Unintentional Displacement of the Retina after Standard Vitrectomy for Rhegmatogenous Retinal Detachment

Shiragami, Chieko; Shiraga, Fumio; Yamaji, Hidetaka; Fukuda, Komei; Takagishi, Mai; Morita, Misako; Kishikami, Takehiro

doi:10.1016/j.ophtha.2009.06.025

Cited by 128 publications

(171 citation statements)

References 19 publications

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“…This is similar to the phenomenon described in the report by Shiragami et al 11 As suggested in the report, these hyperfluorescent lines may develop because the retina is reattached in a slightly different position postoperatively than where it had been before the retinal detachment. These lines remained in one eye for 4 months postoperatively, but had disappeared by 11 months.…”

Section: Discussionsupporting

confidence: 91%

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Ultra-wide-field autofluorescence imaging in non-traumatic rhegmatogenous retinal detachment

Witmer

Cho

Favarone

et al. 2012

Eye

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Purpose Rhegmatogenous retinal detachment (RRD) affects the function of the retina before and after surgical repair. We investigated ultra-wide-field autofluorescence (UAF) abnormalities in patients with acute RRD to improve our understanding of the functional changes in the retina before and after surgery. Methods In this retrospective study, we present the UAF imaging findings of 16 patients with acute, non-traumatic RRD. Imaging was obtained with the Optos 200 Tx (Optos) in 14 eyes preoperatively and in 12 eyes postoperatively. Twelve eyes had RRDs that involved the macula (group A), whereas four eyes had macula-sparing RRDs (group B). Results All patients (100%) with bullous retinal detachments demonstrated hypofluorescence over the area of retinal detachment. A hyperfluorescent leading edge (HLE) to the retinal detachment was observed preoperatively in 100% of eyes in group A and 75% of eyes in group B. Preoperative UAF through the fovea of group A eyes was normal (30%), hypofluorescent (50%) or hyperfluorescent (20%). In all patients with a HLE preoperatively, the HLE resolved by the 1-month postoperative visit. A residual line of demarcation remained in 8 of the 12 eyes (67%). In group A eyes, postoperative granular autofluorescent changes were present in four of the nine (44%) eyes, and were associated with worse preoperative (P ¼ 0.04) and postoperative (P ¼ 0.09) visual acuity. Conclusion UAF imaging reveals abnormalities in RRDs that allow excellent demarcation of the extent of the retinal detachment and assist in preoperative characterization of the detachment and postoperative counselling.

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Section: Discussionsupporting

confidence: 91%

“…10,11 The current report used an ultra-wide-field camera that allows a 2001 view of the retina with a single frame. Peripheral views of the retina are valuable in imaging RRDs because this condition is a peripheral disease (ie, results from a retinal break in the periphery that may progress posteriorly).…”

Section: Discussionmentioning

confidence: 99%

Ultra-wide-field autofluorescence imaging in non-traumatic rhegmatogenous retinal detachment

Witmer

Cho

Favarone

et al. 2012

Eye

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“…16 Macular translocation surgeries for myopic choroidal neovascularization and age-related macular degeneration have also been intentionally moved from the foveal area to other locations. [17][18][19][20][21][22][23][24] Thus, the macular retina is movable depending on the circumstances and can function on any retinal pigment epithelium.…”

