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Do Not Underestimate PFV

ABSTRACT Purpose: To identify the characteristics, frequency and complications of peripheral retinal anomalies associated with persistent fetal vasculature (PFV). Methods: Retrospective, noncomparative case series of patients with PFV who underwent surgery during the last 6 years in a university clinic. Type of PFV, presence of peripheral retinal anomalies, extend of the retrolental membrane and retinal detachment, early and late...

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Parameters Affecting Postoperative Success of Surgery for Stage 4a / 4b ROP

ABSTRACT Objective: Vitreoretinal surgery for stage 4A/4B ROP has diverse results and this study is performed to analyse the preop and perop and postoperative parameters affecting the anatomical and fucntional outcomes. Purpose: To describe the long term anatomical and functional results of surgery for retinal detachment associated with stage 4 retinopathy of prematurity (ROP) and patient and surgery related factors affecting postoperative...

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2018 RETINAWS at EVRS

Kourous A. Rezaei (Course Director)     When the Going Gets Tough The Tough Get Going Challenging Cases in Vitreoretinal Surgery Faculty: Antonio Ciardella, Italy; David Martins, Portugal; Jerzy Nawrocki, Poland; Sengul Ozdek, Turkey; Grazia Pertile, Italy & Malhar Soni, UK Short Synopsis: Retina specialists often work in a “shark-infested” world. Unexpected events are a fact of life. Learning how “not to get bit” is...

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ROP with Congenital Toxoplasmosis: Two Causes of Tractional Retinal Detachment Together

EDITED FILM ABSTRACT This video is about the surgical treatment of retinal detachment (RD) in babies born with systemic toxoplasmosis associated with toxoplasma chorioretinitis related RD. They also had premature births and had some degree of ROP. One of them had buphthalmus and retinal break in addition to tractional RD (combined RD). Hydrocephalus and microphthalmus are also common in these cases. Timely vitreoretinal surgery can salvage...

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Pediatric Vitreoretinal Surgical Course

ABSTRACT This pediatric vitreoretinal surgical course starts with main principles of pediatric VRS and continues with specific surgical diseases: ROP, FEVR, Coats, PFV and pediatric rhegmatogenous retinal detachments. Each talk contains case presentations as surgical videos of the representative cases of each disease presented by the distinguished experienced faculty.   Main Principles of Pediatric VRS by Sengul Ozdek, Turkey Surgical...

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Free ILM Flap Technique Under PFCL for Recurrent and Difficult Macular Holes

Free ILM Flap Technique Under PFCL for Recurrent and Difficult Macular Holes EDITED FILM ABSTRACT This video describes a perfluoro-n-octane (PFO) assisted autologous internal limiting membrane (ILM) transplantation technique for difficult macular hole (MH) cases. We harvest a free ILM flap and transplant it into the MH under a PFO bubble. The time, at which PFO is injected, the extent of coverage of PFO and the sequence of fluid air...

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Do Not Underestimate PFV

Do Not Underestimate PFV EDITED FILM ABSTRACT This video demonstrates an unnoticed problem in anterior PFV cases: elongation of the peripheral retina across pars plicata till the equator of the lens. This elongated retina is sometimes continuous with the fibrovascular membrane at the back of the lens. This anatomical variation may cause some retinal complications like RRD during surgery. When you excise the fibrovascular membrane...

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Last Chance for Treatment of Hypotony: Anterior Encircling Scleral Band

Last Chance for Treatment of Hypotony: Anterior Encircling Scleral Band ABSTRACT Hypotony is usually a consequence of ciliary body trauma, ciliary detachment, ciliary membranes secondary to PVR or endophthalmitis or multible VRS. Here we present 2 cases of hypotonia secondary to endopthalmitis related thick ciliary membranes. They have been operated multible times with the attempts for ciliary membrane peeling without any success....

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Late Cicatricial ROP: Should we Operate ?

Late Cicatricial ROP: Should we Operate ? ABSTRACT Purpose: To report our anatomical and functional results of vitreoretinal surgery in cicatricial retinopathy of prematurity (ROP) patients. Methods: This is a retrospective, consecutive case series. 10 eyes of 9 patients presented with late sequel of cicatricial ROP, who had vitreoretinal surgery, were retrospectively reviewed. Anatomical and functional outcomes were...

