Intraocular Pressure Alters Following Altitude Changes in Patients With Gas-Filled Eyes: Theoretical Analysis

2010 ◽  
Author(s):  
Rouzbeh Amini ◽  
Victor H. Barocas ◽  
H. Pirouz Kavehpour ◽  
Jean Pierre Hubschman
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Theoretical Analysis ◽  
Treatment Options ◽  
Systemic Circulation ◽  
Vitreous Humor ◽  
Vitreous Cavity ◽  
Gas Bubble

Retinal detachment is an eye disorder that, if not treated, can lead to blindness. One of the treatment options is removing all or part of vitreous humor from the vitreous cavity and filling it with a gas bubble. The gas bubble eventually reabsorbs over a few weeks into the systemic circulation.

Management of Large Subretinal Gas Bubble After Pneumatic Retinopexy With Head-Positioning Maneuver

2021 ◽  
pp. 247412642110096
Author(s):  
Jay C. Wang ◽  
William M. Tang ◽  
Dean Eliott
Keyword(s):  
Case Report ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Intervention ◽  
Vitreous Cavity ◽  
Gas Bubble ◽  
Retinal Break ◽  
Pneumatic Retinopexy ◽  
Head Positioning

Purpose: This work reports on the management of a large subretinal gas bubble after pneumatic retinopexy. Methods: A case report is discussed. Results: We report a case of subretinal gas after pneumatic retinopexy for rhegmatogenous retinal detachment that was managed with a series of head-positioning maneuvers to allow the subretinal gas to migrate into the vitreous cavity through the retinal break. Despite the subretinal bubbles being larger than the retinal break, this approach eliminated the subretinal gas and averted surgical intervention. Conclusions: Subretinal gas after pneumatic retinopexy can be successfully managed by head-positioning maneuvers in some cases, even if the subretinal gas bubble is larger than the retinal break.

Extrascleral Filling Using Endoillumination the First Experiencethe

2020 ◽  
pp. 43-49
Author(s):  
V.Y. Markevich ◽  
◽  
T.A. Imshenetskaya ◽  
O.A. Yarmak ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Crystalline Lens ◽  
Vitreous Cavity ◽  
Macular Area ◽  
General Group ◽  
Anatomical Outcome

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.

Treatment of Uncomplicated Cases of Rhegmatogenous Retinal Detachment with an Expanding Gas Bubble

1993 ◽  
Vol 207 (3) ◽  
pp. 140-143 ◽  
Author(s):  
M. Trillo ◽  
M. Facino ◽  
R. Terrile ◽  
M. Corazza ◽  
C. Mosci ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Gas Bubble

Pathogenesis, Epidemiology, and Natural Course of Retinal Detachment

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

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

scholarly journals Persistent Retinal Detachment in Retinoblastoma: The Challenges

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sophia El Hamichi ◽  
Dhariana Acon ◽  
Veronica Kon Graversen ◽  
Aaron S. Gold ◽  
Audina M. Berrocal ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Tumor Regression ◽  
Treatment Options ◽  
Local Treatment ◽  
Visual Outcome ◽  
Poor Visual Outcome ◽  
Age Of Diagnosis ◽  
The Mean ◽  
Ophthalmological Assessment ◽  
Complete Tumor

Introduction. Retinoblastoma (RB) is the most common eye tumor in children. There have been significant improvements in treatment options targeting killing the tumor while also conserving the eye and attempting to conserve functional vision. Retinal detachment (RD) is not an uncommon event and compromises the vision and sometimes RB treatment. Materials and Methods. Retrospective review of 62 patients over a period of 8 years between 2012 and 2019 with eyes treated for RB and having persistent RD that did not resolve after complete tumor regression. Results. Forty-two patients of these 62 cases developed RD (67%). The RD resolved in 35 patients (83% of RD), and 7 patients (16% of RD) developed a persistent RD. In all the persistent RD groups (7 patients/11 eyes), RB and RD were present simultaneously in the first ophthalmological assessment. Sex ratio was 2 females/5 males. The mean age of diagnosis was 11 months. All eyes had advanced RB stages. Eight eyes had local treatment with transpupillary laser, 6 eyes received IAC, and 3 patients received systemic chemotherapy. In 9 eyes, the RD had both exudative and tractional components. Only one eye had a pure tractional RD due to persistent fetal vasculature, and one eye had rhegmatogenous RD component with presence of a tear in addition to exudation. None of the eyes received RD surgical repair. Conclusion. Persistent RD occurs in eyes with advanced RB stages with complex RD with more than one component. The dilemma is performing a vitrectomy in eyes with cancer and poor visual outcome.

scholarly journals Intravitreal methotrexate for the treatment of proliferative vitreoretinopathy

2019 ◽  
Vol 4 (1) ◽  
pp. e000293 ◽  
Author(s):  
Jeffrey David Benner ◽  
David Dao ◽  
John W Butler ◽  
Kelli I Hamill
Keyword(s):  
Adverse Effect ◽  
Intraocular Pressure ◽  
Retrospective Study ◽  
Retinal Detachment ◽  
Retrospective Review ◽  
Proliferative Vitreoretinopathy ◽  
Visual Recovery ◽  
Perfluorocarbon Liquid ◽  
Superficial Punctate Keratopathy

