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Copyright of Bahrain Medical Bulletin is the property of Bahrain Medical Bulletin and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Retinal tears occur as a result of traction at sites of retinal and vitreous adhesion—this allows retrohyaloid fluid into the subretinal space. Prompt management is required to prevent progression to rhegmatogenous retinal detachment (RRD). Aims: To identify the post-procedural outcomes following treatment of retinal tears with laser retinopexy in an emergency setting. Methods: Retrospective review of all patients who underwent emergency slit-lamp laser retinopexy between January and December 2021 in Cork University Hospital, an Irish tertiary referral centre. Results: A total of 87 patients were identified—mean age of 60 ± 12 years and 54% female. Follow-up ranged from 1 week to 11 months. Pre-disposing risk factors were identified—myopia (37%), recent trauma (2%), and RRD family history (5%). All patients had slit-lamp mounted laser-retinopexy performed in the eye-casualty. 63 patients (72%) had a superior break, 66 patients (76%) had a horse-shoe retinal tear, and 21 patients (24%) had a retinal hole. Associated findings included lattice degeneration (26%), sub-retinal fluid (55%), and vitreous haemorrhage (33%). Fourteen patients (16%) required multiple slit-lamp laser retinopexies while 18 patients (21%) required intervention by a vitreo-retinal surgeon including indirect-laser retinopexy (3%), cryotherapy (11%), and pars-plana vitrectomy (6%). At the most recent follow-up, all the patients had anatomically attached retinas. Conclusion: A notable proportion of patients (21%) undergoing emergency laser retinopexy required further intervention. Patients with anteriorly located retinal tears would benefit from an early discussion with a vitreo-retinal surgeon. Departmental training in laser retinopexy and retinal tear management is recommended as part of ongoing quality improvement. [ABSTRACT FROM AUTHOR]

Aim: The aim of this retrospective review was to analyse the frequency of patients presenting with flashes and/or floaters (F/F) on bright versus dark days to the eye emergency department of a tertiary referral hospital (the Mater Misericordiae University Hospital) over a 3-year period. The diagnostic and clinical outcomes of F/F presentations were also analysed. Methods: This retrospective study assessed eye casualty attendances between January 2018 and December 2020. Solar irradiation (j/cm2) at ground level was retrieved from the records of Met Eireann (Irish National Meteorological Service) via their open access records. A review of electronic patient medical records using the in-house database patient centre was carried out of all patients who attended EED of during the study timeline on the 5 'brightest' and 5 'darkest' days of each year. Results: Seven hundred forty patient presentations were analysed in total. Overall, 16% (n = 119) of all patients that attended EED during the timeframe of the study presented with F/F. One hundred six patients (89%) presented with floaters, 40 patients (34%) presented with flashing lights/photopsia, and 35 patients (29%) presented with both F/F. More patients presented to EED with F/F on bright days when compared with dark days (74 vs 45, p < 0.05). Eighty-nine percent of all patients with F/F presented with monocular floaters. There were more floater presentations during bright when compared with dark days (70 vs 36, p < 0.05). More patients were diagnosed with PVD on bright days when compared with those diagnosed with PVD on dark days (43vs 15, p < 0.05). More RDs were diagnosed on dark days compared with bright days (7 vs 3, p < 0.05). Conclusion: This study established that F/F presentations were more likely to present during bright days when compared with dark days. The diagnosis of PVD was more common during bright days, and RDs were diagnosed significantly more frequently on dark days. Although incident solar radiation was correlated with greater floaters/PVD presentation, causation is unlikely, and the duration of PVD may have been longer in patients presenting on bright days (i.e. pseudo-sudden symptoms). [ABSTRACT FROM AUTHOR]

Encircling (360 degree) retinal detachment prophylaxis using indirect ophthalmoscope laser delivery recently achieved strong proof of safety and effectiveness by preventing the development of peripheral retinal tears and detachments in the eyes of patients with Stickler syndrome (syndromic eyes). Untreated, Stickler syndrome patients have a 65% lifetime risk of retinal detachment (half by age 20, 80% bilateral). This report describes an optimal technique of encircling laser retinopexy to also prevent the more common retinal detachments seen in aging (non-syndromic) eyes that share with Stickler syndrome the common pathogenesis of peripheral retinal tears caused by vitreous traction. [ABSTRACT FROM AUTHOR]

