Prevalence and associations of epiretinal membranes. The Blue Mountains Eye Study, Australia.

Internal limiting membrane peeling in macular hole surgery.

Insights Into Epiretinal Membranes: Presence of Ectopic Inner Foveal Layers and a New Optical Coherence Tomography Staging Scheme

Surgical management of idiopathic epiretinal membranes.

Optical coherence tomography use in evaluation of the vitreoretinal interface: a review.

Needle drainage of subretinal fluid with simultaneous observation using the indirect ophthalmoscope has been reported to have a very low complication rate. The technique was evaluated by a prospective clinical trial. The study group consisted of 100 patients undergoing scleral buckling for rhegmatogenous retinal detachment who were randomly assigned to groups treated with needle drainage or conventional two-stage drainage. At 1 month, the retina was anatomically flat in 88% of all cases. Subretinal hemorrhage occurred in 10 of 45 patients (22.2%) after needle drainage and in 7 of 55 patients (12.7%) after conventional drainage. The difference was not statistically significant. Retinal puncture occurred during conventional drainage in one case and in no cases during needle drainage. There were no cases of retinal incarceration. The results showed that subretinal hemorrhage was more common after needle drainage, but a larger study would be required to show whether this difference was statistically significant. The fear that the retina would be damaged by placement of a needle in the subretinal space throughout the drainage procedure was unfounded.

Needle Drainage Of Subretinal Fluid A Randomized Clinical Trial

Purpose: To evaluate the advantages and disadvantages of the retention and removal of silicone oil in the treatment of complicated retinal detachments.



Methods: The records of 344 patients (348 eyes) that underwent vitrectomy and silicone oil injection for complicated retinal detachments were abstracted and analysed. The anatomical and functional results, complications and influencing factors are discussed. The outcome in eyes after removal of the silicone oil was compared with the outcome in a comparable group of eyes in which the silicone oil was retained.



Results: The overall retinal reattachment rate was 63% (220/348). The final vision of 5/300 or better was 52% (115/220) in those eyes with totally attached retinas. The silicone oil-related complications included keratopathy (23%) and secondary glaucoma (11%). Comparing removal of silicone oil with retention of silicone oil, we found: (i) there was no statistical difference in the redetachment rate (19 vs 17%); (ii) Oil-removed eyes had a better final vision (P < 0.05); and (iii) keratopathy (13 vs 23%), secondary glaucoma (11 vs 25%) and optic nerve atrophy (4 vs 18%) were significantly lower in oil-removed eyes.



Conclusion: Silicone oil injection is useful in the treatment of complicated retinal detachments. For reducing the incidence of complications, early removal of silicone oil is recommended in those cases in which the retina is attached, all breaks adequately closed and traction relieved.

Use of silicone oil in the treatment of complicated retinal detachment: Results from 1981 to 1994

Foveal microholes are a possible cause of unilateral or bilateral small central visual defects in the absence of other macular pathology. In 18 eyes of 17 patients we noted the following features: small, dark-reddish holes in the centre of the fovea ranging from 50 to 150 micron in size; normal adjacent retinal pigment epithelium and neuroepithelium; unilateral in most cases; males and females are equally affected; mean age 40 years; insidious onset; no history of direct eye trauma or sungazing; non-progressive; relatively favourable visual outcome; no relationship with regular macular holes; aetiology unknown. These distinctive features justify reporting these patients as an important separate group.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1442-9071.1988.tb01253.x

Microholes of the fovea centralis.

Summary

The occurrence of atypical vascularization of the macular-foveal zone in 20 eyes of 17 patients is described. The significance of this fluorescein stereoangiographic finding is discussed.

Macular-foveal capillaries in human retina.

Ten cases of choroidal melanoma were treated with Argon and/or Krypton laser photocoagulation in this retrospective study. Each patient received an average of 9.6 laser treatment sessions. Three female and seven male patients were treated and followed for an average of 69.9 months. Clinical regression was observed in seven cases (70%).



Tumour size in these successfully treated cases ranged from 4.5 times 5.0 times 1.5 mm to 7.0 times 7.0 times 3.5 mm. Continued growth occurred in one case (10%), tumour recurrence which failed to respond to additional laser treatment in another (10%), and although a recurrence appeared to respond to additional laser in a third case (the largest tumour in the series 11.0 times 9.0 times 2.5 mm) extraocular extension was found at enucleation (10%).



Complications of laser treatment included cystoid macular oedema (Case 5), branch retinal vein occlusion (Cases 3 and 6), vitreous haemorrhage from neovascularisation at the edge of the scar, optic atrophy and thrombotic glaucoma (Case 8), and macular involvement by laser (Cases 4, 7 and 10). All patients remain alive without any clinical evidence of metastatic disease at the end of the follow-up period.



These results suggest that laser photocoagulation treatment is a useful option in the management of small choroidal melanomas. It avoids the psychological trauma of enucleation, and maintains some vision, without compromising life expectancy.

James D. Cairns

Papers

Needle Drainage Of Subretinal Fluid A Randomized Clinical Trial

Use of silicone oil in the treatment of complicated retinal detachment: Results from 1981 to 1994

Microholes of the fovea centralis.

Macular-foveal capillaries in human retina.

Laser photocoagulation treatment of choroidal melanoma.