Peripheral Retinal Degenerations without Risk of Rhegmatogenous Retinal Detachment and Management

Peripheral retinal degenerations are lesions that usually appear incidentally during routine ophthalmologic examination when the peripheral fundus is scanned, and usually do not require treatment. Though skipping these non-progressing lesions do not often lead to problems both legally and medically in terms of both the patient and the physician, the possibility of needing follow-up or lesions that may require prophylactic treatment should lead us to be cautious in this regard. In this review, peripheral retinal degenerations without risk of rhegmatogenous retinal detachment and management of these lesions are summarized.

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Jakub J. Kaluzny ◽  
Bartosz L. Sikorski ◽  
Grzegorz Czajkowski ◽  
Mateusz Burduk ◽  
Bartlomiej J. Kaluzny ◽  
...  

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.


2016 ◽  
Vol 27 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Hua Yan

Purpose To introduce a modified scleral buckling surgery using noncontact wide-angle viewing system and intraocular illumination in the treatment of rhegmatogenous retinal detachment (RRD) without proliferative retinopathy. Methods A modified scleral buckling surgery using noncontact wide-angle viewing system with a 25-G optic fiber through sclerotomy site was performed in 22 eyes of 22 patients with RRD. Twelve women and 10 men were included. The mean age was 49.23 ± 15.19 years. The mean refraction of myopia was -4 D (range -3 to -7 D). The mean duration of RRD was 6.64 ± 3.14 days. The preoperative best-corrected visual acuity (BCVA) ranged from 0.02 to 0.8. Mean follow-up was 9.59 ± 2.24 months. Proliferative retinopathy was grade A in 8 eyes and grade B in 14 eyes. Results This surgery was performed successfully and retinal attachment was achieved in all eyes at the final follow-up. The postoperative BCVA increased in all eyes. No complication was encountered related to this technique. Conclusions This modified scleral buckling surgery brings a panoramic and upright view and easy surgical maneuvers. It may be an additional approach for the management of RRD.


Retinal degenerations are common lesions involving the peripheral retina, and most of them are clinically insignificant. Lattice degeneration, cystic retinal tuft, zonular traction tuft, snail track degeneration, degenerative retinoschisis, white without pressure lesions can result in a rhegmatogenous retinal detachment. In this paper, we aimed to discuss peripheric retinal degenerations that predispose retinal detachment and the treatments for them.


2020 ◽  
Vol 11 (2) ◽  
pp. 282-286
Author(s):  
Mohammad Sharifi ◽  
Mohammad Reza Ansari Astaneh

A 14-year-old boy who had ocular motility disorder which started 2 weeks following retinal surgery (scleral buckling) secondary to rhegmatogenous retinal detachment, was referred to the strabismus clinic. He had significant ocular movement limitations in adduction and elevation under general anesthesia. The forced duction test (FDT) was positive in both adduction and elevation. After buckle removal, FDT was negative. The eye was orthotropic without ocular movement limitation at final follow-up. In conclusion, FDT at the end of the scleral buckling procedure needs to be performed. It may prevent restrictive strabismus after scleral buckling surgery.


2018 ◽  
Vol 10 (2) ◽  
pp. 151-155
Author(s):  
Roshija Khanal Rijal ◽  
Raghunandan Byanju ◽  
Araniko Pandey ◽  
Deepesh Mourya

Objective: To study the anatomical status and visual outcome of scleral buckling surgery in rhegmatogenous retinal detachment (RRD) at tertiary eye care center in Nepal. Method: This is a prospective, noncomparative, consecutive, interventional study of rhegmatogenous retinal detachment managed with scleral buckling surgery performed in Lumbini Eye Institute, Nepal. All the patients underwent surgery by a single experienced surgeon and had at least 3 months follow up. Result: A total of 50 patients (50 eyes) were operated, 38 males and 12 females, with a mean age of 39.46. Retinal reattachment was achieved in 46 (92%). Improved best corrected visual acuity (BCVA) was seen in 84%, whereas in 8% BCVA was same and deteriorated in another 8%. Conclusion: Rhegmatogenous retinal detachment is one of the common causes of visual impairment and blindness. Timely surgical management with scleral buckling surgery can give good anatomical and visual outcome.  


