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Indian Journal of Ophthalmology Jun 2020The present review describes the posterior segment complications following surgical management of glaucoma. Although the majority of glaucoma cases are managed... (Review)
Review
The present review describes the posterior segment complications following surgical management of glaucoma. Although the majority of glaucoma cases are managed medically, still a large number of patients may require surgery. Moreover, with the advent of newer surgical techniques and adjuncts, encountering retinal complications post-surgery is not uncommon. The incidence, signs, management, and prognosis of common complications such as anesthesia-related retinal toxicity, vitreous loss, suprachoroidal hemorrhage, serous choroidal detachment, hypotonic maculopathy, vitreous hemorrhage, retinal detachment and endophthalmitis will be discussed in detail. Awareness of these complications is necessary as their proper and timely management can save vision in an already compromised eye.
Topics: Choroid Hemorrhage; Glaucoma; Humans; Ophthalmologic Surgical Procedures; Postoperative Complications; Retinal Detachment; Retrospective Studies; Vitrectomy; Vitreous Hemorrhage
PubMed: 32461411
DOI: 10.4103/ijo.IJO_1040_19 -
The New England Journal of Medicine Jun 2023
Topics: Humans; Subarachnoid Hemorrhage; Vitreous Hemorrhage; Eye Hemorrhage
PubMed: 37339117
DOI: 10.1056/NEJMicm2215931 -
International Journal of Retina and... 2020To evaluate the safety and efficacy of intravitreal ziv-aflibercept (IVZ) in the management of vitreous hemorrhage (VH) in eyes with previously lasered proliferative... (Review)
Review
BACKGROUND
To evaluate the safety and efficacy of intravitreal ziv-aflibercept (IVZ) in the management of vitreous hemorrhage (VH) in eyes with previously lasered proliferative diabetic retinopathy (PDR).
METHODS
In a prospective multicenter study, previously lasered eyes who had dense VH from PDR underwent intravitreal injection of ziv-aflibercept (IVZ) (1.25 mg aflibercept). Demographic characteristics of the patients, baseline and final logMar visual acuity, number of injections, VH clearance time, and need for vitrectomy were recorded.
RESULTS
Twenty-seven eyes of 21 patients were included in the study. Mean age of study patients was 61.3 ± 14.1 years with mean duration of diabetes mellitus of 22.6 ± 7.8 years. Mean logMAR BCVA at baseline was 1.41 ± 1.26 (Snellen equivalent 20/514) and at the last visit 0.55 ± 0.61 (Snellen equivalent 20/70) with a mean gain of 0.86 EDTRS line (paired student test = 5.1; p ≤ 0.001). Mean number of IVZ 2.4 ± 1.6 (range 1-6). The mean follow-up time was 11.7 ± 11.1 months (range 1-34). Mean time for visual recovery and/or VH clearance was 5.7 ± 3.3 weeks. Eyes, which required multiple injections, the interval period between injections for recurrent VH was 6.4 ± 5.2 months. No subject required vitrectomy. No ocular or systemic adverse effects were noted.
CONCLUSIONS
IVZ injections had good short-term safety and efficacy for the therapy of new or recurrent VH in previously lasered eyes with PDR reducing somewhat the need for vitrectomy.: NCT02486484.
PubMed: 31956432
DOI: 10.1186/s40942-019-0204-9 -
Die Ophthalmologie Oct 2023
Topics: Humans; Vitreous Body; Vitrectomy; Macular Degeneration; Vitreous Hemorrhage
PubMed: 37855978
DOI: 10.1007/s00347-023-01932-3 -
Current Eye Research Jun 2023To discuss the pathophysiology, etiology, and current management strategies of uveitis-glaucoma-hyphema (UGH) syndrome. (Review)
Review
PURPOSE
To discuss the pathophysiology, etiology, and current management strategies of uveitis-glaucoma-hyphema (UGH) syndrome.
METHODS
Literature review.
