Characteristics of sixty myopic eyes with pre-laser in situ keratomileusis retinal examination and post-laser in situ keratomileusis retinal lesions.

PURPOSE: A survey of eyes with pre-laser in situ keratomileusis (LASIK) retinal examinations and characteristics of post-LASIK retinal breaks and retinal detachments (RDs). METHODS: A survey of worldwide vitreoretinal surgeons (424 physicians). Surveyed information included demographics, best-corrected visual acuity, degree of myopia, pre- and post-LASIK retinal findings, follow-up time, and treatment outcome. RESULTS: Sixty eyes with pre-LASIK retinal examinations developed post-LASIK retinal breaks and RDs. There was an average of 2.3 breaks per eye, yielding a total of 140 breaks in the 60 eyes. Forty eyes also had RDs besides the retinal breaks. Large percentages of eyes had substantial myopia (mean myopia, -9.5 +/- 5.8 diopters [D]) and complex vitreoretinal complications. Forty percent developed vitreoretinal complications within 6 months after LASIK. The 20 eyes that developed more extensive RDs (>3 clock hours) had a significantly higher mean myopia than did the 6 eyes that developed limited RD (< or = 3 clock hours) within 12 months after LASIK (-8.92 +/- 6.82 D versus -3.50 +/- 1.97 D, P = 0.03). There were significant statistical differences in distribution of retinal breaks and tears between the temporal and nasal quadrants (P < 0.001, P < 0.001, respectively, chi2, but not between the superior and inferior quadrants. CONCLUSION: Distributions of retinal breaks in this study were comparable with results found in non-LASIK eyes in young myopes. Treatment for post-LASIK vitreoretinal complications was highly successful. The vulnerability of such highly myopic eyes for vitreoretinal complications warrants their close monitoring.

Vitreoretinal surgery of retinal detachment and macular hole associated with optic nerve pit: an optical coherence tomography study.

PURPOSE: To describe the course of a case of macular elevation and a full-thickness macular hole associated with optic nerve pit. METHODS: Case report. A 28-year-old woman who had laser-assisted in situ keratomileusis surgery 2.5 years ago presented with decreased vision, full-thickness macular hole, and macular detachment in association with optic nerve pit. Complete ophthalmic examination was done and optical coherence tomography (OCT) was performed before and after vitreoretinal surgery. RESULTS: OCT showed that the macular elevation consisted of both separation of the inner and outer retinal layers with neurosensory retinal detachment. There was a full-thickness macular hole. After vitreous surgery and intraocular gas tamponade, the macular elevation completely resolved, and OCT showed the flattening of the outer and inner retinal layers but the macular hole was not closed. CONCLUSIONS: OCT is a reliable technique to study macular elevation with a hole associated with optic nerve pit before and after vitrectomy and gas tamponade.

Vitreoretinal surgery of retinal detachment and macular hole associated with optic nerve pit: an optical coherence tomography study.

PURPOSE: To describe the course of a case of macular elevation and a full-thickness macular hole associated with optic nerve pit. CASE REPORT: A 28-year-old woman who had laser-assisted in situ keratomileusis surgery 2.5 years ago presented with decreased vision, full-thickness macular hole, and macular detachment in association with optic nerve pit. Complete ophthalmic examination was done and optical coherence tomography (OCT) was performed before and after vitreoretinal surgery. RESULTS: OCT showed that the macular elevation consisted of both separation of the inner and outer retinal layers with neurosensory retinal detachment. There was a full-thickness macular hole. After vitreous surgery and intraocular gas tamponade, the macular elevation completely resolved, and OCT showed the flattening of the outer and inner retinal layers but the macular hole was not closed. CONCLUSIONS: OCT is a reliable technique to study macular elevation with a hole associated with optic nerve pit before and after vitrectomy and gas tamponade.(Eur J Ophthalmol 2004; 14: 355-7).

Management of hypotony maculopathy and a large filtering bleb after trabeculectomy with mitomycin C: success with argon laser therapy.

We report a patient with postkeratoplasty glaucoma that developed a large, filtering bleb following trabeculectomy with intraoperative antimetabolite treatment. The hypotony and the bleb were managed using argon laser photocoagulation. A 26-year-old female patient underwent penetrating keratoplasty in the left eye for keratoconus. Postoperatively, her elevated intraocular pressure could not be controlled medically, and the patient underwent a trabeculectomy with intraoperative antimetabolite application. Two months later, hypotony maculopathy, optic disc edema, and choroidal folds developed, and her vision dropped. Steroid treatment and soft contact lenses did not help. Photocoagulation was applied twice to the surface of the bleb and the surrounding area. After the photocoagulation therapy, the patient's vision improved, intraocular pressure increased, and the optic disc edema and macular folds had resolved. Argon laser photocoagulation applied to a large filtering bleb associated with hypotony maculopathy is a useful treatment for bleb remodeling and elevating intraocular pressure.

Problems of chorioretinal venous anastomosis by laser for treatment of nonischemic central retinal vein occlusion.

OBJECTIVES: Evaluate the efficacy of chorioretinal venous anastomosis in patients with nonischemic retinal vein occlusions with progressive visual loss and to concentrate on complications. DESIGN: Case series of 6 patients, retrospective study. Six patients with nonischemic central retinal vein occlusions and progressive visual loss. Laser photocoagulation was performed to create a chorioretinal venous anastomosis to be able to supply venous blood to the choroid, bypassing the occlusion. Visual acuity, funduscopic appearance and fluorescein angiographic appearance were determined. RESULTS: Two patients showed a chorioretinal anastomosis (33%), whereas in the other 4 patients the anastomosis could not be created. Yet 1 patient consequently had a neovascular tuft under the laser site. These new vessels caused minor vitreous hemorrhage and a tractional membrane which regressed after 10 months. CONCLUSION: The utilization of a chorioretinal venous anastomosis by laser as a therapeutic modality should be further questioned and thoroughly evaluated and caution must be exercised to avoid vision-threatening complications.

Role of interleukin 8 in the pathogenesis of proliferative vitreoretinopathy.

We investigated the role of interleukin 8 (IL-8) in the pathogenesis of proliferative vitreoretinopathy (PVR). The IL-8 level in the vitreous and the blood of 20 patients with PVR was measured by a specific enzyme-linked immunoassay method. Vitreous from cadaver eyes (n = 20) was used as the control. The IL-8 level in the vitreous was between 31.3 and 65 pg/ml in 40% of eyes with PVR. IL-8 was detected neither in the blood of the patients with PVR nor in the vitreous from cadaver eyes. IL-8 levels in the vitreous did not correlate with either the grade of PVR or the duration of symptoms. These results suggest that IL-8 may play a role in the pathogenesis of PVR.

Ketoconazole induced papilledema.

Ketoconazole was administered in a case of hirsutismus over a period of 4 months with high doses of 800 mg/day, and bilateral papilledema developed. After cessation of the drug the condition disappeared. As far as we know this is the first reported papilledema complication due to Ketoconazole.

Neurofibromatosis associated with retinoblastoma: case report.

A case of neurofibromatosis is presented in a 3-year-old male with leucokoria in his left eye. Enucleation was performed, and on pathological examination the mass filling the globe proved to be retinoblastoma. We believe ours to be the first reported case of this rare association.