Objective To observe the clinical characteristics and therapeutic effect of aphakic retinal detachment (ARD) eyes and pseudophakic retinal detachment (PPRD) eyes.Methods The clinical data of 805 patients,including 321 ARD and 484 PPRD eyes were retrospectively analyzed.The patientsprime;visiual acuity, refraction, intraocular pressure were examined, and the patients also underwent slit lamp microscopy and direct and (or) indirect ophthalmoscopy.The preoperative bestcorrected visual acuity (BCVA) was between light perception (LP) and 0.6.Mainly according to the PVR grade and retinal holes position to take the scleral buckling or vitrectomy combined with scleral buckling. The 805 eyes were divided into 1995-1999 group (243 eyes) and 20002007 group (562 eyes) according to operative time.The follow-up ranged from 3 to 25 months, with an average of 12.3 months.The success standard of surgery was set as anatomic retinal reattachment and the last follow-up time was considered as the judgment time.The surgical complications were recorded at each followup time points. The composition of PPRD,the visual acuity,ocular lesions, surgical methods and results before operation and visual acuity after operation in two groups were analyzed and compared by MantelHaenszel chisquare test. Results The average interval from lens extraction to RD occurrence was 15.4 months in PPRD eyes and 39.1 months in ARD eyes. The final total anatomic success rate was 95.9%, and was 93.5% in the scleral buckle eyes and 97.2% in vitrectomy eyes.The BCVA was better than 0.3 after operation only in 11.9% of the 805 patiens,and the visual acuity increased more than 2 lines in 67.3%. Compared with the ARD eyes,early onset, high proportion of total posterior vitreous detachment,severe PVR,wide RD range,low detection rate of retinal hole and low antomic success rate were found in PPRD eyes.Compared with the 1995-1999 group,the proportion of vitreous surgery,anatomic success rate and better visual acuity were found in 2000-2007 group.Conclusions The ocular lesions of ARD and PPRD is more complicated,the therapeutic effect are improving in recent years.
Objective To evaluate the clinical features of macular retinoschisis (MRS) and macular retinal detachment without hole (MRDH) in highly myopic eyes. Methods The clinical data of 19 patients (24 eyes) with MRS and MRDH from 186 patients (349 eyes) with high myopia were retrospectively analyzed. All of the patients had undergone the examinations of subjective refraction, binocular indirect ophthalmoscope, slit lamp microscope combined with Goldmann threemirror contact lens, fundus images, A/Bscan ultrasonography, and optical coherence tomography (OCT). Results In 349 eyes, 24 (6.9％) had MRS and (or) MRDH at the posterior pole. The results of ocualr fundus examinations showed that all of the 24 eyes (100%) had posterior scleral staphyloma (PS), 2 (8.3%) had vitreomacular traction (VMT), 2 (8.3%) had macular local superficial retinal detachment, and 1 (4.2%) had fullthickness macular hole. The results of Bscan ultrasonography also indicated PS in all 24 eyes (100%), macular local superficial retinal detachment in 7 (29.2%) with a bowlike configuration formed by the detached retina and the coneshaped roof of PS, and VMT in 2 (8.3%). The results of OCT revealed macular outerlayer retinoschisis (ORS) in 22 eyes (91.7%) in which 8 (36.4%) also had macular innerlayer retinoschisis (IRS); MRDH in 5 eyes (20.8%) in which ORS was found in 3 (60.0%) and simplex MRDH in 2 (40.0%) including 1 with VMT; VMT in 13 eyes (54.2%); cystoid macular edema (CME) in 3 eyes (12.5%); and lamellar macular hole in 4 eyes (16.7%). Conclusions MRS and MRDH are common complications in highly myopic eyes with posterior scleral staphyloma.OCT is more sensitive and accurate in detecting MRS and MRDH than routine ophthalmoscopic examination and B-scan ultrasonography.
