fellow eyes. The refraction values observed at ≥3 and ≥12 months following vitrectomy were significantly different as compared with those observed at baseline in the RRD group (P < 0.001) and the ERM group (P < 0.05), respectively. The change in refraction between the RRD and ERM groups was significant (P = 0.030). The multiple linear regression analysis showed that only age was significantly correlated with the change in refraction in RRD (P = 0.018) and ERM (P < 0.001) groups. The change in refraction was significantly and positively correlated with age in RRD (r = −0.461, P = 0.001) and ERM (r = −0.687, P < 0.001) groups. Following lens-sparing vitrectomy, cataract surgery was performed on 30 eyes after 0.89 ± 0.26 years in the RRD group and on 10 eyes after 1.11 ± 0.14 years in the ERM group; there was a significant difference in time to cataract surgery between the groups (P = 0.007). Kaplan–Meier survival analysis demonstrated that there was a significant difference in the rate of cataract surgeries between the RRD and ERM groups (P = 0

  5. Change in refraction after lens-sparing vitrectomy for rhegmatogenous retinal detachment and epiretinal membrane.

    PubMed

    Iwase, Takeshi; Yamamoto, Kentaro; Yanagida, Kosei; Kobayashi, Misato; Ra, Eimei; Murotani, Kenta; Terasaki, Hiroko

    2016-08-01

    The aim of this study was to compare changes in refraction following lens-sparing vitrectomy between patients with rhegmatogenous retinal detachment (RRD) and epiretinal membrane (ERM) and to investigate factors associated with the change in refraction.We reviewed medical records of 49 eyes of 49 patients with RRD (53.6 ± 7.8 years, mean ± standard deviation) and 24 eyes of 24 patients with ERM (50.9 ± 15.7 years) who underwent lens-sparing vitrectomy. Spherical equivalent refractive power was evaluated before and up to 18 months after surgery. The relationship between the change in refraction and several parameters was evaluated.A significant progressive myopic shift in refractive power was observed after vitrectomy in operated RRD and ERM eyes (P < 0.001, P = 0.016, respectively), with no significant difference in fellow eyes. The refraction values observed at ≥3 and ≥12 months following vitrectomy were significantly different as compared with those observed at baseline in the RRD group (P < 0.001) and the ERM group (P < 0.05), respectively. The change in refraction between the RRD and ERM groups was significant (P = 0.030). The multiple linear regression analysis showed that only age was significantly correlated with the change in refraction in RRD (P = 0.018) and ERM (P < 0.001) groups. The change in refraction was significantly and positively correlated with age in RRD (r = -0.461, P = 0.001) and ERM (r = -0.687, P < 0.001) groups. Following lens-sparing vitrectomy, cataract surgery was performed on 30 eyes after 0.89 ± 0.26 years in the RRD group and on 10 eyes after 1.11 ± 0.14 years in the ERM group; there was a significant difference in time to cataract surgery between the groups (P = 0.007). Kaplan-Meier survival analysis demonstrated that there was a significant difference in the rate of cataract surgeries between the RRD and ERM groups (P = 0.022).Following lens

  6. Cytomegalovirus retinitis

    MedlinePlus

    ... to prevent its return. Alternative Names Cytomegalovirus retinitis Images Eye CMV retinitis CMV (cytomegalovirus) References Crumpacker CS. ... 5. Read More Antibody HIV/AIDS Immune response Retinal detachment Systemic WBC count Update Date 12/10/ ...

  7. A 25-Year-Old Man with Exudative Retinal Detachments and Infiltrates without Hematological or Neurological Findings Found to Have Relapsed Precursor T-Cell Acute Lymphoblastic Leukemia

    PubMed Central

    Johnson, Jordan S.; Lopez, James S.; Kavanaugh, Arthur Scott; Liang, Chanping; Mata, Douglas A.

    2015-01-01

    Background Precursor T-cell acute lymphoblastic leukemia (pre-T-ALL) may cause ocular pathologies such as cotton-wool spots, retinal hemorrhage, and less commonly, retinal detachment or leukemic infiltration of the retina itself. However, these findings are typically accompanied by the pathognomonic hematological signs of acute leukemia. Case Presentation In this case report and review of the literature, we describe a particularly unusual case of a 25-year-old man who presented to our hospital with bilateral exudative retinal detachments associated with posterior pole thickening without any hematological or neurological findings. The patient, who had a history of previously treated pre-T-ALL in complete remission, was found to have leukemia cell infiltration on retinal biopsy. Conclusion Our case underscores the fact that the ophthalmologist may be the first provider to detect the relapse of previously treated leukemia, and that ophthalmic evaluation is critical for detecting malignant ocular infiltrates. PMID:26483676

  8. Temporary resolution of foveal schisis following vitrectomy with silicon oil tamponade in X-linked retinoschisis with retinal detachment

    PubMed Central

    Goel, Neha; Ghosh, Basudeb

    2015-01-01

    X-linked retinoschisis (XLR) is an uncommon bilateral vitreoretinal dystrophy characterized by typical foveoschisis in all patients that may be associated with peripheral retinoschisis. A young male with XLR with retinal detachment in his right eye underwent 23 gauge pars plana vitrectomy with silicone oil tamponade. Postoperatively, best-corrected visual acuity (BCVA) improved to 20/120 with an attached retina. Spectral-domain optical coherence tomography showed macular thinning with the collapse of the schitic cavities with silicone oil in situ. Following silicone oil removal at 6 months follow-up, the retina remained attached with a BCVA of 20/80 however the foveal schitic cavities reappeared. This unusual course has not been described previously. PMID:26669343

  9. The use of pars plana vitrectomy in the treatment of a serous retinal detachment secondary to lupus choroidopathy.

    PubMed

    Nicholson, Laura; Sobrin, Lucia

    2013-01-01

    This report describes the use of pars plana vitrectomy (PPV) in the management of a patient with a serous retinal detachment (SRD) secondary to lupus choroidopathy. Surgery was performed after anti-inflammatory treatments and laser photocoagulation failed to resolve the condition. The patient's vision improved, and the subretinal fluid has not reaccumulated at 5 years postoperatively. The high viscosity of the subretinal fluid observed during the procedure may account for the persistence of the SRD despite control of inflammation. PPV surgery can be considered as a treatment option for patients with lupus-related SRD when anti-inflammatory medications are not successful and the subretinal fluid does not reabsorb independently. PMID:24044718

  10. Preoperative peribulbar block in patients undergoing retinal detachment surgery under general anesthesia: a randomized double-blind study.

    PubMed

    Morel, Jérôme; Pascal, Jean; Charier, David; De Pasquale, Véronique; Gain, Philippe; Auboyer, Christian; Molliex, Serge

    2006-04-01

    Retinal detachment surgery is frequently associated with significant postoperative pain and emesis in adults. In this randomized, double-blind, controlled study we sought to demonstrate that 1% ropivacaine peribulbar (PB) block in conjunction with general anesthesia (GA) improves operative conditions and postoperative analgesia compared with GA combined with subcutaneous normal saline injection into the inferior eyelid. Thirty-one patients were included in each group. Anesthesia was performed with target-controlled infusion propofol and continuous remifentanil infusion adjusted to maintain bispectral index values between 40 and 50. Postoperative analgesia included fixed-dose IV infusion of propacetamol and IV injection of nefopam via a patient-controlled analgesia device. Tramadol was infused IV as rescue medication. Demographic data were comparable between the groups and bispectral index values were maintained at the objective target. In the PB group, fewer patients presented an oculocardiac reflex (6 versus 17; P < 0.01); bleeding interfering with the surgical field was reduced (1 versus 11 patients; P < 0.01); mean time to first nefopam request was longer (148 +/- 99 versus 46 +/- 58 min; P < 0.01); mean nefopam consumption was diminished during the first 6 h after tracheal extubation (18.9 +/- 13.9 versus 28.5 +/- 14.7 mg; P < 0.05); immediate postoperative pain scores were lower; and fewer patients required rescue medication (5 versus 23; P < 0.01). The two groups were similar with respect to the incidence of postoperative nausea and vomiting. Overall, PB block combined with GA improved operating conditions and postoperative analgesia in retinal detachment surgery. PMID:16551903

  11. Indications and outcomes of scleral buckle removal in a tertiary eye care center in South India

    PubMed Central

    Kazi, Mohmmad Salman; Sharma, Vishal Ranjan; Kumar, Saurabh; Bhende, Pramod

    2015-01-01

    Purpose: To study the clinical profile of patients undergoing scleral buckle removal (SBR) surgery. Materials and Methods: All consecutive patients undergoing SBR surgery following scleral buckle for retinal detachment repair between January 2002 and December 2011 with a minimum postSBR follow-up of 6 months were included in this study. A record based on analysis of indications, methods, complications, and outcomes of the eyes was performed. Results: One hundred and two eyes of 101 patients (men = 77; 76.24% and women = 24; 23.76%) belonging to the age group of 15–78 years (mean 50 ± 15 years) were included in this study. Time gap between scleral buckle and SBR ranged from 2 to 216 months (mean 61 ± 51 months). Buckle exposure with clinical infection (81; 79.41%) was the most common indication. Of 90 (88.2%) eyes with positive culture, 75 (83.3%) revealed single and 15 (16.6%) revealed multiple microorganisms. Staphylococcus epidermidis (42; 41.2%), was the most common isolate. Fungus was isolated in 3 (2.94%) eyes. Globe perforation (14; 13.7%) and recurrent retinal detachment (7; 6.9%) were the commonest complications. Time gap between SBR and recurrent retinal detachment ranged from 15 days to 50 months (mean 12.2 ± 18.3 months). Conclusions: Most of the exposed scleral buckles developed clinical infection few months to years after surgery, ultimately requiring SBR. Recurrent retinal detachment after SBR may appear from few days to years later warranting a long-term follow-up. PMID:26903723

  12. Orbital cellulitis following silicone-sponge scleral buckles

    PubMed Central

    Nemet, Arie Y; Ferencz, Joseph R; Segal, Ori; Meshi, Amit

    2013-01-01

    Background Acute or chronic infection of the scleral explant is rare. We report seven cases of scleral explant infections that caused orbital cellulitis. Materials and methods This was a retrospective chart review of oculoplastics at oculoplastics and vitreo-retinal units in a secondary referral hospital. All subjects had orbital cellulitis secondary to scleral buckle in the range of January 1990 to March 2010. Demographics, imaging studies, and pathology specimens were reviewed. Results A total of 841 silicone-sponge scleral buckle implants for rhegmatogenous retinal detachment were performed. Forty were extracted (4.75%; annual rate of 1.9 cases). Seven (0.83%) had orbital cellulitis. The mean time from implantation to presentation was 5.7 years. There was bacterial growth in all specimens, with Staphylococcus aureus in four. Conclusions Patients who are operated on with silicone-sponge scleral buckling for rhegmatogenous retinal detachment sometimes require removal of the implant because of infection. However, the infection rate is low. Patients should be followed in the long term for possible complications. PMID:24204118

  13. Clinical and multimodal imaging characteristics of acute Vogt-Koyanagi-Harada disease unassociated with clinically evident exudative retinal detachment.

    PubMed

    Attia, Sonia; Khochtali, Sana; Kahloun, Rim; Ammous, Dhiaeddine; Jelliti, Bechir; Ben Yahia, Salim; Zaouali, Sonia; Khairallah, Moncef

    2016-02-01

    The purpose of this study was to describe the clinical and multimodal imaging findings in acute Vogt-Koyanagi-Harada (VKH) disease without clinically evident exudative retinal detachment (ERD). We retrospectively reviewed the charts of 18 patients (36 eyes), diagnosed with acute VKH disease without clinically evident ERD. All patients underwent complete ophthalmic examination, fundus photography, optical coherence tomography (OCT), B-scan ultrasonography, fluorescein angiography (FA), and indocyanine green angiography (ICGA). Of 18 patients, twelve (66.7 %) were female and 6 (33.3 %) were male. Mean age was 39 years (range, 23-60). Ten patients had been referred with an erroneous diagnosis of primary optic nerve disorder (8; 44.4 %) or isolated anterior uveitis (2; 11.1 %). Anterior chamber or vitreous inflammatory reaction was noted in 22 eyes (61.1 %), each. Fundus findings included optic disc swelling in 30 eyes (83.3 %), retinal striae in 20 eyes (55.5 %), and yellowish deep lesions in 3 eyes (8.3 %). OCT showed a shallow, localized subclinical ERD in 18 eyes (50 %), and retinal pigment epithelial folds in 23 eyes (63.9 %). B-scan ultrasonography showed diffuse, low- to medium-reflective choroidal thickening in all eyes. FA disclosed delayed choroidal perfusion in at least one eye of all patients (100 %), mild pinpoint leakage in 21 eyes (58.3 %), optic disc hyperfluorescence in 35 eyes (97.2 %) and choroidal folds in 13 eyes (36.1 %). ICGA findings included delayed choroidal perfusion in 24 eyes (66.7 %), decrease in the number of large choroidal vessels in 36 eyes (100 %), fuzzy choroidal vessels in 35 eyes (97.2 %), and hypofluorescent dark dots in 28 eyes (77.8 %). The association of bilateral optic disc edema with retinal striae and intraocular inflammatory reaction highly suggests acute VKH disease. A multimodal imaging approach including fundus photography, OCT, B-scan ultrasonography, FA, and ICGA provides important clues for the definite diagnosis and

  14. [Is restriction of physical activity indicated in the prevention of retinal detachment?].

    PubMed

    Karel, I

    1993-06-01

    The author evaluates the importance of different vitreoretinal factors and the role of indirect injury in the pathogenesis of detachment of the retina/DR/and holds the following view as regards subjects inclined to pursue physical activity. Numerous and frequent vitreoretinal risk factors are a forecast of DR only in a small fraction of patients. Indirect injury is not recognized as a cause of DR. Risk factors incl. medium-grade and high-grade myopia are not an indication for restriction of physical activity nor for Caesarean section in pregnant women. Restriction of physical activity acts as a psychic trauma and does not prevent the development of DR. PMID:8348645

  15. Endoilluminator-assisted scleral buckling: Our results

    PubMed Central

    Gogia, Varun; Venkatesh, Pradeep; Gupta, Shikha; Kakkar, Ashish; Garg, Satpal

    2014-01-01

    Aims: The aim was to evaluate the long-term surgical outcomes of endoillumination assisted scleral buckling (EASB) in primary rhegmatogenous retinal detachment (RRD). Methods: Twenty-five eyes of 25 patients with primary RRD and proliferative vitreoretinopathy ≤C2 where any preoperative break could not be localised, were included. All patients underwent 25 gauge endoilluminator assisted rhegma localisation. Successful break determination was followed by cryopexy and standard scleral buckling under surgical microscope. Anatomical and functional outcomes were evaluated at the end of 2 years. Results: At least one intraoperative break could be localized in 23 of 25 (92%) eyes. Median age of these patients was 46 years (range: 17-72). Thirteen eyes (56.52%) were phakic, 8 (34.78%) were pseudophakic and 2 (8.6%) were aphakic. Anatomical success (attachment of retina) was achieved in 22 (95.63%) of 23 eyes with EASB. All eyes remained attached at the end of 2 years. Significant improvement in mean visual acuity (VA) was achieved at the end of follow-up (1.09 ± 0.46 log of the minimum angle of resolution [logMAR]) compared with preoperative VA (1.77 ± 0.28 logMAR) (P < 0.001). Conclusion: EASB can be considered an effective alternative to vitreoretinal surgery in simple retinal detachment cases with the added advantage of enhanced microscopic magnification and wide field illumination. PMID:25230970

  16. Comparison of retinal detachment surgery outcome among patients undergoing pars plana vitrectomy with and without relaxing retinotomy.

