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Vitrectomy Due to Vitreous Hemorrhage and Tractional Retinal Detachment Secondary to Eales' Disease.Turkish Journal of Ophthalmology Apr 2021To investigate visual and anatomical outcomes of vitreoretinal surgeries in patients with Eales' disease.
OBJECTIVES
To investigate visual and anatomical outcomes of vitreoretinal surgeries in patients with Eales' disease.
MATERIALS AND METHODS
In this retrospective study, 22 eyes of 21 patients with vitreous hemorrhage (VH) or tractional retinal detachment (TRD) secondary to Eales' disease who underwent vitreoretinal surgery between January 1997 and December 2015 and had at least 1 year of follow-up were included.
RESULTS
The mean best corrected visual acuity (BCVA) was significantly higher at final visit (0.6±0.9 logMAR) than the preoperative values (1.8±1.1 logMAR) (p<0.001). After surgery, BCVA was stable in 4 eyes (18.2%), increased in 16 eyes (72.7%), and decreased in 2 eyes (9.1%). Although the mean BCVA was better in the VH group (0.3±0.34 logMAR) than the TRD group (0.9±1.1 logMAR), the difference was not statistically significant (p=0.1). Multivariable linear regression analyses revealed that final BCVA was negatively associated with preoperative or postoperative proliferative vitreoretinopathy grade C (PVR-C), preoperative retinal detachment involving the macula, postoperative neovascular glaucoma, and long preoperative duration of disease, and positively associated with preoperative BCVA. Final BCVA was not associated with preoperative retinal and disc neovascularization, rubeosis iridis, total posterior hyaloid detachment, preoperative retinal laser photocoagulation, indication of surgery, diameter of sclerotomy (20 or 23 gauge), preoperative lens status, preoperative or postoperative epimacular membrane, peroperative iatrogenic retinal breaks, postoperative hypotony, cystoid macular edema, and new or recurrent retinal detachment. The primary anatomic success rate was 81.8% and the final anatomic success rate was 90.9%.
CONCLUSION
In Eales' disease, good visual results can be obtained with vitreoretinal surgery if the detachment area does not involve the macula and PVR-C does not develop pre- or postoperatively.
Topics: Adult; Aged; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neovascularization, Pathologic; Retinal Detachment; Retinal Vasculitis; Retrospective Studies; Time Factors; Treatment Outcome; Visual Acuity; Vitrectomy; Vitreous Hemorrhage; Young Adult
PubMed: 33951898
DOI: 10.4274/tjo.galenos.2020.43709 -
The Medical Clinics of North America Jul 1998Nonproliferative diabetic retinopathy may cause visual loss when associated with macular edema or macular ischemia (secondary to retinal capillary nonperfusion).... (Review)
Review
Nonproliferative diabetic retinopathy may cause visual loss when associated with macular edema or macular ischemia (secondary to retinal capillary nonperfusion). Proliferative diabetic retinopathy may cause severe visual loss if complicated by vitreous hemorrhage or traction detachment of the macula. Patients with diabetes benefit from collaboration between the internist and ophthalmologist. Tighter control of blood glucose levels and lower blood pressure reduce the risk of progression of diabetic retinopathy. Regular dilated eye examinations and appropriate intervention with laser or vitrectomy surgery help to preserve vision in patients with established macular edema or proliferative diabetic retinopathy.
Topics: Blindness; Blood Glucose; Diabetic Retinopathy; Disease Progression; Edema; Humans; Hypertension; Ischemia; Laser Therapy; Macula Lutea; Retinal Detachment; Retinal Diseases; Risk Factors; Vision Disorders; Vitrectomy; Vitreous Hemorrhage
PubMed: 9706124
DOI: 10.1016/s0025-7125(05)70027-4 -
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 -
European Journal of Ophthalmology Sep 2023
Topics: Humans; Male; COVID-19; COVID-19 Vaccines; Priapism; Vaccination; Vitreous Hemorrhage
PubMed: 37291877
DOI: 10.1177/11206721231172290 -
BMC Ophthalmology Dec 2017The authors report a case of a rare complication that occurred after botulinum toxin injection to the extraocular muscle, which was easily overlooked and successfully...
BACKGROUND
The authors report a case of a rare complication that occurred after botulinum toxin injection to the extraocular muscle, which was easily overlooked and successfully corrected by surgery.
CASE PRESENTATION
A 34-year-old female patient visited our clinic for diplopia and ocular motility disorder after removal of an epidermoid tumor of the brain. At her initial visit, her best-corrected visual acuity (BCVA) was 20/20 for both eyes. An alternate cover test showed 45 prism-diopter esotropia and 3 prism-diopter hypertropia in the right eye. Following 6 months of observation, the deviation of the strabismus did not improve, and botulinum toxin was injected into the right medial rectus (RMR). After 6 days, she visited our clinic with decreased visual acuity of her right eye. The BCVA was found to be 20/50 for her right eye. Funduscopic examination presented a retinal tear inferonasal to the optic disc with preretinal hemorrhage. Subretinal fluid nasal to the fovea was seen on optical coherence tomography (OCT). Barrier laser photocoagulation was done around the retinal tear; however, her visual acuity continued to decrease, and vitreous hemorrhage and subretinal fluid at the lesion did not improve. In addition, a newly developed epiretinal membrane was seen on OCT. An alternate cover test presented 30 prism-diopter right esotropia. 19 weeks after RMR botulinum toxin injection, she received pars plana vitrectomy, membranectomy, endolaser barrier photocoagulation, and intravitreal bevacizumab (Avastin®) injection. After 4 months, her visual acuity improved to 20/20, and only 4 prism-diopter of right hypertropia and 3 prism-diopter of exotropia were noted. Vitreous opacity and the epiretinal membrane were completely removed, as confirmed by funduscopic and examination.
