Causes and Treatment of Recurrence Other than Proliferative Vitreoretinopathy in Rhegmatogenous Retinal Detachment

2019 ◽  
pp. 219-221
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Surgical Techniques ◽  
Primary Treatment ◽  
Treatment Technique ◽  
Retinal Tears ◽  
Cause Of Failure ◽  
Rate Of Failure

Rhegmatogenous retinal detachment (RRD) is the separation of the neurosensory retina from the retinal pigment epithelium (RPE) due to retinal tears. Surgical techniques are used more frequently in the treatment of RRD. The two most commonly used options are PPV (Pars Plana Vitrectomy) and scleral surgery. When the results of primary treatment are evaluated, especially in patients with advanced PVR, the rate of failure and recurrence is higher than in uncomplicated patients. PVR is the main cause of failure in RRD, which has been treated with conventional surgery and PPV. In cases of treated RRD, other than PVR, recurrence can be seen for different reasons depending on the primary treatment technique. In this review, the causes and treatment of recurrence are discussed.

Retinal Detachments Related to Pathological Myopia

2020 ◽  
pp. 144-147
Keyword(s):  
Retinal Pigment Epithelium ◽  
Retinal Detachment ◽  
High Myopia ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Pathological Myopia ◽  
Retinal Degenerations ◽  
Retinal Tears ◽  
Mechanical Stretching ◽  
Retinal Complications

High myopia or pathological myopia is associated with globe elongation and a refractive error of at least -6.0 diopters (D) and/or axial length of greater than 25.5 mm. Excessive axial elongation of the globe in high myopia can cause mechanical stretching and thinning of the choroid and retinal pigment epithelium layers, resulting in various retinal degenerative changes. It is well known that individuals with pathological myopia have increased risks of retinal complications such as peripheral retinal degenerations, retinal tears, and retinal detachment. This article will review these complications and discuss the current concepts relating to these complications.

Epidemiology, Prevalence and Incidence of Rhegmatogenous Retinal Detachment

2019 ◽  
pp. 135-137
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
High Myopia ◽  
Rhegmatogenous Retinal Detachment ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Cataract Extraction ◽  
Common Type ◽  
Associated Risk Factors

Rhegmatogenous retinal detachment is the most common type of retinal detachments and occurs when subretinal fluid accumulates between the neurosensorial retina and retinal pigment epithelium. Although often caused by vitreous liquefaction, cataract extraction, high myopia, inflammation, and trauma are other associated risk factors. In this article, epidemiology, prevalence, and incidence of rhegmatogenous retinal detachment are aimed to describe.

scholarly journals Spontaneous Resolution of a Rhegmatogenous Retinal Detachment

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Biljana Vukadinovic-Pajovic ◽  
Miroslav Stamenkovic ◽  
Dusan Todorovic ◽  
Suncica Srecković ◽  
Vladimir Jakovljevic
Keyword(s):  
Retinal Pigment Epithelium ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Vitreous Body ◽  
Tertiary Level ◽  
Ophthalmological Examination ◽  
Level Institution ◽  
The Right

Abstract A retinal detachment is the term used to describe detachment of the neurosensory retina from the underlying membrane, the retinal pigment epithelium (RPE). Rhegmatogenous detachments are caused by a break in the retina through which fluid passes from the vitreous cavity into the subretinal space. The incidence of rhegmatogenous retinal detachment in the general population in Europe is 1 in 10 000 persons per year. Danger is the greatest in the age range from 55 to 70 years. Without treatment, blindness in the affected eye may occur. Individual risks depend on the presence or absence of specific factors including myopia, positive family anamnesis, retina rupture, trauma, ablation in the other eye, ablation in a vitreous body, retina high-risk peripheral de-generations and vitreoretinal degenerations. Majority of the untreated rhegmatogenous retina ablations progress to the subtotal or total retinal detachment and blindness. This paper describes a very rare case of the spontaneous complete reattachment of the sensory retina to the retinal pigment epithelium in a patient with the total rhegmatogenous retinal ablation in the right eye. The female patient, who was 52 years old, was examined by an Ophthalmologist after she had experienced a sudden loss of vision, 2 months before appointment. After a detailed ophthalmological examination, a total rhegmatogenous retinal ablation of the right eye was diagnosed. The best corrected visual acuity, evaluated on a Snellen chart, was 2/60. The patient was referred to a tertiary-level Institution since a surgical intervention of the ablation was needed. Due to technical inabilities in the above-mentioned Institution, the operation was not performed, and despite the recommendation to perform the intervention in another tertiary-level Institution, the patient did not have ophthalmological examinations during the following three months. During the next visit, the Ophthalmologist determined that there was a spontaneous retinal fixation on the retinal pigment epithelium and a partial restoration of the visual function of the affected eye which was evaluated at 0.5.

