We describe an unusual case of ultra wide fluorescein angiography (UWFA) documented peripheral retinal neovascularization (NVE) with delayed vitreous hemorrhage after placement of an encircling scleral buckle (a common procedure for repair of retinal detachment). Anterior segment ischemia is a rare complication after scleral buckle surgery for the treatment of retinal detachment and results from altered choroidal flow through the impingement of the anterior and long posterior ciliary arteries. UWFA performed for the evaluation of vitreous hemorrhage confirmed ischemia anterior to the scleral buckle and consequential NVE. This case represents the utility of UWFA in evaluating and managing this exceptionally rare complication associated with a common procedure in the field of vitreoretinal surgery.
Retinal detachment in congenital glaucoma is rare and often associated with a poor prognosis. In this report, we describe ocular manifestations of congenital glaucoma, pre- and post-operative ophthalmic findings, and overall anatomic and functional outcomes after successful rhegmatogenous retinal detachment repair along with a review of the literature. Rhegmatogenous retinal detachment in a 45-year-old monocular patient with congenital glaucoma was successfully repaired with small gauge pars plana vitrectomy, intra-operative perfluorocarbon use and 1,000 centistoke silicone oil tamponade. Best-corrected visual acuity improved from CF to 20/70; however, the post-operative course was complicated by hypotony-associated maculopathy after removal of silicone oil. Five thousand centistoke silicone oil was reinfused with good anatomic and functional outcomes. The functional outcome may ultimately be limited by pre-existing amblyopia and other ocular comorbidities.
Background: Traditionally fundus photographs and optical coherence tomography (OCT) are obtained separately during evaluation of retinal pathology. We describe a novel integrated imaging system (Monaco, Optos) that records both OCT as well as fundus photography concurrently. The present study aims to measure retinal thickness and compare it to OCT obtained with traditional spectral domain OCT in subjects without known retinal disease to establish normative data for clinical use. Methods: In this cross sectional study, fundus photographs and OCT was obtained concurrently in 34 eyes in healthy patients without any known retinal disease with integrated imaging system. OCT with spectralis was also obtained at the same visit for comparison. All subjects underwent a complete ophthalmologic exam to ensure the absence of ocular pathology. OCT was performed by the same operator. Central subfield thickness (CST), central point thickness (CPT), and retinal thickness in nine central subfields were measured with both 1 instruments. Fundus photographs were obtained. Students t-test was used to determine statistical significance. Results: The mean CST as measured with MIIS-SD OCT and Spectralis OCT was 300.53±22.81 μm and 265.18±17.33 μm (P<0.001) respectively. The Pearson's correlation coefficient, r-value was 0.5285, P<0.0013. The mean CPT as measured with MIIS-SD OCT and Spectralis OCT was 268.55±20.70 μm and 230.67±17.75 μm (P<0.001) respectively. The r-value was 0.5697, P<0.0004. The mean difference between retinal thicknesses was 44.88 μm (range, 21 to 91 μm) in the eight ETDRS subfields, with r-value 0.53, P<0.05, ranging from 0.51 to 0.60. Concurrently obtained ultrawide angle fundus photographs revealed (200°) clear media, normal disc, normal vasculature and normal periphery in all patients with excellent resolution.Conclusions: Retinal thickness measurements strongly correlated with those obtained by Spectralis. An increased measurement in thickness of 35.35 μm was noted in the central fovea. In addition, wide-angle fundus photography was successfully obtained in all subjects. Integrated system provides quality fundus photographs as well as OCT, obviates the need for two separate instruments and likely improves the clinic flow.
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