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Vitreous Haemorrhage (vitreous + haemorrhage)
Selected AbstractsOptometrists' examination and referral practices for patients presenting with flashes and floatersOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 3 2002A. Alwitry Introduction:,Patients experiencing flashes and floaters commonly present to their optometrist. Some of these patients may have significant pathology, yet there is a great deal of variability with regard to examination technique and referral practice. Methods:,A questionnaire survey was undertaken to determine the current management of patients presenting to their optometrist with flashes and floaters. All practising community optometrists within Southern Derbyshire received a questionnaire and 74 (56.9%) completed replies were received. Results:,Optometrists estimated that an average of 14 patients per month per optometrist presented with symptoms of flashes and/or floaters. Mydriasis was utilised routinely for examination in approximately half of the patients. Mean relative confidence was 2.0 at identifying a vitreous haemorrhage and 6.5 for vitreous pigment (complete confidence = 0, complete lack of confidence = 10). Eight percent of responders were unfamiliar with the clinical sign of vitreous pigment, and 17% identifying this sign did not refer all such patients to the hospital services. Conclusions:,Patients presenting to their optometrists with flashes and/or floaters make up a sizeable part of the community optometrist's workload and the management of these patients is highly variable. A large proportion of these patients are examined without mydriasis, even in the presence of various risk factors for retinal detachment. There is a relative lack of confidence amongst optometrists with regards the detection of vitreous pigment and the prognostic implications of this finding. Educational measures such as study days may help the level of understanding and heighten the appreciation of the implications of flashes and floaters and the various clinical signs encountered. [source] Reducing the incidence of early postoperative vitreous haemorrhage by preoperative intravitreal bevacizumab in vitrectomy for diabetic tractional retinal detachmentACTA OPHTHALMOLOGICA, Issue 6 2010Ling Yeung Acta Ophthalmol. 2010: 88: 635,640 Abstract. Purpose:, This study aimed to evaluate whether preoperative intravitreal injection of bevacizumab reduces early postoperative vitreous haemorrhage (VH) in vitrectomy for diabetic tractional retinal detachment. Methods:, We conducted a retrospective chart review of a consecutive, interventional case series. This included 29 eyes (27 patients) in the bevacizumab group and 40 eyes (37 patients) in the non-bevacizumab group. For statistical analysis, each patient was assigned to one of four groups according to the haemostatic modalities used (group 1, none; group 2, only long-acting gas; group 3, only preoperative intravitreal bevacizumab; group 4, both long-acting gas and preoperative intravitreal bevacizumab). The primary outcome measure was the incidence of early postoperative VH. The secondary outcome measure was visual acuity (VA) at 1 month. Results:, The incidence of early postoperative VH was highest in group 1 (63%), followed by group 2 (21%), group 3 (20%) and group 4 (5%). Group 3 showed the best visual recovery in the first month. All eyes in group 3 reached VA , 1/100 at 1 month after the operation, compared with 44%, 29% and 42% in groups 1, 2 and 4, respectively. Conclusions:, Preoperative intravitreal injection of bevacizumab may be useful for reducing early postoperative VH in vitrectomy for diabetic tractional retinal detachment. Eyes receiving preoperative intravitreal bevacizumab without the use of long-acting gas achieved the best visual recovery at 1 month after the operation. [source] Jamming of 23-gauge instruments in the microcannula during vitrectomy for severe vitreous haemorrhageACTA OPHTHALMOLOGICA, Issue 4 2010Dong Heun Nam No abstract is available for this article. [source] Longterm results after phacovitrectomy and foldable intraocular lens implantationACTA OPHTHALMOLOGICA, Issue 8 2009Wensheng Li Abstract. Purpose:, This study aimed to evaluate the longterm results of phacovitrectomy and foldable intraocular lens (IOL) implantation in eyes with significant cataract and co-existing vitreoretinal diseases. Methods:, We carried out a retrospective study of 186 eyes of 149 patients with various vitreoretinal abnormalities and visually significant cataracts. Vitreoretinal surgery was combined with phacoemulsification and foldable IOL