Objective To evaluate the diagnostic value of panoramic 200 scanning laser ophthalmoscope for retinal detachment. Method Images of ocular fundus of the patients with retinal detachment were obtained by panoramic 200 scanning laser ophthalmoscopy, which were compared with the results of binocular indirect ophthalmoscopy (BIO). The extent of the retinal detachment, the occurrence of retinal hole or not, and the proliferation were observed. Any discrepancies of the results of the two methods were then analyzed. Results In the images from 75 eyes of 71 patients with retinal detachments which were obtained by panoramic 200 scanning laser ophthalmoscopy, recurrent retinal detachments was found in 3 patients (3 eyes), single retinal detachment was in 13 patients (16 eyes) inc luding intercurrent retinal cyst in 1 patient (1 eye), intercurrent retinal hole was in 43 patients (43 eyes), and intercurrent pre-or sub-retinal proliferation was in 14 patients (15 eyes) (4 eyes having retinal hole simultaneously). The results of panoramic 200 scanning laser ophthalmoscopy and BIO were accordant in 53 patients (56 eyes) and inconsistent in 18 patients (19 eyes) due to the loss of peripheral small retinal holes by panoramic 200 scanning laser ophthalm oscopy. The results of the follow-up examination of 16 patients were accordant with the clinical records. Conclusion Panoramic 200 scanning laser ophthalmoscope has the advantages of non-mydriasis, speediness, and wide view field, and can save external records and provide high-resolution images; it is a valuable diagnosis method for retinal detachment. (Chin J Ocul Fundus Dis, 2006, 22: 317-320)
Objective To investigate the characteristics of fundus angiography with fluorescein and indocyanine green in reattachment of rhegmatogenous retinal detachment． Methods Fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were performed on 21 cases with simple rhegmatogenous retinal detachment postoperatively． Results (1) On the artificial ridge of 21 cases,window defect hyperfluorescence was found in FFA,choroidal vessel dilatation and choroidal filling defect of 14 cases were showed in ICGA;(2) In 6 cases cryocoagulation,fluorescein leakage was showed in FFA and ICGA,leakage of choroid was observed in late stage of ICGA;(3) In 6 cases photocoagulation,a few fluorescein leakage was demonstrated in FFA and none of this feature was found in ICGA;(4) ICGA showed slow filling of choroid of perioptic disc in 2 case,and temporo-inferiorly in 2 case. Conclusion Window defect hyperfluorescence of FFA and choroidal vessel dilatation of ICGA on the artificial ridge were the main characteristics in reattachment of rhegmatogenous retinal detachment. (Chin J Ocul Fundus Dis,20000,16:17-19)
Objective To explore the changes of multifocal electroret inogram (mERG) before and after retinal detachment surgery and its clinical significance. Methods Eighteen patients suffered from rhegmatogen ous retinal detachment underwent mERG before and after surgery using VERIS ScienceTM 4.0. The mERG at different area was compared between preoperative and postope rative surgery. Results Preoperatively, the latencies of a wave and b wave in detached area were statistically longer than in attached area (t=4.541 and 6.784, Plt;0.01). The amplitude densities of a wave and b wave were statistically smaller in detached area than in attached area (t=3.680 and 4.257, Plt;0.01). Postoperatively, the amplitude densities of a wave and b wave at fovea, macula, perimacular area and whole tested area significantly improved. Statistical difference was found before and after surgery, but no statistical difference was found in the latencies of a wave and b wave. The amplitude densities of a wave and b wave in the preoperative detached area were statistically larger after surgery than before surgery (Plt;0.05). Conclusions After retinal detachment surgery, the responses of mERG improve to some degree. mERG was a promising tool to evaluate the recovery of retinal function after surgery . The amplitude densities are more sensitive than the latencies to evaluation of retinal function. (Chin J Ocul Fundus Dis, 2001,17:264-267)
Objective To explore significance of multifocal ERG(MERG) in evaluating visual function in patients with retinal detachment(RD). Methods MERG was tested using VERIS 4.0 visual evoked response imaging system for 21 patients with retinal detachment (22 eyes) and 36 normal subjects (42 eyes). The stimulative visual angles subtendedplusmn;26.6deg;horizontally and plusmn;22.1deg;vertically. Burian-Allen contact lens electrode was used to record the responses from 103 retinal locations in 8 min (16 segments). Results The latencies of a wave and b wave at the 4 quadrans, macular area and extra-macular area in RD group were significantly delayed and their amplitudes markedly decreased comparing with normal group (Plt;0.01). The amplitude densities of b wave at detached area, attached area in RD eyes and at the retina in normal eyes were (3.44plusmn;2.85), (6.34plusmn;3.31),(21.32plusmn;6.48) nV/deg2 respectively. There was statistically significant difference among them (Plt;0.05). Conclusion MERG can evaluate objectively and quantitatively the visual function at macular area, posterior polar detached area and attached area in RD. (Chin J Ocul Fundus Dis,2000,16:244-247)