The prevalent cause of retinal detachment is a full-thickness retinal break and the ingress of fluid into the subretinal space. To prevent progression of the detachment, laser photocoagulation (LPC) lesions are placed around the break in clinical practice to seal the tissue. Unlike the usual application under indirect ophthalmoscopy, we developed a semi-automatic treatment planning software based on a sequence of optical coherence tomography (OCT) scans to perform navigated LPC treatment. The depth information allows demarcation of the border where the neurosensory retina is still attached to the retinal pigment epithelium (RPE), which is critical for prevention of detachment progression. To evaluate the method, artificially provoked retinal breaks were treated in seven ex-vivo porcine eyes. Treatment outcome was assessed by fundus photography and OCT imaging. The automatically applied lesions surrounding each detachment (4.4–39.6 mm2) could be identified as highly scattering coagulation regions in color fundus photography and OCT. Between the planned and applied pattern, a mean offset of 68 µm (SD ± 16.5 µm) and a mean lesion spacing error of 5 µm (SD ± 10 µm) was achieved. The results demonstrate the potential of navigated OCT-guided laser retinopexy to improve overall treatment accuracy, efficiency, and safety. [ABSTRACT FROM AUTHOR]

Copyright of Türkiye Klinikleri Journal of Ophthalmology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Stickler syndrome, a rare inherited disease, carries a lifetime risk of rhegmatogenous retinal detachment (RRD) of up to 65%, higher than any other predisposing condition known. Both syndromic and non-syndromic eyes suffer RRD predominately from the same pathogenesis, vitreous tractional tears in the peripheral retina. Consequently, extraordinary publications in 2021– 2022, each reporting successful prevention of RRD in Stickler syndrome, using 360-degree (encircling) laser retinopexy, provide the first strong evidence upon which similar prophylaxis in non-syndromic eyes at high risk of RRD from peripheral retinal tears can confidently go forward. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the typical presentation of acute posterior vitreous detachment (PVD), including demographics and prevalence of various treatable findings in the same and fellow eye. Methods: Retrospective analysis of medical records from 2346 patients with acute PVD. Descriptive statistics were generated on age, sex, contact date, visual acuity, and slit lamp, and fundoscopy findings. Multivariate regressions were used to generate odds ratios with 95% confidence intervals (CI) to quantify associations between variables. Results: A total of 4692 eyes from 2346 patients were analyzed. Most patients were female (60.5%) with an average age of 62.8 years old. Overall, 605 patients (25.8%) had any additional ocular finding on fundus exam, including pigmentation (N = 184, 7.8%), lattice degeneration (N = 158, 6.7%), tear (N = 131, 5.6%), and hole (N = 131, 5.2%). Unilateral retinal detachment was present in 26 patients (1.1%), and these patients demonstrated a similar rate (26.9%) of additional ocular findings compared to the entire sample size. Female sex (OR 1.21, 95% CI 1.03–1.43, p = 0.020) was independently associated with presentation during spring or summer. Conclusion: Acute PVD is associated with a number of risk factors and peripheral lesions. These findings may be useful in treating and predicting the course and development of PVD. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to determine symptom-level risk factors for retinal tear/retinal detachment (RT/RD) in our patients presenting with symptoms of posterior vitreous detachment (PVD). Methods: We conducted a prospective cohort study of patients presenting to outpatient ophthalmology clinics at a single academic institution with complaint(s) of flashes, floaters, and/or subjective field loss (SFL). Patients received a standardized questionnaire regarding past ocular history and symptom characteristics including number, duration, and timing of flashes and floaters, prior to dilated ocular examination. Final diagnosis was categorized as RT/RD, PVD, ocular migraine, vitreous syneresis, or "other." Simple and multivariate logistic regressions were used to identify symptoms predictive of various pathologies. Results: We recruited 237 patients (age 20–93 years) from March 2018 to March 2019. The most common diagnosis was PVD (141, 59.5%), followed by vitreous syneresis (38, 16.0%) and RT/RD (34, 14.3%). Of those with RT/RD, 16 (47.1%) had retinal tear and 15 (44.1%) had RD. Significant differences in demographic and examination-based factors were observed between these groups. Symptom-based predictive factors for RT/RD were the presence of subjective visual reduction (SVR; OR 2.77, p = 0.03) or SFL (OR 2.47, p = 0.04), and the absence of either floaters (OR 4.26, p = 0.04) or flashes (OR 2.95, p = 0.009). The number, duration, and timing of flashes and floaters did not predict the presence of RT/RD in our cohort. Within the RT/RD group, patients with RT were more likely to report floaters (100% vs. 66.7%, p = 0.018) and less likely to report SFL (0% vs. 86.7%, p < 0.001) compared to those with RD. Conclusion: While well-known demographic and exam-based risk factors for RT/RD exist in patients with PVD symptoms, the relative importance of symptom characteristics is less clear. We found that the presence of SVR and SFL, as well as the absence of either flashes or floaters, predicts RT/RD in patients with PVD symptoms. However, the number, duration, and timing of flashes and floaters may be less relevant in the triage of these patients. [ABSTRACT FROM AUTHOR]

