Unusual presentation of a choroidal melanoma

2021 ◽  
Vol 14 (5) ◽  
pp. e240983
Author(s):  
Sunila Jain ◽  
Kar Yen Phoong
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Pars Plana Vitrectomy ◽  
Visual Loss ◽  
Spindle Cell ◽  
Choroidal Melanoma ◽  
Artificial Eye ◽  
History Of ◽  
Pars Plana ◽  
Eye Clinic

A 49-year-old gentleman presented with a 1-day history of painful deterioration of vision in his right eye. He was lifting heavy weights just before this visual loss. On examination, his vision was perception of light in that eye, with a medically uncontrollable high intraocular pressure and hyphaema almost completely filling his anterior chamber. An ultrasound performed suggested a working diagnosis of a Valsalva related ‘eight ball’ bleed. After an anterior chamber washout, he had another episode of bleeding three days later. A pars plana vitrectomy was performed and the sample obtained was sent off to the laboratory, revealing a choroidal melanoma. Following enucleation, the histology confirmed a large necrotic spindle cell melanoma, with a haemorrhagic background. Fortunately, no liver metastasis was found. Since his diagnosis 3 years ago, he continues to be followed up in an artificial eye clinic and has regular liver scans under the care of his oncologist.

Pars plana vitrectomy combined with irido-zonulo-hyaloidectomy for aqueous misdirection

2019 ◽  
Vol 30 (2) ◽  
pp. 396-398
Author(s):  
Shriji Patel
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Study Design ◽  
Medical Management ◽  
Pars Plana Vitrectomy ◽  
Pars Plana ◽  
Design Materials ◽  
Aggressive Medical Management ◽  
Aqueous Misdirection

Introduction: To review the indications and necessary steps for successful irido-zonulo-hyaloidectomy in persistent aqueous misdirection. Study design/materials and methods: A 60-year-old woman was referred for persistent aqueous misdirection despite aggressive medical management. Her intraocular pressure would elevate with discontinuation of cycloplegics and her lens shifted anteriorly. She underwent standard 25g pars plana vitrectomy with irido-zonulo-hyaloidectomy. Results: The aqueous misdirection resolved with successful creation of the irido-zonulo-hyaloidectomy with noticeable deepening of the anterior chamber immediately. Vision improved to 20/30 and intraocular pressure was controlled without cycloplegics or ocular hypotensives. Conclusion: In persistent cases of aqueous misdirection unresponsive to medical management, irido-zonulo-hyaloidectomy is a useful adjunct to pars plana vitrectomy in ensuring resolution of the misdirection.

scholarly journals Changes in anterior segment optical coherence tomography following pars plana vitrectomy without tamponade

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Alireza Khodabande ◽  
Massood Mohammadi ◽  
Hamid Riazi-Esfahani ◽  
Shahab Karami ◽  
Massood Mirghorbani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Optical Coherence ◽  
Mean Values ◽  
Iop Measurement ◽  
Pars Plana ◽  
The Mean

Abstract Background To evaluate changes in anterior segment morphology on anterior segment optical coherence tomography (AS-OCT) following pars plana vitrectomy (PPV) without tamponade. Methods Patients who underwent PPV without tamponade for epiretinal membrane were evaluated. Eligible patients underwent intraocular pressure (IOP) measurement and AS-OCT preoperatively as well as 1 month and 6 months post-operatively. Anterior chamber width (ACW), anterior chamber depth (ACD), trabecular iris angle (TIA), angle opening distance at 500 and 750 µm (AOD), and trabecular iris space area at 500 and 750 µm (TISA) at four quadrants were recorded and analyzed. Additionally, the mean values of TIA (MTIA), AOD (MAOD), and TISA (MTISA) for each eye (mean of four quadrants) were analyzed. Results 23 patients completed the study. The mean age of participants was 56.4 ± 3.6 years of age and 13/23 (56%) were female. Mean IOP of patients was 18.1 ± 1.1, 18.3 ± 1.1, and 18.1 ± 1.2 preoperatively,1 month post-operatively, and 6 months post-operatively, respectively. (p = 0.83). No difference was detected post-operatively in measurements of ACW, ACD, MTIA, MAOD500, MAOD750, MTISA500, and MTISA750. Conclusion Pars plana vitrectomy without tamponade was not associated with changes in anterior chamber morphology.

Intraocular pressure changes following 20G pars-plana vitrectomy

2011 ◽  
Vol 90 (8) ◽  
pp. 744-749 ◽  
Author(s):  
Carsten Framme ◽  
Susanne Klotz ◽  
Ute E.K. Wolf-Schnurrbusch ◽  
Peter Wiedemann ◽  
Sebastian Wolf
Keyword(s):  
Intraocular Pressure ◽  
Pars Plana Vitrectomy ◽  
Pars Plana ◽  
Pressure Changes

Intraocular Pressure Reduction in the Treatment of Normal-Tension Glaucoma

2020 ◽  
pp. 67-72
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Clinical Trial ◽  
Intraocular Pressure ◽  
Visual Field ◽  
Natural History ◽  
Visual Loss ◽  
Normal Tension Glaucoma ◽  
Pressure Reduction ◽  
Glaucomatous Damage ◽  
Intraocular Pressure Reduction ◽  
History Of

The Collaborative Normal-Tension Glaucoma Study (CNTGS) was a randomized clinical trial to determine the effectiveness of a 30% reduction in intraocular pressure (IOP) (using either medical therapy or filtration surgery) on visual field (VF) progression in eyes with normal-tension glaucoma. The study found that reducing the IOP of patients with normal-tension glaucoma by 30% is beneficial to prevent progression of glaucomatous damage if the visual effects of cataracts are excluded from consideration. However, because not all untreated patients progressed, the natural history of normal-tension glaucoma must be considered before embarking on IOP reduction with therapy that may exacerbate cataract formation, unless normal-tension glaucoma threatens serious visual loss.

