Pneumatic retinopexy combined with scleral buckling in the management of relatively complicated cases of rhegmatogenous retinal detachment: A multicenter, retrospective, observational consecutive case series.

Objective To evaluate the efficacy of maximal pneumatic retinopexy (PR) and subretinal fluid (SRF) drainage combined with scleral buckling (SB) in the treatment of complicated rhegmatogenous retinal detachment (RRD). Methods Patients with RRD who underwent maximal PR and SRF drainage combined with SB from June 2007 to June 2012 were included in this multicenter retrospective study. The outcome measures were the primary and final operation success rates and best-corrected visual acuity (BCVA). Results In total, 159 consecutive patients were included. The mean follow-up period was 13.76 ± 1.97 months. Primary operation success was achieved in 146/159 (91.82%) eyes. After salvage management, the final reattachment rate increased to 98.11%. All eyes had improved BCVA, with 62/159 (38.99%) attaining BCVA of ≥20/40. Conclusions Maximal PR and SRF drainage combined with SB achieved satisfactory anatomical and visual recovery in relatively complicated cases of RRD. The decreased need for vitrectomy makes this surgical approach more widely available.

[Influence of wearing long wavelength filter glasses on refractive development of children's hyperopia].

Objective: To investigate the effect of wearing long wavelength filter glasses on refractive development of children's hyperopia. Methods: Case control study. Seventeen 5-7 years' old children with high hyperopia from optometry clinic of Eye and ENT Hospital Affiliated to Fudan University were enrolled in this research. The experiment design was self-control between right and left eye, 3 children were lost during two years' period of observation, all the children's hyperopic refraction were more than +6.00 D, cycloplegic by 1% atropine. All the children were required to wear long wavelength filter glasses for 6 hours after waking up, the rest of the time with the conventional glasses. Refraction, axis and red/green match point were tested before the intervention and 3, 6, 12, 18, 24 months, after the intervention. Results: After two years' intervention, hyperopia decreased, eye axis increased, the best corrected visual acuity increased both in experimental eyes and control eyes, but there were no statistically significant difference between the two groups at each time point. All children were with normal color vision, compared to the long-wavelength light, the hyperopic eyes were more sensitive to middle-wavelength light, no significant difference was found between two groups, red/green match points were 42.802±1.216 and 42.889±1.560 respectively. After wearing long wavelength filter, red/green match point were significant decreased in the experimental group in 6 months and 12 months time points (6 months: 0.995±0. 543 vs. 0.104±0.143, t=3.04, P=0.005, 12 months: 1.096±0.392 vs. 0.17±0.248, t=2.725, P=0.008). The experiment eyes were more sensitive to long-wavelength light than the control eyes. But in later time, there was no significant difference between two groups. Conclusion: Wearing long wavelength filter glasses two years has no effect on refractive development on children with high hyperopia, but it can cause short-term chromatic adaptation, making hyperopic eyes more sensitive to the long-wavelength light. (Chin J Ophthalmol, 2017, 53: 33-38).

From basic to clinical research: a journey with the retina, the retinal pigment epithelium, the cornea, age-related macular degeneration and hereditary degenerations, as seen in the rear view mirror.

PURPOSE: This Acta Ophthalmologica Award and Gold Medal Honorary Lecture (the Lundsgaard Gold Medal Honorary Lecture) reviews some of the work I have carried out with my mentors and many of my wonderful collaborators and research students over more than 40 years, also including related work by other groups. It concentrates on the basic electrophysiology and ultrastructure of the retina and the retinal pigment epithelium (RPE), as well as covering basic and clinical aspects of the cornea, contact lenses, age-related macular degeneration (AMD) and hereditary diseases. METHODS: The review describes research performed using light and electron microscopy, basic and clinical electrophysiology, genetics and biochemistry in animal experiments and in research on patients. It also outlines clinically used techniques, such as laser and photodynamic treatment and scanning laser ophthalmoscopy. RESULTS: The paper reports on the following subjects: the mechanisms behind some of the electrical potentials originating in the retina and the RPE and the use of these potentials in hereditary diseases; corneal receptors for lectins and presumably for bacteria; the turnover of the photoreceptor outer segment and the formation of lipofuscin, including the relation of these processes to AMD; certain treatments for AMD, and hereditary degenerations in animal models, such as the RPE65 gene mutation in Briard dogs, which makes them a model of Leber's congenital amaurosis. The dogs are now treated successfully with gene therapy in the USA, and a clinical trial is in preparation. CONCLUSIONS: During the last 40 years we have had the good fortune to experience a dramatic growth in knowledge and understanding within ophthalmic science of basic mechanisms. Huge progress has been made in diagnostics and clinical ophthalmological treatments, much to the benefit of our patients. Even a small contribution made by my group to these developments has been well worth the effort, particularly as scientific work is not just deeply satisfying: it is also fun!

Essentials in fitting ocular prostheses for complex congenital and acquired anomalies.

BACKGROUND: Providing ocular prosthetic services is an important aspect of total patient care. A patient who has lost an eye to injury, inflammation, or tumor experiences emotional and psychological trauma similar to that experienced by an amputatee. Congenital absence also creates a special set of circumstances. A prosthesis that is lifelike in appearance is a comfort to the patient, and the physical wearing comfort becomes a primary prerequisite for the patient. CASE REPORTS: A variety of congenital and acquired anomalies are used to illustrate the clinical application of modern-day materials used to fabricate and fit ocular prostheses. A comprehensive evaluative protocol is also presented. CONCLUSION: New materials and better fitting techniques allow more patients to wear prostheses greater comfort and cosmetic approval. The primary care optometrist should be familiar with the options available to the patient and the standard of care in evaluation of patients who wear a prosthesis.

Vitreoretinocoroidopatia: relato de um caso / Vitreoretinocoroidopathy: a case report

A vitreoretinocoroidopatia é uma rara distrofia que apresenta uma anormal hipopigmentaçäo e hiperpigmentaçäo coroidoretiniana, geralmente entre as veias vorticosas e ora serrata em 360 graus, opacidade brancas pré-retinianas nesta área, estreitamento arteriocular, oclusäo capilar, neovascularizaçäo retiniana, condensaçäo fibrilar vítrea e um moderado número de células pigmentadas no vítreo. Sua evoluçäo é extremamente lenta, sendo já encontrada na primeira década da vida em pacientes sadios. Näo há correlaçäo com doenças sistêmicas, ou mesmo descolamento de retina, degeneraçöes retinianas em látice e buracos periféricos da retina.