Copyright of Current Retina Journal / Güncel Retina Dergisi is the property of Anadolu Kitabevi Basim Yayim Medikal Turizm Kirtasiye Tic. Ltd. Sti. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vitreous hemorrhage as common eye presentation and hypertension as common systemic presentation are difficult to designate whether they are coincidental or causal in terms of adverse events of COVID‐19 vaccinations. Temporal association of hypertension and vitreous hemorrhage was noted in a patient repeatedly after the second and third COVID‐19 vaccinations. [ABSTRACT FROM AUTHOR]

Purpose: Traction exerted on the vitreous base during vitrectomy poses a risk for retinal tears. We aimed to quantify core vitreous traction during vitrectomy using spring return and pneumatic cutters. Methods: Juvenile porcine vitreous was vacuum held in a vitreous bath while traction was measured using precision force gauge during vitrectomy. The parameters included were aspiration rate, cut-rate, cutter size, and machine types. Results: An empirical probabilistic model was developed. The traction was proportional to the aspiration rate but insignificantly dependent on the cut-rate. The traction probability was inversely proportional to the exponential function of the traction (p < 0.05). The traction was < 0.003 N for 99% of the time using either 23- or 25-gauge cutters. Conclusion: The tractions measured were considered similar to the causative forces of an iatrogenic retinal tear during a pars plana vitrectomy. The results provide a safety reference matrix of instrumental parameters during vitrectomy. [ABSTRACT FROM AUTHOR]

