Recognising and managing retinal detachments

Ibrar, Ahmed; Maghsoudlou, Panayiotis; Mohamed, El-Ashry

doi:10.12968/hmed.2021.0145

Cited by 4 publications

(5 citation statements)

References 29 publications

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“…Separating chronic macula-off RD into without PVD and with a PVD has important prognostic and surgical implications. Chronic macula-off RD without PVD tends to occur in young patients and have good anatomic success when repaired by scleral buckle [5,6,10,11]. Chronic RD with PVD tends to occur in older patients with higher rates of PVR, low primary surgical success, and high rates of postoperative complications [7,15].…”

Section: Discussionmentioning

confidence: 99%

“…Higher rates of PVR are also noted in chronic macula-off RD with PVD compared to without PVD. Low rates of PVR grade C or greater have been noted in chronic macula-off RD without PVD (i.e., Yao et al reported ~ 10%) [5,6,10]. Anguita et al had rates of PVR at 69% in chronic macula-off RD with PVD [15].…”

Section: Discussionmentioning

confidence: 99%

“…More favorable outcomes are noted in the "no PVD" chronic RD that is more often seen in highly myopic patients with an atrophic hole. These patients can have a demarcation line, are younger, and often lack any symptoms [10]. In asymptomatic cases, Brod et al demonstrated that this risk of progression was lower than the risks associated with repair and thus could be monitored [11].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of chronic macula-off retinal detachment repair

Milner

Marin

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose There have been disparate outcomes in the few studies that have looked at anatomic success and visual acuity (VA) in chronic retinal rhegmatogenous detachment (RRD) repair. Chronic retinal detachments (RD) without a posterior vitreous detachment (PVD) occur in young myopes often secondary to an atrophic hole. These patients are often asymptomatic, and studies report good surgical anatomic results. However, chronic RD with a PVD is symptomatic but presents late due to patient compliance. This paper aims to evaluate this lesser-studied chronic macula-off RD with PVD. Methods After obtaining Institutional Review Board (IRB) approval, patients who had undergone surgical intervention for all diagnosis codes of RD were identified in the Denver Health Medical Center database. Medical records were reviewed, and patients found to have open-globe injuries, tractional RD due to proliferative diabetic retinopathy, macula-on detachments, and RD due to previous ocular surgery were excluded. Similarly, patients without PVD were also excluded. A total of 37 patients with PVD-type chronic macula-off RD were thus identified and preoperative characteristics, surgical intervention, and complications were analyzed. ResultsThe average patient age was 53.8 years. The length of RRD duration ranged from 30 to 365 days (mean 136.7 days). Twenty-six (70.3% patients had proliferative vitreoretinopathy (PVR) grade C or greater. Initial anatomic success-defined as re-attachment after one surgery-was 54.1%. The final attachment was 94.6%. Fifteen of 37 (40.5%) of the patients had issues with drop adherence, positioning, or missing post-operative appointments. Conclusion Chronic macula-off RD with a PVD should be identified as it is associated with much lower rates of initial re-attachment. Socioeconomic factors likely are the driving factor for patients with PVD-type chronic macula-off RD to present late, struggle with positioning, and have difficulty with follow-up and drop compliance. These extended periods without treatment then lead to high rates of PVR and poor initial anatomic success. However, repair of PVD-type chronic macula-off RD should still be pursued as final anatomic success is high.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of chronic macula-off retinal detachment repair

Milner

Marin

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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“…Retinal tears associated with head trauma may present as photopsia (Sornalingam et al, 2018). It is particularly important to assess for retinal tears and retinal detachment when evaluating head trauma because these are emergencies that require prompt intervention (Amos, 1999;Ibrar et al, 2021). Symptoms may be overlooked and attributed to the concussed state (Bedgood et al, 2015).…”