implantation. Main outcome measures were visual acuity (VA), preoperative data, and intraoperative and postoperative complications. Results:, The most common indications for surgery were non-diabetic vitreous haemorrhage and proliferative diabetic retinopathy. Preoperative vision ranged from 0.6 to light perception; postoperative vision ranged from 1.2 to no light perception. Postoperatively, in 162 eyes (87.1%) VA improved by , 3 lines on the decimal chart. In 14 eyes (7.5%), vision remained within 3 lines of preoperative levels and in 10 eyes (5.3%), vision had decreased by the last follow-up. Postoperative complications included elevated intraocular pressure and posterior capsule opacification, corneal edema, macular edema, fibrinous reaction, vitreous hemorrhage, corneal epithelial defects, anterior chamber hyphema, choroidal detachment, persistent macular hole, posterior synechiae, recurrent retinal detachment, rubeosis iridis, neovascular glaucoma. Conclusions:, Combined vitreoretinal surgery and phacoemulsification with foldable IOL implantation is safe and effective in treating vitreoretinal abnormalities co-existing with cataract. Based on extensive experience with the combined procedure, we suggest that combined surgery is recommended in selected patients with simultaneous vitreoretinal pathological changes and cataract. [source] Is there still a place for vitrectomy in the treatment of macular edema due to venous occlusion ?ACTA OPHTHALMOLOGICA, Issue 2009CJ POURNARAS Purpose Persistent macular edema (ME) is the main cause of poor visual outcome in either non-ischemic BRVO or CRVO. Among multiples treatment approaches, vitreoretinal surgery with the goal to achieve the recanalisation of the occluded vessels and/or the resolution of ME, were proposed. Methods Vitrectomy with peeling of the posterior hyaloid and/or the internal limiting membrane,asociated to intravitreal (IVT) triamcinolone , neurotomy, sheathotomy, intravascular rtPA injection were studied in numerous nonrandomized cases series. Results Pars plana vitrectomy has been shown to reduce macular oedema and restore the normal foveal contour without significant change in best corrected visual acuity. In contrast, visual improvement occurs after vitrectomy for vitreous haemorrhage, epiretinal membrane formation and retinal detachment complicating BRVO. Evidence to date does not support any therapeutic benefit from radial optic neurotomy, optic nerve decompression, arteriovenous crossing sheathotomy or intravascular rtPA. Vitrectomy combined with IVT triamcinolone, induces a ME decrease rapidly and durably, without any improvement in visual acuity. Conclusion Vitrectomy with IVT triamcinolne seems to have a more durable effect than IVT triamcinolone alone.Vitrectomy, A-V sheathotomy combined with intravenous t-PA may offer benefits in BRVO. Despite uncertainty and open questions, surgical interventions are likely to be a therapeutic option for RVO in the future. Randomized and controlled studies are needed to confirm these results and to compare them to the natural course of the disease. [source] Outcome indicators for vitrectomy in Terson syndromeACTA OPHTHALMOLOGICA, Issue 2 2009Justus G. Garweg Abstract. Purpose:, There is no general agreement on the best indication and timing of vitrectomy in patients suffering from Terson syndrome. Therefore, we reviewed our cases in order to assess factors interfering with the functional outcome and complication rates after vitrectomy. Methods:, In this retrospective consecutive case series, the records from all patients undergoing vitrectomy for Terson syndrome between 1975 and 2005 were evaluated. Results:, Thirty-seven patients (45 eyes) were identified, 36 of whom (44 corresponding eyes) were eligible. The best-corrected visual acuity (BCVA) at first and last presentation was 0.07 ± 0.12 and 0.72 ± 0.31, respectively. Thirty-five eyes (79.5%) achieved a postoperative BCVA of , 0.5; 26 (59.1%) eyes achieved a postoperative BCVA of , 0.8. Patients operated on within 90 days of vitreous haemorrhage achieved a better final BCVA than those with a longer latency (BCVA of 0.87 ± 0.27 compared to 0.66 ± 0.31; P = 0.03). Patients younger than 45 years of age achieved a better final BCVA than older patients (0.85 ± 0.24 compared to 0.60 ± 0.33; P = 0.006). Retinal detachment developed in four patients between 6 and 27 months after surgery. Seven patients (16%) required epiretinal membrane peeling and seven cataract surgery. Conclusion:, Ninety-eight per cent of our patients experienced a rapid and persisting visual recovery after removal of a vitreous haemorrhage caused by Terson