Copyright of Revista Sociedad Colombiana de Oftalmología is the property of Sociedad Colombiana de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We present 2 cases of iatrogenic retinal penetration from intravitreal (IVT) injections in a retrospective noncomparative case series of 2 patients. The first patient, an 81-year-old Caucasian male, developed dense vitreous hemorrhage soon after receiving an IVT bevacizumab injection for macular edema from central retinal vein occlusion. A 25-g vitrectomy 1 week later showed a retinal hole surrounded by fresh hemorrhages in the same quadrant as the IVT injection. The second patient, an 87-years-old male, developed a retinal detachment after 28 injections of anti-VEGF medications for neovascular AMD. A peripheral round hole was observed during vitrectomy without any lattice degeneration in the same quadrant as prior IVT injections. Both eyes were pseudophakic, had normal axial lengths, and received injections without measuring the injection site. Retinal penetration from IVT injections can result in serious sight-threatening complications. Measuring the injection site from the limbus should be part of safe IVT injection technique. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate vitreous degeneration as a potential risk factor for retinal detachment in dogs after phacoemulsification. Methods: Medical records for dogs with preoperative ocular ultrasound and phacoemulsification between September 28, 2006, and August 2, 2016, were reviewed. Ultrasound images were reviewed by two observers independently, and vitreous echogenicity was graded using an established scale. The following factors were compared between eyes with and without retinal detachment: signalment, operated eye, cataract stage at the time of surgery, and presence or absence of the following: lens‐induced uveitis (LIU), glaucoma, anterior vitreous presentation, lens subluxation, history of prophylactic retinopexy, diabetes mellitus, operating surgeon, concurrent prophylactic retinopexy, posterior capsular tear, phacoemulsification duration, use of automated anterior vitrectomy, placement of an artificial intraocular lens, and intraocular lens type (polymethyl methacrylate or acrylic foldable). Total follow‐up time was recorded. Presence and time from surgery to onset of complications were recorded. Retinal detachment was diagnosed based on observation via indirect ophthalmoscopy or ocular ultrasound. Results: Evaluation for association between vitreous degeneration and retinal detachment included 290 eyes of 180 dogs. There was no statistically significant correlation between vitreous degeneration and postoperative retinal detachment. Retinal detachment was observed in 17 of 290 eyes (5.9%). Vitreous degeneration was marked as present by at least one observer in 189 of 290 eyes (65%). Conclusions: Ultrasonically identifiable vitreous degeneration does not correlate with increased risk of retinal detachment following phacoemulsification. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the frequency of retinal tear, retinal hole, and lattice degeneration in peripheral retinal examination of patients with macular hole. Materials and Methods: The files of patients who underwent pars plana vitrectomy surgery with a diagnosis of macular hole at Eskişehir Osmangazi University Department of Ophthalmology between 2008 and 2018 were retrospectively analyzed. A total of 106 patients with primary macular hole who underwent peripheral retinal examination were included in the study. The frequency of retinal tears, holes, and lattice degeneration associated with macular hole was investigated. Results: Peripheral retinal examination of 106 patients who underwent macular hole surgery revealed retinal tear in 3 patients (2.8%), retinal hole in 4 patients (3.8%), and lattice degeneration in 10 patients (9.4%). Retinal hole and lattice degeneration were observed concomitantly in 1 patient. Conclusion: This study showed that patients with macular hole have concomitant retinal tears and holes, which are also thought to arise due to vitreoretinal traction, at a frequency similar to that in the general population. This result suggests that both the anterior and posterior vitreous may have different pathologies at the same time related to these diseases. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate possible associations between oral anti-vascular endothelial growth factor (VEGF) drugs and ocular side effects.Methods: Spontaneous reports were collected and evaluated by the National Registry of Drug-Induced Ocular Side Effects on the three oral anti-VEGF drugs (pazopanib, sorafenib, and sunitinib) for possible ocular side effects.Results: Reported side effects include blurred or decreased vision (389 cases); periocular or eyelid edema (273 cases); superficial anterior segment toxicity (270 cases); conjunctival, retinal, or vitreous bleeding (77 cases); retinal detachments (RDs) or retinal tears (RTs) (75 cases); extraocular muscle disorders, including ptosis (51 cases); discoloration of eyelashes (36 cases); retinal arterial or venous occlusions (26 cases); optic nerve disorders, including papilledema and ischemic optic neuropathy (21 cases); uveitis (10 cases); and macular edema (7 cases). Spontaneous reports of possible RD or RT have been associated with pazopanib (31 RDs and 12 RTs), sunitinib (24 RDs and 0 RT), and sorafenib (7 RDs and 2 RTs).Conclusions: Oral anti-VEGF drugs can cause superficial anterior segment side effects. Pazopanib has been reported to be possibly linked to RDs and RTs. This study suggests that sorafenib and sunitinib are suspected as well. RDs were seldom differentiated into rhegmatogenous retinal detachments (RRDs) or non-RRDs. The association of oral anti-VEGF drugs with RRD and RT are unclassified although this suggests a "signal" requiring further study. The association of oral anti-VEGF drugs with serous retinal detachments, while rare, is plausible. Patients on this class of drugs should be instructed to seek immediate ophthalmic consultation if retinal symptoms occur. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate possible associations between oral anti-vascular endothelial growth factor (VEGF) drugs and ocular adverse events. Methods: Spontaneous reports were collected and evaluated by the National Registry of Drug-Induced Ocular Side Effects on the three oral anti-VEGF drugs (pazopanib, sorafenib, and sunitinib) for possible ocular adverse events. Results: Reported adverse events include blurred or decreased vision (389 cases); periocular or eyelid edema (273 cases); superficial anterior segment toxicity (270 cases); conjunctival, retinal, or vitreous bleeding (77 cases); retinal detachments (RDs) or retinal tears (RTs) (75 cases); extraocular muscle disorders, including ptosis (51 cases); discoloration of eyelashes (36 cases); retinal arterial or venous occlusions (26 cases); optic nerve disorders, including papilledema and ischemic optic neuropathy (21 cases); uveitis (10 cases); and macular edema (7 cases). Spontaneous reports of possible RD or RT have been associated with pazopanib (31 RDs and 12 RTs), sunitinib (24 RDs and 0 RT), and sorafenib (7 RDs and 2 RTs). Conclusions: Oral anti-VEGF drugs can cause superficial anterior segment adverse events. Pazopanib has been reported to be possibly linked to RDs and RTs. This study suggests that sorafenib and sunitinib are suspected as well. RDs were seldom differentiated into rhegmatogenous retinal detachments (RRDs) or non-RRDs. The association of oral anti-VEGF drugs with RRD and RT are unclassified although this suggests a "signal" requiring further study. The association of oral anti-VEGF drugs with serous retinal detachments, while rare, is plausible. Patients on this class of drugs should be instructed to seek immediate ophthalmic consultation if retinal symptoms occur. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate an innovative approach for closing retinal tears using DuraSeal™ (DS) hydrogel sealant in a rabbit model.Methods: Retinal detachment with a small tear was performed on 20 New Zealand rabbits. Thereafter, rabbits were divided into two groups; the experimental group received a transscleral injection of 0.1 ml DS into the subretinal space whereas the control group received sham injection of saline. Eyes were clinically evaluated using indirect ophthalmoscopy, retinal function was recorded in ten rabbits by electroretinography and the sealant's toxicity was evaluated histopathologically.Results: We found that the DS hydrogel was easily injected transsclerally into the subretinal space of the detached retinas with no major complications. Retinal reattachment was seen in both groups within 2 weeks with no toxicity to the sensory retina. There were no significant differences in retinal function between groups.Conclusion: Subretinal injection of hydrogel through a transscleral route is easy to perform and may open a new avenue in the treatment of retinal detachment. However, the efficacy of the DS as a tamponade for sealing retinal tear is yet to be definite. Long-term clinical, functional, and toxicological studies are needed to evaluate its full potential for clinical applications. [ABSTRACT FROM AUTHOR]