    PubMed

    Frenkel, Tal; Moisseiev, Elad; Neudorfer, Meira; Loewenstein, Anat; Barak, Adiel

    2015-06-01

    The purpose of this four year retrospective study was to compare the anatomical and functional outcomes of complicated retinal detachment (RD) surgery by pars plana vitrectomy (PPV) with and without retinotomy. The main outcome measures were primary anatomical success (defined as retinal re-attachment at the final follow-up after a single operation, with or without silicone in situ), final anatomical success, final best-corrected visual acuity (BCVA) and postoperative complications. Baseline characteristics did not differ between the groups, although there was a borderline significant trend for the retinotomy group to be associated with worse pre-surgical ocular pathology. With a mean follow-up of 18 (± 7.8) months, primary anatomical success was achieved in 76.7% (33 of 43) of the retinotomy group eyes vs. 67.8% (40 of 59) of the eyes in the group without retinotomy. Final anatomical success rates for the retinotomy group and no retinotomy group were 100 and 93.2% respectively. The final BCVA was 1.57 LogMAR with retinotomy and 1.38 without retinotomy, an improvement in both groups. The incidence of postoperative complications was similar in the two groups, while the frequency of macular holes was higher in the retinotomy group. A similar degree of improvement in BCVA following both surgeries indicates their similar efficacy and justifies their performance even in complicated eyes in order to improve the patients' quality of life. With neither approach superior to the other, the choice of method should be left to the surgeon. PMID:25142375

  17. Clinical outcomes of 23-gauge vitrectomy may be better than 20-gauge vitrectomy for retinal detachment repair

    PubMed Central

    Jiang, Ya-Qin

    2015-01-01

    Objective This study compared the clinical outcomes between 23-gauge (23-G) vitrectomy and 20-gauge (20-G) vitrectomy for the repair of retinal detachment (RD). Methods A retrospective comparative analysis of 135 RD patients was conducted between January, 2013 and September, 2014 in the Ophthalmology Department of the Affiliated Hospital of Weifang Medical College. The clinical outcomes of RD patients who underwent 23-G vitrectomy (n = 65) and 20-G vitrectomy (n = 70) were compared. A logistic regression analysis was used for prognostic factors in RD patients. A meta-analysis was performed using the comprehensive Meta-Analysis version 2.0 software. Results Baseline characteristics of RD patients between the 23-G group and the 20-G group were not significantly different (all p>0.05). The postoperative wound closure time was obviously shorter, and postoperative intraocular pressure (IOP; mmHg) and the incidence of macular holes (MH) were evidently lower in the 23-G group than in the 20-G group (all p<0.05). However, no statistical significances in the postoperative retinal reattachment rate or visual acuity improvement in the logarithm of the minimum angle of resolution (logMAR) were detected between the 23-G group and the 20-G group (both p>0.05). The meta-analysis further confirmed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group (all p<0.05), while neither the postoperative retinal reattachment rate nor the visual acuity improvement in the logMAR showed statistical significance (all p>0.05). Conclusions Our retrospective comparative study of RD surgery using 20-G or 23-G techniques revealed a shorter postoperative wound closure time, as well as a lower postoperative IOP and incidence of MH in the 23-G group than in the 20-G group, confirming the superiority of 23-G vitrectomy over 20-G vitrectomy. This study provided a better option of 23-G vitrectomy for clinically

  18. Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy

    PubMed Central

    Oellers, Patrick; Stinnett, Sandra; Hahn, Paul

    2016-01-01

    Purpose Valved cannulas are a recent addition to small-gauge pars plana vitrectomy (PPV) and provide stable intraocular fluidics. The goal of this study was to compare outcomes and postoperative complication rates of valved vs nonvalved cannula small-gauge PPV for repair of retinal detachments (RDs) complicated by Grade C proliferative vitreoretinopathy (PVR). Methods A retrospective chart review of 364 consecutive eyes with either valved or nonvalved cannula PPV for RD repair was performed. The primary outcomes were single surgery and final anatomic success and change in best-corrected visual acuity for repair of RDs complicated by Grade C PVR. Results We identified 36 eyes in the valved group and 31 eyes in the nonvalved group with Grade C PVR RD. The single surgery success was 83% vs 77% (P=0.555) and the final anatomic success was 94% vs 87% (P=0.404) in the valved vs nonvalved eyes, respectively. The mean final visual acuity gain was −0.36 logarithm of the minimum angle of resolution (logMAR; approximate Early Treatment Diabetes Retinopathy Study [ETDRS] score =17 letters) in valved eyes vs −0.33 logMAR (approximate ETDRS score =16 letters) in nonvalved eyes (P=0.81). Postoperative complication rates including postoperative day 1 hypotony, hypertony, and anterior chamber fibrin formation; postoperative retention of intraocular or subretinal perfluorocarbon liquid; and subsequent epiretinal membrane peel were not statistically different between groups. Conclusion Valved cannula PPV yields equivalent visual acuity and anatomic outcomes without increased postoperative complication rates compared to traditional nonvalved cannula PPV for Grade C PVR-associated RD repair. PMID:27313445

  19. Three-Year Efficacy and Safety of a Silicone Oil-Filled Foldable-Capsular-Vitreous-Body in Three Cases of Severe Retinal Detachment

    PubMed Central

    Lin, Xiaofeng; Sun, Xuyuan; Wang, Zhenfang; Jiang, Zhaoxin; Liu, Yaqin; Wang, Peijuan; Gao, Qianying

    2016-01-01

    Purpose We previously designed a novel foldable capsular vitreous body (FCVB) to treat severe retinal detachment and evaluated its performance in a 1-year follow up study. The purpose of this study was to determine the efficacy and safety of a silicone oil (SO)-filled FCVB in a 3-year follow-up. Methods Standard three-port pars plana vitrectomy was performed, and the FCVB was triple folded and implanted in the vitreous cavity of three eyes. The SO then was injected into the capsule to support the retina. The eyes were examined using Goldmann applanation tonometry, fundus photography, optical coherence tomography (OCT), noncontact specular microscopy, and ultrasound biomicroscopy over a 3-year implantation period. Results At the 3-year follow-up, retinal reattachment was achieved in all three cases, with steady intraocular pressure. The visual acuity showed slight fluctuations, and it was slightly increased compared to baseline. Optical coherence tomography revealed decreased retinal thickness and an altered retinal structure in the implanted eyes compared to the control eyes. No keratopathy, glaucoma, SO leakage, SO emulsification, or other apparent complications occurred during the observation period. Conclusion The SO-filled FCVB was effective and safe as a vitreous substitute in three eyes over a 3-year observation period. Translational Relevance Silicone oil emulsification is a severe complication after retinal detachment surgery. On the basis of animal experiments, we investigated a new strategy and product, the FCVB, to overcome this complication. In this pilot study, FCVB limited SO emulsification and migration. This study could lay the foundation for a further multicenter clinical trial. PMID:26855843

  20. Hybrid microincision vitrectomy surgery combined with 20-gauge silicone cannulas for use with 20-gauge horizontal scissors in diabetic tractional retinal detachment

    PubMed Central

    Yamada, Keiko; Maeno, Takatoshi; Yamada, Mitsunori

    2013-01-01

    Purpose To verify the utility and preliminary safety of a 20-gauge silicone cannula for use with 20-gauge horizontal scissors delamination during microincision vitrectomy surgery (MIVS). Methods Thirty-eight eyes in 35 consecutive patients with diabetic tractional retinal detachment, who underwent MIVS between April 2010 and March 2012 and were followed for 3–24 months, were retrospectively assessed using a chart review. Twenty-gauge scissors delamination through a silicone cannula, with an additional 20-gauge port as a hybrid, was primarily selected when treating thick and rigid fibrovascular membranes, including fluctuating vessels over the detached retina near the macula. The main outcome measures included the proportion of patients treated with this hybrid method, the postoperative visual acuity, and the incidence of complications. Results Compared with the 26 eyes treated with MIVS only, 12 eyes (32%) required a hybrid technique with the use of 20-gauge instruments through a silicone cannula in addition to MIVS. Two patients underwent additional surgery. Temporary silicone oil tamponade was performed in one case of retinotomy and one case of schizophrenia. The mean visual acuity (logarithm of the minimum angle of resolution [logMAR]) improved from 1.43 ± 0.85 to 0.72 ± 0.47 at the last follow-up visit. No patients exhibited worsening of their visual acuity postoperatively. No sclerotomy-related complications were recorded during the intraoperative or postoperative periods. Conclusion Hybrid MIVS combined with a 20-gauge silicone cannula for use with 20-gauge horizontal scissors in diabetic tractional retinal detachment eyes is useful and safe due to the reduced risk of sclerotomy-related retinal breaks. This procedure is a reasonable option when performing complex surgery for diabetic vitrectomy. PMID:23946642

  1. Effective Treatment with Intravitreal Injection of Bevacizumab for Exudative Retinal Detachment Secondary to Choroidal Metastasis of Non-Small Cell Lung Carcinoma

    PubMed Central

    Yasui, Hirotoshi; Sato, Kazuhide; Takeyama, Yoshihiro; Nishihara, Hiroaki; Maeda, Matsuyoshi; Gonda, Hideo; Suzuki, Ryujiro

    2015-01-01

    Patient: Male, 68 Final Diagnosis: Non-small cell lung cancer Symptoms: — Medication: — Clinical Procedure: TBLB • PET • OCT • fluorescence angiography Specialty: Oncology Objective: Challenging differential diagnosis Background: Visual disturbance caused by cancer metastasis from other organs is one of the largest challenges to cancer patients’ quality of life (QOL). Lung cancer is the most frequent primary site of choroidal metastasis in men, but improvement of visual disturbance has not always been emphasized in lung cancers. Recently intravitreal bevacizumab is a newer modality being tried for local control of choroidal metastases. Case Report: A 68-year-old man was admitted the hospital with complaint of visual disturbance in his left eye. He was diagnosed with lung adenocarcinoma cT2N0M1b (OSS, OTH) stage IV. The ophthalmologic evaluation showed exudative fluid, which caused retinal detachment under the retina. Fluorescence angiography showed granular hyperfluorescence with leakage consistent with a tumor. He received radiotherapy for bone metastasis and systematic chemotherapy with carboplatin, pemetrexed, and bevacizumab, as well as intravitreal injection of bevacizumab 1.25 mg to improve the visual disturbance. His visual symptom and retinal detachment improved until he died. An autopsy revealed that the metastatic lesion in his left eye was totally cured macroscopically and microscopically. Conclusions: We report a case of exudative retinal detachment secondary to a metastatic choroidal tumor from lung adenocarcinoma, which was treated with chemotherapy and intravitreal injection of bevacizumab. Although he finally died of lung cancer, he maintained his visual QOL and autopsy revealed complete cure of the choroidal metastasis. PMID:26460101

  2. Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis

    PubMed Central

    Shi, Hui; Guo, Tao; Liu, Peng-Cheng; Wang, Qian-Yi; Du, Ya-Ru; Liu, Qing-Yu; He, Meng-Mei; Liu, Jun-Ling; Yu, Jing

    2015-01-01

    Background This meta-analysis was performed to determine the effectiveness of steroids as an adjunct following rhegmatogenous retinal detachment (RRD) surgery. Methods RRD patients with or without proliferative vitreoretinopathy (PVR) were included. The treatment group included patients in whom steroids were used as an adjunct and a control group in which placebo was used. Only randomized controlled trials were included. We searched the main electronic databases and included studies published until July 2014. PVR odds ratio, visual acuity, retinal reattachment rate, and complications were evaluated in three trials. Results Three randomized controlled trials were included in the meta-analysis. There was no significant difference in the incidence of postoperative PVR between groups (heterogeneity I2=48%, P=0.14). However, the incidence of postoperative PVR was lower in the treatment group (I2=0%, P<0.0001) than in the control group when a PVR grade C study was excluded. There was no statistically significant difference in postoperative visual acuity between the treatment and control groups (odds ratio −0.18; 95% confidence interval −0.38, 0.02; P=0.08). The two groups had similar results for primary/final retinal reattachment and reoperation rate. There was no significant difference in postoperative intraocular pressure. Conclusion This systematic review demonstrates that steroids may significantly reduce the incidence of postoperative PVR grade B or lower following RRD surgery. PMID:25834397

  3. Retinal Disorders

    MedlinePlus

    ... be serious enough to cause blindness. Examples are Macular degeneration - a disease that destroys your sharp, central vision Diabetic eye disease Retinal detachment - a medical emergency, when the retina is ... children. Macular pucker - scar tissue on the macula Macular hole - ...

  4. Risk of Tractional Retinal Detachment Following Intravitreal Bevacizumab Along with Subretinal Fluid Drainage and Cryotherapy for Stage 3B Coats’ Disease

    PubMed Central

    Bhat, Vishalakshi; D’Souza, Palmeera; Shah, Parag K.; Narendran, V.

    2016-01-01

    Purpose: To review the surgical outcomes of intravitreal bevacizumab (IVB) along with subretinal fluid drainage with cryotherapy in patients with stage 3B Coats’ disease. Materials and Methods: A retrospective study of seven cases of stage 3B Coats’ disease, who underwent subretinal fluid drainage with cryopexy, from May 2011 to March 2014. Five eyes received additional IVB at the end of surgery. Green laser therapy was performed on telangiectatic vessels postoperatively. Results: The mean age was 34 months (range, 10-84 months). Mean follow-up was 19 months. Six patients (85.7%) had an attached retina at final follow-up. Three out of four patients (75%) that received IVB developed tractional retinal detachments (TRDs). Two eyes that did not receive bevacizumab did not develop any traction. None progressed to neovascular glaucoma or phthisis bulbi. Conclusion: Simultaneous injection of bevacizumab along with subretinal drainage and cryotherapy for advanced Coats’ disease could not avoid TRD. PMID:27162454

  5. Serous Retinal Detachment Associated with Dome-Shaped Macula and Staphyloma Edge in Myopic Patients before and after Treatment with Spironolactone

    PubMed Central

    Fernández-Vega Sanz, Álvaro; Rangel, Carlos Mario; Villota Deleu, Eva; Fernández-Vega Sanz, Beatriz; Sánchez-Ávila, Ronald Mauricio

    2016-01-01

    Objective. Serous retinal detachment (SRD) is a common anatomical complication associated with dome-shaped macula (DSM) and staphyloma margin in myopic patients. Here we described the anatomical and functional outcomes obtained with the use of oral spironolactone, a mineralocorticoid antagonist, in the management of myopic patients with SRD associated with DSM and staphyloma margin. Methods. We evaluated both eyes of twelve myopic patients with long-standing SRD associated with DSM or staphyloma margin. The patients were treated daily for six months with oral spironolactone 50 mg. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT), determined by optical coherence tomography, were evaluated on the first day and on monthly follow-up visits. Results. Pretreatment BCVA (mean ± standard deviation) was 0.406 ± 0.324 LogMAR, and posttreatment BCVA was 0.421 ± 0.354 LogMAR (P = 0.489). Pretreatment CRT was 323.9 ± 78.6 μm, and after six months of treatment it was significantly lower, 291.2 ± 74.5 μm (P = 0.010). There were no treatment-related complications. Conclusions. We evaluated a novel treatment for SRD associated with DSM and staphyloma margin in myopic patients. After six months of treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced; however, there was no improvement in BCVA. PMID:26942003

  6. Serous Retinal Detachment Associated with Dome-Shaped Macula and Staphyloma Edge in Myopic Patients before and after Treatment with Spironolactone.