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A Modified Perfluoro-n-octane Assisted Autologous Internal Limiting Membrane Transplant for Failed Macular Hole Reintervention: A Case Series

A Modified Perfluoro-n-octane Assisted Autologous Internal Limiting Membrane Transplant for Failed Macular Hole Reintervention: A Case Series ABSTRACT We describe a modified perfluoro-n-octane (PFO) assisted autologous internal limiting membrane (ILM) transplantation technique for macular hole (MH) reintervention and present our results from a series of 11 patients. We harvest a free ILM flap and transplant it into the MH under a PFO...

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Surgical Treatment of Advanced Coats Disease

Surgical Treatment of Advanced Coats Disease ABSTRACT Children with advanced Coats disease who had been operated for exudative retinal detachment were involved in the study. The surgical technique included external drainage of subretinal fluid supported with pars plana infusion and cryotherapy application together with anti-VEGF or triamcinolone injection. Pre and postop anatomical and functional status of the eyes will be discussed....

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ARC Vitreoretinal Surgery Rounds

ARC Vitreoretinal Surgery Rounds Dr. Alay Banker, India CONTACT DETAILS     Dr. Lisa Faia, USA: Email: faia.lisa@gmail.com or lfaia@arcpc.net           Dr. Jeremy Wolfe, USA: Email: jwolfe@arcpc.net or jeremydwolfe@gmail.com       Retinopathy of Prematurity Never give up ! Susana Teixeira, Portugal Macular Hole Total Retinal Detachment Myopic Traction Maculopathy Macular Schisis...

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The Impact of Macular and Peripheral Ischemia in DME

Purpose: To describe the effect of macular and peripheral retinal ischemia in diabetic macular edema (DME). Methods: This is a retrospective study on 259 eyes of 187 patients with DME. Degree of macular ischemia and peripheral retinal ischemia were graded in FFA for each case and macular edema with central foveal thickness (CFT) and structural changes of retinal layers were assessed using OCT. Results: There was macular ischemia of...

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Individualized Anti-VEGF Treatment Approach for Neovascular AMD

Aim: To describe the individualized treatment schedule for each neovascular ARMD patient combining PRN and proactive treatment approach. Methods: There are different treatment approaches considering the anti-VEGF treatment for neovascular ARMD. These are monthly treatment, fixed dose with more than monthly intervals or individualized treatments which can be either PRN or treat & extend or wait & extend or observe & plan...

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Definition of Cystoid Macular Degeneration in DME

Purpose: To describe cystoid macular degeneration (CMD) which had no clear definition in diabetic macular edema (DME) and to investigate related characteristics. Method: Retrospective study. Two hundred fifty one eyes of 179 patients who had cystic changes in OCT were enrolled. The horizontal and vertical diameters of the biggest cyst in the area of 1000µm from the center of the fovea were measured for the definition of CMD. The analysis...

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Problematic Induction of Posterior Hyaloid Detachment

Posterior hyaloid was tightly attached to retina and could not detach it with vacuum. I tried to engage the posterior hyaloid with a pick. However, triamcinolone blocked my view and I engaged the retina and tear the retina in the papillomacular bundle area. Contact Details: Email: sozdek@gazi.edu.tr Cell Phone:...

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Suprachoroidal Infusion Line

This presentation is about suprachoroidal infusion line in one 20G and one 23G vitrectomy setting. First thing to be done to avoid such a problem is to check the infusion cannula tip at the beginning. However, when you notice such a complication you will see different ways of solving this problem in this video. Contact Details: Email: sozdek@gazi.edu.tr Cell Phone:...

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Chair Movement

This video is on a retinal abrasion of the posterior pole during core vitrectomy done by one of our fellows caused by a chair movement of the fellow while she was in the vitreous with probes. Contact Details: Email: sozdek@gazi.edu.tr Cell Phone:...

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Macular Buckling

Pathologic myopic eyes are proned to have choroidal effusions during ocular surgeries. This case had macular hole related retinal detachment who had a previous vitrectomy without success. She was offered to have a macular buckling surgery and vitrectomy. A limited subretinal hemorrhage was noted at the beginning of the surgery. We stopped at that moment and observed the choroidal hemorrhage for 10 minutes. Since it did not tend to enlarge,...

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CSCR and Vitelliform Dystrophy as Exudative ARMD Masquerading Diseases

Purpose: There are many entities masquerading ARMD, which have been treated with anti-VEGFs many times without getting any response. In this presentation a chronic CSC and a pattern dystrophy misdiagnosed as exudative ARMD and injected anti-VEGF many times without any success will be presented. Contact Details: Email: sozdek@gazi.edu.tr Cell Phone:...

