Unusual rapid resolution of postsclerectomy exudative retinal detachment with topical NSAIDs therapy in a case of nanophthalmos

Tong, Boding; Wang, Chao; Qi, Xin

doi:10.1177/0300060519847376

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…This aspect is particularly important when the interactions between the scotomas and eye movements are considered, as discussed hereinafter. Spatial distortion reported around central disciform scotomas caused, as a result of chorioretinal scaring after wet AMD, has been thought to be related to physical deformation of the retina near the scar at the scarring process 77,78 . The scotoma carving process results in such distortions without postulating any retinal mechanical distortions (Fig.…”

Section: Discussionmentioning

confidence: 99%

The Invisibility of Scotomas I: The Carving Hypothesis

2023

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Significance Veridical depictions of scene appearance with scotomas allow better understanding of the impact of field loss and may improve the development and implementation of rehabilitation. Explanation and depiction of the invisibility of scotoma may lead to patients’ understanding and thus better compliance with related treatments. Purpose Simulations of perception with scotomas guide training, patient education, and rehabilitation research. Most simulations incorrectly depict scotomas as black patches, though the scotomas and the missing contents are usually invisible to patients. We present a novel approach to capture the reported appearance of scenes with scotomas. Methods We applied a content-aware image resizing algorithm to carve out the content elided under the scotoma. With video sequences we show how and why eye movements fail to increase the visibility of the carved scotomas. Results Numerous effects, reported by patients, emerge naturally from the scotoma carving. Carving-eliminated scotomas over natural images are barely visible, despite causing substantial distortions. Low resolution and contrast sensitivity at farther eccentricities and saccadic blur reduce the visibility of the distortions. In a walking scenario, static objects moving smoothly to the periphery disappear into, and then reemerge out of peripheral scotomas invisibly. Conclusions Scotoma carving provides a viable hypothetical simulation of vision with scotomas, due to loss of neurons at the retinal ganglion cell level and higher. As a hypothesis, it generates predictions that lend themselves to future clinical testing. The different effects of scotomas due to loss of photoreceptors are left for follow-up work.

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Section: Discussionmentioning

confidence: 99%

The Invisibility of Scotomas I: The Carving Hypothesis

2023

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“…20 However, the results of studies on corticosteroid therapy for the treatment of UE are not promising. 7 , 21 , 22 Other medical therapies such as topical non-steroidal anti-inflammatory drugs, topical prostaglandin analogs, and systemic carbonic anhydrase inhibitors have been reported only in a few case reports. 22 , 23…”

Section: Discussionmentioning

confidence: 99%

Treatment of Nanophthalmos-Related Uveal Effusion with Two- vs. Four-Quadrant Partial-Thickness Sclerectomy and Sclerotomy Surgery

Özdek¹,

Yalınbaş²,

Özmen³

et al. 2022

tjo

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Objectives: To report visual and anatomical outcomes following two- or four-quadrant partial-thickness sclerectomy and sclerotomy surgery to treat nanophthalmos (NO)-related uveal effusion (UE). Materials and Methods: Consecutive patients with NO-related UE were treated with four-quadrant or two-quadrant (for those with associated glaucoma) partial-thickness sclerectomy and sclerotomy surgery. Axial length, extent of UE, preoperative, postoperative, and final best corrected visual acuity (BCVA), time to retinal reattachment, and rates of retinal reattachment and recurrence were noted. Results: Fourteen eyes of 10 patients with NO-related UE were operated. Retinal detachment (RD) involved mainly the peripheral retina in 7 (50%) eyes, macula in 2 eyes (14.2%), both macula and peripheral retina in 4 eyes (28.6%), and the whole retina in 1 eye. Eleven eyes had four-quadrant surgery, and 3 eyes with associated glaucoma had two-quadrant surgery. External subretinal drainage was performed in one patient who had total RD. The mean preoperative logMAR BCVA of 1.50±0.53 increased significantly to 0.92±0.49 after surgery (p=0.002). Resolution of RD could be achieved with two-quadrant surgery in only 1 of 3 eyes. In the other 2 eyes, retinal reattachment was achieved after a secondary surgery for the remaining two quadrants to complete four-quadrant sclerectomy. Final outcome was total reattachment of the retina in 11 eyes (78.6%), partial reattachment in 1 eye (7.1%), and recurrence of macular detachment in 2 (14.3%) eyes. Conclusion: Quadrantic partial-thickness sclerectomy and sclerotomy surgery seems effective for treating UE in eyes with NO. Twoquadrant surgery may be tried for mild UE associated with glaucoma to preserve the superior quadrants for future possible glaucoma surgeries, but secondary surgery for the superior quadrants may be needed. External drainage of subretinal fluid may be an option in severe cases to achieve quicker resolution.