Background: Retinal tears complicating the course of a posterior vitreous detachment (PVD) may be unique or multiple, and when multiple they may occur simultaneously or subsequently at different moments in the evolution of a PVD. The purpose of our study was to analyze the prevalence of subsequent retinal tears (SRT) in patients with a PVD, and to identify possible risk factors for SRT.Methods: One hundred and seventy six eyes in 165 consecutive patients that presented one or more retinal tears in the evolution of a symptomatic PVD, with a minimum follow-up of 12 months, were retrospectively evaluated. The primary outcome measure was to characterize the clinical features associated with SRT formation against those eyes with non-subsequent retinal tear (NSRT-retinal tear/s diagnosed at initial examination) formation. For that purpose, this cohort of patients was divided into two different groups: group 1 included eyes presenting one or multiple retinal tears only at initial examination (NSRT), and group 2 eyes that progressed to a further retinal tear/s (SRT) during follow-up.Results: Group 1 comprised 154 eyes from 145 patients, 48.7% males and 51.3% females with a mean age of 56.9 ± 14.0 years (range = 15-89); 17.2% of patients had a previous retinal tear or retinal detachment in the fellow eye; mean number of retinal tears per eye 1.42 ± 0.8 (range = 1-5); 20.8% presented bilateral retinal tears; 59.1% were myopic eyes (p < 0.05). Group 2 comprised 22 eyes from 20 patients; mean age was 53.3 ± 13.6 years (range = 30-69); 63.6% were male (p = 0.13), and 7 patients (31.8%) had a history of SRT or retinal detachment in the fellow eye (p = 0.13). The mean number of retinal tears per eye was 1.36 ± 0.5 (range = 1-2); bilateral retinal tears were noted in 18.2% of eyes; 86.4% were myopic eyes (p = 0.01); 81.8% occurred within a 120 days-period following diagnosis of the first retinal tear.Conclusions: Multiple retinal tears may be diagnosed in the evolution of a PVD. SRT are most frequently observed in myopic patients, and are usually symptomatic. Follow-up must extend for at least 4 months after the initial symptoms. [ABSTRACT FROM AUTHOR]

Purpose: The present study aimed to describe clinical characteristics of patients with posterior vitreous detachment (PVD), to determine the prevalence of retinal tears in PVD patients, and to find predictors for retinal tears in this patient group. Methods: Retrospective analysis of medical records on patients diagnosed with PVD, retinal tears, or vitreous hemorrhage at the Department of Ophthalmology at Sahlgrenska University Hospital, a tertiary eye center. Results: Between February and July 2009, 365 patients consulted the Department of Ophthalmology for PVD-related symptoms. The incidence of retinal tears was 14.5% (n=53) and that of vitreous and/or retinal hemorrhage was 22.7% (n=83). For analysis of possible predictors for complications to PVD, patients diagnosed with retinal tears or vitreous hemorrhage between May and July 2009 were also included in the study, resulting in a total of 426 patients. Predictors of a retinal tear were symptoms of visual impairment (P=0.024), the presence of vitreous or retinal hemorrhage at examination (P<0.001), and a duration of symptoms for, 24 hours (P=0.004). Symptoms of flashes did not constitute an extra risk of retinal tears (P=0.135). Subsequent retinal pathology (follow-up time 4.5 years), including vitreous detachment/hemorrhage or retinal tears/detachment, occurred more often in patients presenting with a retinal tear. For patients with a retinal tear, the relative risk of having a retinal detachment in the same eye during the follow-up time was 17.7 when compared to patients without a retinal tear (risk ratio 17.7, 95% confidence interval 2.2-145). Conclusion: Patients seeking care on the first day have a higher risk of retinal tears. Also, symptoms of visual loss or a history of previous PVD-related pathology and vitreous/retinal hemorrhage at examination indicate a substantially higher risk of retinal complications. These findings may lead to better management and order of priority among these patients. [ABSTRACT FROM AUTHOR]

Purpose: To report the presence of hyper-reflective dots in the vitreous cavity using spectral-domain optical coherence tomography (SD-OCT) in patients with acute symptomatic posterior vitreous detachment (PVD) and investigate their association with the presence of retinal tear. Methods: The medical records of 77 patients with acute symptomatic PVD, who were examined between March 2013 and February 2015, were reviewed. The severity of vitreous hyper-reflective dots (VHDs) was graded using SD-OCT images, and the presence of retinal tear was assessed. Results: Forty-one (53.2%) eyes had mild VHDs, 13 (16.9%) eyes had moderate VHDs, and 14 (18.2%) eyes had severe VHDs. Retinal tear was found in 21 (27.3%) eyes. The presence of severe VHDs was associated with an increased likelihood of retinal tear (positive likelihood ratio, 9.78; 95% confidence interval, 3.02–31.63). In 14 (66.7%) eyes with retinal tear, the mean number of VHDs significantly decreased from 23.2 ± 20.27 to 2.3 ± 2.66 at a mean follow-up interval of 2.8 ± 1.48 weeks (P = 0.002). Conclusions: The presence of severe VHDs is suggestive of retinal tear in patients with acute symptomatic PVD. However, this SD-OCT finding should be limited to the acute phase of PVD. [ABSTRACT FROM PUBLISHER]

