Suprachoroidal Implantation for the Treatment of Retinal Detachment

Poole, Thomas A.; Sudarsky, R. David

doi:10.1016/s0161-6420(86)33553-x

Cited by 34 publications

(20 citation statements)

References 9 publications

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“…It was interesting to find in the literature thoughts of choroidal indentation reported by Poole and Sudarsky in 1986. 5 The limitation then was the direct injection site (using a 27-gauge cannula) and substance used (1% sodium hyaluronate). Yet it worked in 14 patients in treating RD.…”

Section: Discussionmentioning

confidence: 99%

Suprachoroidal Buckling for Retinal Detachment

Rayes

Oshima²

2013

Retina

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T he use of scleral buckles in conjunction with chorioretinal adhesions around the break forms the basis of therapy for many uncomplicated rhegmatogenous retinal detachment (RD). Other techniques for repair include vitrectomy and a gas tamponade or repair by pneumatic retinopexy. Rhegmatogenous RD is repaired by preventing access of intravitreal fluid to the subretinal space via retinal breaks. 1 Fulfilling this base scleral buckling brings retina into contact with treated choroid around retinal tears. 2 This is done by indenting both the sclera and the choroid to the retina, with some potentials of mechanical ocular motility disturbance depending on the size and location of the buckle placement. Based on indenting the choroid alone to close the retinal tear through the suprachoroidal space, we show a novel technique using a special designed catheter to inject and place a suprachoroid filler (long-lasting hyaluronic acid [HA]) in the suprachoroidal space. This filler indent the choroid and creates a suprachoroidal buckling effect to close the tears or support the retina. This is done by a small 3-mm incision and guide the catheter to the tear avoiding all potential difficulties of placing scleral buckles (Video, Supplemental Digital Content; http://links.lww.com/IAE/A144).

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Section: Discussionmentioning

confidence: 99%

Suprachoroidal Buckling for Retinal Detachment

Rayes

Oshima²

2013

Retina

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“…Although the pathogenic mechanisms of combined CD and RRD has yet to be clearly delineated, most authors agree that the hypotony induced by ciliary edema and the detachment associated with RRD may induce CD 2,6,7. The prognosis for combined CD and RRD is worse than that of uncomplicated RRD 1,2,5,8. This unfavorable prognosis has been attributed to factors including poor visualization, difficult identification of causative break, difficult application of retinopexy, and the development of proliferative vitreoretinopathy 1,2,5,9.…”

Section: Discussionmentioning

confidence: 99%

Macular Hole as a Risk Factor of Choroidal Detachment in Rhegmatogenous Retinal Detachment

Kang

Park

Shin

et al. 2008

Korean J Ophthalmol

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PurposeChoroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD) is a rare, but serious condition, which makes the prognosis worse. Previously reported risk factors for CD in RRD patients include high myopia, aphakia, pseudophakia, and advanced age. However, macular hole has not been discussed as an important factor in increasing the risk of CD in RRD patients. The purpose of this study was to evaluate macular hole as a risk factor for CD in eyes evidencing RRD.MethodsThe medical records of 480 patients with primary RRD were reviewed. We compared the CD incidence among the RRD patients in accordance with the presence or absence of macular holes. The relationship between gender, age, presence of systemic disease, refractive errors, lens status, intraocular pressure and the development of CD were also analyzed.ResultsThe incidence (4/21 eyes, 19.0%) of CD in the RRD with macular hole was significantly higher than that (7/459 eyes, 1.5%) observed in the RRD without macular hole (p=0.010). The preoperative intraocular pressure (mean±SD; 2.5±1.3 mmHg) in the RRD with CD and macular hole was significantly lower than that (7.4±4.4 mmHg) observed in the cases of RRD with CD without macular hole (p=0.035). The eyes complicated by CD evidenced a higher prevalence of diabetes mellitus (p=0.024) than was observed in the eyes without CD.ConclusionsThe retinal detachment combined with macular hole creates a predisposition toward the development of profound hypotony and CD.

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“…Safety of injections into the SCS was shown by Einmahl et al [14], wherein a novel poly (ortho ester) biomaterial was evaluated, and by Poole et al, [15] wherein sodium hyaluronate was injected to treat retinal detachments. Einmahl et al, [14] observed that poly (ortho ester) injection in the SCS caused no clinical complications except some slight choroidal pigmentation and presence of vacuoles in the SCS.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Suprachoroidal Drug Delivery with Subconjunctival and Intravitreal Routes Using Noninvasive Fluorophotometry

2012

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PurposeTo determine whether exposure of sodium fluorescein (NaF) to the choroid-retina region in the posterior segment of the eye is greater with suprachoroidal injection when compared to intravitreal and transscleral routes.MethodsSuprachoroidal injection, a new approach for drug delivery to the posterior segment of the eye was validated using a 34 G needle and Indian ink injections in Sprague Dawley rats, followed by histology. Delivery of NaF was compared in Sprague Dawley rats after suprachoroidal, posterior subconjunctival, or intravitreal injections. NaF levels were monitored noninvasively up to 6 hours using Fluorotron Master™, an ocular fluorophotometer Pharmacokinetic parameters were estimated using WinNonlin.ResultsHistological analysis indicated localization of India ink to the suprachoroidal space below sclera, following injection. NaF delivery to choroid-retina was in the order: suprachoroidal > intravitreal >posterior subconjunctival injection. Peak NaF concentration (Cmax) in choroid-retina was 36-fold (p = 0.001) and 25-fold (p = 0.001) higher after suprachoroidal (2744±1111 ng/ml) injection when compared to posterior subconjunctival (76±6 ng/ml) and intravitreal (108±39 ng/ml) injections, respectively. NaF exposure (AUC0–360min) to choroid-retina after suprachoroidal injection was 6-fold (p = 0.001) and 2-fold (p = 0.03) higher than posterior subconjunctival and intravitreal injections, respectively. Choroid-retina Tmax was observed immediately after dosing with suprachoroidal injections and at 10 and 27.5 minutes, respectively, with subconjunctival and intravitreal injections.ConclusionsSuprachoroidal injections are feasible in a rat model. Suprachoroidal injections resulted in the highest bioavailability, that is, the extent and rate of delivery of NaF to choroid-retina, when compared to intravitreal and posterior subconjunctival injections. Ocular fluorophotometry is useful for noninvasive monitoring of NaF in rats following administration by various routes including suprachoroidal route.

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Suprachoroidal Implantation for the Treatment of Retinal Detachment

Cited by 34 publications

References 9 publications

Suprachoroidal Buckling for Retinal Detachment

Suprachoroidal Buckling for Retinal Detachment

Macular Hole as a Risk Factor of Choroidal Detachment in Rhegmatogenous Retinal Detachment

Comparison of Suprachoroidal Drug Delivery with Subconjunctival and Intravitreal Routes Using Noninvasive Fluorophotometry

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