    PubMed

    Fernández-Vega Sanz, Álvaro; Rangel, Carlos Mario; Villota Deleu, Eva; Fernández-Vega Sanz, Beatriz; Sánchez-Ávila, Ronald Mauricio

    2016-01-01

    Objective. Serous retinal detachment (SRD) is a common anatomical complication associated with dome-shaped macula (DSM) and staphyloma margin in myopic patients. Here we described the anatomical and functional outcomes obtained with the use of oral spironolactone, a mineralocorticoid antagonist, in the management of myopic patients with SRD associated with DSM and staphyloma margin. Methods. We evaluated both eyes of twelve myopic patients with long-standing SRD associated with DSM or staphyloma margin. The patients were treated daily for six months with oral spironolactone 50 mg. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT), determined by optical coherence tomography, were evaluated on the first day and on monthly follow-up visits. Results. Pretreatment BCVA (mean ± standard deviation) was 0.406 ± 0.324 LogMAR, and posttreatment BCVA was 0.421 ± 0.354 LogMAR (P = 0.489). Pretreatment CRT was 323.9 ± 78.6 μm, and after six months of treatment it was significantly lower, 291.2 ± 74.5 μm (P = 0.010). There were no treatment-related complications. Conclusions. We evaluated a novel treatment for SRD associated with DSM and staphyloma margin in myopic patients. After six months of treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced; however, there was no improvement in BCVA. PMID:26942003

  7. Combined pars plana vitrectomy-scleral buckle versus pars plana vitrectomy for proliferative vitreoretinopathy.

    PubMed

    Lai, Frank H P; Lo, Ernie C F; Chan, Vesta C K; Brelen, Mårten; Lo, Wai Ling; Young, Alvin L

    2016-04-01

    The purpose of the study is to evaluate the surgical outcomes of combined pars plana vitrectomy-scleral buckle (PPV-SB) versus pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment complicated with proliferative vitreoretinopathy (PVR). One thousand one hundred and seventy four patients with rhegmatogenous retinal detachment surgery between January 2002 and December 2013 were retrospectively reviewed. Patients with grade C PVR treated with either combined PPV-SB or PPV alone were included in the study. Study outcomes included single surgery anatomic success rate and postoperative visual outcome at 12 months postoperatively. Seventy-seven patients with grade C PVR were identified for analysis. At the end of 12-month follow-up, 80.5 % eyes (33/41) in the PPV-SB group and 58.3 % eyes (21/36) in the PPV group achieved single surgery anatomical success. In a multiple logistic regression model, none of the baseline variables (age, gender, macula status, grade of PVR, extent of detachment, presence of vitreous hemorrhage, lens status, status of high myopia) nor types of retinal detachment surgery (use of scleral buckle, barrier endolaser, 360 degree endolaser, cryopexy, retinectomy, tamponade agent, phacoemulsification) had significant effect on single surgery anatomical success. The post-treatment mean logMAR visual acuity of the PPV-SB group was 1.58 ± 0.58 and the PPV group was 1.57 ± 0.61. There was no significant difference in the postoperative visual acuity between the two groups (P = 0.849). For patients with grade C PVR, PPV-SB did not demonstrate a superiority over PPV alone in achieving single surgery anatomical success. PMID:26260357

  8. Postoperative Vision-Related Quality of Life in Macula-Off Rhegmatogenous Retinal Detachment Patients and Its Relation to Visual Function

    PubMed Central

    van de Put, Mathijs A. J.; Hoeksema, Lisette; Wanders, Wouter; Nolte, Ilja M.; Hooymans, Johanna M. M.; Los, Leonoor I.

    2014-01-01

    Objective To determine the vision-related quality of life (VR-QOL) after surgery for macula-off rhegmatogenous retinal detachment (RRD) in relation to visual acuity, contrast acuity, and color vision. Methods In a prospective observational study, we included 55 patients with a macula-off RRD. Best corrected visual acuity (BCVA), color vision (saturated and desaturated color confusion indices (CCI)) and contrast acuity were measured at 12 months postoperatively in both the RRD eye and the fellow control eye, and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was filled out. Results Operated and fellow control eyes differed significantly in mean LogMAR BCVA (P<0.0001), median Log contrast acuity (P<0.0001), saturated CCI (P = 0.009), and desaturated CCI (P = 0.016). Significant correlations were observed between the NEI VFQ-25 overall composite score and postoperative LogMAR BCVA (R = −0.551, P<0.0001), contrast acuity (R = 0.472, P<0.0001), saturated CCI (R = −0.315, P = 0.023), and desaturated CCI (R = −0.283, P = 0.044). Conclusions A lower VR-QOL was highly correlated to a worse postoperative BCVA and contrast acuity and to a lesser extent to color vision disturbances. PMID:25460011

  9. Numerical computational of fluid flow through a detached retina

    NASA Astrophysics Data System (ADS)

    Jiann, Lim Yeou; Ismail, Zuhaila; Shafie, Sharidan; Fitt, Alistair

    2015-02-01

    In this paper, a phenomenon of fluid flow through a detached retina is studied. Rhegmatogeneous retinal detachment happens when vitreous humour flow through a detached retina. The exact mechanism of Rhegmatogeneous retinal detachment is complex and remains incomplete. To understand the fluid flow, a paradigm mathematical model is developed and is approximated by the lubrication theory. The numerical results of the velocity profile and pressure distribution are computed by using Finite Element Method. The effects of fluid mechanical on the retinal detachment is discussed and analyzed. Based on the analysis, it is found that the retinal detachment deformation affects the pressure distribution. It is important to comprehend the development of the retinal detachment so that a new treatment method can be developed.

  10. Retinal detachment repair - series (image)

    MedlinePlus

    ... laser treatment (photocoagulation) can also be used to seals holes in the retina. The choice of cryopexy or photocoagulation is usually determined by the preference of the surgeon-both procedures are equally effective in most cases.

  11. Genetic pediatric retinal diseases

    PubMed Central

    Say, Emil Anthony T.

    2014-01-01

    Hereditary pediatric retinal diseases are a diverse group of disorders with pathologies affecting different cellular structures or retinal development. Many can mimic typical pediatric retinal disease such as retinopathy of prematurity, vitreous hemorrhage, retinal detachment and cystoid macular edema. Multisystem involvement is frequently seen in hereditary pediatric retinal disease. A thorough history coupled with a good physical examination can oftentimes lead the ophthalmologist or pediatrician to the correct genetic test and correct diagnosis. In some instances, evaluation of parents or siblings may be required to determine familial involvement when the history is inconclusive or insufficient and clinical suspicion is high.

  12. Divertor detachment

    NASA Astrophysics Data System (ADS)

    Krasheninnikov, Sergei

    2015-11-01

    The heat exhaust is one of the main conceptual issues of magnetic fusion reactor. In a standard operational regime the large heat flux onto divertor target reaches unacceptable level in any foreseeable reactor design. However, about two decades ago so-called ``detached divertor'' regimes were found. They are characterized by reduced power and plasma flux on divertor targets and look as a promising solution for heat exhaust in future reactors. In particular, it is envisioned that ITER will operate in a partly detached divertor regime. However, even though divertor detachment was studied extensively for two decades, still there are some issues requiring a new look. Among them is the compatibility of detached divertor regime with a good core confinement. For example, ELMy H-mode exhibits a very good core confinement, but large ELMs can ``burn through'' detached divertor and release large amounts of energy on the targets. In addition, detached divertor regimes can be subject to thermal instabilities resulting in the MARFE formation, which, potentially, can cause disruption of the discharge. Finally, often inner and outer divertors detach at different plasma conditions, which can lead to core confinement degradation. Here we discuss basic physics of divertor detachment including different mechanisms of power and momentum loss (ionization, impurity and hydrogen radiation loss, ion-neutral collisions, recombination, and their synergistic effects) and evaluate the roles of different plasma processes in the reduction of the plasma flux; detachment stability; and an impact of ELMs on detachment. We also evaluate an impact of different magnetic and divertor geometries on detachment onset, stability, in- out- asymmetry, and tolerance to the ELMs. Supported by the U.S. Department of Energy Office of Science, Office of Fusion Energy Sciences under Award Number DE-DE-FG02-04ER54739 at UCSD.

  13. Branch retinal vein occlusion.

    PubMed

    Hamid, Sadaf; Mirza, Sajid Ali; Shokh, Ishrat

    2008-01-01

    Retinal vein occlusions (RVO) are the second commonest sight threatening vascular disorder. Branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) are the two basic types of vein occlusion. Branch retinal vein occlusion is three times more common than central retinal vein occlusion and- second only to diabetic retinopathy as the most common retinal vascular cause of visual loss. The origin of branch retinal vein occlusion undoubtedly includes both systemic factors such as hypertension and local anatomic factors such as arteriovenous crossings. Branch retinal vein occlusion causes a painless decrease in vision, resulting in misty or distorted vision. Current treatment options don't address the underlying aetiology of branch retinal vein occlusion. Instead they focus on treating sequelae of the occluded venous branch, such as macular oedema, vitreous haemorrhage and traction retinal detachment from neovascularization. Evidences suggest that the pathogenesis of various types of retinal vein occlusion, like many other ocular vascular occlusive disorders, is a multifactorial process and there is no single magic bullet that causes retinal vein occlusion. A comprehensive management of patients with retinal vascular occlusions is necessary to correct associated diseases or predisposing abnormalities that could lead to local recurrences or systemic event. Along with a review of the literature, a practical approach for the management of retinal vascular occlusions is required, which requires collaboration between the ophthalmologist and other physicians: general practitioner, cardiologist, internist etc. as appropriate according to each case. PMID:19385476

  14. Transpalpebral extrusion of solid silicone buckle.

    PubMed

    Khan, Abadan Amitava

    2009-05-01

    Explants used in retinal reattachment surgery occasionally extrude. Cheese-wiring of the suture through the sclera consequent to raised intraocular pressure allows the buckle to loosen and/or unfold. Subsequent infection, often with Staphylococcus albus, accelerates the process of extrusion. Commonly, such explants are of silicone sponge. The reported case is unusual in that the extrusion occurred through the upper lid, and involved a solid silicone explant. PMID:20671837

  15. Transpalpebral extrusion of solid silicone buckle

    PubMed Central

    Khan, Abadan Amitava

    2009-01-01

    Explants used in retinal reattachment surgery occasionally extrude. Cheese-wiring of the suture through the sclera consequent to raised intraocular pressure allows the buckle to loosen and/or unfold. Subsequent infection, often with Staphylococcus albus, accelerates the process of extrusion. Commonly, such explants are of silicone sponge. The reported case is unusual in that the extrusion occurred through the upper lid, and involved a solid silicone explant. PMID:20671837

  16. [Acute retinal necrosis].

    PubMed

    Lucke, K; Reinking, U; el-Hifnawi, E; Dennin, R H; Laqua, H

    1988-12-01

    The authors report on three patients with acute retinal necrosis who were treated with the virostatic agent Acyclovir and who underwent vitreoretinal surgery with silicone oil filling for total retinal detachment. In two eyes the retina was reattached, but useful vision was only preserved in one patient. Titers from blood and the vitreous, as well as microscopic findings in retinal biopsies, support the view that the necrosis is caused by a herpes simplex virus infection. After therapy with Acyclovir was instituted no further progression on the necrosis was observed. However, the development of retinal detachment could not be prevented. Early diagnosis and antiviral therapy are essential to improve the otherwise poor prognosis in this rare syndrome. PMID:3221657

  17. Transcorneal Electrical Stimulation Therapy for Retinal Disease

    ClinicalTrials.gov

    2012-05-03

    Retinitis Pigmentosa; Macula Off; Primary Open Angle Glaucoma; Hereditary Macular Degeneration; Treated Retina Detachment; Retinal Artery Occlusion; Retinal Vein Occlusion; Non-Arthritic-Anterior-Ischemic Optic-Neuropathy; Hereditary Autosomal Dominant Optic Atrophy; Dry Age Related Macular Degeneration; Ischemic Macula Edema

  18. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    PubMed

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-01-01

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids. PMID:27511757

  19. Establishment of a recessive mutant small-eye rat with lens involution and retinal detachment associated with partial deletion and rearrangement of the Cryba1 gene.

    PubMed

    Yamada, Toshiyuki; Nanashima, Naoki; Shimizu, Takeshi; Nakazawa, Yosuke; Nakazawa, Mitsuru; Tsuchida, Shigeki

    2015-10-15

    From our stock of SDRs (Sprague-Dawley rats), we established a mutant strain having small opaque eyes and named it HiSER (Hirosaki small-eye rat). The HiSER phenotype is progressive and autosomal recessive. In HiSER eyes, disruption and involution of the lens, thickening of the inner nuclear layer, detachment and aggregation of the retina, rudimentary muscle in the ciliary body and cell infiltration in the vitreous humour were observed. Genetic linkage analysis using crossing with Brown Norway rat suggested that the causative gene(s) is located on chromosome 10. Microarray analysis showed that the expression level of the Cryba1 gene encoding βA3/A1-crystallin on chromosome 10 was markedly decreased in HiSER eyes. Genomic PCR revealed deletion of a 3.6-kb DNA region encompassing exons 4-6 of the gene in HiSERs. In HiSER eyes, a chimaeric transcript of the gene containing exons 1-3 and an approximately 250-bp sequence originating from the 3'-UTR of the Nufip2 gene, located downstream of the breakpoint in the opposite direction, was present. Whereas the chimaeric transcript was expressed in HiSER eyes, neither normal nor chimaeric βA3/A1-crystallin proteins were detected by Western blot analysis. Real-time RT (reverse transcription)-PCR analysis revealed that expression level of the Nufip2 gene in the HiSER eye was 40% of that in the SDR eye. These results suggest that the disappearance of the βA3/A1-crystallin protein and, in addition, down-regulation of the Nufip2 gene as a consequence of gene rearrangement causes the HiSER phenotype. PMID:26303524

  20. Color Doppler imaging of retinal diseases.

    PubMed

    Dimitrova, Galina; Kato, Satoshi

    2010-01-01

    Color Doppler imaging (CDI) is a widely used method for evaluating ocular circulation that has been used in a number of studies on retinal diseases. CDI assesses blood velocity parameters by using ultrasound waves. In ophthalmology, these assessments are mainly performed on the retrobulbar blood vessels: the ophthalmic, the central retinal, and the short posterior ciliary arteries. In this review, we discuss CDI use for the assessment of retinal diseases classified into the following: vascular diseases, degenerations, dystrophies, and detachment. The retinal vascular diseases that have been investigated by CDI include diabetic retinopathy, retinal vein occlusions, retinal artery occlusions, ocular ischemic conditions, and retinopathy of prematurity. Degenerations and dystrophies included in this review are age-related macular degeneration, myopia, and retinitis pigmentosa. CDI has been used for the differential diagnosis of retinal detachment, as well as the evaluation of retrobulbar circulation in this condition. CDI is valuable for research and is a potentially useful diagnostic tool in the clinical setting. PMID:20385332

  1. Retinitis Pigmentosa

    MedlinePlus

    ... Action You are here Home › Retinal Diseases Listen Retinitis Pigmentosa What is retinitis pigmentosa? What are the symptoms? ... available? Are there any related diseases? What is retinitis pigmentosa? Retinitis pigmentosa (RP) refers to a group of ...

