Dialysis - Giant Retinal Tear - Retinal Detachment
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25-year-old man was seen in the office on 12/16/2011. He has a new giant retinal tear/retinal detachment in the right eye. He has had symptoms since three days ago. He had a previous episode in this eye in 2008 where he had a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy. Now it looks like that same area is acting up again with a giant tear and detachment. He also has peripheral retinal holes in the eye and you suggested he come here for an evaluation and urgent surgery. His left eye is fine.
VISUAL ACUITY: OD 20/400, OS is 20/20. IOP: OD 13, OS 12.
SLIT LAMP EXAM: The right eye has 1+ cell and flare of the anterior chamber. The lens is clear. The left eye has a clear lens.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a superotemporal giant retinal tear/retinal detachment with a rolled edge extending from 8:00 o’clock around to 1:00 o’clock. There are also open retinal holes down inferiorly at 4:00 and 6:00 o’clock. There is an area of chorioretinal scarring along the bifurcation superotemporal retinal vessel, which was there previously. All of this appears to spare the center of the macula, although it is difficult to say because the flaps are moving back and forth.
OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy.
IMPRESSION: 1. GIANT RETINAL Dialysis RETINAL DETACHMENT – RIGHT EYE
2. PERIPHERAL RETINAL HOLES – RIGHT EYE
3. PREVIOUS CHORIORETINITIS – RIGHT EYE
DISCUSSION: I explained to the patient, given the configuration of the retinal detachment, silicone oil, I think, is completely appropriate because of the risk of PVR because of his previous problems. In addition, because of the other retinal pathology also, in general, with giant retinal tears/retinal detachments, I think a scleral buckle is necessary to support the rest of the retina which is at high risk of problems. I have scheduled him for surgery today. I have warned him that with the oil, his vision is going to be foggy for 3-6 months.
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes800 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes633 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes645 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes514 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes514 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes489 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes564 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes600 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes616 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes782 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes550 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Previous Inflammatory Retinitis - Small Inferior Retinal Holes519 x angesehen25-year-old man vision loss for three days. He had a previous episode in this eye in 3 years ago with a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy at the time for a retinal detachment. That same area has a giant dialysis retinal detachment. OD 20/400, OS is 20/20
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Post-op 2 months vision reasonable under silicone oil - Retina Attached563 x angesehen2 months post-op with silicone oil in eye.
(1 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Post-op 2 months vision reasonable under silicone oil - Retina Attached451 x angesehen2 months post-op with silicone oil in eye.
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Post-op 2 months vision reasonable under silicone oil - Retina Attached506 x angesehen2 months post-op with silicone oil in eye.
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Post-op 2 months vision reasonable under silicone oil - Retina Attached593 x angesehen2 months post-op with silicone oil in eye.
(0 Bewertungen)
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Giant Retinal Diaylsis Retinal Detachment - Post-op 2 months vision reasonable under silicone oil - Retina Attached618 x angesehen2 months post-op with silicone oil in eye.
(0 Bewertungen)
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25-year-old man was seen in the office on 12/16/2011. He has a new giant retinal tear/retinal detachment in the right eye. He has had symptoms since three days ago. He had a previous episode in this eye in 2008 where he had a strange sort of inflammatory lesion. He had laser in that eye and a pneumatic retinopexy. Now it looks like that same area is acting up again with a giant tear and detachment. He also has peripheral retinal holes in the eye and you suggested he come here for an evaluation and urgent surgery. His left eye is fine.
VISUAL ACUITY: OD 20/400, OS is 20/20. IOP: OD 13, OS 12.
SLIT LAMP EXAM: The right eye has 1+ cell and flare of the anterior chamber. The lens is clear. The left eye has a clear lens.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a superotemporal giant retinal tear/retinal detachment with a rolled edge extending from 8:00 o’clock around to 1:00 o’clock. There are also open retinal holes down inferiorly at 4:00 and 6:00 o’clock. There is an area of chorioretinal scarring along the bifurcation superotemporal retinal vessel, which was there previously. All of this appears to spare the center of the macula, although it is difficult to say because the flaps are moving back and forth.
OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy.
IMPRESSION: 1. GIANT RETINAL Dialysis RETINAL DETACHMENT – RIGHT EYE
2. PERIPHERAL RETINAL HOLES – RIGHT EYE
3. PREVIOUS CHORIORETINITIS – RIGHT EYE
DISCUSSION: I explained to the patient, given the configuration of the retinal detachment, silicone oil, I think, is completely appropriate because of the risk of PVR because of his previous problems. In addition, because of the other retinal pathology also, in general, with giant retinal tears/retinal detachments, I think a scleral buckle is necessary to support the rest of the retina which is at high risk of problems. I have scheduled him for surgery today. I have warned him that with the oil, his vision is going to be foggy for 3-6 months.