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“…Shields et al [15] reported the treatment of 104 eyes of patients with UES and found that 95% of patients could be managed with steroids, and only 5% needed scleral window surgery. Tong et al [16] and Kumar et al [25] also demonstrated that nonsteroidal antiinflammatory drugs (NSAIDs) can be effective for UES treatment. Park and Lee [17] reported a 64-yearold UES patient successfully treated with topical latanoprost and oral acetazolamide as well as topical bromfenac without surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the mechanism proposed, a number of surgical procedures, in particular full or partial thickness multisclerectomy, have been promoted [11][12][13][14]. However, some patients have been successfully treated with systemic/ topical steroids [15], NSAIDs [16], latanoprost, and oral acetazolamide topical bromfenac [17,18]. Anti-VEGF agents combined with surgical intervention have been reported as a treatment option [9,10].…”

Section: Introductionmentioning

confidence: 99%

Rapid resolution of severe exudation in uveal effusion syndrome with anti-vascular endothelial growth factor alone in a case of bilateral nanophthalmos: a case report

Song

Fang

2021

J Med Case Reports

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Background Uveal effusion syndrome is a rare disease characterized by exudative detachments of the choroid, ciliary body, and retina. Various surgical procedures and nonsurgical strategies have been described to treat uveal effusion syndrome with limited success. The treatment for uveal effusion syndrome remains a serious challenge for clinicians. To the best of our knowledge, no previous report has described a severe uveal effusion syndrome patient with nanophthalmos treated by using an anti-vascular endothelial growth factor agent alone. We report here one such case with unexpected positive results. Case presentation A 30-year-old Chinese male patient presented with painless vision loss in both eyes that had persisted for 2 months. Examination of the right eye revealed a best corrected visual acuity of 0.03; the best corrected visual acuity of the left eye was finger count/20 cm. The intraocular pressure was normal on both eyes. A-scan revealed an right eye axial length of 15.88 mm and a left eye axial length of 16.21 mm. In the right eye, half of the peripheral choroid and nearly three-fourths of the retina were detached. The left fundus was not visible because of the total retinal detachment located just behind the lens, which could be clearly observed directly with a slit lamp. Considering all the possibilities and available treatments as well as the patient’s intentions after discussion, we first administered an intravitreal injection of ranibizumab 0.5 ml into both eyes. The patient’s visual perception improved 3 days after the injection. One month later, most of the effusion under the choroid and retina was absorbed. Visual acuity improved from finger count to 0.05 in both eyes, and vision quality was remarkably improved. Encouraged by this good result, the patient opted to undergo a second injection 1 month later. Choroidal and retinal detachment completely vanished 30 days after the second injection. Conclusions Using an anti-vascular endothelial growth factor agent alone may be a potentially effective and safe method for managing some types of uveal effusion syndrome, such as in nanophthalmos. The injection may be administered before considering more aggressive procedures in some uveal effusion syndrome patients.

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Unusual rapid resolution of postsclerectomy exudative retinal detachment with topical NSAIDs therapy in a case of nanophthalmos

Cited by 8 publications

References 14 publications

The Invisibility of Scotomas I: The Carving Hypothesis

The Invisibility of Scotomas I: The Carving Hypothesis

Treatment of Nanophthalmos-Related Uveal Effusion with Two- vs. Four-Quadrant Partial-Thickness Sclerectomy and Sclerotomy Surgery

Rapid resolution of severe exudation in uveal effusion syndrome with anti-vascular endothelial growth factor alone in a case of bilateral nanophthalmos: a case report

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