  2. Functionalization of Buckled Graphene

    NASA Astrophysics Data System (ADS)

    Nelson, Timothy C.

    Buckled graphene produced by the halogen based etching of 6H-SiC provides a new route for the functionalization of the graphene surface. This surface provides an important new stepping off point in the development of molecular electronics and sensors. While the graphene surface is relatively inert, the fluorinated defect sites inherent in the buckled graphene surface yield an excellent location for chemical reactions such as nucleophilic substitution. This thesis shows the utility of the fluorinated defect sites through the well characterized diazonium reaction. Buckled graphene films were prepared on silicon carbide substrates using inductively coupled plasma and reactive ion etching, and annealed at 1000° C to coalesce the BG. The films were reacted with benzene, nitrobenzene, acetonitrile, or a nitrophenyl diazonium salt solution. The diazonium salt was chosen due to its known reaction with graphene produced by other methods. Consequently, reaction of the diazonium with buckled graphene would provide a basis for comparing the reactivity of the surface with these other forums of graphene. The interactions of buckled graphene with the other species were investigated as they represent either constituent parts of the diazonium salt or the solvent. The reacted surfaces were analyzed by X-ray photoelectron spectroscopy, which reveals changes in the surface chemical state due to the functionalization of the buckled graphene by each species. Each reaction yielded significant pi-pi bonding, while the diazonium salt reaction produced additional covalently bonded phenyl groups on the buckled graphene surface. The covalent reaction site was shown to be the surface fluorinated defect site. This observation illustrates the utility of the buckled graphene surface in the functionalization of graphene. Moreover, it provides additional confirmation of the nature of the buckled graphene surface.

  3. Buckling of spherical capsules.

    PubMed

    Knoche, Sebastian; Kierfeld, Jan

    2011-10-01

    We investigate buckling of soft elastic capsules under negative pressure or for reduced capsule volume. Based on nonlinear shell theory and the assumption of a hyperelastic capsule membrane, shape equations for axisymmetric and initially spherical capsules are derived and solved numerically. A rich bifurcation behavior is found, which is presented in terms of bifurcation diagrams. The energetically preferred stable configuration is deduced from a least-energy principle both for prescribed volume and prescribed pressure. We find that buckled shapes are energetically favorable already at smaller negative pressures and larger critical volumes than predicted by the classical buckling instability. By preventing self-intersection for strongly reduced volume, we obtain a complete picture of the buckling process and can follow the shape from the initial undeformed state through the buckling instability into the fully collapsed state. Interestingly, the sequences of bifurcations and stable capsule shapes differ for prescribed volume and prescribed pressure. In the buckled state, we find a relation between curvatures at the indentation rim and the bending modulus, which can be used to determine elastic moduli from experimental shape analysis. PMID:22181297

  4. Demarcation laser photocoagulation induced retinal necrosis and rupture resulting in large retinal tear formation.

    PubMed

    Quezada, Carlos; Pieramici, Dante J; Matsui, Rodrigo; Rabena, Melvin; Graue, Federico

    2015-06-01

    Retinal tears after laser photocoagulation are a rare complication that occurs after intense laser. It is talked about among retina specialist occurring particularly at the end of a surgical case while applying endophotocoagulation; to the best our knowledge, there are no reports in the literature of a large retinal tear induced after attempted in-office demarcation laser photocoagulation (DLP) that simulated a giant retinal tear. DLP has been employed in the management of selected cases of macula sparring rhegmatogenous retinal detachment (RRD). Even though extension of the retinal detachment through the "laser barrier" is considered a failure of treatment, few complications have been described with the use of this less invasive retinal detachment repair technique. We describe a case of a high myopic woman who initially was treated with demarcation laser photocoagulation for an asymptomatic retinal detachment associated with a single horseshoe tear and a full thickness large retinal tear was created where the laser was placed. Intense laser photocoagulation resulted in abrupt laser induced retinal necrosis and rupture creating this large retinal break. Proper laser technique should reduce the risks associated with this procedure. PMID:25770055

  5. Diode laser contact transscleral retinal photocoagulation: a clinical study.

    PubMed Central

    McHugh, D A; Schwartz, S; Dowler, J G; Ulbig, M; Blach, R K; Hamilton, P A

    1995-01-01

    AIM--To examine the clinical efficacy of contact transscleral retinal photocoagulation with a diode laser. METHODS--Transscleral retinal photocoagulation was performed on 36 eyes. The conditions treated included peripheral retinal breaks associated with retinal detachments (30 eyes) and giant retinal tears (six eyes). Of the 30 eyes with retinal detachments, 28 underwent transscleral photocoagulation to the site of drainage of subretinal fluid in an attempt to reduce the risk of hemorrhage. RESULTS--Threshold lesions were obtained with irradiances of between 95.4 W/cm2 and 191 W/cm2. Satisfactory chorioretinal adhesion was achieved in all eyes with retinal breaks and giant retinal tears. The only significant complications of treatment encountered were punctate choroidal haemorrhages (three eyes). Drainage related choroidal haemorrhage following earlier photocoagulation occurred in two of 28 eyes. CONCLUSIONS--This study confirms the clinical potential of transscleral diode laser photocoagulation in the therapy of surgical retinal conditions. Images PMID:8562540

  6. Acquired retinal folds in the cat.

    PubMed

    MacMillan, A D

    1976-06-01

    Retinal folds were found in 5 cats. The apparent cause of the folding was varied: in 1 cat the folds appeared after a localized retinal detachment; in 2 cats the condition accompanied other intraocular abnormalities associated with feline infectious peritonitis; 1 cat had active keratitis, and the retinal changes were thought to have been injury related; and 1 cat, bilaterally affected, had chronic glomerulonephritis. PMID:945253

  7. Buckling instability in arteries.

    PubMed

    Vandiver, Rebecca M

    2015-04-21

    Arteries can become tortuous in response to abnormal growth stimuli, genetic defects and aging. It is suggested that a buckling instability is a mechanism that might lead to artery tortuosity. Here, the buckling instability in arteries is studied by examining asymmetric modes of bifurcation of two-layer cylindrical structures that are residually stressed. These structures are loaded by an axial force, internal pressure and have nonlinear, anisotropic, hyperelastic responses to stresses. Strain-softening and reduced opening angle are shown to lower the critical internal pressure leading to buckling. In addition, the ratio of the media thickness to the adventitia thickness is shown to have a dramatic impact on arterial instability. PMID:25661070

  8. Retinal pigment epithelium in incontinentia pigmenti.

    PubMed

    Mensheha-Manhart, O; Rodrigues, M M; Shields, J A; Shannon, G M; Mirabelli, R P

    1975-04-01

    An 18-month-old white girl with incontinentia pigmenti presented clinically with leukokoria of the right eye. B-scan ultrasound demonstrated a retrolental mass consistent with a detached retina. Histologic examination of the skin revealed changes compatible with the intermediate verrucous phase of the disease. Microscopic examination of the right eye showed retinal detachment and nodular proliferation of the retinal pigment epithelium. The nodules contained macrophages laden with melanin and lipofuscin. An unusually large amount of lipofuscin was present for a child of this age. The basic pigmentary abnormality may affect the retinal pigment epithelium, resulting in changes in the overlying neurosensory retina that may lead to the retinal dysplasia or retinal detachemnt often associated with this condition. PMID:1119517

  9. Buckling of a holey column.

    PubMed

    Pihler-Puzović, D; Hazel, A L; Mullin, T

    2016-09-14

    We report the results from a combined experimental and numerical investigation of buckling in a novel variant of an elastic column under axial load. We find that including a regular line of centred holes in the column can prevent conventional, global, lateral buckling. Instead, the local microstructure introduced by the holes allows the column to buckle in an entirely different, internal, mode in which the holes are compressed in alternate directions, but the column maintains the lateral reflection symmetry about its centreline. The internal buckling mode can be accommodated within a smaller external space than the global one; and it is the preferred buckling mode over an intermediate range of column lengths for sufficiently large holes. For very short or sufficiently long columns a modification of the classical, global, lateral buckling is dominant. PMID:27501288

  10. Descemet membrane detachment.

    PubMed

    Mackool, R J; Holtz, S J

    1977-03-01

    Four eyes of three patients had extensive postoperative Descemet membrane (DM) detachment. Blood was present just anterior to the DM in three of the four eyes and later converted to and persisted as pigment. Haziness of the cornea at the level of the DM could be seen with reattachment. Detachments of the DM are classified as planar when there is 1 mm or less separation of the DM from its overlying stroma in all areas. Nonplanar DM detachments exceed 1 mm of separation. Planar detachments have a much better prognosis than nonplanar detachments do, with or without descemetopexy. Repair of DM detachments, when necessary, should include air injection, with the lease possible instrumentation of the DM. PMID:843278

  11. The secondary buckling transition: wrinkling of buckled spherical shells.

    PubMed

    Knoche, Sebastian; Kierfeld, Jan

    2014-07-01

    We theoretically explain the complete sequence of shapes of deflated spherical shells. Decreasing the volume, the shell remains spherical initially, then undergoes the classical buckling instability, where an axisymmetric dimple appears, and, finally, loses its axisymmetry by wrinkles developing in the vicinity of the dimple edge in a secondary buckling transition. We describe the first axisymmetric buckling transition by numerical integration of the complete set of shape equations and an approximate analytic model due to Pogorelov. In the buckled shape, both approaches exhibit a locally compressive hoop stress in a region where experiments and simulations show the development of polygonal wrinkles, along the dimple edge. In a simplified model based on the stability equations of shallow shells, a critical value for the compressive hoop stress is derived, for which the compressed circumferential fibres will buckle out of their circular shape in order to release the compression. By applying this wrinkling criterion to the solutions of the axisymmetric models, we can calculate the critical volume for the secondary buckling transition. Using the Pogorelov approach, we also obtain an analytical expression for the critical volume at the secondary buckling transition: The critical volume difference scales linearly with the bending stiffness, whereas the critical volume reduction at the classical axisymmetric buckling transition scales with the square root of the bending stiffness. These results are confirmed by another stability analysis in the framework of Donnel, Mushtari and Vlasov (DMV) shell theory, and by numerical simulations available in the literature. PMID:25039007

  12. The Incidence of Rhegmatogenous Retinal Complications in Macular Surgery After Prophylactic Preoperative Laser Retinopexy

    PubMed Central

    Tosi, Gian Marco; Esposti, Pierluigi; Romeo, Napoleone; Marigliani, Davide; Cevenini, Gabriele; Massimo, Patrizio; Nuti, Elisabetta; Esposti, Giulia; Ripandelli, Guido

    2016-01-01

    Abstract The aim of the study is to evaluate the clinical characteristics of intraoperative retinal breaks (RBs) and postoperative retinal detachment (RRD) in patients undergoing pars plana vitrectomy (PPV) for macular disorders, who were treated preoperatively with prophylactic peripheral laser retinopexy. This observational cohort study comprised of 254 patients who underwent macular surgery and were preoperatively subjected to prophylactic laser retinopexy anterior to the equator. The main outcome measures were the incidence and characteristics of intraoperative RBs and postoperative RRD. Intraoperative RBs occurred in 14 patients (5.5%). Ten patients presented a sclerotomy-related RB (3.9%) and 4 patients a nonsclerotomy-related RB (1.6%). Two patients showed postoperative RRD (0.7%). Neither of the 2 patients with postoperative RRD was macula-off at presentation: one of them was successfully operated on with scleral buckling and the other was managed by observation alone. A significantly increased risk for the intraoperative development of sclerotomy-related RB was found in 20-gauge PPV compared with 23/25-gauge PPV. Preoperative prophylactic peripheral laser retinopexy does not guarantee the prevention of intraopertaive RBs or postoperative RRD. However, it might prevent the involvement of the macula when RRD occurs postoperatively. PMID:27057893

  13. Osmotic buckling of spherical capsules.

    PubMed

    Knoche, Sebastian; Kierfeld, Jan

    2014-11-01

    We study the buckling of elastic spherical shells under osmotic pressure with the osmolyte concentration of the exterior solution as a control parameter. We compare our results for the bifurcation behavior with results for buckling under mechanical pressure control, that is, with an empty capsule interior. We find striking differences for the buckling states between osmotic and mechanical buckling. Mechanical pressure control always leads to fully collapsed states with opposite sides in contact, whereas uncollapsed states with a single finite dimple are generic for osmotic pressure control. For sufficiently large interior osmolyte concentrations, osmotic pressure control is qualitatively similar to buckling under volume control with the volume prescribed by the osmolyte concentrations inside and outside the shell. We present a quantitative theory which also captures the influence of shell elasticity on the relationship between osmotic pressure and volume. These findings are relevant for the control of buckled shapes in applications. We show how the osmolyte concentration can be used to control the volume of buckled shells. An accurate analytical formula is derived for the relationship between the osmotic pressure, the elastic moduli and the volume of buckled capsules. This also allows use of elastic capsules as osmotic pressure sensors or deduction of elastic properties and the internal osmolyte concentration from shape changes in response to osmotic pressure changes. We apply our findings to published experimental data on polyelectrolyte capsules. PMID:25209240

  14. Buckling testing of composite columns

    NASA Astrophysics Data System (ADS)

    Barbero, Ever; Tomblin, John

    1992-11-01

    Euler buckling test results are presented for large composite columns relevant to the mass production of composite structural members by pultrusion. The experimental procedure employed yields highly reproducible and accurate results. All percentage differences between theory and experiment are below 6.2 percent; the theoretically predicted long-column buckling load is accurate even in the case of the most complex composite materials.

