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Objectives: To evaluate the efficacy of human amniotic membrane (hAM) transplantation for complex retinal detachments (RD). Materials and Methods: A retrospective analysis of consecutive patients who underwent vitreoretinal surgery with hAM transplantation for complex RD was conducted. The indications included high myopic macular hole (MH)-associated RD (n = 5), traumatic large macular tears (n = 4), combined RD with MH due to cicatricial retinopathy of prematurity (n=2) and severe retinitis (n=1), and morning glory syndrome (n=1). Surgical procedures, anatomical and functional results, and complications were noted. Results: Thirteen eyes of 13 patients with a median age of 7 years (range, 0-65 years) were included. The follow-up was 15 months (range, 6-30 months). All eyes achieved MH sealing. Sealing occurred after a single surgery in 75% of eyes, while 25% required a second surgery due to hAM contraction/dislocation. The retina was attached and silicone oil could be removed in 92% of eyes during follow-up. The mean logarithm of the minimum angle of resolution visual acuity increased from 2.08[+ or -]0.49 to 1.78[+ or -]0.70 (p = 0.07). Optical coherence tomography showed good integration of the hAM grafts with the retina, albeit without discernible retinal layer differentiation in any case. Conclusion: Amniotic membrane grafting appears to be promising for anatomical sealing of MHs and posterior retinal tears in complex RDs such as those associated with degenerative myopia, severe trauma, tractional membranes, and retinal shortening, where conventional surgical techniques are likely to fail. Further research is needed to clarify the regenerative potential and functional capacity of hAM grafts in severe retinal pathologies. Keywords: Human amniotic membrane, retinal detachment, macular hole, high myopia

Persistent fetal vasculature (PFV) syndrome is characterized by abnormal regression of the fetal hyaloid system and may occur in various forms. In this report, two atypical cases associated with posterior capsular defect and ectopic lens material located along Cloquet's canal are discussed. Ultrasonography of these patients presenting with bilateral total cataracts revealed a hyaloidal stalk extending from the optic nerve head to the retrolental area. During lensectomy, it was observed that lens particles were moving anteriorly from the central mid-vitreous to the aspiration port and that the posterior capsule was developmentally defective. There was no pathological vascular remnant, rather the lens material partially filled Cloquet's canal through the opening in the posterior capsule and created a pseudo-stalk appearance on the preoperative ultrasonography. We aim to discuss possible mechanisms underlying these cases, which may help to improve our understanding of the PFV spectrum. Keywords: Congenital cataract, Cloquet's canal, persistent fetal vasculature, persistent hyperplastic primary vitreous, anatomical variation

The main conference is a 1-day event which took place during the annual meeting of the French Society of Ophthalmology (SFO) on May 6, 2023. The organization provides practical and regulatory support to help design and carry out such studies, and plays an active role in the implementation of clinical research projects by funding research projects. Marcio B. Nehemy, MD; Carlos E. Veloso; MD; Institute of Vision, Federal University of Minas Gerais, Belo Horizonte, Brazil Patient presented with a pre-phthisical eye, disorganized anterior segment, increased choroidal thickness, and a total retinal detachment accompanied by severe proliferative vitreoretinopathy. [...]we injected silicone oil and sutured a clear cornea to complete the procedure.

This case report describes a surgical technique using double-layer human amniotic membrane (hAM) grafting to repair a high myopic macular hole (MH)-related chronic retinal detachment (RD) with subretinal bands in a child with Knobloch syndrome. A 4-year-old boy diagnosed with Knobloch syndrome presented with macular atrophy in the right eye and chronic total RD with subretinal bands associated with a myopic MH in the left eye. The surgery involved an encircling band, pars plana vitrectomy, and subretinal band extraction through a retinotomy. The retinotomy and MH were sealed using hAM with a 5000 centistoke (cS) silicone oil (SO) tamponade. RD recurred two weeks postoperatively due to hAM contracture, leading to MH reopening. A second intervention included replacing the contracted graft with two larger hAM grafts; the first positioned under the MH and the second over the MH in a sandwich configuration, with 5000 cS SO tamponade. Eighteen months after SO removal, a flat retina, closed MH, and ambulatory vision were achieved. In conclusion, double-layer hAM grafting provides a strong seal for MH in high myopia-associated RD where conventional techniques fail. Keywords: Pediatric retinal detachment, human amniotic membrane, Knobloch syndrome, macular hole-related retinal detachment, pediatric high myopia