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Young Do Yeo ◽  
Yu Cheol Kim

Abstract Rhegmatogenous retinal detachment (RRD) is a vision-threatening pathology. Optical coherence tomography (OCT) is useful for evaluating retinal damage and visual prognosis in patients with RRD. Outer retinal undulation (ORU) is often observed on preoperative OCT in RRD. Therefore, we evaluated the correlation between ORU seen on preoperative OCT and pre/post-operative factors in RRD. Patients with RRD (114 eyes) underwent reattachment surgery and ≥ 6 months of follow-up. According to the condition of the macula on preoperative OCT, cases were divided into macula-on RRD (65 eyes) or macula-off RRD (49 eyes). Patients were classified into acute (< 10 days), subacute (10–30 days), and chronic (> 30 days) symptom duration groups. Clinical findings, histories, and relationships with OCT findings, including ORU, were analyzed. Subacute symptom duration was significantly associated with ORU on preoperative OCT (p = 0.001) and had a higher prevalence of ORU (73.7%) than did acute (OR = 4.48) or chronic (OR = 7.467) durations. Ellipsoid zone (EZ) disruption was significantly associated with poorer best-corrected visual acuity (BCVA) than normal EZ integrity at 6 months postoperatively (p = 0.012). ORU on preoperative OCT suggests a 10–30 days morbidity duration in RRD. EZ integrity is useful for predicting postoperative BCVA in macula-off RRD.


2020 ◽  
Vol 9 (12) ◽  
pp. 3982
Author(s):  
Francesco Barca ◽  
Daniela Bacherini ◽  
Francesco Dragotto ◽  
Ruggero Tartaro ◽  
Chiara Lenzetti ◽  
...  

Background: The aim of the study was to evaluate pre-operative and post-operative retinal vasculature using optical coherence tomography angiography (OCTA) in patients who underwent rhegmatogenous retinal detachment (RRD) surgery repair. Materials and Methods: A total of 33 eyes were included in this prospective consecutive observational study: 15 affected by macula-ON and 18 by macula-OFF RRD. Superficial (SCP), deep capillary plexus (DCP), and foveal avascular zone (FAZ) area variations were evaluated by OCTA and correlated with visual acuity (VA) during a six-month follow-up. Results: In the macula-ON group, the preoperative vascular density (VD) of the whole SCP (wSCP) on affected eyes was lower than that of the fellow eyes (p < 0.05); this difference disappeared at 6 months after surgery (p = 0.88). The wSCP VD and the parafoveal SCP (pfSCP) VD increased during follow-up (p < 0.05); moreover, the higher the preoperative wSCP and pfSCP VD, the better the baseline VA (p < 0.05). In the macula-OFF group, at the first and sixth months after surgery, the larger the FAZ, the lower the VA (p < 0.05). Conclusions: Macula-ON SCP VD affected preoperative VA, and it was lower than the fellow eye, but recovered over time. In the macula-OFF group, a larger FAZ area was related to a worse VA, as is the case in diabetes and in retinal vein occlusion (RVO).


2011 ◽  
Vol 2011 ◽  
pp. 1-2
Author(s):  
Tural Galbinur ◽  
Itay Chowers

Exposure of implanted episcleral element is a rare complication of buckling procedures. We describe a 40-year-old man who presented to our clinic complaining of foreign body sensation and irritation in his left eye which lasted several months. The patient history was positive for bilateral rhegmatogenous retinal detachment which was treated with sclera buckling. Upon presentation the left eye demonstrated phthisis and an exposed and infected sclera buckle and explant in the lower quadrants. The explant was removed, and the patient was treated with antibiotics. This case suggests that wide encircling sclera element might erode through the conjunctiva of eyes undergoing phthisis. Integrity of the conjunctiva overlying episcleral implant should be evaluated during routine follow-up exams to exclude exposure of the implant particularly in eyes undergoing phthisis.


2020 ◽  
Author(s):  
Yan Fu ◽  
Yue-ling Zhang ◽  
Zhaohui Gu ◽  
Ren-Fei Geng ◽  
Xin-Yu Yuan

Abstract Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and needs further surgery. The purpose of this study is to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD.Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included the causative factors, visual outcomes of RD recurrence, and the perioperative factors most affecting the recurrence of RD.Results After retinal reattachment, we observed recurrence of RD after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most recurrence (69%) occurred within 6 months after surgery. Univariate analysis showed that the primary risk factor significantly associated with recurrent RD was the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C ( P = 0.003). Logistic regression analysis showed that a PVR ≥ Grade C (odds ration [OR]: 9.421, 95% confidence interval [CI]: 2.432 - 56.39; P =0.020) was a significant predictor for the development of recurrent RD. The recurrence of RD resulted in a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit compared with the reattachment group ( P =0.000). Eyes with PVR prior to primary surgery or at the diagnosis of re-detachment showed a worse final BCVA.Conclusions The presence of PVR ≥ Grade C was the predominant risk factor for the recurrence of RD. PVR prior to primary surgery, or at the diagnosis of re-detachment, limited the recovery of final visual acuity.


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