  15. Modeling of Detached Solidification

    NASA Technical Reports Server (NTRS)

    Regel, Liya L.; Wilcox, William R.; Popov, Dmitri

    1997-01-01

    Our long term goal is to develop techniques to achieve detached solidification reliably and reproducibly, in order to produce crystals with fewer defects. To achieve this goal it is necessary to understand thoroughly the physics of detached solidification. It was the primary objective of the current project to make progress toward this complete understanding. 'Me products of this grant are attached. These include 4 papers and a preliminary survey of the observations of detached solidification in space. We have successfully modeled steady state detached solidification, examined the stability of detachment, and determined the influence of buoyancy-driven convection under different conditions. Directional solidification in microgravity has often led to ingots that grew with little or no contact with the ampoule wall. When this occurred, crystallographic perfection was usually greatly improved -- often by several orders of magnitude. Indeed, under the Soviet microgravity program the major objective was to achieve detached solidification with its resulting improvement in perfection and properties. Unfortunately, until recently the true mechanisms underlying detached solidification were unknown. As a consequence, flight experiments yielded erratic results. Within the past three years, we have developed a new theoretical model that explains many of the flight results. This model gives rise to predictions of the conditions required to yield detached solidification.

  16. Probabilistic progressive buckling of trusses

    NASA Technical Reports Server (NTRS)

    Pai, Shantaram S.; Chamis, Christos C.

    1991-01-01

    A three-bay, space, cantilever truss is probabilistically evaluated to describe progressive buckling and truss collapse in view of the numerous uncertainties associated with the structural, material, and load variables (primitive variables) that describe the truss. Initially, the truss is deterministically analyzed for member forces, and member(s) in which the axial force exceeds the Euler buckling load are identified. These member(s) are then discretized with several intermediate nodes and a probabilistic buckling analysis is performed on the truss to obtain its probabilistic buckling loads and respective mode shapes. Furthermore, sensitivities associated with the uncertainties in the primitive variables are investigated, margin of safety values for the truss are determined, and truss end node displacements are noted. These steps are repeated by sequentially removing the buckled member(s) until onset of truss collapse is reached. Results show that this procedure yields an optimum truss configuration for a given loading and for a specified reliability.

  17. Buckling failures in insect exoskeletons.

    PubMed

    Parle, Eoin; Herbaj, Simona; Sheils, Fiona; Larmon, Hannah; Taylor, David

    2016-02-01

    Thin walled tubes are often used for load-bearing structures, in nature and in engineering, because they offer good resistance to bending and torsion at relatively low weight. However, when loaded in bending they are prone to failure by buckling. It is difficult to predict the loading conditions which cause buckling, especially for tubes whose cross sections are not simple shapes. Insights into buckling prevention might be gained by studying this phenomenon in the exoskeletons of insects and other arthropods. We investigated the leg segments (tibiae) of five different insects: the locust (Schistocerca gergaria), American cockroach (Periplaneta americana), death's head cockroach (Blaberus discoidalis), stick insect (Parapachymorpha zomproi) and bumblebee (Bombus terrestris audax). These were tested to failure in cantilever bending and modelled using finite element analysis (FEA). The tibiae of the locust and the cockroaches were found to be approximately circular in shape. Their buckling loads were well predicted by linear elastic FEA, and also by one of the analytical solutions available in the literature for elastic buckling. The legs of the stick insect are also circular in cross section but have several prominent longitudinal ridges. We hypothesised that these ridges might protect the legs against buckling but we found that this was not the case: the loads necessary for elastic buckling were not reached in practice because yield occurred in the material, causing plastic buckling. The legs of bees have a non-circular cross section due to a pollen-carrying feature (the corbicula). We found that this did not significantly affect their resistance to buckling. Our results imply that buckling is the dominant failure mode in the tibia of insects; it likely to be a significant consideration for other arthropods and any organisms with stiff exoskeletons. The interactions displayed here between material properties and cross sectional geometry may provide insights for the

  18. Angel-closure glaucoma following scleral buckling operations.

    PubMed

    Perez, R N; Phelps, C D; Burton, T C

    1976-01-01

    We have observed 22 patients with angle-closure glaucoma following scleral buckling operations. These patients did not have narrow anterior chamber angles preoperatively, and several were aphakix with surgical iris colobomas. The angle-closure glaucoma was manifest by a hazy cornea, elevated intraocular pressure, closed angle, absence or iris bombé, and presence of choroidal detachments. Treatment with cycloplegics and corticosteroids was more effective than treatment with miotics. A likely pathogenic mechanism is congestion and swelling of the ciliary body due to a temporary interference by the scleral buckle with venous drainage. Episcleral implants accounted for a statistically significant higher incidence of angle-closure glaucoma as compared to intrascleral implants. PMID:936397

  19. Retinitis Pigmentosa.

    ERIC Educational Resources Information Center

    Carr, Ronald E.

    1979-01-01

    The author describes the etiology of retinitis pigmentosa, a visual dysfunction which results from progressive loss of the retinal photoreceptors. Sections address signs and symptoms, ancillary findings, heredity, clinical diagnosis, therapy, and research. (SBH)

  20. Inhibition of the alternative complement pathway preserves photoreceptors after retinal injury.

    PubMed

    Sweigard, J Harry; Matsumoto, Hidetaka; Smith, Kaylee E; Kim, Leo A; Paschalis, Eleftherios I; Okonuki, Yoko; Castillejos, Alexandra; Kataoka, Keiko; Hasegawa, Eiichi; Yanai, Ryoji; Husain, Deeba; Lambris, John D; Vavvas, Demetrios; Miller, Joan W; Connor, Kip M

    2015-07-22

    Degeneration of photoreceptors is a primary cause of vision loss worldwide, making the underlying mechanisms surrounding photoreceptor cell death critical to developing new treatment strategies. Retinal detachment, characterized by the separation of photoreceptors from the underlying retinal pigment epithelium, is a sight-threatening event that can happen in a number of retinal diseases. The detached photoreceptors undergo apoptosis and programmed necrosis. Given that photoreceptors are nondividing cells, their loss leads to irreversible visual impairment even after successful retinal reattachment surgery. To better understand the underlying disease mechanisms, we analyzed innate immune system regulators in the vitreous of human patients with retinal detachment and correlated the results with findings in a mouse model of retinal detachment. We identified the alternative complement pathway as promoting early photoreceptor cell death during retinal detachment. Photoreceptors down-regulate membrane-bound inhibitors of complement, allowing for selective targeting by the alternative complement pathway. When photoreceptors in the detached retina were removed from the primary source of oxygen and nutrients (choroidal vascular bed), the retina became hypoxic, leading to an up-regulation of complement factor B, a key mediator of the alternative pathway. Inhibition of the alternative complement pathway in knockout mice or through pharmacological means ameliorated photoreceptor cell death during retinal detachment. Our current study begins to outline the mechanism by which the alternative complement pathway facilitates photoreceptor cell death in the damaged retina. PMID:26203084

  1. Inhibition of the alternative complement pathway preserves photoreceptors after retinal injury

    PubMed Central

    Sweigard, J. Harry; Matsumoto, Hidetaka; Smith, Kaylee E.; Kim, Leo A.; Paschalis, Eleftherios I.; Okonuki, Yoko; Castillejos, Alexandra; Kataoka, Keiko; Hasegawa, Eiichi; Yanai, Ryoji; Husain, Deeba; Lambris, John D.; Vavvas, Demetrios; Miller, Joan W.; Connor, Kip M.

    2015-01-01

    Degeneration of photoreceptors is a primary cause of vision loss worldwide, making the underlying mechanisms surrounding photoreceptor cell death critical to developing new treatment strategies. Retinal detachment, characterized by the separation of photoreceptors from the underlying retinal pigment epithelium, is a sight-threatening event that can happen in a number of retinal diseases. The detached photoreceptors undergo apoptosis and programmed necrosis. Given that photoreceptors are nondividing cells, their loss leads to irreversible visual impairment even after successful retinal reattachment surgery. To better understand the underlying disease mechanisms, we analyzed innate immune system regulators in the vitreous of human patients with retinal detachment and correlated the results with findings in a mouse model of retinal detachment. We identified the alternative complement pathway as promoting early photoreceptor cell death during retinal detachment. Photoreceptors down-regulate membrane-bound inhibitors of complement, allowing for selective targeting by the alternative complement pathway. When photoreceptors in the detached retina were removed from the primary source of oxygen and nutrients (choroidal vascular bed), the retina became hypoxic, leading to an up-regulation of complement factor B, a key mediator of the alternative pathway. Inhibition of the alternative complement pathway in knockout mice or through pharmacological means ameliorated photoreceptor cell death during retinal detachment. Our current study begins to outline the mechanism by which the alternative complement pathway facilitates photoreceptor cell death in the damaged retina. PMID:26203084

  2. Spontaneous resorption of sub-retinal cortical lens material

    PubMed Central

    Gadkari, Salil S; Kulkarni, Sucheta R; Dole, Kuldeep

    2014-01-01

    We report a rare case of retained sub-retinal cortical material, which underwent spontaneous resorption. Patient presented with a left eye traumatic retinal detachment with a large retinal tear and posteriorly dislocated cataractous lens. Vitrectomy, lensectomy, silicone oil injection, and endolaser were performed. A good visual result was achieved. The report draws attention to this condition and highlights possible technique for minimizing risk of this complication in similar cases. PMID:25116782

  3. Divertor plasma detachment

    NASA Astrophysics Data System (ADS)

    Krasheninnikov, S. I.; Kukushkin, A. S.; Pshenov, A. A.

    2016-05-01

    Regime with the plasma detached from the divertor targets (detached divertor regime) is a natural continuation of the high recycling conditions to higher density and stronger impurity radiation loss. Both the theoretical considerations and experimental data show clearly that the increase of the impurity radiation loss and volumetric plasma recombination causes the rollover of the plasma flux to the target when the density increases, which is the manifestation of detachment. Plasma-neutral friction (neutral viscosity effects), although important for the sustainment of high density/pressure plasma upstream and providing the conditions for efficient recombination and power loss, is not directly involved in the reduction of the plasma flux to the targets. The stability of detachment is also discussed.

  4. Cyclic capacity of tubular beam-columns with local buckling: Numerical and experimental studies

    SciTech Connect

    Skallerud, B.; Amdahl, J.; Johansen, A.; Eide, O.I.

    1996-12-31

    The present investigation addresses the cyclic capacity of tubular members subjected to both local and global buckling during cyclic loading. Diameter to thickness ratios of 45 and 60 are studied. The performance of FE models, both a beam model and shell model, is compared to test results in terms of load versus displacement behavior and energy accumulation. Some problems regarding the prediction of local strain histories in the local buckle zone are pointed out. Damage accumulation models in terms of energy per cycle are discussed, aiming at possible member detachment criteria.

  5. Tensile buckling of advanced turboprops

    NASA Technical Reports Server (NTRS)

    Chamis, C. C.; Aiello, R. A.

    1982-01-01

    Theoretical studies were conducted to determine analytically the tensile buckling of advanced propeller blades (turboprops) in centrifugal fields, as well as the effects of tensile buckling on other types of structural behavior, such as resonant frequencies and flutter. Theoretical studies were also conducted to establish the advantages of using high performance composite turboprops as compared to titanium. Results show that the vibration frequencies are not affected appreciably prior to 80 percent of the tensile speed. Some frequencies approach zero as the tensile buckling speed is approached. Composites provide a substantial advantage over titanium on a buckling speed to weight basis. Vibration modes change as the rotor speed is increased and substantial geometric coupling is present.

  6. Buckling of Branched Cytoskeletal Filaments

    NASA Astrophysics Data System (ADS)

    Quint, D. A.; Schwarz, J. M.

    2011-03-01

    In vitro experiments of growing dendritic actin networks demonstrate reversible stress-softening at high loads, above some critical load. The transition to the stress-softening regime has been attributed to the elastic buckling of individual actin filaments. To estimate the critical load above which softening should occur, we extend the elastic theory of buckling of individual filaments embedded in a network to include the buckling of branched filaments, a signature trait of growing dendritic actin networks. Under certain assumptions, there will be approximately a seven-fold increase in the classical critical bucking load, when compared to the unbranched filament, which is entirely due to the presence of a branch. Moreover, we go beyond the classical buckling regime to investigate the effect of entropic fluctuations. The result of compressing the filament in this case leads to an increase in these fluctuations and eventually the harmonic approximation breaks down signifying the onset of the buckling transition. We compute corrections to the classical critical buckling load near this breakdown.

  7. The Incidence of Rhegmatogenous Retinal Complications in Macular Surgery After Prophylactic Preoperative Laser Retinopexy: A Retrospective Study.

    PubMed

    Tosi, Gian Marco; Esposti, Pierluigi; Romeo, Napoleone; Marigliani, Davide; Cevenini, Gabriele; Massimo, Patrizio; Nuti, Elisabetta; Esposti, Giulia; Ripandelli, Guido

    2016-04-01

    The aim of the study is to evaluate the clinical characteristics of intraoperative retinal breaks (RBs) and postoperative retinal detachment (RRD) in patients undergoing pars plana vitrectomy (PPV) for macular disorders, who were treated preoperatively with prophylactic peripheral laser retinopexy.This observational cohort study comprised of 254 patients who underwent macular surgery and were preoperatively subjected to prophylactic laser retinopexy anterior to the equator. The main outcome measures were the incidence and characteristics of intraoperative RBs and postoperative RRD.Intraoperative RBs occurred in 14 patients (5.5%). Ten patients presented a sclerotomy-related RB (3.9%) and 4 patients a nonsclerotomy-related RB (1.6%). Two patients showed postoperative RRD (0.7%). Neither of the 2 patients with postoperative RRD was macula-off at presentation: one of them was successfully operated on with scleral buckling and the other was managed by observation alone. A significantly increased risk for the intraoperative development of sclerotomy-related RB was found in 20-gauge PPV compared with 23/25-gauge PPV.Preoperative prophylactic peripheral laser retinopexy does not guarantee the prevention of intraopertaive RBs or postoperative RRD. However, it might prevent the involvement of the macula when RRD occurs postoperatively. PMID:27057893

  8. Retinal Macroglial Responses in Health and Disease

    PubMed Central

    de Hoz, Rosa; Rojas, Blanca; Ramírez, Ana I.; Salazar, Juan J.; Gallego, Beatriz I.; Triviño, Alberto; Ramírez, José M.

    2016-01-01

    Due to their permanent and close proximity to neurons, glial cells perform essential tasks for the normal physiology of the retina. Astrocytes and Müller cells (retinal macroglia) provide physical support to neurons and supplement them with several metabolites and growth factors. Macroglia are involved in maintaining the homeostasis of extracellular ions and neurotransmitters, are essential for information processing in neural circuits, participate in retinal glucose metabolism and in removing metabolic waste products, regulate local blood flow, induce the blood-retinal barrier (BRB), play fundamental roles in local immune response, and protect neurons from oxidative damage. In response to polyetiological insults, glia cells react with a process called reactive gliosis, seeking to maintain retinal homeostasis. When malfunctioning, macroglial cells can become primary pathogenic elements. A reactive gliosis has been described in different retinal pathologies, including age-related macular degeneration (AMD), diabetes, glaucoma, retinal detachment, or retinitis pigmentosa. A better understanding of the dual, neuroprotective, or cytotoxic effect of macroglial involvement in retinal pathologies would help in treating the physiopathology of these diseases. The extensive participation of the macroglia in retinal diseases points to these cells as innovative targets for new drug therapies. PMID:27294114

  9. Detached rock evaluation device

    DOEpatents

    Hanson, David R.