Purpose: To assess the accuracy of B-scan ultrasound (U/S) in diagnosing cases of acute fundus obscuring vitreous hemorrhage (FOVH) using a standardized scan protocol and dedicated ophthalmic ultrasonographer. Methods: Consecutive patients presenting with acute FOVH of unknown cause, between January 2013 and December 2014, were prospectively recruited. Patients underwent a scan performed by a dedicated ultrasonographer, utilizing a systematic scan sequence and using an ocular specific U/S device. The U/S findings were compared to the findings during vitrectomy or after spontaneous hemorrhage clearance. Results: Fifty-eight eyes (58 patients) were included. An underlying rhegmatogenous retinal detachment (RRD) and retinal tears without RRD were reported in nine and 14 patients, respectively. Nineteen of these patients underwent vitrectomy, and the other four underwent laser retinopexy or cryopexy alone. An additional six patients with suspected but uncertain retinal tears underwent vitrectomy, during which tears were confirmed in three, two had retinal vessel avulsions, and one had retinal new vessels. There was “complete” agreement between the B-scan findings and clinical findings in 78% of patients, “partial” agreement in 19%, and agreement was not tested in 3%. When the agreement was “partial”, the disagreements did not affect patient management. The sensitivity was 100% for the detection of RRD, and for the detection of new retinal tears in patients without retinal detachment. Conclusion: B-scan U/S scan was highly sensitive in identifying the pathology in acute FOVH. Our results show an improvement from previously reported results, likely related to the standardized scan protocol and dedicated ophthalmic ultrasonographer. [ABSTRACT FROM AUTHOR]

Copyright of Acta Ophthalmologica Polonica / Klinika Oczna is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An improved solution to the mechanics-based mathematical model for retinal detachment developed by Bottega et al. (2013, Math. Med. Biol., 30, 287-310) is found by removing the simplifying assumption of negligible meridian displacement employed in that study. The model considers retinas with and without central tears and takes contraction of the vitreous and extension of its fibrils, along with a pressure difference across the retina, as the impetus for detachment propagation. Exact analytical solutions are established for the meridian and radial displacements of detaching retinas with and without tears, and numerical simulations are performed based on these solutions. Inclusion of the meridian displacements is seen to result in substantially larger radial displacements without affecting the 'dimpling' behaviour of the detaching retina observed previously. However, the critical stress for detachment propagation is substantially decreased by the inclusion of the meridian displacement. The effects of changes in material and geometric parameters, as well as the influence of the presence and size of the retinal tear on detachment propagation are also studied. The model predicts that retinal detachment propagates catastrophically, which is in agreement with the results found by Bottega et al. (2013, Math. Med. Biol., 30, 287-310) and also with clinical observations. Results show that the inclusion of the meridian displacements enhances the previously seen stabilizing effect a retinal tear can have with regard to detachment propagation. The meridian displacement is similarly seen to enhance the influence that the size of the tear has on this effect. [ABSTRACT FROM AUTHOR]

Purpose: It is aimed to report on a 16-year-old patient with acquired ocular toxoplasmosis complicated by a retinal tear. Methods: Retrospective medical chart review Results: A 16-year-old Caucasian female presented with vision loss in her right eye. In addition to a white active lesion between the fovea and the optic nerve head, marked vitreous opacification was noted. She was diagnosed with ocular toxoplasmosis. The patient was treated with oral azithromycin, clindamycin, and trimethoprimsulfamethoxazole. One month later, retinochoroiditis resolved and vitreous cleared. Three months after onset, patient presented with floaters in the right eye and a retinal tear was located at the temporal region of the retina. Prophylactic argon laser treatment that encircled the retinal tear was performed. No other abnormalities were noted during 6 months of follow-up. Conclusions: Retinal tear associated with ocular toxoplasmosis is rare; however, a retinal tear can occur due to vitreoretinal traction following post-inflammatory structural alteration of the vitreous. Retinal tears may be seen during the healing phase, when the inflammation turns into tightening of vitreous substance. Careful retinal examination in cases of ocular toxoplasmosis is warranted, especially in patients with severe vitreous inflammation. [ABSTRACT FROM AUTHOR]