Systemic vascular occlusive disease associated with neurofibromatosis type 1 (NF1) has been reported in the aortic, cerebral, renal, celiac, and mesenteric vessels and is referred to as NF1 vasculopathy. Although retinal vascular involvement in patients with NF1 usually manifests as retinal capillary hemangiomatosis, a few cases of NF1 with retinal vascular occlusive disease have also been described. Here, we report a 2-year-old girl with NF1 who presented with branch retinal vein occlusion and peripheral retinal ischemia secondary to NF1. This case demonstrates that NF1-related retinal occlusive vasculopathy may occur in very young patients and that detailed fundus examination with fluorescein angiography is necessary in all patients with NF1. Keywords: Neurofibromatosis type 1, NF1 vasculopathy, occlusive vascular disease, branch retinal vein occlusion

Avascular peripheral retina in an infant is a common characteristic of numerous pediatric retinal vascular disorders and often presents a diagnostic challenge to the clinician. In this review, key features of each disease in the differential diagnosis, from retinopathy of prematurity, familial exudative vitreoretinopathy, Coats disease, incontinentia pigmenti, Norrie disease, and persistent fetal vasculature, to other rare hematologic conditions and telomere disorders, will be discussed by expert ophthalmologists in the field. Keywords: Avascular retina, retinopathy of prematurity, familial exudative vitreoretinopathy, Coats disease, incontinentia pigmenti, persistent fetal vasculature, Norrie disease

Objectives: To evaluate the characteristics and surgical outcomes of late-onset rhegmatogenous retinal detachment (RRD) associated with regressed retinopathy of prematurity (ROP) and the status of fellow eyes. Materials and Methods: Retrospective review of consecutive cases undergoing surgery for regressed ROP-related RRD and the fellow eyes between 2012-2022. Demographic data, fundus findings, retinal detachment characteristics, surgical procedures, and anatomic and functional outcomes were analyzed. Anatomic success was defined as retinal attachment after silicone oil removal at final follow-up. Results: Fifteen eyes of 14 patients with a history of regressed ROP underwent surgical repair for RRD at a mean age of 12 (range, 3-26) years. Primary surgical intervention yielded a 53% failure rate overall. This rate was 33% for scleral buckling (SB), 100% for pars plana vitrectomy (PPV), and 40% for combined SB-PPV surgery. Eyes with posterior cicatricial changes and/or proliferative vitreoretinopathy (PVR) demonstrated a higher tendency for recurrence. The final anatomic success rate was 73% after a mean number of 2.3 (range, 1-5) surgeries. The chances of restoring useful vision diminished with repeated surgery despite the improvement in anatomic success. In the fellow eyes, peripheral retinal pathologies were universally observed, with posterior cicatricial changes noted in 33%. Conclusion: The study reveals a significant initial failure rate in surgical treatment of cases with late-onset RRD associated with regressed ROP, particularly in eyes with posterior cicatricial changes or PVR, suggesting the need for a combined surgical approach as an initial strategy in such high-risk cases. The consistent presence of retinal abnormalities in fellow eyes calls for proactive monitoring and potential prophylactic intervention. Keywords: Retinopathy of prematurity, ROP, retinal detachment, regressed ROP, cicatricial ROP

PurposeTo identify the characteristics of peripheral retinal anomalies associated with persistent fetal vasculature (PFV) and evaluate the complications and outcomes.MethodsRetrospective, noncomparative case series of patients with PFV who underwent surgery. Type of PFV, presence of peripheral retinal anomalies, extent of the retrolental membrane, complications, and functional and anatomical results were evaluated.ResultsTwenty-nine eyes of 28 patients were enrolled in the study: 14 eyes (48.3%) with anterior PFV, 10 eyes (34.5%) with posterior PFV, and 5 eyes (17.2%) with combined PFV. The retina was found to elongate anteriorly as finger-like projections beyond the ora serrata, incorporating into retrolental fibrovascular tissue in 81.8% of the anterior PFV cases. Cases with more extensive retrolental tissue had a higher risk of retinal complications (p = 0.009) and anterior segment complications (p = 0.026) than those with localized disease. Leaving the peripheral part of the fibrovascular tissue in place led to complications by later contraction. A total of 35.7% of the anterior PFV cases had 20/200 or better vision at the final follow-up versus 6.7% of the cases with posterior involvement. Retinal attachment was achieved in 12 eyes (80%) with posterior involvement. Four eyes (13.7%) resulted in total retinal detachment at final follow-up.ConclusionsThe high incidence of peripheral retinal anomalies that are found in anterior PFV patients and their relation to retinal complications warrant careful examination of the ora serrata-ciliary body area. Limbal approach may be preferred as a safer method in cases with an extensive fibrovascular membrane obscuring the view. Leaving the peripheral part of the fibrovascular tissue may result in severe postoperative complications, which should be avoided.

