-
Journal Francais D'ophtalmologie Jun 2017Vogt-Koyanagi-Harada (VKH) disease is defined as a severe bilateral, chronic granulomatous panuveitis associated with serous retinal detachments, disk edema, and... (Review)
Review
Vogt-Koyanagi-Harada (VKH) disease is defined as a severe bilateral, chronic granulomatous panuveitis associated with serous retinal detachments, disk edema, and vitritis, with central nervous system, auditory, and integumentary manifestations. It is an autoimmune inflammatory condition mediated by T cells that target melanocytes in individuals genetically susceptible to the disease. Vogt-Koyanagi-Harada disease presents clinically in 4 different phases: prodromal, acute inflammatory, chronic, and recurrent, with extraocular manifestations including headache, meningitis, hearing loss, poliosis, and vitiligo. Optical coherence tomography (OCT) allows earlier diagnosis of VKH disease by revealing heterogeneous exudative detachments of the retina in the acute stage and choroidal thickening, and by demonstrating choroidal thinning in the chronic stage. Treatment of this disease is initially with intravenous corticosteroids, with, if needed, a transition to immunosuppressant drugs for long-term control. Patients with VKH disease can have good final visual outcomes if treated promptly and aggressively.
Topics: Diagnosis, Differential; Humans; Panuveitis; Prognosis; Retinal Detachment; Tomography, Optical Coherence; Uveomeningoencephalitic Syndrome
PubMed: 28579215
DOI: 10.1016/j.jfo.2017.02.006 -
The British Journal of Ophthalmology Jan 2022Graft detachment is the most common complication of endothelial keratoplasty. With the ongoing advancements in the field of endothelial keratoplasty, our understanding... (Review)
Review
Graft detachment is the most common complication of endothelial keratoplasty. With the ongoing advancements in the field of endothelial keratoplasty, our understanding of risk factors of graft detachments and its management has been evolving. Various prevention measures have been described in literature including presoaking the donor graft, anterior chamber tamponade, venting incisions, sutures to prevent dislocation of graft. Management of a detached graft involves secondary interventions such as rebubbling, suturing and regrafts. In this review, we discuss graft detachment in different types of endothelial keratoplasty techniques including Descemet stripping endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and Descemet's membrane endothelial keratoplasty; with emphasis on incidence, risk factors, preventive measures and their management.
Topics: Anterior Chamber; Descemet Membrane; Descemet Stripping Endothelial Keratoplasty; Endothelium, Corneal; Graft Survival; Humans; Postoperative Complications; Visual Acuity
PubMed: 33397659
DOI: 10.1136/bjophthalmol-2020-318092 -
Survey of Ophthalmology 2021Pneumatic retinopexy (PR) has been widely advocated for treatment of selected rhegmatogenous retinal detachments: those with small, anterior, superior, retinal breaks... (Review)
Review
Pneumatic retinopexy (PR) has been widely advocated for treatment of selected rhegmatogenous retinal detachments: those with small, anterior, superior, retinal breaks and little or no proliferative vitreoretinopathy. It has been suggested that PR is underused and is advantageous because it is an outpatient clinic or office procedure, short in duration, nonincisional, and cost saving - with reduced perioperative morbidity, faster postoperative recovery, better and faster visual recovery, a low rate of complications and a high rate of overall success compared with scleral buckling or pars plana vitrectomy. We reevaluated these advantages to substantiate the effectiveness and efficiency of PR and critically define its role in the treatment of rhegmatogenous retinal detachment. We found that PR has a much higher rate of subsequent reoperation and proliferative vitreoretinopathy than scleral buckling or pars plana vitrectomy for simple, good prognosis rhegmatogenous retinal detachments. PR often involves multiple procedures that largely negates its potential cost savings and subjects the patient to prolonged stress and disability. Scleral buckling rather than PR is ideally suited for simple, good prognosis rhegmatogenous retinal detachments for surgeons who feel comfortable with the technique; alternatively, pars plana vitrectomy is indicated.
Topics: Humans; Retinal Detachment; Retrospective Studies; Scleral Buckling; Treatment Outcome; Visual Acuity; Vitrectomy
PubMed: 33359545
DOI: 10.1016/j.survophthal.2020.12.007 -
International Journal of Ophthalmology 2017Paediatric retinal detachment (PRD) is an uncommon and challenging disease; it differs from adult detachments in etiology, anatomical characteristics, management and... (Review)
Review
Paediatric retinal detachment (PRD) is an uncommon and challenging disease; it differs from adult detachments in etiology, anatomical characteristics, management and prognosis. PRDs can be particularly challenging, even for the most expert paediatric surgeons due to the higher prevalence of total retinal detachments, late diagnosis and bilateral involvement with respect to those which occur in adulthood. Moreover, the anatomical success, when achieved, is frequently not related to a functional recover. Postsurgical adverse events, refractive errors and amblyopia may additionally undermine the final outcome. Up to date there are few reviews regarding the approach of retinal detachment in children, mainly dealing with rhegmatogenous retinal detachment. In this review, rhegmatogenous, retinopathy of prematurity-related and Coats'-related PRDs were considered. The available literature from the last decades were reviewed and summarized. Epidemiology, etiology and clinical presentation, together with therapeutic approaches and outcomes have been reviewed and discussed.
PubMed: 29062781
DOI: 10.18240/ijo.2017.10.18 -
Cell May 2018The detachment of plant organs is highly choreographed, requiring the enzymatic dissolution of the middle lamella between cell layers at the base of the detaching organ....
The detachment of plant organs is highly choreographed, requiring the enzymatic dissolution of the middle lamella between cell layers at the base of the detaching organ. Now, Lee et al. demonstrate that abscission efficiency and plant health rely on the spatial confinement of enzymatic activity and mechanical features that ensure a smooth separation.