Purpose: To describe a new method for training residents in ophthalmology in performing laser retinopexy around retinal breaks, and its practicality. Methods: The simulator consists of a model eye that can be adjusted to fit any laser instrument, with a retinal break created in it. The retinal breaks are made of paper strips and can simulate tears and holes. The simulator is used with a three-mirror lens and real laser instrument. Results: The simulator creates conditions simulating near-real laser retinopexy and has been used successfully in training 3 novice residents who have never performed this procedure before. Conclusions: This simulator is simple, reusable and inexpensive. We believe it may be a valuable instructional tool in training residents in performing laser retinopexy, shorten their learning curve and improve their efficiency it in. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

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ABSTRACT Purpose The aim of this study is to determine if oral fluoroquinolone exposure is associated with an increased hazard for having a retinal tear or detachment. Methods A retrospective cohort study was performed using individuals who met inclusion criteria from The Health Improvement Network database. Cohorts were created for individuals who had a prescription written for either an oral fluoroquinolone or an oral β-lactam antibiotic (comparison group). Subjects were excluded if they had a previous diagnosis of a retinal tear or detachment (hereafter retinal break (RB)), or a procedure code to treat an RB, where in the practice for less than 365 days, had a previous prescription for either antibiotic within 365 days of the index date or had intraocular surgery or a diagnosis of endophthalmitis within 90 days prior to the antibiotic prescription. Covariates of interest were age, gender, diabetes, and year of index. The primary outcome measure of interest was the hazard ratio (HR) of undergoing a procedure to treat an RB within 7, 30, 90, or 365 days after exposure to an oral fluoroquinolone prescription versus an oral β-lactam prescription. Results After exclusions, 6 604 423 prescriptions (290 393 fluoroquinolone; 6 314 030 β-lactam) from 3 413 498 patients (247 073 fluoroquinolone; 3 303 641 β-lactam) and 2685 RB procedures were eligible for analysis (661 retinal tears and 2024 retinal detachments). For fluoroquinolones, 0, 1, 5, and 23 RBs occurred at the 7-, 30-, 90-, and 365-day time points, respectively. For β-lactam prescriptions, 7, 28, 87, and 373 RBs occurred at the 7-, 30-, 90-, and 365-day time points, respectively. Because of zero events occurring in the fluoroquinolone cohort during the 7-day observation period, an unadjusted or an adjusted HR (and subsequent p-value or confidence intervals) was unable to be calculated. Univariate and multivariate analyses demonstrated that fluoroquinolones were not significantly associated with RB in the 30-, 90-, or 365-day observation periods (30-day HR = 0.78, p = 0.80, 95%CI: 0.11, 5.71; 90-day HR = 1.25, p = 0.63, 95%CI: 0.51, 3.08; and 365-day HR = 1.35, p = 0.16, 95%CI: 0.89, 2.06). Conclusions Our results do not support an association between oral fluoroquinolone use and subsequent procedures to treat an RB. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A mechanics-based mathematical model for retinal detachment is developed, incorporating an energy-based criterion for propagation. Retinas with and without central tears are considered and contraction of the vitreous and extension of its fibrils, along with a pressure difference across the retina, are taken as the stimuli for detachment propagation. In addition to the equations of motion, boundary and matching conditions, the variational formulation yields the self-consistent energy release rate that governs detachment, and formulae for critical stress and critical deflections that provide a rational basis for measuring critical parameters. Exact analytical solutions are established for axisymmetric detachment of retinas with and without tears, and numerical simulations are performed based on these solutions. The results yield characteristic behaviour, including threshold levels and stability of detachment, ‘dimpling’ of the detaching retina, the effects of changes in material and geometric parameters, and the influence of the presence and size of the retinal tear on detachment propagation. The model predicts that once detachment ensues it does so in an unstable manner and is extensive in scope. This is in agreement with clinical observation. Results also suggest that, under appropriate conditions, the presence and size of a retinal tear or hole can have a ‘stabilizing’ effect with regard to detachment propagation. [ABSTRACT FROM PUBLISHER]

Aims: To characterize photopsia in posterior vitreous detachment (PVD), retinal tears (RT) and rhegmatogenous retinal detachment (RRD). Methods:  Seventy seven patients presenting to an eye emergency department and vitreoretinal clinic with photopsia had documentation of their symptoms. Results: A total of 27 patients had PVD alone, 7 had RTs and 25 RRD. In patients with isolated PVD, photopsia were temporal (94%), lasting seconds (81%) and vertically orientated (59%) flashes. Patients with photopsia located in quadrants other than temporal were more likely to have RRD ( p = 0.0003). Patients with an oblique or horizontal orientation of their photopsia were likely to have RRD or RT ( p = 0.001, specificity 96%, sensitivity 40%). Conclusions: Most patients with PVD have a typical presentation of photopsia, with temporal, vertically orientated, momentary flashes. Patients with RTs or RRD may describe subtle differences in their photopsia which may raise the index of suspicion for the presence of a complication from PVD. [ABSTRACT FROM AUTHOR]