Retinal Anatomy, Mechanisms of Retinal Adhesion, Retinal Tears, and Pathogenetic Mechanisms of Retinal Detachment

2020 ◽  
pp. 139-143
Keyword(s):  
Retinal Detachment ◽  
Close Contact ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Posterior Vitreous Detachment ◽  
Pressure Gradients ◽  
Retinal Tears ◽  
Mechanical Bond ◽  
Lattice Degeneration ◽  
Retinal Adhesion

Retinal detachment (RD) is the separation of the retinal pigment epithelium (RPE) and the neurosensorial layer of the retina. To ensure visual function, these two subunits must be in close contact with each other, but there is no mechanical bond between them. In the formation of this connection, mainly the adhesive forces due to RPE metabolism, interfotoreseptic matrix, and some pressure gradients are involved. Against these factors, the retina is also exposed to opposing forces. The most common cause of retinal tear is the posterior vitreous detachment (PVD). Retinal injuries are divided into subgroups as atrophic holes, retinal tears, and retinal dialysis. Lattice degeneration, degenerative retinoschisis, and peripheral cystoid degeneration are predisposing to the development of RD.

Advanced Vitrectomy Surgery in Rhegmatogenous Retinal Detachment; Indications and Techniques

2019 ◽  
pp. 205-210
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Techniques ◽  
Scleral Buckling ◽  
Treatment Modalities ◽  
Success Rates ◽  
Retinal Tears ◽  
Pars Plana ◽  
Anatomical Success ◽  
Vitrectomy Surgery

The main goal in the treatment of rhegmatogenous retinal detachment (RRD) is the localization of retinal tears, removal of tractions, and closure of retinal tears. Despite the use of pneumatic retinopexy, scleral buckling, and vitrectomy as standard treatment modalities, the preference for pars plana vitrectomy (PPV) in the treatment of RRD has increased steadily in recent years. The reason for this increase is the widespread use of small-sized transconjunctival surgery, improvement of bimanual surgery, use of liquid perfluorocarbons, improved vitrectomy devices and more safe and successful removing of peripheral vitreous bases, visualization of membranes with vital dyes, safe retinopexy with use of curved laser probe even with phakic cases. Besides these, PPV and advanced surgical techniques are more needed in complicated detachments. Nevertheless, the surgeon has a specially important role in the surgical technique of choice. Although the control of the procedures can be performed much more successfully with the PPV in the case of complicated RRD patients during surgery, anatomical success rates are still not very high. In this article, the applications of advanced vitrectomy surgery in RRD are discussed in detail.

scholarly journals Staged approach to treatment of combined hamartoma of the retina and retinal pigment epithelium

2020 ◽  
Author(s):  
KhP Takhchidi ◽  
NKh Takhchidi ◽  
TA Kasmynina ◽  
EP Tebina
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Retinal Detachment ◽  
Clinical Case ◽  
Rhegmatogenous Retinal Detachment ◽  
Pigment Epithelium ◽  
Benign Lesion ◽  
Retinal Pigment ◽  
Exudative Retinal Detachment ◽  
Staged Approach

Combined hamartoma of the retina and retinal pigment epithelium (RPE) is a rare congenital benign lesion. It is most often detected in young adults and adolescents. The disorder is mostly asymptomatic, however, in 24% of patients the loss of visual function results from complications, such as epiretinal fibrosis associated with tractional distortion of the fovea, hemophthalmos, choroidal neovascularization, exudative retinal detachment, macular edema, and combined tractional/rhegmatogenous retinal detachment. Currently, there is no consensus on the combined hamartoma complications management. The reported clinical case demonstrates the feasibility of staged approach to treatment of combined hamartoma of the retina and RPE complicated by epiretinal fibrosis and partial hemophthalmos using the advanced diagnosis (optical coherence tomography) and treatment methods.

scholarly journals Scleral buckling—a brief historical overview and current indications

2019 ◽  
Vol 258 (3) ◽  
pp. 467-478
Author(s):  
Aijing Wang ◽  
Martin P. Snead
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Techniques ◽  
Scleral Buckling ◽  
Effective Technique ◽  
Retinal Breaks ◽  
Retinal Tears ◽  
Pars Plana ◽  
Retinal Hole ◽  
The Right

AbstractThe key to successful management of rhegmatogenous retinal detachment (RRD) is to find and seal all of the retinal breaks, and the two main surgical techniques used to achieve this are scleral bucking (SB) or pars plana vitrectomy (PPV). Techniques for SB have remained mostly unchanged for the last 60 years, whilst PPV techniques and instruments have developed substantially over that time and have greatly contributed to increased success rate for types and configurations of retinal detachments unsuitable or difficult to manage with buckling alone. However, there is a growing dependency to rely on PPV as the sole and only approach for repair of all types of retinal detachment, such that some centres are no longer offering training in scleral buckling. There are also many studies comparing SB with PPV, but many of these lack information on the type, technique or rationale for deployment of the buckle. Many studies deploy the same scleral buckle technique without customising it to the type, position or number of tears being treated. Scleral buckling is not a one-size-fits-all technique. It requires careful patient selection and careful buckle selection and orientation tailored to the tear(s) to ensure success. When used appropriately, it is a simple and highly effective technique, particularly for retinal dialyses, round retinal hole detachments and selected cases of retinal detachment associated with horseshoe retinal tears. There is no doubt that for some more complex cases, such as multiple large breaks, giant retinal tears, bullous detachments and cases complicated by proliferative retinopathy, PPV offers a safer and more effective management. However, SB remains an important and relevant surgical technique, and for the right cases, the results can be superior to PPV with reduced comorbidity.

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