ABSTRACT
·AIMS:To investigate the etiological factors and various effects of severe vitreous hemorrhage ( VH ) in Northern China.·METHODS:Files on patients presenting with VH treated with vitrectomy between January 2011 and January 2014 were retrieved from medical records.·RESULTS:A total of 1335 eyes of 1275 patients ( 735 males, 540 females) presenting with VH were included in this study. Proliferative diabetic retinopathy ( PDR ) , retinal vein occlusion ( RVO) , either retinal detachment or retinal hole (RD/RH), ocular trauma, Eales disease, and either age- related macular degeneration or polypoidal choroidal vasculopathy ( AMD/PCV ) constituted the etiology of VH in more than 90% of the patients. The most common causes of VH were ocular trauma ( 40%) , PDR (19. 5%), and Eales disease (19. 1%) in the youth group, PDR (34. 4%), RVO (30. 8%), and RD/RH (12. 2%) in the middle-aged group, and RVO ( 35. 7%) , PDR ( 26. 6%) , RD/RH (14. 6%), and AMD/PCV (8%) in the elder group.· CONCLUSION: PDR, RVO, and ocular trauma are usually the main causes of VH. Within each group, the most common causes of VH were ocular trauma and Eales disease in the youth group, PDR, RVO, and RD/RH in the middle-aged group, and RVO, PDR, RD/RH, and AMD/PCV in the elder group. In addition, we found that males with ocular trauma are at high risk for VH, PDR and Eales disease often present bilateral VHs, and PDR and RVO have a high risk of recurrence.
ABSTRACT
Talipes equinovarus deformity associated with arthrogryposis multiplex congenita(AMC) is rigid and its treatment is still controversial. The purpose of this study is to review the trend of recurrence after soft tissue release, and to delineate the risk factors affecting recurrence. Forty-one clubfeet in 24 AMC patients underwent soft tissue release as the first operation at the average age of 1 year 2 months (range, 6 months - 5 years 11 months) and were followed up for an average of 5 year 6 months (range, 2 years 1 month 14 years 5 months). Types of soft tissue release were Turcos posteromedial release (PMR) in 26 cases and posteromediolateral release (PMLR) using the modified Cincinati incision in 15 cases. Recurrences occurred in seventeen clubfeet (41%). A variety of recurrent deformity was corrected by redo PMR or PMLR, osteotomy, talectomy, arthrodesis, or Ilizarov technique. Average number of operations was 1.5 per case. Four parameters were analyzed in relation to recurrence: type of arthrogryposis, initial equinus deformity, type of primary soft tissue release, and age at the first operation. Recurrence occurred in proportion to the severity of initial equinus deformity, and was more frequent in amyoplasia type than in distal arthrogryposis type. However, neither the type of soft tissue release nor the age at the first operation was significant contributing factor to recurrence.