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Advances in the Treatment of Retinal Detachment
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Advances in the Treatment of Retinal Detachment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (20 June 2023) | Viewed by 5675

Special Issue Editor

Prof. Dr. Makoto Inoue

E-Mail Website
Guest Editor
Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo 181-8611, Japan
Interests: vitreoretinal diseases; vitreoretinal surgery; vitrectomy; macular edema; retinal detachment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Most rhegmatogenous retinal detachments are rapidly progressive conditions that can lead to blindness if left untreated. Until around 1990, initial surgery for rhegmatogenous retinal detachment underwent mainly with scleral buckling, and vitrectomy was performed only for rhegmatogenous retinal detachment associated with retinal break located deeply and for proliferative vitreoretinopathy (PVR). The subsequent introduction of small-incision vitrectomy and wide-angle viewing systems have improved the efficacy and safety of vitrectomy, which is believed to be the reason for its widespread use as the initial surgery for rhegmatogenous retinal detachment. Even if the initial retinal reattachment rate improves, however, postoperative visual acuity will deteriorate if PVR or macular pucker occurs, even if the patient undergoes reoperation. Drugs to prevent PVR such as methotrexate and prophylactic internal limiting membrane peeling have also been reported. This Section discusses recent advances in the treatment of retinal detachment.

Prof. Dr. Makoto Inoue
Guest Editor

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Keywords

  • retinal detachment
  • wide-angle viewing system
  • vitrectomy
  • scleral buckling
  • proliferative vitreoretinopath

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Published Papers (3 papers)