PurposeTo examine the short-term effect of Seprafilm® for patching retinal breaks in experimental rhegmatogenous retinal detachment of rabbit eyes.MethodsExperimental retinal detachment with a break was made and repaired by fluid–gas exchange during vitreous surgery in 10 rabbit eyes. In seven eyes, Seprafilm® was applied to cover iatrogenic retinal breaks entirely (study group) and in other three eyes operations were finished without Seprafilm® application (control group). Funduscopic examination was carried out in both groups and in study group optical coherence tomography (OCT) was performed to observe Seprafilm® on the retinal break. Eyes of study group were enucleated on 7th and 14th postoperative day for histological evaluation.ResultsThe funduscopic examination showed that the retina was reattached in all eyes of study group. Meanwhile all three eyes of control group resulted in proliferative vitreoretinopathy. OCT showed that Seprafilm® adhered to the retina tightly. Funduscopic examination and OCT showed Seprafilm® dissolved within 14 days. Histological examination revealed that Seprafilm® adhered tightly to the retina and there was no inflammatory change at the Seprafilm® application sites.ConclusionsIn our small number of this study, Seprafilm® was found to be beneficial to patch small and posteriorly located retinal breaks in vitreous surgery for rhegmatogenous retinal detachment. [ABSTRACT FROM AUTHOR]

Background: The purpose of this report is to describe the occurrence of a retinal tear, pre-retinal and vitreous hemorrhages after completing a session of whole-body vibration training. Though our patient is the third documented case of vitreous hemorrhage following whole-body vibration training, he is the first to show a close association of a retinal tear and vitreous hemorrhage with whole-body vibration training.Case Presentation: This case report describes a 59-year-old male who had acute onset of floaters and shadows in the left eye. The results of the examination revealed a temporal retinal tear, inferior pre-retinal hemorrhage, and mild vitreous hemorrhage. He was successfully treated using laser photocoagulation with resolution of vitreous and pre-retinal hemorrhages on 4-month follow up.Conclusions: With the rise in popularity of whole-body vibration training exercise, it is important for the medical and athletic community to be aware of possible associated ocular complications. We believe that high-force vibration training may cause retinal tears in susceptible persons. [ABSTRACT FROM AUTHOR]

OBJECTIVE:To report the outcomes following treatment of retinal tears with argon laser photocoagulation by trainee doctors as an emergency procedure. METHODS:Retrospective, case note analysis of 100 consecutive patients treated between August 2000 and December 2002 at a tertiary referral hospital. RESULTS:The case notes of 100 consecutive patients (41 male, 59 female) with a mean age of 57.5 years were reviewed. Out of these 90 were symptomatic. The follow-up period ranged from 1 week to 8 months.All patients had argon laser retinopexy in the Emergency department. The on-call Registrar performed the procedure on 94 patients, and Senior House Officers performed the other six. A total of 98 procedures were performed on the slit lamp and two by laser indirect ophthalmoscope. In all, 24 patients needed further treatment with either indirect laser, cryotherapy, or surgery.At the last follow-up, all the patients had anatomically attached retinas. CONCLUSION:A significant proportion of patients (24%) undergoing laser retinopexy in the emergency department needed further treatment. The relative inexperience in using the indirect laser, together with its unavailability in the Emergency department, may be the contributory factors. There seems to be scope for supervised training in using the laser indirect ophthalmoscope for the trainees in the Ophthalmic Emergency department.Eye (2005) 19, 52-54. doi:10.1038/sj.eye.6701416 Published online 16 April 2004 [ABSTRACT FROM AUTHOR]

The article presents a case study of a 43-year-old woman with known optic disc melanocytoma in her left eye complaining of new floaters. When she presented at the ophthalmic clinic, her vision was 6/6 along with the observation of a pigmentary posterior vitreous detachment (PVD) on ultrasonic (US) and optical coherence tomographic (OCT). A further examination to look for peripheral tears to rule out melanocytomas or retinal breaks, is suggested.

Inhibition of angiogenesis is a target in the treatment of a variety of malignancies. Sorafenib is an oral inhibitor of multiple tyrosine kinases involved in tumor angiogenesis. A related case of ophthalmologic toxicity has been reported with another vascular endothelial growth factor receptor inhibitor, sunitinib.We report the first case of retinal tear possibly associated with sorafenib. [ABSTRACT FROM AUTHOR]

Objective: To propose a possible link between dental extraction and intra-ocular complications. Background: Several publications in medical literature describe intra-ocular complications after different dental procedures. Results: Retinal detachment and vitreous hemorrhage following dental extraction with an appropriate anesthesia. Conclusion: Systemic complications following dental treatments should not be neglected and proper medical treatment must be provided as soon as possible. [ABSTRACT FROM AUTHOR]