ABSTRACT
PURPOSE: To report the visual and anatomic outcomes of albino retinal detachment (ARD) repair. METHODS: Collaborative retrospective analysis of ARD. Outcome measures were number of surgical interventions, final retinal reattachment, and best corrected visual acuity (BCVA) at last follow-up. RESULTS: Seventeen eyes of 16 patients (12 males; mean age =37.8 years) had the following complications at presentation: macula off (14), total (7) or inferior detachment (5), proliferative vitreoretinopathy (5), detectable break (16), lattice (5), horseshoe tears (9), and giant tear or dialysis (4). Mean number of interventions was 1.8 (range =1-5) and included cryopexy (15) with scleral buckle (11), and/or vitrectomy (8). Mean initial BCVA was counting finger (CF) 1 m and at last follow-up (mean 77 months) CF4m with mean improvement of 4.5 lines (early treatment diabetic retinopathy study) (P=0.05). Intraoperative choroidal hemorrhage occurred in three eyes. The retina was finally attached in 14 eyes, with residual inferior detachment in three eyes with silicone oil in situ. Silicone oil was kept in six of seven eyes because of residual inferior detachment (3) and removal of silicone oil, which led to redetachment (1) or fear of redetachment (2). CONCLUSION: Repair of ARD may require several interventions, with the need to keep silicone oil in several cases due to nystagmus and reduced melanin pigment.
ABSTRACT
PURPOSE: To describe the optical coherence tomography (OCT) characteristics of patients with group 2A idiopathic parafoveal telangiectasis (IPFT) and to correlate them with biomicroscopic and fluorescein angiographic (FA) findings based on Gass and Blodi staging classification for group 2A IPFT. METHODS: Fifty-two eyes of 26 consecutive patients with IPFT underwent biomicroscopic fundus examination, color fundus photography, FA, and OCT. Main outcome measures were OCT characteristics and their correlation with biomicroscopy and FA. RESULTS: The most common OCT findings that help differentiate between stages in group 2A IPFT are 1) highly reflective dots in the inner retina that correspond with microvessels seen by FA in Stage 1 (5 eyes [62.5%]); 2) the presence of hyporeflective intraretinal spaces in the absence of retinal thickening and highly reflective dots in the retina in Stage 2 (9 [81.8%] and 10 eyes [90.9%], respectively); 3) in Stage 3, both outer and inner retina exhibit areas of similar high reflectivity. In addition, the retinal pigment epithelium (RPE)/choriocapillaris complex is thickened or disrupted as evidenced by an area of high reflectivity (13 eyes [81.2%]); 4) a highly reflective area nasal or temporal to the fovea in the inner or outer retinal layers in Stage 4 suggesting RPE proliferation and migration (13 eyes [100%]); and 5) a fusiform thickening and duplication of the highly reflective RPE/choriocapillaris complex corresponding to choroidal neovascularization in Stage 5 (4 eyes [100%]). Our OCT characteristics correlated well with biomicroscopic and FA findings for Stages 4 and 5. However, the hyporeflective spaces that are evident on OCT could not be seen clinically at the slit lamp or on FA. In addition, our OCT findings on eyes with group 2A IPFT Stage 3 have not, to our knowledge, been previously described. CONCLUSIONS: Optical coherence tomography findings in group 2A IPFT were characteristic for each stage and may be helpful in making the diagnosis as well as defining the anatomical staging proposed by Gass and Blodi. Optical coherence tomography complements biomicroscopic and FA findings in the evaluation of group 2A IPFT.
Subject(s)
Retinal Diseases/diagnosis , Retinal Vessels/pathology , Telangiectasis/diagnosis , Tomography, Optical Coherence , Adult , Aged , Female , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Photography , Retinal Diseases/classification , Retrospective Studies , Telangiectasis/classificationABSTRACT
PURPOSE: To describe 19 patients (20 eyes) who developed a macular hole (MH) after undergoing bilateral LASIK for the correction of myopia. DESIGN: Noncomparative, interventional, retrospective, multicenter case series. PARTICIPANTS: Nineteen patients (20 eyes) who developed an MH after bilateral LASIK for the correction of myopia at 10 institutions in Venezuela, Colombia, Puerto Rico, Spain, and the United States. METHODS: Chart review. MAIN OUTCOME MEASURE: Macular hole development. RESULTS: The MH formed between 1 to 83 months after LASIK (mean, 12.1). In 60% of cases, the MH developed < or =6 months after LASIK, and in 30% of cases it developed > or =1 year after LASIK. Eighteen of 19 (94.7%) patients were female. Mean age was 46 years (range, 25-65). All eyes were myopic (range, -0.50 to -19.75 diopters [mean, -8.9]). Posterior vitreous detachment was not present before and was documented after LASIK in 55% of eyes. A vitrectomy closed the MH on the 14 eyes that underwent surgical management, with an improvement of final best-corrected visual acuity in 13 of 14 (92.8%) patients. Our 20 eyes with a full-thickness MH after LASIK reflect an incidence of approximately 0.02% (20/83938). CONCLUSION: An MH may infrequently develop after LASIK for the correction of myopia. Our study shows that vitreoretinal surgery can be successful in restoring vision for most myopic eyes with an MH after LASIK. Vitreoretinal interface changes may play a role in MH formation after LASIK for the correction of myopia.
Subject(s)
Cornea/surgery , Keratomileusis, Laser In Situ/adverse effects , Myopia/surgery , Postoperative Complications , Retinal Perforations/etiology , Adult , Aged , Female , Humans , Male , Middle Aged , Retinal Perforations/surgery , Retrospective Studies , Risk FactorsABSTRACT
Reportar nuestra experiencia con el uso de propósito: describir veinte y ocho ojos (26 pacientes) que desarrollaron agujeros maculares (AM) unilaterales de espersor total (16 ojos de 15 pacientes) o membranas neovasculares o coroideas subfoveales (CNV)(12 ojos de 11 pacientes) luego de procedimiento de LASIK bilateral para la correción de miopía. Serie de casos. Los AM se formaron ente una 30 meses luego de LASIK (promedio: 7.5 meses), 93.7 por ciento de los pacientes fueron género femenino. La media edad fue de 43.9 años (25-58). Todos los ojos fueron miopes (rango: -0.50 a -15.25 dioptrias [D]; promedio: -7.94 D). El despremdimiento del Vítreo posterior estuvo no presente antes del LASIK y se documentó posterior al procedimiento en 56.2 por ciento de los ojos. La Viterctomía cerró los agujeros maculares en 11 ojos que fueron a manejo quirúrgico mejorandose la agudeza visual final corregida en todos los pacientes. La incidencia de nuestros quince pacientes (ojos) con AM de espesor cpmpleto post LASIK reflejaron un valor de 0.03 por ciento (16/46,486). Adicionalmente, la CNV ocurrió en una media de 25.2 meses (rango: 1 a 60 meses) luego del LASIK. La miopia en este grupo de pacientes presentó un promedio de -15.12D (rengo:-13:00D a-25.50D). Nuve de nuestros casos se beneficiearon de la Terapia fotdinámica (PDT) con mejoría o estabilidad de la agudeza visual en 77.7 por ciento de los casos. Nuestros doce pacientes con CNV luego del LASIK representan una incidencia del 0.02 por ciento (12/46,486).El LASIK parece ser un procedimiento seguro con una baja incidencia de complicaciones vitero-retinales, sin embargo la CNV y el agujero macular pueden desarrollarse luego del LASIK