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9 pages, 249 KiB  
Article
Effect of the COVID-19 Pandemic on Surgical Outcomes for Rhegmatogenous Retinal Detachments
by Masaharu Mizuno, Kosuke Nakajima, Aya Takahashi, Tomoka Ishida, Kazunari Hirota, Takashi Koto, Akito Hirakata and Makoto Inoue
J. Clin. Med. 2023, 12(4), 1522; https://doi.org/10.3390/jcm12041522 - 15 Feb 2023
Viewed by 1975
Abstract
We reviewed the medical records of 438 eyes in 431 patients who had undergone surgeries for rhegmatogenous retinal detachments (RRD) or proliferative vitreoretinopathy (PVR ≥ Grade C) to determine whether the COVID-19 pandemic had affected outcomes. The patients were divided into 203 eyes [...] Read more.
We reviewed the medical records of 438 eyes in 431 patients who had undergone surgeries for rhegmatogenous retinal detachments (RRD) or proliferative vitreoretinopathy (PVR ≥ Grade C) to determine whether the COVID-19 pandemic had affected outcomes. The patients were divided into 203 eyes in Group A that had undergone surgery from April to September 2020, during the pandemic, and 235 eyes in Group B that had undergone surgery from April to September 2019, before the pandemic. The pre- and postoperative visual acuity, macular detachment, type of retinal breaks, size of the RRD, and surgical outcomes were compared. The number of eyes in Group A was fewer by 14%. The incidence of men (p = 0.005) and PVR (p = 0.004) was significantly higher in Group A. Additionally, the patients in Group A were significantly younger than in Group B (p = 0.04). The differences in the preoperative and final visual acuity, incidence of macular detachment, posterior vitreous detachment, types of retinal breaks, and size of the RRD between the two groups were not significant. The initial reattachment rate was significantly lower at 92.6% in Group A than 98.3% in Group B (p = 0.004). The COVID-19 pandemic affected the surgical outcomes for RRD with higher incidences of men and PVR, younger aged patients and lower initial reattachment rates even though the final surgical outcomes were comparable. Full article
(This article belongs to the Special Issue Advances in the Treatment of Retinal Detachment)
10 pages, 537 KiB  
Article
First Nation-Wide Study of the Incidence and Characteristics of Retinal Detachment in Poland during 2013–2019
by Michal Szymon Nowak, Michał Żurek, Iwona Grabska-Liberek and Piotr Kanclerz
J. Clin. Med. 2023, 12(4), 1461; https://doi.org/10.3390/jcm12041461 - 12 Feb 2023
Cited by 1 | Viewed by 1532
Abstract
Aims: The present study aimed to analyze the incidence and characteristics of all types of retinal detachment (RD) in the overall population of Polish adults during 2013–2019. Methods: Data from all levels of healthcare services at public and private institutions recorded in the [...] Read more.
Aims: The present study aimed to analyze the incidence and characteristics of all types of retinal detachment (RD) in the overall population of Polish adults during 2013–2019. Methods: Data from all levels of healthcare services at public and private institutions recorded in the National Health Fund (NHF) database were evaluated. International Classification of Diseases codes (ICD-9 and ICD-10) and unique NHF codes were used to identify RD patients and RD treatment procedures. Results: In the period 2013–2019, 71,073 patients with RD were newly diagnosed in Poland. The average incidence was 32.64/100,000 person-years (95% CI: 31.28–33.99) and it increased with the age of patients, with the highest rate in the group of patients ≥70 years of age. The overall incidences of rhegmatogenous RD, traction RD, serous RD, other RD and unspecified RD were 13.72/100,000, 2.03/100,000, 1.02/100,000, 7.90/100,000 and 7.97/100,000 person-years, respectively. The most common surgical treatment for RD in Poland was PPV performed on average in 49.80% of RD patients. The risk factor analyses showed that rhegmatogenous RD was significantly associated with age (OR 1.026), male sex (OR 2.320), rural residence (OR 0.958), DM type 2 (OR 1.603), any DR (OR 2.109), myopia (OR 2.997), glaucoma (OR 2.169) and uveitis (OR 2.561). Traction RD was also significantly associated with age (OR 1.013) and male sex (OR 2.785) as well as with any DR (OR 2.493), myopia (OR 2.255), glaucoma (OR 1.904) and uveitis (OR 4.214). Serous RD was significantly associated with all analyzed risk factors except DM type 2. Conclusions: The total incidence of retinal detachment in Poland was higher than found in previously published studies. Our study demonstrated that diabetes type 1 and diabetic retinopathy are risk factors of development of serous RD, which is presumably associated with the disruption of the blood–retinal barriers in these conditions. Full article
(This article belongs to the Special Issue Advances in the Treatment of Retinal Detachment)
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8 pages, 868 KiB  
Brief Report
Vitreal Concentrations of Vascular Endothelial Growth Factor in Patients with Rhegmatogenous Retinal Detachment
by Hossein Hasanpour, Maria Cristina Kenney, Baruch D. Kuppermann, Mohammad Riazi Esfahani, Mozhgan Rezaei Kanavi, Mithalesh Kumar Singh and Masoud Soheilian
J. Clin. Med. 2023, 12(4), 1259; https://doi.org/10.3390/jcm12041259 - 5 Feb 2023
Cited by 2 | Viewed by 1624
Abstract
The purpose of this study is to evaluate the concentration of vascular endothelial growth factor (VEGF) in the vitreous humor of patients with primary rhegmatogenous retinal detachment (RRD). This is a prospective case control study. Eighteen patients with primary RRD without proliferative vitreoretinopathy [...] Read more.
The purpose of this study is to evaluate the concentration of vascular endothelial growth factor (VEGF) in the vitreous humor of patients with primary rhegmatogenous retinal detachment (RRD). This is a prospective case control study. Eighteen patients with primary RRD without proliferative vitreoretinopathy C (PVR C) were enrolled as cases, and twenty-two non-diabetic retinopathy patients who were candidates for complete pars plana vitrectomy due to Macular Hole or Epiretinal Membrane were included as the control group. Undiluted vitreal samples were collected during the initiation of Pars Plana Vitrectomy (PPV) prior to any infusion into the posterior cavity. Vitreous samples were also collected from 21 fresh cadaveric globes. The vitreous concentration of VEGF was measured by enzyme-linked immunosorbent assay (ELISA) technique and compared between these two groups. The vitreal concentration of VEGF was 0.643 ± 0.088 ng/mL in the RRD group. Measured concentrations of VEGF in controls were 0.043 ± 0.104 ng/mL, and in cadaveric eyes they were 0.033 ± 0.058 ng/mL. The mean VEGF concentration in the RRD group was statistically higher than in the control group (p < 0.0001) and cadaveric eyes (p < 0.0001). Our study shows that vitreal VEGF concentrations significantly increase in patients with RRD. Full article
(This article belongs to the Special Issue Advances in the Treatment of Retinal Detachment)
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