[Familial exudative vitreo-retinopathy in a Tunisian family]

Familial exudative vitreoretinopathy [FEVR] is a hereditary ocular disorder with retinal and vitreous abnormality similar to those seen in retinopathy of prematurity. It manifests with a premature arrest of peripheral retinal capillaries. We report an observation of aTunisian family whose 5 members presented clinical signs of FEVR. We report a case of a Tunisian family whose mother and 4 children had fundus ocular abnormalities calling up for FEVR. Clinical manifestations were various with retinal detachment, temporal vasculature traction, macular ectopia and macular edema. FEVR diagnostic was made based on these clinical presentations and after eliminating premature retinopathy. FEVR is one of the causes of retinal detachment in children with retinopathy of prematurity. when FEVR is suspected, families members must be examinated in order to confirm the diagnostic, to detect signs of this disease and to prevent its complications in these cases

Perfluoroctano líquido como tamponante vitreorretiniano de curta duração no pós-operatório de portadores de descolamento de retina por ruptura gigante / Perfluoroctane liquid as a short-term vitreous-retinal tamponade in the postoperative period in patients with retinal detachment due to giant tears

OBJETIVOS: Relatar os resultados de vitrectomia via pars plana com utilização de perfluocarbono líquido (Perfluoroctano-Ophtalmos®), como tamponante vítreo-retiniano de curta duração, no pós-operatório de portadores de descolamento de retina, por ruptura gigante. MÉTODOS: Estudaram-se dez desses pacientes. Todos os casos eram complicados por vitreorretinopatia proliferativa grau B ou pior com rupturas que variavam em extensão de 90° a 210°. O perfluorocarbono líquido foi introduzido, por via pars plana, com o volume necessário para ultrapassar o limite posterior da ruptura, permanecendo no pós-operatório por cinco dias, estando os pacientes em decúbito dorsal. Após esse período submetiam-se a segunda intervenção para troca do perfluorocarbono líquido para gás ou óleo de silicone. RESULTADOS: Após período de acompanhamento médio de 16,2 ± 12,4 meses (2 a 43 meses), 80 por cento das retinas estavam aplicadas, sendo necessária a repetição desta técnica em 1 caso (10 por cento) caso e em 2 casos (20 por cento) não houve reaplicação da retina por vitreorretinopatia avançada. Houve melhora da acuidade visual em 5 casos (50 por cento). CONCLUSÃO: Observaram-se bons resultados quanto à aplicação da retina (80 por cento) e melhora da acuidade visual (50 por cento) quando do uso do perfluorocarbono líquido como tamponante vitreorretiniano de curta duração no pós-operatório de cirurgias de descolamento de retina por rupturas gigantes.

PURPOSE: To report pars plana vitrectomy results of intravitreous use of liquid perfluorocarbon as a short-term postoperative tamponade in retinal detachment due to giant tears in a series of patients. METHODS: Ten of those patients, all of them complicated by proliferative vitreoretinopathy grade B or worse, with tear extension varying from 90° to 210° were studied. Perfluorocarbon liquid was injected via pars plana until the posterior tear limit, remaining in the postoperative period during five days, with the patients in supine position. After this period, the patients underwent a second surgical procedure to exchange the liquid perfluorocarbon for gas or silicone oil. RESULTS: The retinas of eight patients were attached (80 percent) after a mean follow-up of 16.2 ± 12.4 months (from 2 to 43 months). It was necessary to repeat this technique in one (10 percent) case, and there was no attachment of the retina in two (20 percent) cases due to advanced proliferative vitreoretinopathy. Visual acuity improved in five (50 percent) cases. CONCLUSION: Good results (80 percent) and improvement of the visual acuity (50 percent) were observed with the use of intravitreous liquid perfluorocarbon as short-term tamponade in the postoperative period in patients with retinal detachments due to giant tears.

Retinal Angiomatous Proliferation and Intravitreal Bevacizumab Injection

PURPOSE: To evaluate the short-term efficacy and safety of intravitreal bevacizumab injection (IVBI) in patients with retinal angiomatous proliferation (RAP). METHODS: Seven eyes of 5 patients with RAP were included in this study. All of the eyes evidenced stage 2 RAP lesions, except for one eye with a stage 3 lesion. IVBI (1.25 mg/0.05 cc) were conducted at 4 or 6-week intervals. Complete ocular examinations, angiographic results and optical coherence tomographic findings before and after the IVBI were analyzed at baseline and upon the follow-up visits. RESULTS: Seven eyes were studied in 5 patients who had undergone IVBI. Partial (3 eyes) or complete (4 eyes) regression of RAP was noted after IVBI in all of the studied eyes. Visual acuity improved in 5 of the eyes, and was stable in 2 of the eyes. One eye evidenced severe intraocular inflammation after IVBI and a subsequent development of new RAP, which was controlled with vitrectomy and repeat IVBI. CONCLUSIONS: This treatment was effective over 6 months, stabilizing or improving visual acuity and reducing angiographic leakage. These short-term results suggest that IVBI may constitute a promising therapeutic option, particularly in the early stages of RAP.