    1986-01-01

    A rock detachment evaluation device (10) having an energy transducer unit 1) for sensing vibrations imparted to a subject rock (172) for converting the sensed vibrations into electrical signals, a low band pass filter unit (12) for receiving the electrical signal and transmitting only a low frequency segment thereof, a high band pass filter unit (13) for receiving the electrical signals and for transmitting only a high frequency segment thereof, a comparison unit (14) for receiving the low frequency and high frequency signals and for determining the difference in power between the signals, and a display unit (16) for displaying indicia of the difference, which provides a quantitative measure of rock detachment.

  10. Examination of postmortem retinal folds: A non-invasive study.

    PubMed

    Oshima, Toru; Yoshikawa, Hiroshi; Ohtani, Maki; Mimasaka, Sohtaro

    2015-02-01

    The postmortem retinal fold has been previously documented, but its mechanism of formation is not known. All previous studies of the fold involved invasive techniques and the postmortem ocular fundus has yet to be non-invasively examined. Our study used the non-invasive techniques of monocular indirect ophthalmoscopy and ocular echography to examine 79 postmortem eyes of 42 bodies. We examined whether the postmortem retinal fold was associated with postmortem time, position, and/or age. Age was significantly associated with postmortem retinal fold formation (Mann-Whitney U test, P = 0.013), which led us to examine the effect of posterior vitreous detachment (PVD) on retinal folds. The absence of a PVD was statistically associated with the presence of a retinal fold (Fisher's exact test, P < 0.0001). Interestingly, the presence of a PVD was also significantly correlated with retinal fold height (Mann-Whitney U test, P < 0.0001). Therefore, we hypothesized that retinal folds result from postmortem vitreoretinal traction caused by eyeball flaccidity. We also believe that the loss of retinochoroidal hydrostatic pressure plays a role. It is important that forensic pathologists not confuse a postmortem retinal fold with traumatic retinal detachment or perimacular retinal folds caused by child abuse. When child abuse is suspected, forensic pathologists should perform enucleation and a subsequent histological examination for confirmation. PMID:25623189

  11. Bilateral Cytomegalovirus Retinitis in a Patient with Systemic Lupus Erythematosus

    PubMed Central

    Haze, Masaya; Kobayashi, Takatoshi; Kakurai, Keigo; Shoda, Hiromi; Takai, Nanae; Takeda, Sayako; Tada, Rei; Maruyama, Kouichi; Kida, Teruyo; Ikeda, Tsunehiko

    2016-01-01

    Purpose The purpose of this study was to report the case of a patient who underwent vitrectomy for bilateral rhegmatogenous retinal detachment caused by cytomegalovirus (CMV) retinitis while undergoing steroid and immunosuppressant therapy for systemic lupus erythematosus (SLE). Case Report We report on a 29-year-old female who was undergoing steroids and immunosuppressants treatment for SLE at Osaka Medical College Hospital, Takatsuki City, Japan. Examination of the patient due to prolonged and worsening diarrhea revealed positive test results for C7-HRP, and she was diagnosed with CMV colitis. She was subsequently admitted to the hospital and started on intravenous ganciclovir for treatment. Approximately 1.5 months later, her primary complaint was deterioration of the upper visual field in her left eye, and she was then referred to the Department of Ophthalmology. Numerous granular exudative spots were found around the lower retinal area of her left eye with retinal breaks that had developed in an area of retinal necrosis that resulted in retinal detachment. After time was allowed for the patient's general condition to improve, a vitrectomy was performed on that eye. The patient subsequently developed a similar retinal detachment in her right eye, for which she underwent a vitrectomy. Although the patient required multiple surgeries on both eyes, her retinas currently remain reattached and the inflammation has subsided. Conclusion The findings of this study show that strict attention must be paid to SLE patients on immunosuppressive therapy due to the possible association of CMV retinitis. PMID:27462259

  12. Plastic folding of buckling structures.

    PubMed

    Colin, Jérôme; Coupeau, Christophe; Grilhé, Jean

    2007-07-27

    Atomic force microscopy observations of the free surface of gold thin films deposited on silicon substrates have evidenced the buckling of the films and the formation of blister patterns undergoing plastic folding. The classical elastic buckling and plastic deformation of the films are analyzed in the framework of the Föppl-Von Kármán theory of thin plates introducing the notion of low-angle tilt boundaries and dislocation distributions to describe this folding effect. It is demonstrated that, in agreement with elementary plasticity of bent crystals, the presence of such tilt-boundaries results in the formation of buckling patterns of lower energy than "classical" elastic blisters. PMID:17678376

  13. Retinal Prosthesis

    PubMed Central

    Weiland, James D.; Humayun, Mark S.

    2015-01-01

    Retinal prosthesis have been translated from the laboratory to the clinical over the past two decades. Currently, two devices have regulatory approval for the treatment of retinitis pigmentosa. These devices provide partial sight restoration and patients use this improved vision in their everyday lives. Improved mobility and object detection are some of the more notable findings from the clinical trials. However, significant vision restoration will require both better technology and improved understanding of the interaction between electrical stimulation and the retina. This paper reviews the recent clinical trials, highlights technology breakthroughs that will contribute to next generation of retinal prostheses. PMID:24710817

  14. Foveomacular retinitis.

    PubMed Central

    Kuming, B S

    1986-01-01

    A group of patients is described who developed the clinical features of foveomacular retinitis. No causative factors were isolated, and all patients strongly denied any type of sun gazing. It is possible that there is a group of patients who have the features of foveomacular retinitis but have not had any direct exposure to the sun. These patients would then constitute a primary type of foveomacular retinitis, as opposed to a secondary type which has a known cause and is synonymous with solar retinopathy. Images PMID:3790482

  15. Artery Buckling: New Phenotypes, Models, and Applications

    PubMed Central

    Han, Hai-Chao; Chesnutt, Jennifer K. W.; Garcia, Justin R.; Liu, Qin; Wen, Qi

    2012-01-01

    Arteries are under significant mechanical loads from blood pressure, flow, tissue tethering, and body movement. It is critical that arteries remain patent and stable under these loads. This review summarizes the common forms of buckling that occur in blood vessels including cross-sectional collapse, longitudinal twist buckling, and bent buckling. The phenomena, model analyses, experimental measurements, effects on blood flow, and clinical relevance are discussed. It is concluded that mechanical buckling is an important issue for vasculature, in addition to wall stiffness and strength, and requires further studies to address the challenges. Studies of vessel buckling not only enrich vascular biomechanics but also have important clinical applications. PMID:23192265

  16. Buckling modes in pantographic lattices

    NASA Astrophysics Data System (ADS)

    Giorgio, Ivan; Della Corte, Alessandro; dell'Isola, Francesco; Steigmann, David J.

    2016-07-01

    We study buckling patterns in pantographic sheets, regarded as two-dimensional continua consisting of lattices of continuously distributed fibers. The fibers are modeled as beams endowed with elastic resistance to stretching, shearing, bending and twist. Included in the theory is a non-standard elasticity due to geodesic bending of the fibers relative to the lattice surface. xml:lang="fr"

  17. Stability of Detached Solidification

    NASA Technical Reports Server (NTRS)

    Mazuruk, K.; Volz, M. P.; Croell, A.

    2009-01-01

    Bridgman crystal growth can be conducted in the so-called "detached" solidification regime, where the growing crystal is detached from the crucible wall. A small gap between the growing crystal and the crucible wall, of the order of 100 micrometers or less, can be maintained during the process. A meniscus is formed at the bottom of the melt between the crystal and crucible wall. Under proper conditions, growth can proceed without collapsing the meniscus. The meniscus shape plays a key role in stabilizing the process. Thermal and other process parameters can also affect the geometrical steady-state stability conditions of solidification. The dynamic stability theory of the shaped crystal growth process has been developed by Tatarchenko. It consists of finding a simplified autonomous set of differential equations for the radius, height, and possibly other process parameters. The problem then reduces to analyzing a system of first order linear differential equations for stability. Here we apply a modified version of this theory for a particular case of detached solidification. Approximate analytical formulas as well as accurate numerical values for the capillary stability coefficients are presented. They display an unexpected singularity as a function of pressure differential. A novel approach to study the thermal field effects on the crystal shape stability has been proposed. In essence, it rectifies the unphysical assumption of the model that utilizes a perturbation of the crystal radius along the axis as being instantaneous. It consists of introducing time delay effects into the mathematical description and leads, in general, to stability over a broader parameter range. We believe that this novel treatment can be advantageously implemented in stability analyses of other crystal growth techniques such as Czochralski and float zone methods.

  18. Characteristic Findings of Optical Coherence Tomography in Retinal Angiomatous Proliferation

    PubMed Central

    Lim, Eun-Hae; Kim, Chul Gu; Cho, Sung Won; Lee, Tae Gon

    2013-01-01

    Purpose To identify the unique pathologic findings of retinal angiomatous proliferation (RAP) in optical coherence tomography (OCT). Methods Retrospectively, 29 eyes of 25 patients with age-related macular degeneration and complicated RAP were analyzed. All 29 eyes had choroidal neovascularization (CNV) in the area of pigment epithelial detachment (PED) or adjacent to it, which was visible with fluorescein angiography or indocyanine green angiography. Cross-sectional images were obtained by OCT scanning through the CNV lesions. Results Six distinctive findings of OCT included drusen (100%), inner retinal cyst (80%), outer retinal cyst (68%), fibrovascular PED (84%), serous retinal detachment (40%), and PED (68%). Conclusions Through analysis of OCT findings, we revealed six different types of lesions distinctive of RAP which may provide helpful diagnostic information for subsequent treatment and predicting the prognosis of RAP. PMID:24082773

  19. Clinical assessment of retinal elevations: a review of methods and a novel clinical technique.

    PubMed Central

    Rose, G E

    1988-01-01

    A new clinical test for the detection of retinal elevation is described. The test, based on alterations of retinal surface light reflexes during indirect ophthalmoscopy, is extremely sensitive to very shallow detachments. The optics, the degree of sensitivity, and the limitations of the new clinical technique are examined and other clinical methods are reviewed. PMID:3052573

  20. Thermal-structural panel buckling tests

    NASA Technical Reports Server (NTRS)

    Thompson, Randolph C.; Richards, W. Lance

    1991-01-01

    The buckling characteristics of a titanium matrix composite hat-stiffened panel were experimentally examined for various combinations of thermal and mechanical loads. Panel failure was prevented by maintaining the applied loads below real-time critical buckling predictions. The test techniques used to apply the loads, minimize boundary were shown to compare well with a finite-element buckling analysis for previous panels. Comparisons between test predictions and analysis for this panel are ongoing.

  1. Sediment detachment by rain power

    NASA Astrophysics Data System (ADS)

    Gabet, Emmanuel J.; Dunne, Thomas

    2003-01-01

    In interrill areas, overland flow is often incapable of detaching soil particles so detachment is primarily by raindrop impact. We derive a mathematical expression, rain power (R, W m-2), relating the energy expenditure of raindrops impacting a soil surface to the rate of detachment of soil particles. Rain power incorporates rainfall, hillslope, and vegetation characteristics and is modulated by flow depths. Rainfall simulation experiments on natural hillslopes were performed to measure detachment rates and across-slope flow depth distributions in surface runoff. Our results indicate that flow depths follow a Poisson distribution, and this observation is used to develop a dimensionless function, A(?, d), that accounts for the interaction of flow depths (h) and raindrop diameter (d) in moderating detachment rates. Rain power correlates well with the detachment rate of fine-grained particles (ψ, g m-2 s-1) so that ψ = 0.011R1.4A(?, d) (n = 44, R2 = 0.88, p < 0.005). We generalize this result to represent natural rainfall conditions and present a method for modeling sediment detachment rates and sediment discharge along entire lengths of hillslopes under the range of conditions where detached sediment is transported as wash load. Modeling simulations demonstrate the temporal and spatial variation in detachment rates caused by increases in flow depth.

  2. And the Variscan Orogen Buckled

    NASA Astrophysics Data System (ADS)

    Pastor-Galán, D.; Groenewegen, T.; Gutiérrez-Alonso, G.; Langereis, C. G.

    2013-12-01

    Oroclines are the largest scale folds in nature, and as folds can be produced by bending or by buckling. The most commonly invoked bending mechanisms are indentation (the Himalayan syntaxes) and slab roll-back (The Calabria Arc) whereas buckling usually are commonly related with collision of the apex of ribbon continents along strike (Alaskan oroclines). In Western Europe the tectonostratigraphic zonation of Variscan orogen shows a complex 'S' shape pattern recently interpreted as a double orocline consisting of a northern and southern arc. The northern arc, known as Cantabria-Asturias Arc or Cantabrian Orocline, was developed after closure of the Rheic Ocean and the building and collapse of the Variscan orogenic edifice and, therefore, is considered post-Variscan in age. On the other hand, neither the geometry nor the kinematics of the so-called Central Iberian orocline, situated at the south of the Iberian peninsula are properly known. However, it seems reasonable to think that both oroclines developed at the same time as other coupled oroclines, such as the New England oroclines or the Carpathian oroclines. The particular paleogeography of the Variscan belt in Pangea and the kinematics of the oroclinal formation make impossible the mechanisms of indentation or buckling of a ribbon continent. The occurrence of an intense syn- and slightly post-Cantabrian orocline magmatic event (310-290 Ma) has been linked to the development of the orocline(s) due to the particular spatial-temporal distribution of these post-tectonic granitoids and its isotopic signature which would imply that the oroclines (if synchronous) are thick-skinned. This magmatic pulse has also been interpreted as due to slab roll-back. We present widespread evidences of buckling around the whole orocline at different lithospheric levels and new insights of the particular geometry of the southern orocline which is difficult to reconcile with a roll-back related origin. Therefore, a major change in the

  3. Simplified dynamic buckling assessment of steel containments

    SciTech Connect

    Farrar, C.R.; Duffey, T.A.; Renick, D.H.

    1993-02-01

    A simplified, three-degree-of-freedom analytical procedure for performing a response spectrum buckling analysis of a thin containment shell is developed. Two numerical examples with R/t values which bound many existing steel containments are used to illustrate the procedure. The role of damping on incipient buckling acceleration level is evaluated for a regulatory seismic spectrum using the two numerical examples. The zero-period acceleration level that causes incipient buckling in either of the two containments increases 31% when damping is increased from 1% to 4% of critical. Comparisons with finite element results on incipient buckling levels are favorable.

  4. Buckling of conical shell with local imperfections

    NASA Technical Reports Server (NTRS)

    Cooper, P. A.; Dexter, C. B.