Topics: Arabidopsis; Arabidopsis Proteins; Cell Wall; Lignin
PubMed: 29856951
DOI: 10.1016/j.cell.2018.05.025 -
Klinische Monatsblatter Fur... Jan 2019The number of retinal detachments in children is rarely compared to the number of retinal detachments in adults; only 3 - 7% occur in children. The main predisposing...
The number of retinal detachments in children is rarely compared to the number of retinal detachments in adults; only 3 - 7% occur in children. The main predisposing factors are trauma, myopia, hereditary vitreoretinopathies, retinopathy of prematurity, malformations and Coats' disease. The most frequent paediatric retinal detachments are trauma-associated and vitreoretinopathies are the most common cause of inherited retinal detachment. Disease-specific surgical treatments are discussed. Episcleral buckling surgery should be the preferred method in any case of clear lens, especially for treatment of oradialysis and well-defined localization of peripherally retinal tears. In those suffering from vitreoretinopathy, primary vitrectomy is necessary. The intravitreal use of VEGF-inhibitors to treat vasoproliferative retinopathy in children is a new and effective tool, but we need further results about safety and side-effects in young patients. The functional and anatomical outcomes of retinal detachment in children are less successful than in adults. Further surgical innovations and etiology-specific treatment strategies are required to improve the outcome in this group.
Topics: Adult; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Retinal Detachment; Retinal Perforations; Retrospective Studies; Sclera; Scleral Buckling; Treatment Outcome; Vitrectomy
PubMed: 28599337
DOI: 10.1055/s-0043-106301 -
Proceedings. Biological Sciences Mar 2021Animals can be permanently attached to a substrate in terrestrial environments at certain stages of their development. Pupa adhesion has evolved multiple times in...
Animals can be permanently attached to a substrate in terrestrial environments at certain stages of their development. Pupa adhesion has evolved multiple times in insects and is thought to maintain the animal in a place where it is not detectable by predators. Here, we investigate whether pupa adhesion in can also protect the animal by preventing potential predators from detaching the pupa. We measured the adhesion of species sampled from the same area and found that pupa adhesion varies among species, which can be explained by different glue production strategies. Then, we compared attached and manually detached pupae in both field and laboratory assays to investigate the role of pupa adhesion to prevent predation. First, we found that attached pupae remain onsite 30% more than detached pupae in the field after 3 days, probably because they are less predated. Second, we observed that attached pupae are less efficiently predated by ants in the laboratory: they are not carried back to the ant nest and more ants are needed to consume them onsite. Our results show that pupa adhesion can prevent the animal from being taken away by predators and is crucial for fly survival.
Topics: Animals; Ants; Drosophila; Insecta; Predatory Behavior; Pupa
PubMed: 33726597
DOI: 10.1098/rspb.2021.0088 -
Indian Journal of Ophthalmology Dec 2018Rhegmatogenous retinal detachment (RRD) repair is one of the most common vitreoretinal surgeries a surgeon performs. In an ideal scenario, RRD can be repaired with a... (Review)
Review
Rhegmatogenous retinal detachment (RRD) repair is one of the most common vitreoretinal surgeries a surgeon performs. In an ideal scenario, RRD can be repaired with a single surgical intervention; however, despite excellent skill, flawless technique, and the introduction of high-end technology, up to 10% of cases require additional interventions to ultimately repair recurrent detachments. It is thus important to study the outcomes of multiple interventions to understand whether performing repeat vitrectomy on patients with a history of failed surgeries is worthwhile. Thus, recurrent retinal detachment (re-RD) remains a significant challenge for vitreoretinal surgeons as well as the patients considering the economic and the emotional burden of undergoing multiple interventions. The advent of microincision vitrectomy system, perfluorocarbon liquids, and effective intraocular tamponades has opened new doors for managing re-RDs. In this article, we have reviewed and summarized the various causes and approaches for management for optimal anatomical and functional outcomes.
Topics: Disease Management; Humans; Recurrence; Retinal Detachment; Scleral Buckling; Treatment Outcome; Visual Acuity; Vitrectomy
PubMed: 30451176
DOI: 10.4103/ijo.IJO_1212_18 -
Plant-environment Interactions... Aug 2021Leaf level gas-exchange measurements can be made on detached foliage to address the challenge of access to the crown of tall trees. However, detachment may impact leaf...
Leaf level gas-exchange measurements can be made on detached foliage to address the challenge of access to the crown of tall trees. However, detachment may impact leaf gas exchange. This necessitates the study of gas-exchange characteristics of foliage on detached branches to assess the feasibility of using detached branches for gas-exchange analysis. We compared photosynthetic parameters and stomatal conductance in foliage of attached and detached branches of balsam fir [ (L.) Mill.] during the growing season. Data were analyzed using a linear mixed-effect model, with fixed and random effects (branch status and measurement month, and tree number, respectively). Branch detachment had no significant effects on: (i) photosynthesis at the current ambient CO concentration (400 µmol mol, ); (ii) maximum rates of Ribulose-1,5-bisphosphate (RuBP) carboxylation ( ) and regeneration ( ); (iii) the ratio of to (i.e., : ), and (iv) stomatal conductance ( ) during the study period ( = 0.120-0.335). There was a strong seasonal effect on all gas-exchange variables ( ≤ 0.001-0.015). Gas-exchange measurements made on detached foliage during the warm summer months should be performed with care. Reliable gas-exchange measurements can be obtained using balsam fir foliage on detached branches 50-80 cm in length, in cooler growing-season months, up to 30 min after detachment.
PubMed: 37283699
DOI: 10.1002/pei3.10059