Section: Discussionmentioning

confidence: 99%

Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling

Kawano

Ito

Kondo

et al. 2013

Eye

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Purpose To determine whether there is a displacement of the fovea toward the optic disc after successful macular hole (MH) surgery with internal limiting membrane (ILM) peeling. Methods The medical records of 54 eyes of 53 patients that had undergone pars plana vitrectomy with ILM peeling and gas or air tamponade for an idiopathic MH were evaluated. Spectral-domain optical coherence tomography (OCT) had been performed before and 46 months after the surgery. The preoperative distances between the center of the MH and the optic disc (MH-OD), center of the MH and the bifurcation or crossing of retinal vessels (MH-RV) were measured in the OCT images. In addition, the postoperative distance between the center of the fovea and optic disc (F-OD) and the center of the fovea and the same bifurcation or crossing of retinal vessels (F-RV) were measured in the OCT images. Results The F-OD was 2.67 ± 0.33 disc diameters (DD), which was significantly shorter than that of the MH-OD of 2.77 ± 0.33 DD (Po0.001). The F-RV was also significantly shorter than the MH-RV on the inner nasal area (from 0.85 ± 0.16DD to 0.79 ± 0.15DD; Po0.001), the inner temporal area (from 0.82±0.15DD to 0.77±0.14DD; Po0.001), and outer nasal area (from 1.70 ± 0.31DD to 1.65 ± 0.32DD; Po0.001), but it was significantly longer than the MH-RV in the outer temporal area (from 1.65±0.29DD to 1.68±0.29DD; Po0.001).Conclusion Our results showed that successful closure of a MH by vitrectomy with ILM peeling and gas tamponade leads to a displacement of the center of the macula toward the optic disc.

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“…Following the work of Shiragami et al, 3 we have been monitoring fundus autofluorescence findings in a series of retinal detachment patients. Our findings, to date, indeed confirm that the displacement is typically non-uniform, with evidence of retinal stretch rather than simply a uniform shift in position.…”

mentioning

confidence: 99%

“…This has been our experience as well, and is in keeping with previous findings that the extent of dysmetropsia (change in image size) is non-uniform in symptomatic patients following retinal detachment repair. 2 Following the work of Shiragami et al, 3 we have been monitoring fundus autofluorescence findings in a series of retinal detachment patients. Our findings, to date, indeed confirm that the displacement is typically non-uniform, with evidence of retinal stretch rather than simply a uniform shift in position.…”

mentioning

confidence: 99%

Does unintentional macular translocation after retinal detachment repair influence visual outcome? Comment

Lee

Doğramacı

Williamson

2011

Clinical Exper Ophthalmology

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We read with interest the report by Pandya et al.1 of five patients with unintentional macular translocation following retinal detachment repair. Of note, symptoms of vertical deviation were only noted in patients 3, 4 and 5 despite retinal displacement in all five patients, as evidenced by fundus autofluorescence imaging. This is despite patients 1 and 2 having good postoperative macular function (bestcorrected visual acuities of 6/6 and 6/12, respectively). It would be interesting to know what the vision was in the fellow eyes and if vertical fusion range was examined to help consider why only some of their subjects were symptomatic.It is also noteworthy, particularly in patients 1, 2 and 5, that the extent of displacement is non-uniform within the macula. This has been our experience as well, and is in keeping with previous findings that the extent of dysmetropsia (change in image size) is non-uniform in symptomatic patients following retinal detachment repair. 2Following the work of Shiragami et al., 3 we have been monitoring fundus autofluorescence findings in a series of retinal detachment patients. Our findings, to date, indeed confirm that the displacement is typically non-uniform, with evidence of retinal stretch rather than simply a uniform shift in position. In keeping with a non-uniform shift, we have found that many of our symptomatic patients have only been partially improved with prismatic correction. We wonder if this has been the experience of the authors as well.Finally, the authors suggest that the displacement found could be because of the effect of gravity in upright patients following surgery, and propose face-down positioning instead. It would be helpful to know how these five patients were positioned following surgery. If the facedown positioning is not perfect, or results in pooling of fluid at the macula rather than drainage peripherally, 4 tangential stretch forces could be exerted on the macula itself with face-down positioning.

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Unintentional Displacement of the Retina after Standard Vitrectomy for Rhegmatogenous Retinal Detachment

Cited by 128 publications

References 19 publications

Ultra-wide-field autofluorescence imaging in non-traumatic rhegmatogenous retinal detachment

Ultra-wide-field autofluorescence imaging in non-traumatic rhegmatogenous retinal detachment

Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling

Does unintentional macular translocation after retinal detachment repair influence visual outcome? Comment

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