syndrome. A shorter time between occurrence of vitreous haemorrhage and surgery as well as a younger patient age are predictive of a better outcome. Generally, the surgical risk is low, but complications (namely retinal detachment) may occur late after surgery. [source] Jamming of 25-gauge instruments in the cannula during vitrectomy for vitreous haemorrhageACTA OPHTHALMOLOGICA, Issue 2 2008Hajime Shinoda Abstract. Purpose:, To report the jamming of 25-gauge instruments in the cannula during vitreous surgery for non-clearing vitreous haemorrhage. Methods:, Forty-five eyes underwent vitrectomy with 25-gauge instruments for non-clearing vitreous haemorrhage (VH group). The incidence of 25-gauge instruments jamming in the cannula was determined retrospectively and compared with that in 112 eyes that underwent vitrectomy for epiretinal membrane (ERM group), also using 25-gauge instruments. Results:, The 25-gauge vitreous cutter or light pipe became jammed in the cannula in three eyes (7%) in the VH group and the instrument locked inside the cannula had to be removed with the cannula. None of the 25-gauge instruments in the ERM group jammed (p = 0.022, Fisher's exact probability test). Two of three eyes developed giant retinal breaks near the sclerotomy but no retinal break related to the sclerotomy was detected in the ERM group. Examination of the cutter revealed blood trapped between the cutter and the cannula. Conclusions:, Twenty-five gauge instruments may become jammed in the cannula in eyes with non-clearing vitreous haemorrhage. Clinicians should be aware of this surgical complication when 25-gauge instruments are used in vitreous haemorrhage. [source] Intravitreal bevacizumab in recurrent diabetic vitreous haemorrhage after vitrectomyACTA OPHTHALMOLOGICA, Issue 2 2008José Mª Ruiz-Moreno No abstract is available for this article. [source] Comparison of visual acuity measurements and Purkinje's vessel shadow perception for prediction of postoperative visual acuity in different ophthalmological diseasesACTA OPHTHALMOLOGICA, Issue 2 2007Stephan Schulze Abstract. Purpose:, Prediction of postoperative visual acuity (VA) is extremely important to the patient and highly relevant to the surgeon. However, objective evaluation of the macula is frequently impossible in cases such as mature cataract, cataract in high myopia or vitreous haemorrhage. This study compares different preoperative examination techniques used to predict postoperative VA. Methods:, We retrospectively evaluated the charts of all patients who underwent any of the following procedures at our hospital in 2004: phacoemulsification for mature cataract or cataract in high myopia; vitrectomy for diabetic vitreous haemorrhage; macular pucker, and macular hole. The following methods were evaluated: preoperative distance and reading VA; laser interferential VA; Purkinje's vessel shadow perception, and postoperative distance VA. Results:, Complete documentation was available for 136 patients (29 mature cataracts, 25 immature cataracts in high myopia, 42 vitreous haemorrhages, 19 macular puckers, 21 macular holes). In cases of preoperative mature cataract, a positive Purkinje's vessel shadow perception predicted a postoperative VA , 20/50 (odds ratio 11.2). In cases of high myopia, interferential VA correlated best with visual outcome (p < 0.05). In macular surgery laser interferential VA predicted postoperative VA to be better and preoperative reading VA predicted it to be worse than it actually turned out after surgery. Laser interferential VA and last known VA prior to vitreous haemorrhage (mean of 20 months previously) correlated best with postoperative VA (p < 0.05) in cases of vitreous haemorrhage. Purkinje's vessel shadow perception , if positive , predicted a postoperative VA , 20/300 in these cases (odds ratio 15.0). Conclusions:, Postoperative VA after vitrectomy for macular pucker or macular hole and in cases of cataract in high myopia is best predicted by laser interferential VA. Postoperative VA after vitrectomy for diabetic vitreous haemorrhage is best predicted by prehaemorrhage VA or laser interferential VA, especially when prehaemorrhage VA is unknown. Positive Purkinje's vessel shadow perception is an excellent method of predicting postoperative VA , 20/300 in cases of vitreous haemorrhage and VA = 20/50 in mature cataract. [source] 33 cases of airsoft gun pellet ocular injuries in Copenhagen, Denmark, 1998,2002ACTA OPHTHALMOLOGICA, Issue 6 2006Jon Peiter Saunte Abstract. Purpose:, To evaluate the incidence and ocular effects of blunt trauma due to injury from airsoft gun pellets. Methods:, We conducted