Introduction The pandemic of COVID-19 has been caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Apart from respiratory malfunction, COVID-19 causes a system-wide thromboembolic state, leading to serious cardiovascular, cerebrovascular and peripheral vascular manifestations. However, our knowledge regarding retinal manifestations due to systemic COVID-19 is minimal. This systematic review has comprehensively summarized all retinal manifestations secondary to COVID-19 disease recorded till date since the beginning of the pandemic. Methods All studies published till November 27, 2020, which have reported retinal manifestations in COVID-19 patients were systematically reviewed using the PRISMA statement. Results We included 15 articles: 11 case reports and four cross-sectional case series. The most commonly reported manifestations which did not affect visual acuity were retinal hemorrhages and cotton wool spots. The most common vision threatening manifestation was retinal vein occlusion with associated macular edema. Rarely, patients may also present with retinal arterial occlusions and ocular inflammation. These manifestations may occur from as soon as within a week after the onset of COVID-19 symptoms to more than 6 weeks after. Conclusion Mostly causing milder disease, COVID-19 may however lead to severe life-threatening thromboembolic complications, and systemic antithrombotic therapy has been suggested as a prophylactic and therapeutic management strategy for patients affected with serious systemic disease. However, both sick and apparently healthy patients may suffer from various retinal complications which may lead to loss of vision as well. No consensus regarding management of retinal complications with anticoagulants or anti-inflammatory medications have been proposed; however, they may be tackled on individual basis.
Context:Surgical outcome of retropupillary fixation of iris claw lens.Aims:To evaluate the various indications, intra and post-operative complications, and visual outcome of retropupillary fixation of iris claw lens in aphakic eyes.Settings and Design:The study design is a retrospective study at a tertiary eye care center.Methods:Review of medical records of 61 aphakic eyes of 61 patients, who were rehabilitated with retropupillary fixation of an iris claw lens, with a follow-up duration of at least 1 year.Statistical Analysis Used:Data analysis was performed using paired t-test and Chi-square test.Results:Mean preoperative uncorrected visual acuity was 1.66 ± 0.3 LogMAR and postoperative acuity at 1 year was 0.53 ± 0.5 LogMAR (P = 0.00001). Preoperative distant best-corrected visual acuity was 0.30 ± 0.48 LogMAR and postoperative acuity at 1 year was 0.27 ± 0.46 LogMAR (P = 0.07). Mean preoperative astigmatism was 1.43 ± 1.94 D and postoperatively was 1.85 ± 2.16 D (P = 0.0127). Mean endothelial cell count was 2353.52 ± 614 cells/mm2 preoperatively which decreased to 2200 ± 728 cells/mm2 at 1 year follow-up (P = 0.006). There was no significant difference in central macular thickness and intraocular pressure pre and post-surgery. Complications included ovalization of pupil in 9.83%, hypotony in 1.63%, toxic anterior segment syndrome in 1.63%, cystoid macular edema in 11.47%, epiretinal membrane in 3.27%, and iris atrophy in 6.55%.Conclusion:Iris claw is a safe and an effective method of rehabilitating aphakic eyes.
Purpose: To evaluate the clinical profile, visual outcomes, and complications among young adult patients with type 1 diabetes mellitus (insulin-dependent DM-T1DM) in comparison with patients with type 2 diabetes mellitus (T2DM) undergoing vitrectomy for complications of proliferative diabetic retinopathy (PDR). Methods: A retrospective review of patients between 18 and 45 years with T1DM undergoing vitrectomy for complications of PDR between June 2017 and June 2019, with a minimum follow-up of 12 months. Consecutive patients between 30 and 45 years with type 2 diabetes (non-insulin-dependent DM-T2DM) who underwent vitrectomy for the same indications were retrospectively enrolled as the control group. Results: There were 42 eyes (28 patients) in the T1DM group and 58 eyes (47 patients) in the T2DM group. The average age at operation was 35.9 ± 6.88 years and 39.8 ± 3.03 years, respectively ( P < 0.001). At the end of follow-up, the mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from 1.53 ± 0.55 to 1.30 ± 0.93 ( P value 0.07) in the T1DM group and from 1.59 ± 0.46 to 1.00 ± 0.78 in the T2DM group ( P = 0.0001). The rate of the primary and final reattachment was 76.2% and 88.1% in the T1DM group and 84.5% and 96.6% in the T2DM group. Preoperative macular tractional retinal detachment (MTRD) and neovascular glaucoma (NVG) in both the groups, chronic kidney disease (CKD) and lack of preoperative Pan retinal photocoagulation (PRP) in the T1DM group, hypertension (HTN) and, resurgery in the T2DM group, were risk factors for poor vision at the final follow-up. Conclusion: The visual and anatomic outcomes were poorer in the T1DM patients which could be due to the longer duration of diabetes with worse glycemic control, associated comorbidities like CKD, and a higher incidence of MTRD.
BackgroundIsoexpansile concentrations of intraocular gases are typically used as tamponading agent in macular hole surgery. Using a small volume of the pure form of these gases may achieve the same result without increasing the incidence of postoperative complications. The purpose of this study was to evaluate the anatomical and visual outcomes following macular hole surgery with 2 cc pure (100 %) sulfur hexafluoride (SF6) gas tamponade.MethodsA retrospective study of eyes with idiopathic macular holes that underwent 23-gauge pars plana vitrectomy with 2 cc pure SF6 gas tamponade. Macular hole surgery was performed alone or in combination with phacoemulsification in eyes with cataract. Preoperative and postoperative data including best corrected visual acuity recorded in LogMAR units, slit-lamp biomicroscopy, and optical coherence tomography were analysed. Surgical complications were also recorded.ResultsSeventy six eyes of seventy five patients were analysed. A closure rate of 100 % was achieved with reoperation in 4 eyes. There was a significant improvement in best-corrected visual acuity from a mean of 0.65 LogMAR preoperatively to 0.36 at 6 months (p value 0.004). Forty five (59 %) eyes gained at least 2 lines on the Snellen visual acuity chart. Postoperative elevation in intraocular pressure (≥30 mmHg) was documented in 3 eyes (4 %).ConclusionMacular hole surgery with 2 cc pure SF6 gas tamponade achieved a high success rate with a low incidence of complications. The smaller volume of gas required makes it a cheaper technique.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0254-9) contains supplementary material, which is available to authorized users.
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