CONCLUSIONS
Sudden loss of vision after injection of botulinum toxin into the extraocular muscle may suggest a serious complication, and a prompt, thorough ophthalmic examination should be performed. If improvements are not observed, rapid surgical intervention is recommended to prevent additional complications.
Topics: Adult; Botulinum Toxins; Female; Humans; Injections, Intramuscular; Injections, Intraocular; Neurotoxins; Retinal Detachment; Vitreous Hemorrhage
PubMed: 29237498
DOI: 10.1186/s12886-017-0649-2 -
Case Reports in Ophthalmological... 2021To report a case of high-altitude retinopathy with vitreous hemorrhage.
PURPOSE
To report a case of high-altitude retinopathy with vitreous hemorrhage.
METHODS
An apparently healthy 29-year-old boy presented with a history of floater and slight diminution of vision in the left eye after climbing the mountain 4760 meters high.
RESULTS
The visual acuity at presentation was 20/20 in the right eye and 20/30 in the left eye. Anterior segment findings of both eyes were unremarkable. Fundus evaluation revealed bilaterally dilated major retinal veins. The right eye revealed clear, quiet vitreous, healthy macula, and pink and smooth optic disc. There was fresh vitreous hemorrhage confined just one disc diameter away at the superior and inferior part of the optic nerve in the left eye. The macula and optic nerve head of this eye grossly looked normal. Complete blood count, haemoglobin, ESR, CRP, sugar, renal function test, lipid panel, and serology for HIV, HCV, VDRL, and HBsAg were normal. The Mantoux test and chest X-ray also revealed normal findings. Physician consultation did not reveal other abnormalities. On the 3 week of follow-up, his vision was 20/20 in both eyes. Fundus examination revealed clear vitreous in both eyes though some venous dilation and tortuosities were still evident in the left eye. A macular OCT scan showed almost normal-appearing fundus.
CONCLUSIONS
Vitreous hemorrhage following climbing high altitude can be one of the manifestations of high-altitude retinopathy.
PubMed: 34422422
DOI: 10.1155/2021/7076190 -
Medical Hypothesis, Discovery &... 2012Terson's syndrome has had multiple definitions. The original definition is unlikely to have included Terson's original case. An updated definition based on mechanism is...
Terson's syndrome has had multiple definitions. The original definition is unlikely to have included Terson's original case. An updated definition based on mechanism is proposed and related to the original case described by Terson.
PubMed: 24600631
DOI: No ID Found -
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 -
Srpski Arhiv Za Celokupno Lekarstvo 2013The course and prognosis of vitreous hemorrhage (VH) are difficult to predict in spite of so far published experimental and clinical studies.
INTRODUCTION
The course and prognosis of vitreous hemorrhage (VH) are difficult to predict in spite of so far published experimental and clinical studies.
OBJECTIVE
The goal of this study was to follow the course and evaluate prognosis of vitreous hemorrhage.
METHODS
The experiment was performed on 19 Chinchilla rabbits (Oryctolagus cuniculus), both males and females (38 eyes), weighing 2500-3000 g, which were treated with autologous blood (B) from marginal ear vein--the first group, and the second group was treated with both blood and corticosteroids (B+CS). The course of vitreous hemorrhage was examined.
RESULTS
Our results have shown that the cellular reaction to vitreous hemorrhage is different, compared to hemorrhage in other types of tissue, which is due to absence of an early polymorphonuclear cellular reaction. Number of cells within vitreous body is very low.
CONCLUSION
Vitreous hemorrhage has unusual course followed by a small number of cells (mostly polymorphonuclear cells). This is most important fact why VH is cleared very slowly (about 6 to 9 weeks). CS has moderate influence on the acceleration ofVH absorption.
Topics: Adrenal Cortex Hormones; Animals; Disease Models, Animal; Disease Progression; Female; Fibrinolysis; Glucocorticoids; Male; Prognosis; Rabbits; Vitreous Body; Vitreous Hemorrhage
PubMed: 24502089
DOI: 10.2298/sarh1312732v -
The Journal of International Medical... Dec 2017Objective To evaluate the etiologies for dense vitreous hemorrhage in adults with non-traumatic and reveal management of early vitrectomy for the disease. Methods Study...
Objective To evaluate the etiologies for dense vitreous hemorrhage in adults with non-traumatic and reveal management of early vitrectomy for the disease. Methods Study included 105 eyes from 105 patients. Outcome measures were etiologies of vitreous hemorrhage, formation of retinal and/or disk neovascular membrane (NVM), incidence of retinal tear and detachment, visual acuity (VA) and postoperative complications. Results Mean time between presentation and surgery was 7.1 days. The most common etiologies were retinal vein occlusion (RVO) (58.1%), retinal tear (22.9%) and retinal vasculitis (10.4%). Most RVO (77.0%) and retinal vasculitis (72.7%) eyes were associated with retinal and/or disk NVM. Retinal tear and retinal detachment was found in 24 and 48 eyes, respectively. VA improved significantly from 1/70 to 0.6 following vitrectomy. The most common postoperative complication was cataract (28.6%). Conclusion RVO, retinal tear and retinal vasculitis were the most common causes of dense vitreous hemorrhage. Early vitrectomy has a good outcome with acceptable complication rates in this setting.
Topics: Adult; Aged; Diabetic Retinopathy; Female; Humans; Male; Middle Aged; Visual Acuity; Vitrectomy; Vitreous Hemorrhage; Wounds and Injuries
PubMed: 28627981
DOI: 10.1177/0300060517708942