Here we report three cases of flap-related complications following temporal inverted internal limiting membrane (ILM) flap technique for the repair of macular holes (MH). The first case showed a flap closure pattern in which the MH completely closed at 2 months spontaneously. The second case showed early anatomical and functional improvement provided by an immediate closure of the MH but developed flap contracture and nasally located epiretinal membrane (ERM) at postoperative 18 months. There was no functional deterioration, thus no further intervention was required. In the third case, early postoperative flap dislocation was observed and an additional surgery to reposition the flap was needed. The flap closure pattern observed with inverted ILM flap techniques may represent the ongoing healing process of large MHs and may be related to delayed spontaneous anatomical closure. ILM flap contracture and ERM formation may be a harmless long-term complication. Dislocation of the ILM flap is an unexpected early postoperative complication that may necessitate a second surgery for flap repositioning. Keywords: Macular hole, vitrectomy, inverted internal limiting membrane flap, flap contracture, flap dislocation, flap closure

[LANGUAGE=”English”]ObjectivesTo evaluate the characteristics and surgical outcomes of late-onset rhegmatogenous retinal detachment (RRD) associated with regressed retinopathy of prematurity (ROP) and the status of fellow eyes.Materials and MethodsRetrospective review of consecutive cases undergoing surgery for regressed ROP-related RRD and the fellow eyes between 2012-2022. Demographic data, fundus findings, retinal detachment characteristics, surgical procedures, and anatomic and functional outcomes were analyzed. Anatomic success was defined as retinal attachment after silicone oil removal at final follow-up.ResultsFifteen eyes of 14 patients with a history of regressed ROP underwent surgical repair for RRD at a mean age of 12 (range, 3-26) years. Primary surgical intervention yielded a 53% failure rate overall. This rate was 33% for scleral buckling (SB), 100% for pars plana vitrectomy (PPV), and 40% for combined SB-PPV surgery. Eyes with posterior cicatricial changes and/or proliferative vitreoretinopathy (PVR) demonstrated a higher tendency for recurrence. The final anatomic success rate was 73% after a mean number of 2.3 (range, 1-5) surgeries. The chances of restoring useful vision diminished with repeated surgery despite the improvement in anatomic success. In the fellow eyes, peripheral retinal pathologies were universally observed, with posterior cicatricial changes noted in 33%.ConclusionThe study reveals a significant initial failure rate in surgical treatment of cases with late-onset RRD associated with regressed ROP, particularly in eyes with posterior cicatricial changes or PVR, suggesting the need for a combined surgical approach as an initial strategy in such high-risk cases. The consistent presence of retinal abnormalities in fellow eyes calls for proactive monitoring and potential prophylactic intervention.[LANGUAGE=”Turkish”]AmaçRegrese prematüre retinopatisi (ROP) ilişkili geç dönem yırtıklı retina dekolmanlarının (YRD) özelliklerini, bu olgularda cerrahi sonuçları ve diğer gözlerin durumunu incelemek.Gereç ve Yöntem2012-2022 yılları arasında regrese ROP ilişkili YRD nedeniyle cerrahi geçiren olgular ve diğer gözleri, demografik özellikler, fundus bulguları, retina dekolmanı özellikleri, uygulanan cerrahiler, anatomik ve fonksiyonel sonuçlar açısından retrospektif olarak incelendi. Anatomik başarı, silikon alınması sonrası son kontrolde retinanın yatışık kalması olarak tanımlandı.BulgularRegrese ROP öyküsü olan ortalama 12 yaşında (3-26 yaş aralığında) 14 hastanın 15 gözüne, YRD gelişimi nedeniyle cerrahi uygulandı. Tüm olgularda, primer cerrahi başarısızlık oranı %53 olup; bu oran, ilk cerrahi olarak skleral çökertme (SÇ) uygulananlarda %33, pars plana vitrektomi (PPV) uygulananlarda %100, kombine SÇ-PPV uygulananlarda %40 idi. Posterior skatrisyel değişiklikler ve/veya proliferatif vitreoretinopati (PVR) olan gözlerde nüks eğilimi daha yüksekti. Ortalama 2,3 (aralık, 1-5) cerrahi sonrasında nihai anatomik başarı oranı %73 idi. Tekrarlayan cerrahilerde, anatomik başarıdaki artışa rağmen, fonksiyonel kazanım sınırlı kaldı. Tüm olguların diğer gözlerinde periferik retinal patolojiler yaygın olarak gözlendi ve %33’ünde skatrisyel ROP ilişkili posterior fundus değişiklikleri bulundu.SonuçRegrese ROP ilişkili geç dönem YRD olgularında, posterior skatrisyel değişiklikler ve PVR varlığında primer cerrahi başarısızlığının yüksek olması, yüksek riskli olgularda başlangıç stratejisi olarak kombine cerrahi yaklaşımının gerekliliğini ortaya koymaktadır. Diğer gözlerdeki periferik retinal anomalilerin sıklığı, proaktif izlem ve profilaktik müdahale ihtiyacını gündeme getirmektedir.