RESULTS
The classic UGH syndrome associated with anterior chamber intraocular lenses (ACIOL) have decreased in incidence with the modernization of IOL design and surgical techniques. The current UGH syndrome is increasing in prevalence largely related to a parallel increase in late onset dislocations of intraocular lenses (IOLs) and the developing techniques to remedy that condition. The modern features of UGH can present as cystoid macular edema, intraocular pressure elevation typically not attributed to UGH, and recurrent vitreous hemorrhage, unlike the original description as described by Ellingson in 1978. Medical management to control inflammation, reduce intraocular pressure, and reduced the bleeding diathesis are mainstays of therapy. However, surgery with IOL repositioning or exchange should be reserved for cases that are refractory to or progressing despite medical treatment.
CONCLUSIONS
UGH syndrome is an increasingly common, poorly understood, and often subtle, manifestation of an anatomic disturbance post intraocular surgery that persists with continued evolution of intraocular surgical techniques and new imaging modalities to aid in its diagnosis.
Topics: Humans; Hyphema; Glaucoma, Open-Angle; Glaucoma; Uveitis; Lens Implantation, Intraocular; Lenses, Intraocular; Lens Diseases; Syndrome; Postoperative Complications
PubMed: 36476057
DOI: 10.1080/02713683.2022.2156547 -
Practical Neurology Apr 2020
Topics: Aneurysm, Ruptured; Female; Humans; Intracranial Aneurysm; Middle Aged; Subarachnoid Hemorrhage; Syndrome; Vitreous Hemorrhage
PubMed: 31666299
DOI: 10.1136/practneurol-2019-002326 -
West African Journal of Medicine Sep 2022Information on the causes and outcome of treatment of vitreous hemorrhage (VH) in sub-Saharan Africa is limited.
BACKGROUND
Information on the causes and outcome of treatment of vitreous hemorrhage (VH) in sub-Saharan Africa is limited.
OBJECTIVES
To determine the causes and postoperative vision after vitrectomy for VH.
DESIGN
A retrospective review of records from consecutive eyes, with VH greater than one-month duration, who had vitrectomy and adjunctive treatment in a retina unit in Nigeria.
METHODS
We assessed the change between preoperative and postoperative visual acuity, bio data, cause of VH, duration of follow up, and additional treatment. Data was analyzed using SPSS statistical package 17.0 to determine the significance of the change in visual acuity for each cause of VH. A p value <0.05 was considered statistically significant.
RESULTS
Of the 221 eyes of 219 patients, the common causes of VH were trauma 43 eyes, (19.7%), proliferative diabetic retinopathy, 37 eyes (17.0%) and proliferative sickle cell retinopathy, 30 eyes (13.8%). There was no association between cause and the presenting preoperative visual acuity. There was a statistically significant association between cause of VH and postoperative visual outcome. Postoperative visual improvement was significant for branch retinal vein occlusion, central retinal vein occlusion, proliferative diabetic retinopathy with VH only, proliferative sickle cell retinopathy, and trauma with VH only, p value = 0.000, 0.002, 0.001, 0.039, and 0.000 respectively. Postoperative visual change was not significant in age-related macular degeneration and polypoidal choroidal vasculopathy (p value = 0.155, 0.428 respectively).
CONCLUSION
Significant improvements in visual acuity can be achieved with active treatment of VH in the majority of cases in Nigeria. This information is useful for discussions on prognosis and agrees with previous studies.
Topics: Anemia, Sickle Cell; Diabetic Retinopathy; Humans; Retinal Diseases; Vitrectomy; Vitreous Hemorrhage
PubMed: 36128750
DOI: No ID Found -
Retina (Philadelphia, Pa.) Apr 2021To report a case of vitreous seeding in a medium-sized choroidal melanoma and review the literature. (Review)
Review
PURPOSE
To report a case of vitreous seeding in a medium-sized choroidal melanoma and review the literature.
METHODS
Observational case report and review of literature for pathogenesis, role of vitreous biopsy, and treatment outcomes.