Background/aimsPreventing and treating proliferative vitreoretinopathy (PVR) remain a serious challenge for vitreoretinal surgeons. PVR is a devastating complication of retinal detachment that results in recurrent detachment and limits visual recovery. At present, there is no effective treatment for PVR.Materials and methodsA retrospective review was performed on a cohort of five consecutive eyes with severe PVR and recurrent retinal detachment that were treated with relaxing retinectomy, extended perfluorocarbon liquid tamponade (4–5 weeks) and a series of intravitreal methotrexate (MTX) injections (100–200 µg/0.05 mL for 10 weeks).ResultsAll five patients remained reattached (100%) with 11–27 months of follow-up (mean = 17.4). 4 eyes recovered ambulatory vision (>20/200) with normal intraocular pressure and non-fibrotic laser scars along with the relaxing retinectomy. The initial patient remained reattached, but only had hand motions vision. The only adverse effect noted was mild superficial punctate keratopathy in one patient.ConclusionThis small, retrospective study suggests that a series of MTX injections may be beneficial for treating complex retinal detachment caused by PVR. Further study is indicated.

Safety of 6000 intravitreal dexamethasone implants

2019 ◽  
Vol 104 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Bindu Rajesh ◽  
Javier Zarranz-Ventura ◽  
Adrian T Fung ◽  
Catharina Busch ◽  
Niroj Kumar Sahoo ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Macular Oedema ◽  
Real Life ◽  
Cystoid Macular Oedema ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone ◽  
Phakic Eyes

PurposeTo evaluate the real-life safety profile of intravitreal dexamethasone implant injection for various retinal conditions.MethodsRetrospective multicenter analysis of intravitreal dexamethasone implant injections (700 µg) due to various retinal conditions including central retinal venous occlusion (1861 injections), diabetic macular oedema (3104 injections), post-surgical cystoid macular oedema (305 injections) and uveitis (381 injections). The eyes were evaluated mainly for the occurrence of adverse events such as glaucoma, cataract, retinal detachment and endophthalmitis along during the follow-up period.ResultsA total of 6015 injections in 2736 eyes of 1441 patients (mean age of 65.7±12.9 years) were in total analysed over an average period of 18 months (range 6 months to 102 months). A total of 576 eyes (32.5% of the phakic eyes) developed cataract requiring surgical intervention. However, visually insignificant cataract progression was observed in another 259 phakic eyes (14.6%) which did not require surgical removal. A total of 727 eyes (26.5%) experienced an intraocular pressure (IOP) rise of >25 mm Hg, with 155 eyes (5.67%) having a prior history of glaucoma and 572 eyes (20.9%) having new onset IOP rise. Overall, more than 90% of eyes with IOP rise were managed medically, and 0.5% eyes required filtering surgery. Endophthalmitis (0.07%), retinal detachment (0.03%) and vitreous haemorrhage (0.03%) were rare. There was no significant change in visual acuity (p=0.87) and central macular thickness (p=0.12) at the last follow-up.ConclusionThis is the largest real-life study assessing the safety of intravitreal dexamethasone implant injections in various retinal conditions. Cataract progression and intraocular pressure rise are the most common side effects, but are often rather easily manageable.

scholarly journals Epidemiological Properties of Primary Open Angle Glaucoma in Nigeria

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lawan Abdu
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
High Reliability ◽  
Treatment Options ◽  
Late Presentation ◽  
Open Angle ◽  
Long Term Effects ◽  
Eye Care

Background. Primary open angle glaucoma (POAG) is progressive chronic optic neuropathy in adults in which intraocular pressure (IOP) and other currently unknown factors contribute to damage. POAG is the second commonest cause of avoidable blindness in Nigeria.Pattern of Presentation. POAG is characterized by late presentation. Absence of pain which is a driving force for seeking medical help, inadequacy of trained eye care personnel, paucity of facilities, misdistribution of resources, lack of awareness, poor education, and poverty may all contribute to this. Medical and surgical treatment options available are challenging and tasking.Screening for Glaucoma. Screening is the presumptive identification of unrecognized disease (POAG) by applying test(s) which can be applied rapidly. Such test(s) should be of high reliability, validity, yield, acceptable, and cost effective. The test should ideally be sensitive, specific, and efficient. It is difficult to select a suitable test that meets these criteria. Intraocular pressure (IOP) appears to be the easiest option. But, high IOP is not diagnostic nor does normal value exclude the disease. Health education is a possible strategy in early case detection and management.Treatment of POAG. Glaucoma treatment can either be medical or surgical (this includes laser). Considering unavailability, potency, cost, and long-term effects of medication, surgery (trabeculectomy) could be a better option. Laser trabeculoplasty is available in a few centers. Viscocanalostomy is not routinely performed. Patient education is vital to success as management is for life.Conclusion. POAG remains a cause of avoidable blindness in Nigeria. There is need for long-term strategy to identify patients early and institute prompt management. Improvement in training of eye care personnel and provision of up to date equipment is essential in achieving this goal.

scholarly journals Incidence and risk factors for intraocular pressure rise after the scleral buckle surgery for retinal detachment

2021 ◽  
Vol 33 (4) ◽  
pp. 444
Author(s):  
Tarannum Mansoori ◽  
GandrapuPoojitha Mohan ◽  
SatishGooty Agraharam ◽  
Nagalla Balakrishna ◽  
Veerandranath Pesala
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Pressure Rise ◽  
Scleral Buckle
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