scholarly journals Vitreoretinal Surgery and Panretinal Photocoagulation in a Patient with Multiple Large Retinal Capillary Hemangiomas (von Hippel-Lindau Disease): A Novel Approach

2019 ◽  
Vol 10 (3) ◽  
pp. 327-333 ◽  
Author(s):  
Guilherme Sturzeneker ◽  
André Maia ◽  
Melina Morales ◽  
Rubens N. Belfort
Keyword(s):  
Pars Plana Vitrectomy ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Positive Outcome ◽  
Intravitreal Injections ◽  
Panretinal Photocoagulation ◽  
Von Hippel Lindau ◽  
Retinal Capillary ◽  
Pars Plana ◽  
Vhl Disease

The authors present a novel surgical approach for the treatment of retinal capillary hemangiomas (RCHs) secondary to von Hippel-Lindau (VHL) disease. This is a case report of a 23-year-old male patient with VHL that presented with multiple large RCHs and a thick epiretinal membrane (ERM) in his left eye, with best-corrected visual acuity (BCVA) of 20/80. This condition was surgically addressed with 23-gauge pars plana vitrectomy, ERM and internal limiting membrane peeling, and panretinal photocoagulation. Three monthly intravitreal injections of bevacizumab were administered after surgery. In a 14-month follow-up period, hemangiomas have regressed after laser therapy, macular anatomy has improved, retina remained completely attached, and there has been no development of new tumors or proliferative vitreoretinopathy. The patient achieved a BCVA of 20/40 in the treated eye. Panretinal photocoagulation combined with pars plana vitrectomy may be useful to reduce development of new capillary hemangiomas and reduce overall occurrence of complications in patients with VHL disease. Postoperative intravitreal injections of bevacizumab may have a role in this positive outcome.

SCLERAL IMBRICATION COMBINED WITH PARS PLANA VITRECTOMY WITHOUT INTERNAL LIMITING MEMBRANE PEELING FOR MYOPIC SCHISIS

Retina ◽  
2016 ◽  
Vol 36 (10) ◽  
pp. 1927-1934 ◽  
Author(s):  
Takayuki Baba ◽  
Sumiyoshi Tanaka ◽  
Tomohiro Nizawa ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Pars Plana

scholarly journals Microinvasive pars plana vitrectomy versus panretinal photocoagulation in the treatment of severe non-proliferative diabetic retinopathy (the VIP study): study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043371
Author(s):  
Wenbin Zheng ◽  
Shida Chen ◽  
Xiaohu Ding ◽  
Kunbei Lai ◽  
Sainan Xiao ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Randomised Controlled Trial ◽  
Pars Plana Vitrectomy ◽  
Controlled Trial ◽  
Diabetic Macular Oedema ◽  
Panretinal Photocoagulation ◽  
Progression Rate ◽  
Thickness Change ◽  
Pars Plana ◽  
Randomised Controlled

IntroductionDiabetic retinopathy (DR) is the main cause of adult visual impairment worldwide. Severe non-proliferative DR (sNPDR) is an important clinical intervention stage. Currently, panretinal photocoagulation (PRP) is the standard treatment for sNPDR. However, PRP alone cannot completely prevent NPDR progression. One explanation might be that PRP does not remove the detrimental vitreous that plays an important role in DR progression. Microinvasive pars plana vitrectomy (PPV) was shown to be a safe and effective method to treat late-stage proliferative DR (PDR) by completely removing the pathological vitreous. However, whether PPV is effective in controlling sNPDR remains unknown. In this trial, we aim to compare the effectiveness of microinvasive PPV with that of PRP for sNPDR progression control.Methods and analysisThis single centre, parallel group, randomised controlled trial aims to evaluate the clinical efficacy of microinvasive PPV in preventing the progression of sNPDR compared with PRP. A total of 272 adults diagnosed with sNPDR will be randomised 1:1 to the microinvasive PPV and PRP groups. The primary outcome is the disease progression rate, calculated as the rate of sNPDR progressed to PDR from baseline to 12 months after treatment. The secondary outcomes include the change in best-corrected visual acuity, re-treatment rate, diabetic macular oedema occurrence, change in central retinal thickness, change in the visual field, cataract occurrence and change in the quality of life.Ethics and disseminationThe Ethics Committee of Zhongshan Ophthalmic Center approved this study (2019KYPJ108). The results will be presented at scientific meetings and submitted for publication to peer-reviewed journals.Trial registration numberNCT04103671.

Properties of Gases Used in Vitrectomy Surgery in Rhegmatogenous Retinal Detachment

2019 ◽  
pp. 172-175
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Visual Loss ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Scleral Buckle ◽  
Pneumatic Retinopexy ◽  
The World ◽  
Pars Plana ◽  
Vitrectomy Surgery

Despite improvements in vitreoretinal surgery techniques, rhegmatogenous retinal detachment is still one of the major causes of visual loss in the world. Pneumatic retinopexy (PR), scleral buckle, and pars plana vitrectomy (PPV) are the modalities that are used in the treatment of retinal detachment. Intraocular gases, which are frequently used in PR and PPV, are indispensable molecules due to their tamponade effects. In order to get favorable postoperative outcomes, the proper type of gas selection should be made by considering the properties of the gases, indications, potential complications, and findings of the patients together.

scholarly journals Risk of newly developing visual field defect and neurodegeneration after pars plana vitrectomy for idiopathic epiretinal membrane

2020 ◽  
pp. bjophthalmol-2020-317478
Author(s):  
Kunihiko Akino ◽  
Norihiro Nagai ◽  
Kazuhiro Watanabe ◽  
Norimitsu Ban ◽  
Toshihide Kurihara ◽  
...  
Keyword(s):  
Visual Field ◽  
Epiretinal Membrane ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Visual Field Defects ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Ilm Peeling ◽  
Idiopathic Epiretinal Membrane ◽  
Pars Plana

Background/AimsPars plana vitrectomy (PPV) is widely performed in patients with idiopathic epiretinal membrane (iERM) to improve vision. Postoperative visual field defects (VFDs) have been previously reported. However, whether they occur when using the most recent PPV system, and the frequency of VFDs as measured by standard automated perimetry, remain poorly documented and were examined in this study.MethodsData of 30 eyes (30 patients; mean age, 66.1 years; 15 men) who underwent PPV for iERM during February 2016–June 2019 and had preoperative and postoperative visual field measurements using standard automated perimetry (Humphrey visual field analyser 30-2 program) were retrospectively analysed. Eyes with diseases other than iERM, including moderate-to-severe cataract or preoperative VFDs were excluded.ResultsVFD, defined by the Anderson and Patella’s criteria, was found in 73.3% of the eyes 1 month after PPV. After age adjustment, internal limiting membrane (ILM) peeling was identified as a risk factor for postoperative VFD (p=0.035; 95% CI 1.173 to 92.8). Postoperative VFD was frequently observed nasally (86.4%, p=0.002), and on optical coherence tomography measurements, ganglion cell layer (GCL) thinning was found temporal to the fovea (p=0.008). Thinning of the superior and inferior retinal nerve fibre layers and of the GCL temporal to the fovea were significant in eyes after ILM peeling (all p<0.05).ConclusionILM peeling may cause inner retinal degeneration and lead to the development of VFDs after PPV, which should be further examined.

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