Long-term risk of glaucoma after encircling scleral buckle.

PURPOSE: To determine the long-term risk of developing glaucoma after an encircling scleral buckle procedure. METHODS: Retrospective case series of patients with at least 10 years of follow-up who underwent successful, unilateral retinal detachment repair by encircling scleral buckle. The main outcome measure was the proportion of eyes that developed perimetric glaucoma of buckled compared with fellow eyes. RESULTS: Sixty-eight patients with an average postoperative follow-up of 21 years were included. Perimetric glaucoma developed in 13% (9 patients), and an additional 22% (15 patients) had preperimetric glaucoma or were glaucoma suspects. Perimetric glaucoma was present in 2.9% of patients in the buckled eye only, 8.8% in the fellow eye only (P = 0.27), and 1.3% in both eyes. There was no increased prevalence of ocular antihypertensive use in buckled (5.9%) compared with fellow eyes (11.8%, P = 0.36). CONCLUSION: Our study showed no evidence of increased risk for developing glaucoma after repair of retinal detachment in eyes that underwent an encircling scleral buckling technique compared with fellow eyes with follow-up of at least 10 years.

Optical coherence tomography of idiopathic juxtafoveolar telangiectasia.

BACKGROUND AND OBJECTIVE: To document optical coherence tomography (OCT) findings in a series of eyes with group 2A idiopathic juxtafoveal telangiectasia. PATIENTS AND METHODS: This study is a retrospective review of patient charts, OCT, fundus photography, and fluorescein angiography involving 23 eyes (12 patients). Mean retinal thickness in 9 macular areas was calculated and compared to previously published measurements from normal eyes. RESULTS: OCT in 8 of 13 stage 3 eyes revealed foveal cysts without evidence of cystoid macular edema on fluorescein angiography or biomicroscopy, and 1 lamellar hole. In stage 3 eyes, mild retinal thickening was found in 7 of 9 macular areas (P < .05). CONCLUSIONS: OCT commonly reveals foveal cysts in stage 3 idiopathic juxtafoveal telangiectasia. Consistent findings of associated mild macular thickening and lack of late petaloid hyperfluorescence on fluorescein angiography suggest that these cysts differ in pathophysiology from cystoid macular

Intravitreal triamcinolone does not alter basal vascular endothelial growth factor mRNA expression in rat retina.

Intravitreal triamcinolone inhibits choroidal neovascularization. To investigate if vascular endothelial growth factor (VEGF) is affected, we examined VEGF expression after intravitreal triamcinolone administration in rat retina. Using in situ hybridization, we have found dense clustered VEGF mRNA signals in the retinal pigment epithelium, moderate patchy signals in the inner nuclear layer, and positive labeling in a sub-population of ganglion cells. Densitometry and northern blot analysis revealed no significant alteration of VEGF mRNA expression pattern and level 3-21 days after triamcinolone injection. Our data indicate that intravitreal triamcinolone does not affect basal VEGF mRNA expression in normal adult rat retina.

Twenty-year follow-up for scleral buckling.

OBJECTIVE: To the report 20-year follow-up data for patients receiving a scleral buckle for treatment of a primary rhegmatogenous retinal detachment (RRD). METHODS: Nonconsecutive, retrospective case series. We identified 227 eyes with primary RRD who were treated with a scleral buckle, and for whom at least 20 years of follow-up data were available. Results were classified into 3 subgroups: retina reattached with 1 procedure; retina reattached with 1 or more additional vitreoretinal procedures; or retina detached at 20 years. RESULTS: One hundred eighty-six eyes (82%) achieved retinal reattachment with 1 scleral buckling procedure and with a median final visual acuity of 20/40 at 20 years of follow-up. An additional 30 eyes (13%) achieved retinal reattachment after 1 or more additional vitreoretinal procedures, with a median final visual acuity of 20/50. Eleven eyes (5%) were detached at the 20-year follow-up examination, with a final visual acuity in all eyes of no light perception. CONCLUSIONS: Scleral buckling for primary RRD achieves anatomical efficacy and preservation of central vision in the majority of eyes at 20 years' follow-up. The 1-operation success rate was 82%, overall success rate was 95%, and median final visual acuity was 20/40. This study may serve as a basis for comparison with the long-term results of other surgical techniques used in the treatment of primary RRDs.