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American Journal of Ophthalmology May 2017
Topics: Bevacizumab; Diabetic Retinopathy; Humans; Vitreous Hemorrhage
PubMed: 28325547
DOI: 10.1016/j.ajo.2017.02.008 -
PloS One 2023To explore the changes in vitreous body after vitreous hemorrhage and assess its prognosis from the perspective of vitreoretinal interface.
PURPOSE
To explore the changes in vitreous body after vitreous hemorrhage and assess its prognosis from the perspective of vitreoretinal interface.
METHODS
The experiment was performed on 32 New Zealand rabbits (64 eyes), weighing 2500-3000 g for 4 months and unlimited gender, which was injected with 0.2 mL of autologous blood into the center of vitreous cavity-the study group (right eyes), and the control one was treated in the same manner with equal volumes of saline. The rabbits were randomly and equally divided into the following four batches according to the days of observation: Days 3, 7, 14, and 30 after injection. IOP and severity grading were evaluated before rabbits' execution and eyeballs were enucleated. The anterior segment was separated to flow out the vitreous body naturally to detect the liquefaction degree and viscosity. Then, chemical composition of electrolytes, PCT and bFGF were determined by colorimetry and enzyme-linked immunosorbent assay (ELISA). Finally, the incidence of posterior vitreous detachment (PVD) was observed after vitreous sampled. The studies were double-blind.
RESULTS
After injection, the extent of vitreous opacity and coagulum size decreased over time. Both the degree of liquefaction and the length of tow differed significantly between two groups at different time points (all p < 0.001). The liquefaction degree in the study group rose obviously from the Day 14, which the viscosity declined significantly on the initial time. Biochemical markers fluctuated temporarily, except for basic fibroblast growth factor (bFGF), which continued to rise and was correlated with the liquefaction degree (r = 0.658, p < 0.001). Besides, the incidence of PVD increased from the 14th day (p < 0.05), and it was highly positively correlated with the number of macrophages (r = 0.934; p < 0.001).
CONCLUSION
After vitreous hemorrhage, the changes of the vitreous body are relatively minor earlier (2-4 weeks), but irreversible later. Specifically, the degree of liquefaction increases with a decrease in viscosity, and the chemotaxis of macrophages and bFGF induce incomplete PVD.
Topics: Animals; Rabbits; Injections; Interdisciplinary Studies; Vitreous Body; Vitreous Detachment; Vitreous Hemorrhage
PubMed: 36745670
DOI: 10.1371/journal.pone.0281165 -
Retina (Philadelphia, Pa.) Sep 2023To describe photoreceptor damage in patients with Terson syndrome as a potential cause for inconsistent clinical outcomes.
PURPOSE
To describe photoreceptor damage in patients with Terson syndrome as a potential cause for inconsistent clinical outcomes.
METHODS
Clinical evaluation and retinal imaging in six patients.
RESULTS
Four patients were women and two men, with an average age of 46.8 years (SD 8.9). Four patients suffered aneurysmal subarachnoid hemorrhage, one vertebral artery dissection, and one superior sagittal sinus thrombosis. In 11 eyes, a consistent pattern of outer retinal changes within the central retina affecting the ellipsoid zone and the outer nuclear layer was observed, indicating photoreceptor damage. Areas of photoreceptor damage showed poor spatial correlation with intraocular hemorrhage, particularly subinternal limiting membrane hemorrhage. The observed retinal abnormalities demonstrated incomplete recovery over long-term follow-up 3.5 to 8 years posthemorrhage, irrespective of surgical or conservative treatment strategy, and had variable impact on the patients' visual function.
CONCLUSION
The observations suggest that photoreceptor damage in Terson syndrome likely represents a distinct manifestation of this condition, which could be caused by transient ischemia of the outer retina secondary to acute rise in intracranial pressure.
Topics: Male; Humans; Female; Middle Aged; Vitreous Hemorrhage; Macula Lutea; Retina; Subarachnoid Hemorrhage; Visual Acuity; Tomography, Optical Coherence
PubMed: 37253246
DOI: 10.1097/IAE.0000000000003842 -
Nepalese Journal of Ophthalmology : a... Jan 2020Vitreous hemorrhage is one of the most common diseases presenting to emergency department and leading cause of painless vision loss.
INTRODUCTION
Vitreous hemorrhage is one of the most common diseases presenting to emergency department and leading cause of painless vision loss.
OBJECTIVES
To determine the profile of vitreous hemorrhage in patients presented to Outpatient Department (OPD) and emergency Department of Tilganga Institute of Ophthalmology (TIO).
