Quick Referral and Urgent Surgery to Preempt Foveal Detachment in Retinal Detachment Repair

Kikushima, Wataru; Imai, Atsushi; Hirano, Takao; Iesato, Yasuhiro; Toriyama, Yuichi; Murata, Mitsuo; Murata, Toshinori

doi:10.1097/apo.0b013e3182a81240

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…Excessive traction due to fibrovascular proliferation (FVP) in a thinned ischemic retina of diabetic patient can result in formation of retinal break, and this can result in a combined tractional and rhegmatogenous retinal detachment (CRD). Vitreoretinal surgery should be performed as soon as possible for these cases as the detachment can progress rapidly with development of proliferative vitreoretinopathy.…”

Section: Indications For Surgerymentioning

confidence: 99%

Surgical treatment for diabetic vitreoretinal diseases: a review

Sharma

Fong

Lai³

et al. 2016

Clinical Exper Ophthalmology

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Over the past four decades, advancements in surgical instrumentations and techniques have significantly improved the postoperative anatomical and visual outcomes of patients with various diabetic vitreoretinal diseases. In particular, surgical interventions for previously serious and untreatable blinding proliferative diabetic retinopathy can now be performed, with much better results. The advents of micro incisional vitrectomy system with better visualization system like binocular indirect ophthalmomicroscope and stateof-the-art instrumentation revolutionized the era of diabetic vitrectomy. High-speed vitrectors, finer instruments, chromo-assisted vitrectomy and use of antivascular endothelial growth factors not only change the paradigm but also help achieve much better outcome after diabetic vitrectomies. In this review, we will discuss and summarize the indications, surgical considerations, surgical techniques, potential complications and outcomes of vitreoretinal surgery for diabetic eye diseases.

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Section: Indications For Surgerymentioning

confidence: 99%

Surgical treatment for diabetic vitreoretinal diseases: a review

Sharma

Fong

Lai³

et al. 2016

Clinical Exper Ophthalmology

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“…Since eye complaints are common in emergency departments across the United States [ 7 – 12 ], and since prompt and appropriate care is important for visual prognosis [ 1 – 4 , 19 ], it is important that EM physicians are well prepared to encounter these cases. However, in this study, a substantial proportion of responders report not feeling comfortable using basic ophthalmic equipment, performing an eye exam, making vision or in some cases potentially life-saving diagnoses, or performing vision-saving procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Delayed care for ophthalmic emergencies can lead to irreversible vision loss or blindness [ 1 – 4 ], which decreases quality of life for patients and leads to significant personal and societal costs [ 5 , 6 ]. Much of the responsibility to recognize the emergency and initiate prompt and appropriate care falls on emergency medicine (EM) physicians, as ocular complaints represent a substantial proportion of emergency department (ED) visits [ 7 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Training in and comfort with diagnosis and management of ophthalmic emergencies among emergency medicine physicians in the United States

Uhr

Governatori²,

Zhang

et al. 2020

Eye

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Background/objectives Patients with ophthalmic emergencies often present to emergency rooms. Emergency medicine (EM) physicians should feel comfortable encountering these conditions. We assessed EM physicians’ comfort working up, diagnosing, and managing ophthalmic emergencies. Subjects/methods 329 EM physicians participated in this cross-sectional multicentre survey. Questions inquired about the amount, type, and self-perceived adequacy of ophthalmic training. Likert scales were used to assess confidence and comfort working up, diagnosing, and managing ophthalmic emergencies. Results Participants recall receiving a median of 5 and 10 h of ophthalmic training in medical school and residency, respectively. Few feel this prepared them for residency (16.5%) or practice (52.0%). Only 50.6% feel confident with their ophthalmic exam. Most (75.0%) feel confident in their ability to identify an ophthalmic emergency, but 58.8% feel well prepared to work them up. Responders feel more comfortable diagnosing acute retrobulbar hematoma (72.5%), retinal detachment (69.8%), and acute angle closure glaucoma (78.0%) than central retinal artery occlusion (28.9%) or giant cell arteritis (53.2%). Only 60.2% feel comfortable determining if canthotomy and cantholysis is necessary in the setting of acute retrobulbar hematoma, and 40.3% feel comfortable performing the procedure. There was a trend towards attending physicians and providers in urban and academic settings feeling more comfortable diagnosing and managing ophthalmic emergencies compared to trainees, non-urban, and non-academic physicians. Conclusions Many participants do not feel comfortable using ophthalmic equipment, performing an eye exam, making vision or potentially life-saving diagnoses, or performing vision-saving procedures, suggesting the need to increase ophthalmic training in EM curricula.

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“…Чрезмерное растяжение истонченной ишемизированной сетчатки за счет фиброваскулярной пролиферации при ПДР может привести к разрыву сетчатки и к развитию ТРОС. В таких случаях ППВ должна быть выполнена как можно скорее, поскольку отслойка может быстро прогрессировать с развитием полной слепоты [57].…”

Section: витреоретинальная хирургияunclassified

Role of Vitrectomy in the Treatment of Diabetic Retinopathy

Petrachkov¹,

Korobov²,

Arzhukhanov³

2021

Oftalʹmologiâ

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Diabetic retinopathy (DR) is a socially significant disease with a steady tendency to increase, in which there is a high risk of disability due to persistent loss of vision. There are three main pathogenetically substantiated methods of DR treatment: laser coagulation of the retina; intravitreal injections of VEGF inhibitors, steroid drugs; vitreoretinal surgery. In the later stages of DR, vitrectomy is the main method of its complications treating, but there is no clear understanding of the timeliness of this operation. The analysis of the results of original research on this problem is carried out. It has been shown that with the advent of new instruments, modified vitrector, operating microscopes, viewing systems and vitreoretinal combines, vitrectomy led to a change in the paradigm of DR treatment. These advances have resulted in better surgical control and greater precision, while at the same time shorter surgical times and fewer surgical complications. There is a tendency to perform vitrectomy at earlier stages of DR, which has a pathogenetic rationale. This could be a leap forward in the treatment of DR as a preventive measure against the development of proliferative DR.

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Quick Referral and Urgent Surgery to Preempt Foveal Detachment in Retinal Detachment Repair

Abstract: More than half (51.9%) of our cohort had already been fovea-off by outpatient presentation. Therefore, efforts to urge patients to visit operating facilities promptly seem to be as important as the urgent surgeries themselves.

Cited by 4 publications

References 18 publications

Surgical treatment for diabetic vitreoretinal diseases: a review

Surgical treatment for diabetic vitreoretinal diseases: a review

Training in and comfort with diagnosis and management of ophthalmic emergencies among emergency medicine physicians in the United States

Role of Vitrectomy in the Treatment of Diabetic Retinopathy

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