    1974-01-01

    Small geometric imperfections in thin-walled shell structures can cause large reductions in buckling strength. Most imperfections found in structures are neither axisymmetric nor have the shape of buckling modes but rather occur locally. This report presents the results of a study of the effect of local imperfections on the critical buckling load of a specific axially compressed thin-walled conical shell. The buckling calculations were performed by using a two-dimensional shell analysis program referred to as the STAGS (Structural Analysis of General Shells) computer code, which has no axisymmetry restrictions. Results show that the buckling load found from a bifurcation buckling analysis is highly dependent on the circumferential arc length of the imperfection type studied. As the circumferential arc length of the imperfection is increased, a reduction of up to 50 percent of the critical load of the perfect shell can occur. The buckling load of the cone with an axisymmetric imperfections is nearly equal to the buckling load of imperfections which extended 60 deg or more around the circumference, but would give a highly conservative estimate of the buckling load of a shell with an imperfection of a more local nature.

  5. Gene Transcription Profile of the Detached Retina (An AOS Thesis)

    PubMed Central

    Zacks, David N.

    2009-01-01

    Purpose: Separation of the neurosensory retina from the retinal pigment epithelium (RPE) yields many morphologic and functional consequences, including death of the photoreceptor cells, Müller cell hypertrophy, and inner retinal rewiring. Many of these changes are due to the separation-induced activation of specific genes. In this work, we define the gene transcription profile within the retina as a function of time after detachment. We also define the early activation of kinases that might be responsible for the detachment-induced changes in gene transcription. Methods: Separation of the retina from the RPE was induced in Brown-Norway rats by the injection of 1% hyaluronic acid into the subretinal space. Retinas were harvested at 1, 7, and 28 days after separation. Gene transcription profiles for each time point were determined using the Affymetrix Rat 230A gene microarray chip. Transcription levels in detached retinas were compared to those of nondetached retinas with the BRB-ArrayTools Version 3.6.0 using a random variance analysis of variance (ANOVA) model. Confirmation of the significant transcriptional changes for a subset of the genes was performed using microfluidic quantitative real-time polymerase chain reaction (qRT-PCR) assays. Kinase activation was explored using Western blot analysis to look for early phosphorylation of any of the 3 main families of mitogen-activated protein kinases (MAPK): the p38 family, the Janus kinase family, and the p42/p44 family. Results: Retinas separated from the RPE showed extensive alterations in their gene transcription profile. Many of these changes were initiated as early as 1 day after separation, with significant increases by 7 days. ANOVA analysis defined 144 genes that had significantly altered transcription levels as a function of time after separation when setting a false discovery rate at ≤0.1. Confirmatory RT-PCR was performed on 51 of these 144 genes. Differential transcription detected on the microarray

  6. Buckling of C60 whiskers

    NASA Astrophysics Data System (ADS)

    Asaka, Koji; Kato, Ryoei; Miyazawa, Kun'ichi; Kizuka, Tokushi

    2006-08-01

    The authors demonstrated the mechanics of materials for crystalline whiskers composed of C60 molecules; compressive deformation of the whiskers was observed by in situ transmission electron microscopy with simultaneous force measurement by means of an optical cantilever method, as used in atomic force microscopy. In response to compression along the long axis, the whiskers bent first elastically, then buckled. A whisker with 160nm diameter fractured brittlely at a strain of 0.08. According to Euler's formula, Young's modulus of the whisker was estimated to be 32-54GPa, which is 160%-650% of that of C60 bulk crystals.

  7. Post-Buckling Analysis of Curved Honeycomb Sandwich Panels Containing Interfacial Disbonds

    NASA Technical Reports Server (NTRS)

    Pineda, Evan J.; Bednarcyk, Brett A.; Krivanek, Thomas K.

    2016-01-01

    A numerical study on the effect of facesheet-core disbonds on the post-buckling response of curved honeycomb sandwich panels is presented herein. This work was conducted as part of the development of a damage tolerance plan for the next-generation Space Launch System heavy lift launch vehicle payload fairing. As such, the study utilized full-scale fairing barrel segments as the structure of interest. The panels were composed of carbon fiber reinforced polymer facesheets and aluminum honeycomb core. The panels were analyzed numerically using the finite element method incorporating geometric nonlinearity. In a predetermined circular region, facesheet and core nodes were detached to simulate a disbond, between the outer mold line facesheet and honeycomb core, induced via low-speed impact. Surface-to-surface contact in the disbonded region was invoked to prevent interpenetration of the facesheet and core elements and obtain realistic stresses in the core. The diameter of this disbonded region was varied and the effect of the size of the disbond on the post-buckling response was observed. Significant changes in the slope of the edge load-deflection response were used to determine the onset of global buckling and corresponding buckling load. Finally, several studies were conducted to determine the sensitivity of the numerical predictions to refinement in the finite element mesh.

  8. Probabilistic Dynamic Buckling of Smart Composite Shells

    NASA Technical Reports Server (NTRS)

    Chamis, Christos C.; Abumeri, Galib H.

    2007-01-01

    A computational simulation method is presented to evaluate the deterministic and nondeterministic dynamic buckling of smart composite shells. The combined use of intraply hybrid composite mechanics, finite element computer codes, and probabilistic analysis enable the effective assessment of the dynamic buckling load of smart composite shells. A universal plot is generated to estimate the dynamic buckling load of composite shells at various load rates and probabilities. The shell structure is also evaluated with smart fibers embedded in the plies right next to the outer plies. The results show that, on the average, the use of smart fibers improved the shell buckling resistance by about 10% at different probabilities and delayed the buckling occurrence time. The probabilistic sensitivities results indicate that uncertainties in the fiber volume ratio and ply thickness have major effects on the buckling load while uncertainties in the electric field strength and smart material volume fraction have moderate effects. For the specific shell considered in this evaluation, the use of smart composite material is not recommended because the shell buckling resistance can be improved by simply re-arranging the orientation of the outer plies, as shown in the dynamic buckling analysis results presented in this report.

  9. Probabilistic Dynamic Buckling of Smart Composite Shells

    NASA Technical Reports Server (NTRS)

    Abumeri, Galib H.; Chamis, Christos C.

    2003-01-01

    A computational simulation method is presented to evaluate the deterministic and nondeterministic dynamic buckling of smart composite shells. The combined use of composite mechanics, finite element computer codes, and probabilistic analysis enable the effective assessment of the dynamic buckling load of smart composite shells. A universal plot is generated to estimate the dynamic buckling load of composite shells at various load rates and probabilities. The shell structure is also evaluated with smart fibers embedded in the plies right below the outer plies. The results show that, on the average, the use of smart fibers improved the shell buckling resistance by about 10 percent at different probabilities and delayed the buckling occurrence time. The probabilistic sensitivities results indicate that uncertainties in the fiber volume ratio and ply thickness have major effects on the buckling load while uncertainties in the electric field strength and smart material volume fraction have moderate effects. For the specific shell considered in this evaluation, the use of smart composite material is not recommended because the shell buckling resistance can be improved by simply re-arranging the orientation of the outer plies, as shown in the dynamic buckling analysis results presented in this report.

  10. Optical Coherence Tomography of Retinal and Choroidal Tumors

    PubMed Central

    Say, Emil Anthony T.; Shah, Sanket U.; Ferenczy, Sandor; Shields, Carol L.

    2011-01-01

    Optical coherence tomography (OCT) has revolutionized the field of ophthalmology since its introduction 20 years ago. Originally intended primarily for retina specialists to image the macula, it has found its role in other subspecialties that include glaucoma, cornea, and ocular oncology. In ocular oncology, OCT provides axial resolution to approximately 7 microns with cross-sectional images of the retina, delivering valuable information on the effects of intraocular tumors on the retinal architecture. Some effects include retinal edema, subretinal fluid, retinal atrophy, photoreceptor loss, outer retinal thinning, and retinal pigment epithelial detachment. With more advanced technology, OCT now provides imaging deeper into the choroid using a technique called enhanced depth imaging. This allows characterization of the thickness and reflective quality of small (<3 mm thick) choroidal lesions including choroidal nevus and melanoma. Future improvements in image resolution and depth will allow better understanding of the mechanisms of visual loss, tumor growth, and tumor management. PMID:21811667

  11. Optical Coherence Tomography of Retinal and Choroidal Tumors

    PubMed Central

    Say, Emil Anthony T.; Shah, Sanket U.; Ferenczy, Sandor; Shields, Carol L.

    2012-01-01

    Optical coherence tomography (OCT) has revolutionized the field of ophthalmology since its introduction 20 years ago. Originally intended primarily for retina specialists to image the macula, it has found its role in other subspecialties that include glaucoma, cornea, and ocular oncology. In ocular oncology, OCT provides axial resolution to approximately 7 microns with cross-sectional images of the retina, delivering valuable information on the effects of intraocular tumors on the retinal architecture. Some effects include retinal edema, subretinal fluid, retinal atrophy, photoreceptor loss, outer retinal thinning, and retinal pigment epithelial detachment. With more advanced technology, OCT now provides imaging deeper into the choroid using a technique called enhanced depth imaging. This allows characterization of the thickness and reflective quality of small (<3 mm thick) choroidal lesions including choroidal nevus and melanoma. Future improvements in image resolution and depth will allow better understanding of the mechanisms of visual loss, tumor growth, and tumor management. PMID:23008756

  12. Detachable acoustic electric feedthrough

    NASA Astrophysics Data System (ADS)

    Moss, Scott; Skippen, Jeremy; Konak, Michael; Powlesland, Ian; Galea, Steve

    2010-04-01

    This paper outlines the development and characterisation of a detachable acoustic electric feedthrough (DAEF) to transfer power and data across a metal (or composite) plate. The DAEF approach is being explored as a potential means of wirelessly powering in-situ structural health monitoring systems embedded within aircraft and other high value engineering assets. The DAEF technique operates via two axially aligned piezoelectric-magnet structures mounted on opposite sides of a plate. Magnetic force is used to align the two piezoelectric-magnet structures, to create an acoustic path across a plate. The piezoelectric-magnet structures consisted of Pz26 piezoelectric disk elements bonded to NdFeB magnets, with a standard ultrasonic couplant (High-Z) used between the magnet and plate to facilitate the passage of ultrasound. Measured impedance curves are matched to modeled curves using the Comsol multi-physics software coupled with a particle-swarm approach, allowing optimised Pz26 material parameters to be found (i.e. stiffness, coupling and permittivity matrices). The optimised Pz26 parameters are then used in an axi-symmetric Comsol model to make predictions about the DAEF power transfer, which is then experimentally confirmed. With an apparent input power of 1 VA and 4.2 MHz drive frequency, the measured power transfer efficiency across a 1.6 mm Al plate is ~34%. The effect of various system parameters on power transfer is explored, including bondline thickness and plate thickness. DAEF data communication is modelled using LTspice with three-port one-dimensional piezoelectric models, indicating that data rates of 115 kBit/s are feasible.

  13. Stochastic behavior of nanoscale dielectric wall buckling

    PubMed Central

    Friedman, Lawrence H.; Levin, Igor; Cook, Robert F.

    2016-01-01

    The random buckling patterns of nanoscale dielectric walls are analyzed using a nonlinear multi-scale stochastic method that combines experimental measurements with simulations. The dielectric walls, approximately 200 nm tall and 20 nm wide, consist of compliant, low dielectric constant (low-k) fins capped with stiff, compressively stressed TiN lines that provide the driving force for buckling. The deflections of the buckled lines exhibit sinusoidal pseudoperiodicity with amplitude fluctuation and phase decorrelation arising from stochastic variations in wall geometry, properties, and stress state at length scales shorter than the characteristic deflection wavelength of about 1000 nm. The buckling patterns are analyzed and modeled at two length scales: a longer scale (up to 5000 nm) that treats randomness as a longer-scale measurable quantity, and a shorter-scale (down to 20 nm) that treats buckling as a deterministic phenomenon. Statistical simulation is used to join the two length scales. Through this approach, the buckling model is validated and material properties and stress states are inferred. In particular, the stress state of TiN lines in three different systems is determined, along with the elastic moduli of low-k fins and the amplitudes of the small-scale random fluctuations in wall properties—all in the as-processed state. The important case of stochastic effects giving rise to buckling in a deterministically sub-critical buckling state is demonstrated. The nonlinear multiscale stochastic analysis provides guidance for design of low-k structures with acceptable buckling behavior and serves as a template for how randomness that is common to nanoscale phenomena might be measured and analyzed in other contexts. PMID:27330220

  14. Stochastic behavior of nanoscale dielectric wall buckling

    NASA Astrophysics Data System (ADS)

    Friedman, Lawrence H.; Levin, Igor; Cook, Robert F.

    2016-03-01

    The random buckling patterns of nanoscale dielectric walls are analyzed using a nonlinear multi-scale stochastic method that combines experimental measurements with simulations. The dielectric walls, approximately 200 nm tall and 20 nm wide, consist of compliant, low dielectric constant (low-k) fins capped with stiff, compressively stressed TiN lines that provide the driving force for buckling. The deflections of the buckled lines exhibit sinusoidal pseudoperiodicity with amplitude fluctuation and phase decorrelation arising from stochastic variations in wall geometry, properties, and stress state at length scales shorter than the characteristic deflection wavelength of about 1000 nm. The buckling patterns are analyzed and modeled at two length scales: a longer scale (up to 5000 nm) that treats randomness as a longer-scale measurable quantity, and a shorter-scale (down to 20 nm) that treats buckling as a deterministic phenomenon. Statistical simulation is used to join the two length scales. Through this approach, the buckling model is validated and material properties and stress states are inferred. In particular, the stress state of TiN lines in three different systems is determined, along with the elastic moduli of low-k fins and the amplitudes of the small-scale random fluctuations in wall properties—all in the as-processed state. The important case of stochastic effects giving rise to buckling in a deterministically sub-critical buckling state is demonstrated. The nonlinear multiscale stochastic analysis provides guidance for design of low-k structures with acceptable buckling behavior and serves as a template for how randomness that is common to nanoscale phenomena might be measured and analyzed in other contexts.

  15. detached_shells_carbon_stars

    NASA Astrophysics Data System (ADS)

    Hony, Sacha; Bouwman, Jeroen; Waters, Laurens

    2004-09-01

    We propose to obtain 19-37 micrometer IRS spectra of the detached shells around nearby carbon-stars. We have selected a small (11) sample of bright, well studied, carbon-stars with known detached shells. The sample covers a range of angular diameters of the detached shells from 8-200" and stellar effective temperatures between 800-2600 K. With the spectra of the dust in the detached shell we aim to establish: i) The location of the shell. ii) The chemistry of the shell in order to constrain it's origin. iii) Test the MgS identification for the ``30'' micrometer emission feature. iv) Determine observationally the relationship between the ``30'' micrometer feature peak-position and the distance to the star. These observations will contribute greatly to the understanding AGB-star mass loss, in general, and the phenomenon of detached shells around carbon-stars, in particular. They will also be used to develop a diagnostic tool that allows to study detached shell properties of distant carbon-stars, that cannot be spatially resolved, based on their IR spectrum alone. The total requested time is 2.5h.