MATERIALS AND METHODS
This is a hospital based observational non interventional descriptive study. Total 198 patients were enrolled who visited OPD and Emergency department of TIO from August 1st 2012 to July 30th 2013.
RESULT
Total 198 patients (201 eyes) were enrolled for the study, out of which 144 were male and 54 females. 195 were unilateral and 3 bilateral cases. Most common age group of presentation of vitreous hemorrhage was 51-60 years (24.75%). Most common presenting complaint was sudden onset of decreased vision (95%). Most common etiology of vitreous hemorrhage was branch retinal vein occlusion (22.38%). Among the total subjects, 57.7% of the patient were managed with medical therapy, 35.8% surgically and 6.47 % with combined medical and surgical treatment.
CONCLUSION
Branch retinal vein occlusion (BRVO) is the most common cause of vitreous hemorrhage. Diabetes and hypertension are the most commonly associated systemic illnesses.
Topics: Eye; Female; Humans; Male; Middle Aged; Nepal; Retinal Vein Occlusion; Tertiary Care Centers; Vitreous Hemorrhage
PubMed: 32799245
DOI: 10.3126/nepjoph.v12i1.30338 -
Indian Journal of Ophthalmology Aug 2023Prepapillary vascular loops are a type of congenital vascular anomaly seen on or around the optic disk. Patients with this condition are usually asymptomatic and are...
BACKGROUND
Prepapillary vascular loops are a type of congenital vascular anomaly seen on or around the optic disk. Patients with this condition are usually asymptomatic and are detected incidentally on routine fundus examinations. Differential diagnosis for this condition includes neovascularization of the disk and collaterals on the disk. Prepapillary capillary loops are not associated with any systemic condition. They are usually unilateral in presentation, but can rarely be bilateral.
PURPOSE
To discuss the new proposed classification of prepapillary capillary loops.
SYNOPSIS
: Prepapillary capillary loops are classified based on their location around the disk, loop characteristics such as elevation, shape, and covering, and presence of vitreoretinal traction.
HIGHLIGHTS
The most common vascular loops are arterial in origin and rarely venous in origin. They can sometimes be associated with spontaneous and recurrent vitreous hemorrhage, branch retinal artery or vein occlusion, and subretinal hemorrhage. It is an important differential diagnosis in spontaneous vitreous hemorrhage. Treatment is symptomatic.
VIDEO LINK
: https://youtu.be/gbq_oP7Y2q4.
Topics: Humans; Vitreous Hemorrhage; Retinal Vessels; Retinal Artery; Eye Abnormalities
PubMed: 37530298
DOI: 10.4103/IJO.IJO_639_23 -
Retinal Cases & Brief Reports Nov 2023To report a novel surgical technique for evacuating submacular hemorrhage using the infusion stream of a 25-gauge vitrectomy system.
PURPOSE
To report a novel surgical technique for evacuating submacular hemorrhage using the infusion stream of a 25-gauge vitrectomy system.
METHODS
Surgical case and video.
RESULTS
A 54-year-old man was taken to the operating room for a total hyphema, nonclearing vitreous hemorrhage, and elevated intraocular pressure after multiple tractional retinal detachment repairs by an outside surgeon. Intraoperatively, the hyphema and vitreous hemorrhage were cleared, and the source of bleeding was discovered to be an avulsed vessel through a pre-existing retinal break just superior to the optic nerve. A large submacular hemorrhage was also present that was unable to be drained through the break by aspiration alone. With the vitreous cavity under fluid, the infusion cannula was manipulated to guide the infusion stream onto the macula. The stream was directed in a distal to proximal manner toward the retinal break, and the submacular blood was successfully expressed out through the break. Postoperatively, the retina remained attached with almost complete resolution of the submacular hemorrhage.
CONCLUSION
Using the mechanical pressure of the infusion stream can be an effective method for evacuating large subretinal hemorrhages.
