Traumatic retinal detachment—the difficulty and importance of correct diagnosis

Hoogewoud, Florence; Chronopoulos, Argyrios; Varga, Zsolt; Souteyrand, Georges; Thumann, Gabriele; Schutz, James Scott

doi:10.1016/j.survophthal.2015.07.003

Cited by 26 publications

(11 citation statements)

References 52 publications

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“…It is supposed that the rate of traumatic RD is at the level of 0.2/10.000 [3]. There is no generally accepted definition of traumatic RD; thus the diagnosis is based on the particular history [4]. RD is seen in up to 30% among all serious eye injuries and has a poor prognosis for successful outcome [5].…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Nowomiejska

Chorągiewicz

Borowicz

et al. 2017

Journal of Ophthalmology

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Purpose. To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma. Methods. Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis. Results. Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases. Conclusions. Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

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Section: Introductionmentioning

confidence: 99%

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Nowomiejska

Chorągiewicz

Borowicz

et al. 2017

Journal of Ophthalmology

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“…По данным источников литературы, частота развития отслойки сетчатки после транссклерального удаления ИТ достигала 79 %, в то время как при эндовитреальной хирургии отслойка сетчатки развивается только в 11-20 % [13].…”

Section: Discussionunclassified

“…Согласно принципам современной витреоретинальной хирургии, главной целью многоэтапных хирургических вмешательств при тяжелых проникающих ранениях является достижение максимального анатомического эффекта, то есть восстановление структурной целостности глазного яблока и удаление внутриглазного инородного тела [9][10][11]. Особенно это касается реактивных ИТ, состоящих из металла или дерева, в то время как ИТ из стекла и пластика являются практическими ареактивными и не вызывают вторичных дистрофических изменений глазного яблока в позднем, послеоперационном периоде [12][13][14][15].…”

Section: Introductionunclassified

Clinical Analyses of Efficiency of Multicomponental, Vitreoretinal Surgery of Eye Trauma

Алиев

Абдулаев

et al. 2019

Oftalʹmologiâ

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Eye trauma is one of the leading causes of blindness and low vision in young working age people. It gives this particular group of diseases a special social significance. The absence of a universal surgical treating tactic is explained by the variety of traumatic agents and the various types of injuries. Penetrating wounds with the introduction of a foreign body, accompanied by detachment of the retina, vascular membrane, hemorrhagic and infectious complications are the most difficult in the clinical plan.Material and methods: 103 with penetrating eye injuries were operated during the period from 2015 to 2017. 29 of them were involving the introduction of foreign bodies, which were removed at different times: 18 eyes (62 %) — at 7–10 days, 8 eyes 27.5 %) — 14–28 days after injury and 3 eyes (10.3 %) — more than 1 month. In all cases, subtotal vitrectomy 25G (68.9 %) was performed, in some cases, 23-hedge vitrectomy was preferred (31 %) due to pronounced fibro-proliferative changes in the vitreous body. In the case of a foreign body impacted into the shells with dimensions greater than 4 mm, the real cavity was tamped with PFOS.Results. The adherence of the detached retina was achieved in 14 cases, adherence of the choroid — 4 cases. Uveitis was observed in 5 cases, ophthalmic hypertension in 12 patients in the early postoperative period. Hypertension was compensated by using the antihypertensive regimen. 5 patients at the time of hospitalization had a Vis = 0, the operation was of a diaphragm-preserving nature, since a foreign body that was not removed was the cause of the development of subatrophy of the eyeball in 16 % of cases. The remaining patients had stable, positive dynamics of visual functions in the postoperative period.Conclusion: Surgery tactics for extensive eye injuries are individual, and the amount of intervention depends largely on the parameters of the traumatic agent, so planned surgery is preferable to emergency because it allows for detailed preoperative examination and to get valuable information about the condition of the eye. The exceptions are injuries with symptoms of acute endophthalmitis. Multi-unit operations provide optimal conditions for the preservation of the eye as an organ and contribute to the restoration of visual functions.

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“…Classification of retinal detachment as traumatic in origin with certainty is often problematic, if only because there is no universally accepted consensus definition of traumatic retinal detachment and because there is often a rather long interval between the traumatic event and the retinal detachment [3]. These uncertainties also lead to considerable uncertainty in reports on the frequency of traumatic or partially traumatic detachment.…”

Section: The Pathogenesis Of Traumatic Retinal Detachmentmentioning

confidence: 99%

“…These uncertainties also lead to considerable uncertainty in reports on the frequency of traumatic or partially traumatic detachment. A recently published review article reports the percentage in the literature of traumatic retinal detachments as 6 to 19 % of all detachments [3], though it must be observed that numerous older literature references were used and there may possibly be a reporting bias in corresponding articles in favour of a traumatic origin. Blunt globe injuries represent the highest proportion of causative events in the literature, and younger persons are affected much more often than is the case with non-traumatic detachments.…”

Section: The Pathogenesis Of Traumatic Retinal Detachmentmentioning

confidence: 99%

Contextual Assessment of Retinal Injuries – Tasks of the Ophthalmological Expert

Tost

Stahl

2020

Klin Monbl Augenheilkd

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The ophthalmologic assessment of causal relationships is subject to formal guidelines, depending on the legal field (social law in the statutory accident insurance, civil law in the private accident insurance). After determining all objective and subjective findings of the individual case with complete recording of the medical facts, the ophthalmologist has the task of making a summarizing assessment of the existing cause-and-effect relationship. With regard to the distinction between retinal damage caused by an accident or retinal disease not caused by an accident, it is necessary to weigh up the natural causality according to the state of medical experience on the basis of the criteria strength of association, consistency, specificity, temporal sequence, dose dependence, agreement with previous findings, experimental reliability and analogous consideration. All records of medical findings from the patientʼs medical history and the individual description of the accident must be included in the expert opinion. In the case of several competing causes (often accident and pre-existing damage), the social law in the statutory accident insurance must present the causal contributions with roughly estimated probabilities. In civil law, valid for the private accident insurance, the existence of partial causality (approx. 25, 50, 75%) must be evaluated.

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Traumatic retinal detachment—the difficulty and importance of correct diagnosis

Cited by 26 publications

References 52 publications

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Clinical Analyses of Efficiency of Multicomponental, Vitreoretinal Surgery of Eye Trauma

Contextual Assessment of Retinal Injuries – Tasks of the Ophthalmological Expert

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