  16. Macro stress mapping on thin film buckling

    SciTech Connect

    Goudeau, P.; Villain, P.; Renault, P.-O.; Tamura, N.; Celestre, R.S.; Padmore, H.A.

    2002-11-06

    Thin films deposited by Physical Vapour Deposition techniques on substrates generally exhibit large residual stresses which may be responsible of thin film buckling in the case of compressive stresses. Since the 80's, a lot of theoretical work has been done to develop mechanical models but only a few experimental work has been done on this subject to support these theoretical approaches and nothing concerning local stress measurement mainly because of the small dimension of the buckling (few 10th mm). This paper deals with the application of micro beam X-ray diffraction available on synchrotron radiation sources for stress mapping analysis of gold thin film buckling.

  17. Active control of buckling of flexible beams

    NASA Technical Reports Server (NTRS)

    Baz, A.; Tampe, L.

    1989-01-01

    Mathematical models are presented that simulate the dynamic characteristics of shape memory alloy actuators made of nickel-titanium alloy (Nitinol) controlling the buckling of compressive structural members. A closed-loop computer-controlled system has been designed, based on the proposed mathematical models, and has been implemented to control the buckling of simple beams. The performance of the computer-controlled system is evaluated experimentally and compared with the theoretical predictions to validate the developed models. The results emphasized the importance of buckling control and suggest the potential of shape memory alloy actuators as attractive means for controlling structural deformation in a simple and reliable way.

  18. Sector mapping method for 3D detached retina visualization.

    PubMed

    Zhai, Yi-Ran; Zhao, Yong; Zhong, Jie; Li, Ke; Lu, Cui-Xin; Zhang, Bing

    2016-10-01

    A new sphere-mapping algorithm called sector mapping is introduced to map sector images to the sphere of an eyeball. The proposed sector-mapping algorithm is evaluated and compared with the plane-mapping algorithm adopted in previous work. A simulation that maps an image of concentric circles to the sphere of the eyeball and an analysis of the difference in distance between neighboring points in a plane and sector were used to compare the two mapping algorithms. A three-dimensional model of a whole retina with clear retinal detachment was generated using the Visualization Toolkit software. A comparison of the mapping results shows that the central part of the retina near the optic disc is stretched and its edges are compressed when the plane-mapping algorithm is used. A better mapping result is obtained by the sector-mapping algorithm than by the plane-mapping algorithm in both the simulation results and real clinical retinal detachment three-dimensional reconstruction. PMID:27480739

  19. Slab detachment during continental collision: Influence of crustal rheology and interaction with lithospheric delamination

    NASA Astrophysics Data System (ADS)

    Duretz, T.; Gerya, T. V.

    2013-08-01

    Collision between continents can lead to the subduction of continental material. If the crust remains coupled to the downgoing slab, a large buoyancy force is generated. This force slows down convergence and promotes slab detachment. If the crust resists to subduction, it may decouple from the downgoing slab and be subjected to buoyant extrusion. We employ two-dimensional thermo-mechanical modelling to study the importance of crustal rheology on the evolution of subduction-collision systems. We propose simple quantifications of the mechanical decoupling between lithospheric levels (σ*) and the potential for buoyant extrusion of the crust (ξ*). The modelling results indicate that a variable crustal rheological structure results in slab detachment, delamination, or the combination of both mechanisms. A strong crust provides coupling at the Moho (low σ*) and remains coherent during subduction (low ξ). It promotes deep subduction of the crust (180 km) and slab detachment. Exhumation occurs in coherent manners via eduction and thrusting. Slab detachment triggers the development of topography (> 4.5 km) close to the suture. A contrasting style of collision occurs using a weak crustal rheology. Mechanical decoupling at the Moho (high σ*) promotes the extrusion of the crust (high ξ), disabling slab detachment. Ongoing shortening leads to buckling of the crust and development of topography on the lower plate. Collisions involving rheologically layered crust allow decoupling at mid-crustal depths. This structure favours both the extrusion of upper crust and the subduction of the lower crust. Such collisions are successively affected by delamination and slab detachment. Topography develops together with the buoyant extrusion of crust onto the foreland and is further amplified by slab detachment. Our results suggest that the occurrence of both delamination (Apennines) and slab detachment (Himalayas) in orogens may indicate differences in the initial crustal structure of

  20. Buckling optimisation of sandwich cylindrical panels

    NASA Astrophysics Data System (ADS)

    Abouhamzeh, M.; Sadighi, M.

    2016-06-01

    In this paper, the buckling load optimisation is performed on sandwich cylindrical panels. A finite element program is developed in MATLAB to solve the governing differential equations of the global buckling of the structure. In order to find the optimal solution, the genetic algorithm Toolbox in MATLAB is implemented. Verifications are made for both the buckling finite element code and also the results from the genetic algorithm by comparisons to the results available in literature. Sandwich cylindrical panels are optimised for the buckling strength with isotropic or orthotropic cores with different boundary conditions. Results are presented in terms of stacking sequence of fibers in the face sheets and core to face sheet thickness ratio.

  1. Calculating Buckling And Vibrations Of Lattice Structures

    NASA Technical Reports Server (NTRS)

    Anderson, M. S.; Durling, B. J.; Herstrom, C. L.; Williams, F. W.; Banerjee, J. R.; Kennedy, D.; Warnaar, D. B.

    1989-01-01

    BUNVIS-RG computer program designed to calculate vibration frequencies or buckling loads of prestressed lattice structures used in outer space. For buckling and vibration problems, BUNVIS-RG calculates deadload axial forces caused in members by any combination of externally-applied static point forces and moments at nodes, axial preload or prestrain in members, and such acceleration loads as those due to gravity. BUNVIS-RG is FORTRAN 77 computer program implemented on CDC CYBER and VAX computer.

  2. Buckling transition in long α-helices

    SciTech Connect

    Palenčár, Peter; Bleha, Tomáš

    2014-11-07

    The treatment of bending and buckling of stiff biopolymer filaments by the popular worm-like chain model does not provide adequate understanding of these processes at the microscopic level. Thus, we have used the atomistic molecular-dynamic simulations and the Amber03 force field to examine the compression buckling of α-helix (AH) filaments at room temperature. It was found that the buckling instability occurs in AHs at the critical force f{sub c} in the range of tens of pN depending on the AH length. The decrease of the force f{sub c} with the contour length follows the prediction of the classic thin rod theory. At the force f{sub c} the helical filament undergoes the swift and irreversible transition from the smoothly bent structure to the buckled one. A sharp kink in the AH contour arises at the transition, accompanied by the disruption of the hydrogen bonds in its vicinity. The kink defect brings in an effective softening of the AH molecule at buckling. Nonbonded interactions between helical branches drive the rearrangement of a kinked AH into the ultimate buckled structure of a compact helical hairpin described earlier in the literature.

  3. Giant retinal tears. Surgical techniques and results using perfluorodecalin and silicone oil tamponade.

    PubMed

    Mathis, A; Pagot, V; Gazagne, C; Malecaze, F

    1992-01-01

    Intraoperative use of perfluorocarbon liquids in the management of giant retinal tears was introduced about 4 years ago. Twenty-four patients were operated on for giant retinal tears using perfluorodecalin and silicone oil tamponade. All patients underwent pars plana vitrectomy, unfolding of the giant retinal tears by perfluorodecalin, perfluorodecalin-silicone oil exchange, and endophotocoagulation. The lens was removed in 10 of 14 phakic patients, and encircling scleral buckle was placed in 18 cases. Twenty-three of 24 retinas remained successfully attached with a minimum of 6 months of follow-up. Short-term results of intraoperative use of perfluorodecalin and silicone oil tamponade in the management of giant retinal tears are encouraging. Perfluorodecalin offers the advantage of low cost compared with other perfluoro-carbon liquids like perfluoro-n-octane. The exchange with silicone oil offers the advantages of easy removal of perfluorodecalin and absence of posterior slippage of the retinal tear. PMID:1455087

  4. Buckling condensation in constrained growth

    NASA Astrophysics Data System (ADS)

    Dervaux, Julien; Ben Amar, Martine

    2011-03-01

    The multiple complexities inherent to living objects have motivated the search for abiotic substitutes, able to mimic some of their relevant physical properties. Hydrogels provide a highly monitorable counterpart and have thus found many applications in medicine and bioengineering. Recently, it has been recognized that their ability to swell could be used to unravel some of the universal physical processes at work during biological growth. However, it is yet unknown how the microscopic distinctions between swelling and biological growth affect macroscopic changes (shape, stresses) induced by volume variations. To answer this question, we focus on a clinically motivated example of growth. Some solid tumors such as melanoma or glioblastoma undergo a shape transition during their evolution. This bifurcation appears when growth is confined at the periphery of the tumor and is concomitant with the transition from the avascular to the vascular stage of the tumor evolution. To model this phenomenon, we consider in this paper the deformation of an elastic ring enclosing a core of different stiffness. When the volume of the outer ring increases, the system develops a periodic instability. We consider two possible descriptions of the volume variation process: either by imposing a homogeneous volumetric strain (biological growth) or through migration of solvent molecules inside a solid network (swelling). For thin rings, both theories are in qualitative agreement. When the interior is soft, we predict the emergence of a large wavelength buckling. Upon increasing the stiffness of the inner disc, the wavelength of the instability decreases until a condensation of the buckles occurs at the free boundary. This short wavelength pattern is independent of the stiffness of the disc and is only limited by the presence of surface tension. For thicker rings, two scenarios emerge. When a volumetric strain is prescribed, compressive stresses accumulate in the vicinity of the core and the

  5. The intracapsular versus the extracapsular cataract technique in relationship to retinal problems.

    PubMed Central

    Wetzig, P C; Thatcher, D B; Christiansen, J M

    1979-01-01

    Five hundred and sixty-four consecutive eyes after cataract surgery with intraocular lens implantation were studied in relationship to the incidence of retinal detachment and cystoid macular edema in the intra vs the extracapsular extraction technique. In 124 eyes undergoing intracapsular cataract extraction, three (2.4%) developed retinal detachment. In 440 eyes undergoing extracapsular cataract extraction two (0.45%) developed retinal detachment. In 87 eyes undergoing intracapsular cataract extraction 7 (8%) developed cystoid macular edema. In 327 eyes undergoing extracapsular cataract extraction 4 (1.2%) developed cystoid macular edema. This study cannot be compared with other series in the literature because high risk cases and those with vitreous loss were excluded. PMID:545830

  6. Size distribution of detached drops

    NASA Astrophysics Data System (ADS)

    Baluev, V. V.; Stepanov, V. M.

    1989-10-01

    The law governing the size distribution of detached gas-liquid streams of drops has been determined analytically, and a comparison is carried out against experimental data existing in the literature. The derived theoretical relationships offer an excellent description of existing experimental results.

  7. Buckling analysis of Big Dee Vacuum Vessel

    SciTech Connect

    Lightner, S.; Gallix, R.

    1983-12-01

    A simplified three-dimensional shell buckling analysis of the GA Technologies Inc., Big Dee Vacuum Vessel (V/V) was performed using the finite element program TRICO. A coarse-mesh linear elastic model, which accommodated the support boundary conditions, was used to determine the buckling mode shape under a uniform external pressure. Using this buckling mode shape, refined models were used to calculate the linear buckling load (P/sub crit/) more accurately. Several different designs of the Big Dee V/V were considered in this analysis. The supports for the V/V were equally-spaced radial pins at the outer diameter of the mid-plane. For all the cases considered, the buckling mode was axisymmetric in the toroidal direction. Therefore, it was possible to use only a small angular sector of a toric shell for the refined analysis. P/sub crit/ for the Big Dee is about 60 atm for a uniform external pressure. Also investigated in this analysis were the effects of geometrical imperfections and non-uniform pressure distributions.

  8. Mechanical buckling of veins under internal pressure.

    PubMed

    Martinez, Ricky; Fierro, Cesar A; Shireman, Paula K; Han, Hai-Chao

    2010-04-01

    Venous tortuosity is associated with multiple disease states and is often thought to be a consequence of venous hypertension and chronic venous disease. However, the underlying mechanisms of vein tortuosity are unclear. We hypothesized that increased pressure causes vein buckling that leads to a tortuous appearance. The specific aim of this study was to determine the critical buckling pressure of veins. We determined the buckling pressure of porcine jugular veins and measured the mechanical properties of these veins. Our results showed that the veins buckle when the transmural pressure exceeds a critical pressure that is strongly related to the axial stretch ratio in the veins. The critical pressures of the eight veins tested were 14.2 +/- 5.4 and 26.4 +/- 9.0 mmHg at axial stretch ratio 1.5 and 1.7, respectively. In conclusion, veins buckle into a tortuous shape at high lumen pressures or reduced axial stretch ratios. Our results are useful in understanding the development of venous tortuosity associated with varicose veins, venous valvular insufficiency, diabetic retinopathy, and vein grafts. PMID:20094913

  9. Mechanical Buckling of Veins under Internal Pressure

    PubMed Central

    Martinez, Ricky; Fierro, Cesar A.; Shireman, Paula K.; Han, Hai-Chao

    2010-01-01

    Venous tortuosity is associated with multiple disease states and is often thought to be a consequence of venous hypertension and chronic venous disease. However, the underlying mechanisms of vein tortuosity are unclear. We hypothesized that increased pressure causes vein buckling that leads to a tortuous appearance. The specific aim of this study was to determine the critical buckling pressure of veins. We determined the buckling pressure of porcine jugular veins and measured the mechanical properties of these veins. Our results showed that veins buckle when the transmural pressure exceeds a critical pressure that is strongly related to the axial stretch ratio in the veins. The critical pressures of the eight veins tested were 14.2 ± 5.4 mmHg and 26.4 ± 9.0 mmHg at axial stretch ratio 1.5 and 1.7, respectively. In conclusion, veins buckle into a tortuous shape at high lumen pressures or reduced axial stretch ratios. Our results are useful in understanding the development of venous tortuosity associated with varicose veins, venous valvular insufficiency, diabetic retinopathy and vein grafts. PMID:20094913

  10. A Biomechanical Model of Artery Buckling

    PubMed Central

    Han, Hai-Chao

    2010-01-01

    The stability of arteries under blood pressure load is essential to the maintenance of normal arterial function and the loss of stability can lead to tortuosity and kinking that are associated with significant clinical complications. However, mechanical analysis of arterial bent buckling is lacking. To address this issue, this paper presents a biomechanical model of arterial buckling. Using a linear elastic cylindrical arterial model, the mechanical equations for arterial buckling were developed and the critical buckling pressure was found to be a function of the wall stiffness (Young’s modulus), arterial radius, length, wall thickness, and the axial strain. Both the model equations and experimental results demonstrated that the critical pressure is related to the axial strain. Arteries may buckle and become tortuous due to reduced (sub-physiological) axial strain, hypertensive pressure, and a weakened wall. These results are in accordance with, and provide a possible explanation to the clinical observations that these changes are the risk factors for arterial tortuosity and kinking. The current model is also applicable to veins and ureters. PMID:17689541