Disease relevance of Retinal Perforations

• A four-year-old girl, while undergoing a repeat excisional biopsy for a progressive orbital hemangioma, sustained an accidental intraocular injection of methylprednisolone acetate (Depo-Medrol) resulting in a mass of intravitreal and subretinal depot material as well as a retinal tear, retinal detachment, and rapid cataract formation [1].
• PARTICIPANTS: One hundred thirty eyes with idiopathic macular holes of 1 year or less and a refracted Early Treatment Diabetic Retinopathy Study visual acuity of 20/80 or worse were treated with 1.1 microg recombinant TGF-beta2 or placebo to the macular hole after fluid-gas exchange [2].
• PARTICIPANTS: The authors used a confocal SLO (Heidelberg Retina Angiograph [HRA]) to perform oral fluorescein angiography in 47 patients, 13 of whom were without any retinal disease and 34 with a variety of retinal diseases including macular holes and pucker, inflammatory diseases, retinal vascular diseases, and age-related macular degeneration [3].
• METHODS: Forty-six consecutive eyes that had previously undergone unsuccessful macular hole surgery were re-treated with epiretinal membrane dissection, adjunctive autologous serum, and 16% perfluoropropane (C3F8) gas tamponade [4].
• The majority of ophthalmologists who responded to a questionnaire regarding the relationship between miotics and retinal detachment felt that such a relationship does exist, and that myopia and aphakia/pseudophakia predispose to the formation of new retinal breaks or to retinal detachment from pre-existing breaks with miotics [5].

High impact information on Retinal Perforations

• Permeability was tested by applying methylene blue to the film covering the retinal break [6].
• Fluorophore-assisted retinal break detection using antibodies to glial fibrillary acidic protein [7].
• A multi-input system analysis was used to explore the field topography of ERG responses to local luminance modulation in patients with retinitis pigmentosa, pericentral pigmentary retinal dystrophy, branch retinal arterial occlusion, or idiopathic macular hole [8].
• Retinal detachment associated with macular hole in high myopia: using the vitreous anatomy to optimize the surgical approach [9].
• OBJECTIVE: The study aimed to report incidence and to assess risk factors of postoperative glaucoma in patients with stage 3 idiopathic macular hole treated with pars plana vitrectomy, removal of posterior hyaloid membrane, and perfluoropropane gas tamponade [10].

Chemical compound and disease context of Retinal Perforations

• This study evaluates the fluorescein angiographic changes that occur after macular hole surgery [11].
• The management of giant retinal tears using perfluoroperhydrophenanthrene. A multicenter case series. Vitreon Collaborative Study Group [12].
• CONCLUSIONS: Silicone oil tamponade of macular holes is effective and safe [13].
• Of 816 eyes with retinal breaks, lattice degeneration, or retinoschisis-the types of pathology most conducive to detachment-70% were treated with xenon-arc photocoagulation or cryoapplication [14].
• Triamcinolone-assisted internal limiting membrane peeling during idiopathic macular hole surgery [15].

Biological context of Retinal Perforations

• The results of a study designed to determine the effect of a pars plana vitrectomy, fluid-gas exchange, and intravitreal instillation of TGF-beta 2 in eyes with a full-thickness macular hole and reduced visual acuity are reported [16].
• We studied the fellow eyes of eyes with macular holes by fundus photography, fluorescein angiography, and central visual field testing [17].
• AIM: To determine the efficacy of apraclonidine hydrochloride 1% in preventing intraocular pressure (IOP) spikes following idiopathic macular hole (IMH) surgery with platelet adjunct and intraocular gas tamponade [18].
• The present study examined the phagocytic and digestive activities of retinal pigment epithelial cells (RPE cells) at sites of experimentally produced retinal tears, using the phagocytosis of the latex particles by these cells as a measure of phagocytic activity, and their acid phosphatase activity as a measure of their digestive activity [19].

Anatomical context of Retinal Perforations

• All eyes were normal by light microscopy except for those injected with 10 mg of ceftazidime, which showed disruption of photoreceptors (primarily outer segments) in the foveas with cystic changes in all three and macular holes in two of three [20].
• PURPOSE: To examine three layers of membranes detected by triamcinolone acetonide (TA) and indocyanine green (ICG) during surgery for macular hole and retinal detachment (MHRD) as a result of high myopia [21].
• METHODS: A macular hole with sharp margins and small yellow deposits on the surface of the retinal pigment epithelium appeared in the left eye of a female patient, 53 years old, 12 months after LASIK for the correction of -6.75 D of myopia (follow-up after LASIK, 22 months) [22].
• Findings in the literature include corneal perforation, a vascularized corneal leukoma, a non pigmented epithelial cyst of the anterior chamber, eyelid coloboma, microphthalmos, retinal hole, axial myopia and retinal detachment [23].

Gene context of Retinal Perforations

• Vitreous VEGF concentration in the eyes with PDR (1067 +/- 1076 pg/ml) was significantly higher than in eyes with macular holes (34 +/- 5.5 pg/ml) [24].
• For both macular hole and PDR patients angiopoietin 2 was below the limit of detection [25].
• RESULTS: Angiopoietin 1 concentrations were low in patients with macular hole (median 17 pg/ml) while in NPDR with CSMO they were 2002 pg/ml (range 289-5820 pg/ml) and in PDR 186 pg/ml (range 26-2292 pg/ml) [25].
• METHODS: Concentrations of IL-6 and sIL-6R molecules in vitreous fluids were measured in eyes with PVR and idiopathic macular hole (MH), and the localization of IL-6 and IL-6R on the PVR fibrous membrane was studied [26].
• Vitreous MMP-9 concentration was also significantly higher in eyes with PDR (7.5 +/- 3.8 ng/ml) than in eyes with macular holes (4.2 +/- 1.4 ng/ml) [24].

Analytical, diagnostic and therapeutic context of Retinal Perforations

• CONCLUSIONS: Active searching and prophylactic laser treatments for retinal tears developed before and after cataract extraction in patients with high myopia are recommended [27].
• METHODS: 13 patients (14 eyes) who developed a macular hole after bilateral LASIK for the correction of myopia participated in the study [28].
• METHODS: The levels of PEDF and VEGF were measured by enzyme-linked immunosorbent assay in the vitreous of 46 eyes of 43 patients who underwent vitrectomy with diabetic retinopathy (DR) (32 eyes of 29 patients) and an idiopathic macular hole (MH) (14 eyes of 14 patients) [29].
• METHODS: Three patients who sustained unilateral blunt trauma to the eye and developed traumatic macular hole were followed with ophthalmic examination, fundus photography, fluorescein angiography, and optical coherence tomography (OCT) [30].
• Combined cataract surgery with intraocular lens implant and macular hole surgery was associated with intravitreal perfluoropropane at 15% concentration and with face-down positioning for 21 days [31].

References