a non-comparative case series based on the files of 33 patients who suffered ocular injury from airsoft guns and were admitted to one university emergency eye clinic in Copenhagen during a 5-year period. Results:, A total of 33 eyes in 33 patients were examined. Thirty male and three female patients were affected. Mean age was 13 years (range 3,49 years). Mean follow-up time was 6.5 days (range 1,540 days). On initial examination, we found: hyphaema (n = 28), corneal abrasion (n = 22), retinal oedema (n = 11), subconjunctival haemorrhage (n = 10), palpebral haemorrhage and/or oedema (n = 9), iris dialysis (n = 7), intraocular pressure (IOP) >,31 mmHg (n = 4), IOP <,9 mmHg (n = 4), vitreous haemorrhage (n = 2) and cataract (n = 1). One patient had brown corneal discoloration due to severe chronic hyphaema that required surgery. The final visual acuity was 1.0 in 20 patients and ,,0.7 in five patients. Conclusion:, The airsoft gun trauma resulted in anterior and posterior segment ocular injuries that required acute medical intervention and for which some patients were hospitalized. Trauma mainly occurred in children and youths. A longterm risk of glaucoma is expected. Eye care professionals and parents as well as manufacturers of airsoft guns should advise participants to wear adequate protection when involved in this activity. [source] Telangiectasis as a cause of intra-schitic haemorrhage in optic disc pit maculopathyACTA OPHTHALMOLOGICA, Issue 1 2004Shauna M. Quinn Abstract. Purpose:, To present a patient with the novel finding of vascular telangiectasis as a cause of intra-schitic haemorrhage, occurring in optic disc pit-associated maculopathy. Methods:, A clinical history was detailed. Clinical examination included visual acuity assessment and slit-lamp microscopy. Fluorescein angiography was performed. Results:, A temporal optic disc pit, macular retinoschisis and a circumscribed detachment of the outer retinal layer and inner leaf holes were noted. A retinal haemorrhage extending into the schitic cavity was present, along with an associated vitreous haemorrhage. Fluorescein angiography showed telangiectatic vessels in association with the haemorrhage. Conclusion:, This is the first reported case of vascular telangiectasis as a cause of intra-schitic haemorrhage occurring in optic disc pit-associated maculopathy. [source] Outcome of vitrectomy in patients with Terson syndromeACTA OPHTHALMOLOGICA, Issue 2 2002Jan Ståle Ritland ABSTRACT. Purpose:, To report findings and evaluate the results of vitrectomy in 22 eyes with Terson syndrome. Methods:, We reviewed retrospectively the records of patients who underwent pars plana vitrectomy as a result of vitreous haemorrhage. Twelve cases concerned unilateral vitrectomy and five concerned bilateral vitrectomy. The time interval between intracranial haemorrhage and vitrectomy was 1,10 months (mean 5.9 months). Results:, During a mean follow-up of 23.3 months (range 1,69 months) visual acuity (VA) improved in 21 of 22 eyes. Preoperative VA was ,,0.1 in 20 of 22 eyes, while postoperative VA was ,,0.5 in 16 of 21 eyes. Poor visual outcomes were mainly caused by retinal detachments (seven eyes, in which three were caused by proliferative vitreoretinopathy), epiretinal membranes (seven eyes) and optic atrophy (one eye). Our study concurs with recent reports suggesting early vitrectomy in bilateral cases and in cases where ultrasonography shows epiretinal membrane or proliferative retinopathy formation. [source] Avastin as an adjunct to vitrectomy in the management of severe proliferative diabetic retinopathy: a prospective case seriesCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 5 2008Jonathan Yeoh FRANZCO Abstract Purpose:, Bevacizumab (Avastin) is a monoclonal antibody which targets all isoforms of vascular endothelial growth factor A. Its potent anti-angiogenic effects have been shown to cause regression of neovascularization in proliferative diabetic retinopathy. The aim of this study is to investigate the role of Avastin as an adjunct to vitrectomy in the management of severe diabetic eye disease. Methods:, Sixteen patients (18 eyes) with severe proliferative diabetic retinopathy were recruited into the study. All eyes underwent a single intravitreal injection of bevacizumab 1.25 mg in 0.05 mL prior to vitrectomy surgery for the management of tractional retinal detachment or vitreous haemorrhage due to severe proliferative diabetic retinopathy. Results:, At 3 months, seven eyes had visual acuities which were better than baseline, four were unchanged and seven were worse. At 6 months, 14 eyes had visual acuities better