RESULTS
A case of 57-year-old man diagnosed with vitreous seeding in the left eye 1 year after episcleral brachytherapy for medium-sized choroidal melanoma. The patient was initially diagnosed to have subretinal and vitreous hemorrhage due to rupture of a retinal artery macroaneurysm for which focal laser and intravitreal antivascular endothelial growth factor injections were administered. Over the next 9 months, the vitreous hemorrhage cleared and choroidal melanoma with retinal invasion became evident. One year after brachytherapy, the primary tumor regressed with resolution of surrounding subretinal fluid and hemorrhage. However, gradual decline in the visual acuity from 20/50 to 20/500 with increase of pigmented debris over the retinal surface and in the vitreous cavity was noted. A vitreous biopsy confirmed the presence of viable melanoma cells (epithelioid type), and the eye was enucleated. Histopathology showed microscopic persistence of primary tumor with diffuse vitreous seeding.
CONCLUSION
Vitreous seeding of choroidal melanoma poses a diagnostic and management challenge.
Topics: Brachytherapy; Choroid Neoplasms; Eye Enucleation; Eye Neoplasms; Humans; Male; Melanoma; Middle Aged; Neoplasm Seeding; Vitreous Body
PubMed: 33009220
DOI: 10.1097/IAE.0000000000002989 -
American Journal of Ophthalmology Case... Mar 2022To report a case of preretinal hemorrhage from extraretinal neovascularization related to capillary non-perfused retina within a large schisis in a pediatric patient...
PURPOSE
To report a case of preretinal hemorrhage from extraretinal neovascularization related to capillary non-perfused retina within a large schisis in a pediatric patient with X-linked retinoschisis (XLRS).
OBSERVATIONS
A 4-year old male with an mutation and XLRS presented with preretinal and vitreous hemorrhage in the right eye. Retinal imaging, including wide angle fluorescein angiography (FA) and optical coherence tomography (OCT), showed vitreoretinal traction on extraretinal neovascularization and capillary non-perfused retina in the schisis cavity. Laser treatment to the non-perfused retina within the schisis was successful in reducing extraretinal neovascularization.
CONCLUSIONS
Vitreous hemorrhage is a well-known occurrence in XLRS. Imaging using wide angle FA and OCT were helpful to determine the causes of hemorrhage in order to develop a management plan.
PubMed: 35198819
DOI: 10.1016/j.ajoc.2022.101395 -
Vitreous Hemorrhage in Pediatric Patients With X-Linked Retinoschisis: Characteristics and Outcomes.Ophthalmic Surgery, Lasers & Imaging... Sep 2023To report the management and outcomes of vitreous hemorrhage in pediatric patients with X-linked retinoschisis (XLRS).
OBJECTIVE
To report the management and outcomes of vitreous hemorrhage in pediatric patients with X-linked retinoschisis (XLRS).
MATERIALS AND METHODS
Retrospective case series of pediatric patients with XLRS with vitreous hemorrhage between January 2000 and January 2022 at the Bascom Palmer Eye Institute.
RESULTS
Nine patients (12 eyes) met inclusion criteria. The average age at presentation was 5.75 years and mean follow-up time was 6 years. All eyes (58.3%) that underwent fluorescein angiography exhibited peripheral capillary dropout. Six of 12 eyes (50%) were observed without intervention. Four of 12 eyes (33.3%) underwent intravitreal injection of bevacizumab and 2 (16.6%) underwent vitreoretinal surgery. Seven of 12 eyes (58.3%) had documented recurrence of vitreous hemorrhage during follow-up. All retinas were attached and had clear media at final follow-up.
CONCLUSION
Fluorescein angiography is a helpful tool to evaluate the vascular phenotype in XLRS. Favorable anatomic outcomes were noted in this cohort, but recurrence of vitreous hemorrhage was common. .
Topics: Child; Humans; Bevacizumab; Retina; Retinoschisis; Retrospective Studies; Vitreous Hemorrhage
PubMed: 37642422
DOI: 10.3928/23258160-20230803-01