ABSTRACT
BACKGROUND: Stickler syndrome is a collagenopathy caused by mutations in the genes COL2A1 (STL1) or COL11A1 (STL2). Affected patients manifest ocular, auditory, articular, and craniofacial manifestations in varying degrees. Ocular symptoms include myopia, retinal detachment, cataract, and glaucoma. The aim of this systematic review was to evaluate the prevalence of ocular manifestations and the outcome of prophylactic treatment on reducing the risk of retinal detachment. METHOD: A systematic literature search was performed in the PubMed database. Information on the cross-study prevalence of myopia, retinal detachment, cataract, glaucoma, visual impairment, severity and age of onset of myopia and retinal detachments. Studies that reported on the outcome of prophylactic treatment against a control group were explored. RESULTS: 37 articles with 2324 individual patients were included. Myopia was found in 83% of patients, mostly of a moderate to severe degree. Retinal detachments occurred in 45% of patients. Generally, the first detachment occurred in the second decade of life in STL1 patients and later in STL2. Cataracts were more common in STL2 patients, 59% versus 36% in STL1. Glaucoma (10%) and visual impairment (blind: 6%; vision loss in one eye: 10%) were rare. Three studies reported on the effect of prophylactic treatment being protective. CONCLUSION: Ocular manifestations are common in Stickler patients, but the comparison between studies was difficult because of inconsistencies in diagnostic and inclusion criteria by different studies. Sight-threatening complications such as retinal detachments are common but although prophylactic therapy is reported to be effective in retrospective studies, evidence from randomized trials is missing.
Subject(s)
Arthritis/prevention & control , Collagen Type II/genetics , Collagen Type XI/deficiency , Connective Tissue Diseases/prevention & control , Hearing Loss, Sensorineural/prevention & control , Mutation , Retinal Detachment/prevention & control , Vitreous Detachment/prevention & control , Arthritis/genetics , Arthritis/pathology , Collagen Type XI/genetics , Connective Tissue Diseases/genetics , Connective Tissue Diseases/pathology , Cryotherapy , Hearing Loss, Sensorineural/genetics , Hearing Loss, Sensorineural/pathology , Humans , Laser Therapy , Retinal Detachment/genetics , Retinal Detachment/pathology , Vitreous Detachment/genetics , Vitreous Detachment/pathologySubject(s)
Humans , Male , Female , Book Reviews as Topic , Vitreous Detachment/epidemiology , Vitreous Detachment/prevention & control , Vitreoretinal Surgery/methods , Vitreoretinal Surgery/trends , Vitreoretinal Surgery , Cryotherapy/instrumentation , Cryotherapy/methods , Cryotherapy/trends , Laser Therapy/methods , Vitreoretinal Surgery/instrumentation , Cryotherapy/statistics & numerical data , Cryotherapy , Laser Therapy/instrumentation , Laser Therapy/standards , Laser TherapyABSTRACT
A significant percentage of patients with diabetic macular edema respond poorly to conventional laser photocoagulation. One associated factor in such patients with refractory diabetic macular edema is the absence of posterior vitreous detachment (PVD). Several invasive methods, such as surgical induction of PVD result in resolution of macular edema and improvement in visual acuity. Being invasive such modalities may have important surgical risks, such as retinal detachment and endophthalmitis. Recently, laser in situ keratomeilusis (LASIK), a well-accepted refractive procedure, has been reported to produce posterior vitreous detachment in patients with myopia. We herein hypothesize that application of LASIK suction ring, an external procedure, may be useful in the induction of PVD in patients with refractory diabetic macular edema and may have a better safety profile.
Subject(s)
Diabetic Retinopathy/surgery , Keratomileusis, Laser In Situ/instrumentation , Keratomileusis, Laser In Situ/methods , Macular Edema/surgery , Vitrectomy/instrumentation , Vitrectomy/methods , Vitreous Detachment/prevention & control , Animals , Diabetic Retinopathy/complications , Humans , Keratomileusis, Laser In Situ/adverse effects , Macular Edema/etiology , Treatment Outcome , Vacuum , Vitreous Detachment/etiologyABSTRACT
PURPOSE: We present our result of topical administration of iodine in group of patients with corpus vitreous degeneration. MATERIAL AND METHODS: Corpus vitreous degeneration was studied in 360 patients (660 eyes), 184 male and 176 female. Treatment last form 6 to 12 month. We administrate iodine 3-4 times a day as an eye drops. The untreated control group consist of 110 person (204 eyes) 80 male and 50 female with similar corpus vitreous degeneration. RESULTS: The results are discussed in relation to our own vitreous degeneration scale. We come to a conclusion that topical administration of iodine reduce corpus vitreous degeneration.
