The purpose of this study is to compare anatomical and visual outcomes after using silicone oil (SO) or C 3 F 8 gas as tamponades after pars plana vitrectomy (PPV) for retinal detachment (RD) associated with giant retinal tears (GRTs). Methods: A retrospective chart review was conducted for cases that underwent PPV for GRT-associated RD. We excluded eyes that had prior vitreoretinal surgery, a history of ocular trauma or worse than grade B proliferative vitreoretinopathy (PVR). Baseline demographic and ocular characteristics, surgical details and postoperative anatomical and visual outcomes were recorded and statistically analyzed. Results: We included 88 eyes; 48 eyes had C 3 F 8 gas and 40 eyes had SO as a tamponading agent. Mean age was 39 years. All eyes underwent 23G PPV with no adjuvant scleral buckling and phacovitrectomy was performed for all phakic eyes. Final retinal reattachment was achieved in 86 eyes (97.7%). One eye from each group had recurrent RD. Postoperative vision was significantly better in the gas group (p= 0.008). Prolonged increase of IOP developed in 6 eyes in the SO group and 5 eyes in the gas group. Prolonged uveitis developed in 4 eyes in the gas group and 6 eyes in the oil group (P= 0.04). Epiretinal membranes (ERM) developed in 10 eyes in the gas group and 9 eyes in the oil group. We found no significant difference between both groups regarding postoperative glaucoma or ERM formation. Conclusion: Both agents achieved similar favorable anatomical outcomes in a series of eyes with fresh GRT-associated RD and low-grade PVR, with better visual outcome and less frequent uveitis associated with the use of gas tamponade.
Background: Epiretinal membranes (ERMs) have been reported after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Peeling of the internal limiting membrane (ILM) can prevent post-PPV ERM formation but has a potential negative impact on macular structure and function. Purpose: To investigate the anatomical and functional outcomes of ILM peeling during PPV for primary RRD. Methods: This was a prospective nonrandomized study that included 60 eyes of 60 patients with a primary maculaoff RRD and less than grade C proliferative vitreoretinopathy (PVR). Eyes were allocated into 2 groups; Group A underwent PPV without ILM peeling and Group B had ILM peeling. At postoperative month 6, all patients underwent retinal imaging using spectral domain optical coherence tomography (OCT) and OCT angiography and macular function was assessed using multifocal electroretinogram (mfERG). Baseline characteristics and postoperative anatomical and visual outcomes were recorded and statistically analyzed. Results: We enrolled 30 eyes of 30 patients in each group. In Group A, mean age was 44.6 years, while the mean age of Group B patients was 49.9 years. Postoperative LogMAR visual acuity was significantly better in Group A than in Group B (p < 0.001). ERMs were demonstrated on OCT in 13.3% of Group A and none of Group B patients (p = 0.04). Retinal dimples were found in 53.3% of Group B and none of Group A eyes (p < 0.001). OCTA showed a greater vessel density of the superficial capillary plexus (SCP) in Group A compared to Group B eyes (p = 0.046), while no difference was found regarding deep capillary vessel density (p = 0.7). Mean amplitude of mfERG P1 wave was significantly higher in Group A eyes than in Group B (p = 0.002). Both the SCP vessel density and P1 amplitude were positively correlated with visual acuity (p < 0.001). Conclusion: This study suggests that ILM peeling prevents ERM development in eyes undergoing PPV for uncomplicated macula-off RRD, but potential damage to macular structure and function were found. Trial registration Retrospectively registered on 09/24/2019 on ClinicalTrials.gov with an ID of NCT04139811.
IntroductionThe purpose of this research was to study the effect of increased axial myopia, in non-glaucomatous eyes, and its correlation with ONH parameters, and RNFL thickness, using Cirrus HD 4000 SD-OCT.MethodsThe myopia group included 86 eyes of 86 patients, while the control group involved 92 eyes of 92 patients, attending the Ophthalmology Outpatient Clinic in Minia University Hospital, between November 2013 and March 2015. ONH parameters and peripapillary RNFL thickness measurement were evaluated by using SD-OCT, selecting the standard optic disc cube 200 × 200.ResultsThe mean age of the myopia group was (36.55 ± 9.44), the mean spherical equivalent was (−12.70 ± 3.87 D), and the mean axial length was (27.88 ± 1.92 mm). The control group had mean age of (34.82 ± 8.87), mean spherical equivalent of −0.65 ± 0.41 D, and mean AL of (22.16 ± 0.82). A significant difference was reported between the two groups, regarding disc area (p = 0.01), rim area (p = 0.001), vertical C/D (p = 0.01), average C/D ratio (p = 0.001), average and temporal RNFL thickness (p = 0.0001, p = 0.001, respectively).ConclusionA significant difference was found between highly myopic non-glaucomatous eyes and the control group, regarding ONH parameters and RNFL thickness as measured by SD-OCT. As OCT magnification adjusted ONH parameters were larger, global and the temporal RNEL were thicker in the myopia group, those magnification adjusted parameters helped in an accurate evaluation of ONH and RNFL in highly myopic eyes, in order to avoid misdiagnosis of glaucoma in such eyes.
Purpose To describe the clinical profile of patients with HLA-B27-associated uveitis at 2 Egyptian tertiary eye centers. Methods A retrospective study reviewing the medical records of all patients with HLA-B27-associated uveitis served at 2 uveitis referral clinics in Egypt between January 2010 and June 2018. Results The study included a total of 554 patients. Anterior uveitis was the most common type. Ankylosing spondylitis was an important systemic comorbidity in the present study, affecting 27.4% of our patients. Cataract was the most frequent ocular complication. By the conclusion of the study, 6.1% of the affected eyes had a BSCVA poorer than 20/200. Conclusion The clinical profile of HLA-B27-associated uveitis in our cohort of Egyptian patients is similar to that reported from other regions of the world. In our study, a relatively high rate of cataract was observed.
Purpose:Spectral Domain Optical Coherence Tomography (SD-OCT) was used to evaluate retinal and vitreo-retinal changes that occur in highly myopic patients.Methods:This prospective study included 472 eyes of 472 patients suffering from high myopia (> -6.00 D), between May 2012 and December 2015. All patients were examined, using Cirrus HD OCT (Zeiss Cirrus TM HD-OCT model 4000), to detect any retinal or vitreo-retinal interface abnormalities.All obtained data was analyzed using Statistical Package for the Social Sciences software version 17 (SPSS Inc, Chicago, IL, USA) and the paired two-sided t-test. Bivariate correlations were performed between different parameters using the Spearman correlation coefficient (r).Results:Mean spherical equivalent (MSE) was -13.11± 4.35D. Mean axial length (AL) was 28.5±1.62 mm. Posterior vitreous detachment (PVD) was the most frequent OCT finding; representing 33.4% of the cases, 13.7% of them were associated with macular traction. A statistically significant positive correlation was found between AL and MTM, full thickness macular hole, PVD with traction, and dome shaped macula (r = 0.49 and P = 0.001, r = 0.422 and P = 0.0001, r = 0.25 and P = 0.03, r=0.475, P=0.001 respectively)Conclusion:OCT is a valuable tool in detecting retinal and vitreo-retinal interface abnormalities in highly myopic eyes, and it can be used for follow up of those patients to avoid advanced retinal damage.
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