Topics: Male; Humans; Middle Aged; Tissue Plasminogen Activator; Fibrinolytic Agents; Vitreous Hemorrhage; Retinal Perforations; Hyphema; Combined Modality Therapy; Retinal Hemorrhage; Vitrectomy
PubMed: 35858278
DOI: 10.1097/ICB.0000000000001300 -
Retina (Philadelphia, Pa.) May 2015
Topics: Angiogenesis Inhibitors; Antibodies, Monoclonal, Humanized; Diabetic Retinopathy; Female; Humans; Male; Postoperative Hemorrhage; Vitrectomy; Vitreous Hemorrhage
PubMed: 25856018
DOI: 10.1097/IAE.0000000000000600 -
American Journal of Ophthalmology Mar 2016
Topics: Female; Humans; Male; Visual Acuity; Vitrectomy; Vitreous Hemorrhage
PubMed: 26768792
DOI: 10.1016/j.ajo.2015.12.011 -
Ophthalmology Jul 2015
Topics: Amputation, Traumatic; Choroid Hemorrhage; Eye Injuries, Penetrating; Humans; Hyphema; Male; Metals; Middle Aged; Optic Nerve Injuries; Vitreous Hemorrhage
PubMed: 26711478
DOI: 10.1016/j.ophtha.2014.12.028 -
JAMA Ophthalmology Jul 2021Although there were no differences in mean visual acuity (VA) over 24 weeks after vitrectomy with panretinal photocoagulation (PRP) vs aflibercept in a randomized... (Randomized Controlled Trial)
Randomized Controlled Trial
Visual Acuity, Vitreous Hemorrhage, and Other Ocular Outcomes After Vitrectomy vs Aflibercept for Vitreous Hemorrhage Due to Diabetic Retinopathy: A Secondary Analysis of a Randomized Clinical Trial.
IMPORTANCE
Although there were no differences in mean visual acuity (VA) over 24 weeks after vitrectomy with panretinal photocoagulation (PRP) vs aflibercept in a randomized clinical trial among eyes with vitreous hemorrhage due to proliferative diabetic retinopathy (PDR), post hoc analyses may influence treatment choices.
OBJECTIVE
To compare exploratory outcomes between treatment groups that may affect treatment choices for patients with vitreous hemorrhage due to PDR.
DESIGN, SETTING, AND PARTICIPANTS
This post hoc analysis of a randomized clinical trial conducted at 39 DRCR Retina Network sites included adults with vision loss due to PDR-related vitreous hemorrhage for whom vitrectomy was considered. Data were collected from November 2016 to January 2020.
INTERVENTIONS
Random assignment to 4 monthly injections of aflibercept vs vitrectomy with PRP. Both groups could receive aflibercept or vitrectomy during follow-up based on protocol-specific criteria.
MAIN OUTCOMES AND MEASURES
Visual acuity area under the curve (adjusted for baseline VA) and clearance of vitreous hemorrhage.
RESULTS
A total of 205 eyes were included in the analysis (115 male [56%] and 90 [44%] female participants; mean [SD] age, 57 [11] years). Among 89 eyes with a baseline VA of 20/32 to 20/160 (47 receiving aflibercept, including 4 [9%] that had undergone vitrectomy; 42 undergoing vitrectomy, including 3 [7%] that had received aflibercept), the adjusted mean difference in VA letter score over 24 weeks between the aflibercept and vitrectomy groups was -4.3 (95% CI, -10.6 to 1.9) compared with -16.7 (95% CI, -24.4 to -9.1) among 59 eyes with baseline VA worse than 20/800 (P = .02 for interaction; 26 in the aflibercept group, including 6 [23%] that had undergone vitrectomy; 33 in the vitrectomy group, including 8 [24%] that had received aflibercept). In the full cohort, the median time to clearance of the initial vitreous hemorrhage was 36 (interquartile range [IQR], 24-52) weeks in the aflibercept group vs 4 (IQR, 4-4) weeks in the vitrectomy group (difference, 32 [95% CI, 20-32] weeks; P < .001).
CONCLUSIONS AND RELEVANCE
Both initial aflibercept and vitrectomy with PRP are viable treatment approaches for PDR-related vitreous hemorrhage. Although this study did not find a significant difference between groups in the primary outcome of mean VA over 24 weeks of follow-up, eyes receiving initial vitrectomy with PRP had faster recovery of vision over 24 weeks when baseline VA was worse than 20/800 and faster vitreous hemorrhage clearance. Approximately one-third of the eyes in each group received the alternative treatment (aflibercept or vitrectomy with PRP). These factors may influence treatment decisions for patients initiating therapy for PDR-related vitreous hemorrhage.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02858076.
Topics: Angiogenesis Inhibitors; Diabetes Mellitus; Diabetic Retinopathy; Female; Humans; Intravitreal Injections; Male; Middle Aged; Ranibizumab; Receptors, Vascular Endothelial Growth Factor; Recombinant Fusion Proteins; Treatment Outcome; Vascular Endothelial Growth Factor A; Visual Acuity; Vitrectomy; Vitreous Hemorrhage
PubMed: 33956075
DOI: 10.1001/jamaophthalmol.2021.1110