than baseline, one was unchanged and three were worse. Seven of the 18 eyes (38.8%) had postoperative rebleeds, six of which required surgical washout. Conclusion:, Avastin improved the ease of the surgery in these complex eyes and the early results are encouraging. We have found it to be particularly useful in diabetic eyes with traction detachments of short duration in which there is still active neovascularization. [source] Intravitreal bevacizumab (Avastin®) in proliferative diabetic retinopathyACTA OPHTHALMOLOGICA, Issue 6 2008Angelo M. Minnella Abstract. Purpose:, To evaluate the efficacy and safety of intravitreal bevacizumab in proliferative diabetic retinopathy (PDR) patients. Methods:, This interventional case series study included 15 eyes of 10 patients with bilateral PDR: 13 eyes with severe PDR and active new vessels (NV) and two eyes with recurrent vitreous haemorrhages. Study eyes received a single intravitreal injection of 1.25 mg (0.05 ml) bevacizumab. All eyes were followed up for 3 months, and eight of them for 9 months. Reinjection was performed in three eyes 4,6 months after the first injection. Study eyes were evaluated by fluorescein angiography at baseline, 1, 3 and 9 months. Quantitative planimetric analysis (QPA) of NV area was measured before and after treatment. All eyes received or completed panretinal photocoagulation (PRP) 1 month after the first injection. Results:, As early as at 1 month, all study eyes had a regression (paired t -test, P = 0.01) of QPA-estimated NV area. The eyes with recurrent vitreous haemorrhages had clearing of bleeding. These early effects were maintained at 3 months for all eyes and tended to be stable at 9 months. The fast and measurable efficacy of bevacizumab allowed a subsequent complete and safe PRP. Conclusion:, Intravitreal bevacizumab did not reveal any side-effects and was effective in the regression of NV areas and the resolution of vitreous haemorrhages. This approach is potentially useful in allowing (within a planned temporal window) a safe and efficient PRP to be performed while minimizing the risk of its complications. [source] Comparison of visual acuity measurements and Purkinje's vessel shadow perception for prediction of postoperative visual acuity in different ophthalmological diseasesACTA OPHTHALMOLOGICA, Issue 2 2007Stephan Schulze Abstract. Purpose:, Prediction of postoperative visual acuity (VA) is extremely important to the patient and highly relevant to the surgeon. However, objective evaluation of the macula is frequently impossible in cases such as mature cataract, cataract in high myopia or vitreous haemorrhage. This study compares different preoperative examination techniques used to predict postoperative VA. Methods:, We retrospectively evaluated the charts of all patients who underwent any of the following procedures at our hospital in 2004: phacoemulsification for mature cataract or cataract in high myopia; vitrectomy for diabetic vitreous haemorrhage; macular pucker, and macular hole. The following methods were evaluated: preoperative distance and reading VA; laser interferential VA; Purkinje's vessel shadow perception, and postoperative distance VA. Results:, Complete documentation was available for 136 patients (29 mature cataracts, 25 immature cataracts in high myopia, 42 vitreous haemorrhages, 19 macular puckers, 21 macular holes). In cases of preoperative mature cataract, a positive Purkinje's vessel shadow perception predicted a postoperative VA , 20/50 (odds ratio 11.2). In cases of high myopia, interferential VA correlated best with visual outcome (p < 0.05). In macular surgery laser interferential VA predicted postoperative VA to be better and preoperative reading VA predicted it to be worse than it actually turned out after surgery. Laser interferential VA and last known VA prior to vitreous haemorrhage (mean of 20 months previously) correlated best with postoperative VA (p < 0.05) in cases of vitreous haemorrhage. Purkinje's vessel shadow perception , if positive , predicted a postoperative VA , 20/300 in these cases (odds ratio 15.0). Conclusions:, Postoperative VA after vitrectomy for macular pucker or macular hole and in cases of cataract in high myopia is best predicted by laser interferential VA. Postoperative VA after vitrectomy for diabetic vitreous haemorrhage is best predicted by prehaemorrhage VA or laser interferential VA, especially when prehaemorrhage VA is unknown. Positive Purkinje's vessel shadow perception is an excellent method of predicting postoperative VA , 20/300 in cases of vitreous haemorrhage and VA = 20/50 in mature cataract. [source] | ||||||||||