Properties of Gases Used in Vitrectomy Surgery in Rhegmatogenous Retinal Detachment

2019 ◽  
pp. 172-175
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Visual Loss ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Scleral Buckle ◽  
Pneumatic Retinopexy ◽  
The World ◽  
Pars Plana ◽  
Vitrectomy Surgery

Despite improvements in vitreoretinal surgery techniques, rhegmatogenous retinal detachment is still one of the major causes of visual loss in the world. Pneumatic retinopexy (PR), scleral buckle, and pars plana vitrectomy (PPV) are the modalities that are used in the treatment of retinal detachment. Intraocular gases, which are frequently used in PR and PPV, are indispensable molecules due to their tamponade effects. In order to get favorable postoperative outcomes, the proper type of gas selection should be made by considering the properties of the gases, indications, potential complications, and findings of the patients together.

scholarly journals Pars Plana Vitrectomy and the Risk of Ocular Hypertension and Glaucoma: Where Are We?

2020 ◽  
Vol 9 (12) ◽  
pp. 3994
Author(s):  
Tommaso Rossi ◽  
Guido Ripandelli
Keyword(s):  
Anterior Chamber ◽  
Ocular Hypertension ◽  
Oxygen Tension ◽  
Pars Plana Vitrectomy ◽  
Open Angle Glaucoma ◽  
Crystalline Lens ◽  
Cataract Extraction ◽  
Oxygen Scavenger ◽  
Clinical Series ◽  
Pars Plana

Purpose is to review the pathogenic mechanism for ocular hypertension and glaucoma development after pars plana vitrectomy. Both acute and chronic causes are considered, and special attention is paid to the theories and clinical evidence on the risk of developing Open Angle Glaucoma (OAG) after Pars Plana Vitrectomy (PPV). Most existing scientific literature on the issue agree on the role of ascorbate as an oxygen scavenger within the vitreous chamber. Oxygen tension in the vitreous and anterior chamber is maximum inn proximity of the retinal surface and endothelium, respectively and steeply decreases toward the lens, on both sides, and trabecular meshwork. Vitreous removal and, to a lesser extent, liquefaction, greatly reduces oxygen tension gradient in vitreous chamber while cataract extraction has similar effects on anterior chamber oxygen gradients. Oxygen derivatives originated from the cornea and retina are actively reduced by the vitreous gel and/or the crystalline lens. Vitreous removal and cataract extraction reduce drastically this function. Most reported clinical series confirm this hypothesis although protocol difference and follow-up length greatly impact the reliability of results.

Intraocular Pressure Elevation after Simple Pars Plana Vitrectomy

Ophthalmology ◽  
1997 ◽  
Vol 104 (5) ◽  
pp. 781-786 ◽  
Author(s):  
Uday R. Desai ◽  
Amir A. Alhalel ◽  
Rhett M. Schiffman ◽  
Thomas J. Campen ◽  
Gangadhara Sundar ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Pars Plana Vitrectomy ◽  
Pressure Elevation ◽  
Intraocular Pressure Elevation ◽  
Pars Plana

The Management of Giant Retinal Tears with Silicone Oil

2003 ◽  
Vol 13 (2) ◽  
pp. 192-195 ◽  
Author(s):  
N. Ünlü ◽  
H. Kocaoğlan ◽  
M.A. Acar ◽  
M. Sargin ◽  
B.S. Aslan ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Functional Results ◽  
Ocular Surgery ◽  
Giant Retinal Tear ◽  
Perfluorocarbon Liquids ◽  
Retinal Tears ◽  
History Of ◽  
Pars Plana ◽  
Silicone Oil Tamponade

Purpose To report the surgical success of vitrectomy with silicone oil tamponade in the treatment of retinal detachment associated with giant retinal tears due to various factors. Methods We retrospectively evaluated 21 eyes of 21 patients with retinal tears 90° or greater that underwent vitrectomy, with injection of perfluorocarbon liquids and silicone oil tamponade. Eight eyes (38.1%) had previous ocular surgery (4 aphakia-pseudophakia, 4 pars plana vitrectomy), 4 eyes (19.0%) had a history of trauma (blunt injuries in 2 and penetrating injury in 2), 3 (14.3%) had high myopia. Six eyes (28.6%) had no known condition predisposing to development of giant retinal tear. Results Retinal attachment was obtained in 17 (80.5%) of 21 eyes, with a mean follow-up of 12.5 months. Visual acuity improved in 15 eyes (71.4%). Conclusions Pars plana vitrectomy with silicone oil tamponade proved highly effective in giant retinal tears in terms of anatomical and functional results.

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