Biomicroscopia ultra-sônica na hipotonia ocular pós-vitrectomia / Ultrasound biomicroscopy in eyes with hipotony secondary to vitrectomy

Propósito: Descrever os achados da biomicroscopia ultra-sônica (BUS) em olhos com hipotonia ocular pós-vitrectomia. Local: Hospital Säo Geraldo da Universidade Federal de Minas Gerais e Instituto da Visäo. Pacientes e Métodos: A biomicroscopia ultra-sônica (BUS) de alta freqüência foi realizada em treze olhos com hipotonia ocular pós-vitrectomia. A patologia de base que ensejou a vitrectomia incluiu nove olhos em pré-atrofia (trauma: cinco olhos, descolamento de retina com vitreorretinopatia proliferativa: dois olhos, descolamento hemorrágico de coróide: um olho e endoftalmite com descolamento de retina: um olho), dois olhos com vitreorretinopatia proliferativa (PVR), um olho com retinopatia diabética proliferativa e um olho com trauma penetrante. Resultados: Cinco olhos apresentaram descolamento tracional do corpo ciliar (DTCC), quatro olhos apresentaram descolamento tracional do corpo ciliar (DTCC) associado à hipotrofia do corpo ciliar (HCC), dois olhos apresentaram descolamento primário (sem traçäo) do corpo ciliar (DPCC) e dois olhos apresentaram hipotrofia do corpo ciliar (HCC). Conclusöes: Na hipotonia ocular pós-vitrectomia a BUS mostrou quatro padröes diferentes. Esses achados säo muito importantes para o esclarecimento da fisiopatologia da hipotonia ocular, proporcionando um planejamento racional de tratamento desses olhos em fase de pré-atrofia.

Proliferaçäo vítreo-retiniana após retinopexia: influência da crioterapia / Proliferative vitreoretinopathy: the influence of cryoterapy

Foram analisados, de forma retrospectiva, 136 pacientes com descolamento da retina provocado por ruptura única, ou múltipla, pequena(s), localizada(s) no hemisfério retiniano superior, sem retinopatia vítreo-proliferativa pré-operatória (RVP), operados por pneumo-retinopexia (RP) ou introflexäo escleral setorial (IE), com crio ou laser no tratamento térmico das rupturas. O objetivo foi o de analisar a possível influência da crioterapia na gênese do PVR pós-operatório. Grupo I consistiu de 36 olhos operados por RP + laser; Grupo 2, 34 olhos, RP + crio; Grupo 3, 40 olhos, IE + laser; e Grupo 4, 25 olhos, IE + crio. O número de afácicos, a faixa etária, o número de quadrantes descolado, a acuidade pré-operatória e o tempo de seguimento foram semelhantes

A new curved vitreous cutter for managing phakic retinal detachment with proliferative vitreoretinopathy.

In the presence of proliferations anteriorly, adequate excision of the vitreous base is essential. To enable a good vitreous base excision, removal of lens often becomes necessary as it may be damaged while attempting to remove peripheral vitreous. To avoid damage or the need to remove the crystalline lens we have used a new modified curved vitreous cutter along with a wide angle observation system binocular indirect ophthalmomicroscope (BIOM). Use of BIOM during vitreous surgery enables easy viewing of the retinal periphery without the need for scleral depression. Sclerotomies are made as for any regular three-port vitrectomy procedure and the vitrectomy is carried out using the curved vitreous cutter, including the vitreous base, avoiding damage to the crystalline lens. The modified curved vitreous cutter is helpful in removing the peripheral vitreous without damaging the crystalline lens, giving the patient the advantage of intraocular lens implantation at a later date.

Experiencia con vitrectomía en DR con PVR severa: 1993 a 1995 / Experience with vitrectomy in DR with severe PVR: 1993 to 1995

Se presenta un grupo de 40 pacientes con desprendimiento de retina y PVR con mayor C3 operados por el autor, con un seguimiento de 2 meses a 3 años. Se clasificaron los pacientes según la patología asociada y se analizan las distintas posibilidades de tratamiento como la necesidad de lensectomía o extracción del LIO, uso de retinotomías periféricas, y elección del tamponamiento interno. Para un éxito superior al 80 por ciento en aplicar en forma permanente la retina se requirieron en promedio 2 cirugías por caso y se concluye que la extracción del cristalino o del LIO permiten un mucho mejor pronóstico, la retinotomías también mejoran sustancialmente los resultados, y la elección del tamponamiento es materia de experiencia del cirujano, existiendo una frecuencia de reoperaciones y de éxito final similar entre el C3F8 y el aceite de silicona

Scleral buckling retinal detachments complicated by proliferative vetroretinopathy

A total of 30 eyes of 30 patients with primary rhegmatogenous [retinal detachment [RD] complicated by proliferative vitreoretinopathy [PVR] were treated by cryopexy and scleral buckling alone. The patients were followed up for at least 6 months after the operation, the eyes of the 30 patients were divided into three groups: Group A [13 eyes - minimal PVR]: showed vitreous haze and vitreous pigment clumps. Group B [10 eyes - moderate PVR] showed wrinkling of the inner retinal surface, rolled edge of retinal break, retinal stiffness and vessel tortousity. Group C-1 [7 eyes - marked PVR] showed full thickness fixed retinal folds affecting one retinal quadrant. In group A, a final success rate [after second operation] of 76.8% was reached. This rate declined to 70% in group B then 57.1% in group C-1. The overall success rate was 69.9%. Vision better than counting fingers was achieved in 90% of cases of group A, 71.4% in group B and 56% in group C-1