Section: Flashing Lights After Tbimentioning

confidence: 99%

Traumatic brain injury: Mechanisms, manifestations, and visual sequelae

et al. 2023

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Traumatic brain injury (TBI) results when external physical forces impact the head with sufficient intensity to cause damage to the brain. TBI can be mild, moderate, or severe and may have long-term consequences including visual difficulties, cognitive deficits, headache, pain, sleep disturbances, and post-traumatic epilepsy. Disruption of the normal functioning of the brain leads to a cascade of effects with molecular and anatomical changes, persistent neuronal hyperexcitation, neuroinflammation, and neuronal loss. Destructive processes that occur at the cellular and molecular level lead to inflammation, oxidative stress, calcium dysregulation, and apoptosis. Vascular damage, ischemia and loss of blood brain barrier integrity contribute to destruction of brain tissue. This review focuses on the cellular damage incited during TBI and the frequently life-altering lasting effects of this destruction on vision, cognition, balance, and sleep. The wide range of visual complaints associated with TBI are addressed and repair processes where there is potential for intervention and neuronal preservation are highlighted.

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“…Currently, the diagnosis of RD mainly relies on optical coherence tomography and B-scan ultrasonography; the results of these examinations can help to identify the type of RD and extent of detachment (Ibrar et al, 2021). However, such examinations only explore ocular visual function in RD patients; it has been unclear whether CNS abnormalities exist in such patients.…”

Section: Introductionmentioning

confidence: 99%

Machine learning analysis reveals aberrant dynamic changes in amplitude of low-frequency fluctuations among patients with retinal detachment

Wang

Cheng

et al. 2023

Front. Neurosci.

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BackgroundThere is increasing evidence that patients with retinal detachment (RD) have aberrant brain activity. However, neuroimaging investigations remain focused on static changes in brain activity among RD patients. There is limited knowledge regarding the characteristics of dynamic brain activity in RD patients.AimThis study evaluated changes in dynamic brain activity among RD patients, using a dynamic amplitude of low-frequency fluctuation (dALFF), k-means clustering method and support vector machine (SVM) classification approach.MethodsWe investigated inter-group disparities of dALFF indices under three different time window sizes using resting-state functional magnetic resonance imaging (rs-fMRI) data from 23 RD patients and 24 demographically matched healthy controls (HCs). The k-means clustering method was performed to analyze specific dALFF states and related temporal properties. Additionally, we selected altered dALFF values under three distinct conditions as classification features for distinguishing RD patients from HCs using an SVM classifier.ResultsRD patients exhibited dynamic changes in local intrinsic indicators of brain activity. Compared with HCs, RD patients displayed increased dALFF in the bilateral middle frontal gyrus, left putamen (Putamen_L), left superior occipital gyrus (Occipital_Sup_L), left middle occipital gyrus (Occipital_Mid_L), right calcarine (Calcarine_R), right middle temporal gyrus (Temporal_Mid_R), and right inferior frontal gyrus (Frontal_Inf_Tri_R). Additionally, RD patients showed significantly decreased dALFF values in the right superior parietal gyrus (Parietal_Sup_R) and right paracentral lobule (Paracentral_Lobule_R) [two-tailed, voxel-level p < 0.05, Gaussian random field (GRF) correction, cluster-level p < 0.05]. For dALFF, we derived 3 or 4 states of ALFF that occurred repeatedly. There were differences in state distribution and state properties between RD and HC groups. The number of transitions between the dALFF states was higher in the RD group than in the HC group. Based on dALFF values in various brain regions, the overall accuracies of SVM classification were 97.87, 100, and 93.62% under three different time windows; area under the curve values were 0.99, 1.00, and 0.95, respectively. No correlation was found between hamilton anxiety (HAMA) scores and regional dALFF.ConclusionOur findings offer important insights concerning the neuropathology that underlies RD and provide robust evidence that dALFF, a local indicator of brain activity, may be useful for clinical diagnosis.

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Recognising and managing retinal detachments

Cited by 4 publications

References 29 publications

Outcomes of chronic macula-off retinal detachment repair

Outcomes of chronic macula-off retinal detachment repair

Traumatic brain injury: Mechanisms, manifestations, and visual sequelae

Machine learning analysis reveals aberrant dynamic changes in amplitude of low-frequency fluctuations among patients with retinal detachment

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