RESUMO
PURPOSE: To evaluate risk factors for failure of scleral buckling in rhegmatogenous retinal detachment (RRD) in an adult Moroccan population. METHODS: A retrospective study of 432 eyes of 422 patients undergoing scleral buckling (SB) for primary RRD between 2001 and 2009 was carried out. Statistical analysis of risk factors for failure was performed using binary logistic regression. RESULTS: Mean patient age was 43 ± 15 years, and 45.4% were myopic. The median recurrence was at 10 months. The final failure rate was 22.5%. Univariate analysis shows that significant risk factors for failure were extent of RRD ≥ 3 quadrants (P<0.001), advanced PVR (P<0.001) and worsening PVR postoperatively (P<0.001). In the multivariate model, the only significant risk factor for failure was the worsening postoperative PVR (P<0.001). CONCLUSIONS: Our findings suggest that worsening of PVR after surgery is the major risk factor for failure of SB in RRD. Thus, it is necessary to recognize the risk factors contributing to PVR and to plan the most appropriate, earliest and least traumatic surgical treatment of RRD.
Assuntos
Complicações Pós-Operatórias/etiologia , Descolamento Retiniano/cirurgia , Recurvamento da Esclera , Adulto , Estudos de Coortes , Diagnóstico Tardio/estatística & dados numéricos , Oftalmopatias Hereditárias/diagnóstico , Oftalmopatias Hereditárias/epidemiologia , Oftalmopatias Hereditárias/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Recurvamento da Esclera/métodos , Recurvamento da Esclera/reabilitação , Recurvamento da Esclera/estatística & dados numéricos , Falha de TratamentoRESUMO
We report a case of cat-scratch disease neuroretinitis. A 26-year-old man was referred for severe right visual loss. Posterior segment examination showed a papilledema with macular edema. Bartonella henselae immunoglobulin G testing was positive. Four weeks of antibiotic therapy combining oral ciprofloxacin and doxycycline led to progressive resolution of the neuroretinitis and improvement in visual acuity. This report reminds that B. henselae infection can be the cause of neuroretinitis. Its prognosis can be improved by early treatment.
Assuntos
Bartonella henselae , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/diagnóstico , Retinite/diagnóstico , Retinite/microbiologia , Adulto , Animais , Antibacterianos/uso terapêutico , Bartonella henselae/imunologia , Doença da Arranhadura de Gato/tratamento farmacológico , Gatos , Ciprofloxacina/uso terapêutico , Doxiciclina/uso terapêutico , Quimioterapia Combinada , Humanos , Masculino , Retinite/tratamento farmacológico , Resultado do TratamentoRESUMO
The prepapillary vascular loops are rare congenital vascular anomalies. Often unilateral and asymptomatic, they may be complicated by ischemic events by twisting or thrombosis of the loop. We report a rare case of double prepapillary arterial loop complicated by left retinal ischemia due to thrombosis of the loop.