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Epiretinal Membranes in Neovascular Age-related Macular Degeneration: Effect on Outcomes of Anti-VEGF Therapy

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Introduction: Vitreomacular interface changes of AMD patients such as posterior vitreous detachment (PVD), vitreomacular adhesion (VMA) and vitreomacular traction (VMT) have been addressed in several clinical studies using optic coherence tomography (OCT).However role of epiretinal membrane (ERM) has not been investigated in the concept...

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Sclerotomy Construction in Pediatric Vitrectomy

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Pediatric vitreoretinal surgery is completely different from adult surgery because of the anatomical considerations. These differences start with the sclerotomy construction since the pars plana is not well developed. Here I will talk about the tricks of the sclerotomy construction in vitrectomy for ROP and PFV syndromes specifically to...

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My Way in Recurrent Optic Pit Maculopathy

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   My standard approach to macular detachment associated to optic pit is vitrectomy with posterior hyaloid removal, ILM peeling with or without laser temporal to optic nerve head and gas as a first line treatment. In case of recurrence of macular detachment, I usually use ILM flaps around the optic nerve head to use as a seal over the pit...

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Different Surgical Solutions for Optic Pit Maculopathy

In this video step-by-step surgical solutions to optic pit related macular detachment are presented. We show vitrectomy with posterior hyaloid removal, ILM peeling, laser PK temporal to optic nerve head and gas as a first line treatment. ILM flaps around the optic nerve head to use as a seal over the pit as a second line treatment and using autologous fibrin to seal the pit as a third line treatment in recurrent macular detachments. We...

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Tachyphylaxis During Ranibizumab Treatment of Exudative Age-related Macular Degeneration

Purpose: To determine the rate of tachyphylaxis during Ranibizumab therapy for exudative age-related macular degeneration (AMD). Methods: The records of patients treated with Ranibizumab were retrospectively reviewed. Tachyphylaxis was defined as an initial good response to Ranibizumab followed by a decrease or absence of the response to Ranibizumab despite a minimum of two injections du ring follow-up in patients with exudative...

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Surgical Approach to Massive Subretinal Hemorrhages Secondary to Neovascular ARMD

Purpose: Different surgical management of massive subretinal hemorrhage secondary to ARMD will be defined. Methods: Pars plana vitrectomy (PPV) with 360 retinotomy and removal of subretinal hemorrhage and membrane +/- choroidal patch graft is performed to 3 cases of massive subretinal hemorrhage secondary to ARMD and the results and surgical videos will be presented. Take home message: Subretinal surgery is unavoidable in such cases to...

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RPE Tears Associated with Anti-VEGF Therapy

Purpose: To evaluate the prevalence of retinal pigment epithelium (RPE) tears associated with anti-VEGF therapy and its relation with neovascular retinal pigment epithelial detachment (PED). Methods: A total of 226 patients with exudative age-related macular degeneration treated with intravitreal anti-VEGF were included retrospectively in the study. The presence of RPE tears; the effect of the presence, height, and duration of PED on the...

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Individualized Approach to Neovascular ARMD Treatment

Purpose: To define a new approach for treatment of neovascular ARMD cases with less frequent visits and injections. Methods: Neovascular ARMD cases that have been followed-up for 1-2 year period were analyzed retrospectively and those who had regular intervals of recurrence were identified. An individualized visit and injection period was defined for each of those patients separately. Effectiveness: Those cases that had regular...

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Ozurdex in Vitrectomized Eyes

Purpose: To define the effectiveness of dexamethasone implant in macular edema in vitrectomized eyes. Methods: Two eyes of 2 patients, (one with diabetic macular edema, the other with macular edema secondary to central retinal vein occlusion) who had been treated with intravitreal anti-VEGFs, triamcinolone, laser photocoagulations and vitrectomy + ILM peeling earlier without any response, were treated with IV dexamethasone implant as a...

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Postoperative Macular Hole Closure Patterns and Its Relation with the Visual Outcome

To demonstrate the different postoperative macular hole closure patterns after macular hole surgery and their effect on the visual outcome.

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Salvage of a Suprachoroidal Infusion

Purpose: To define different approaches in case of suprachoroidal infusion cannula. Methods: Two different ways will be demonstrated to solve this problem. Effectiveness: Both of the solutions work quite safely. Take home message: This problem may occur during the learning curve especially in hypotonic eyes. Extra care should be taken to avoid this problem in such eyes. When it occurs, one of these ways can be chosen to solve the...

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PPV with Choroid-RPE Patch Graft for Massive Hemorrhage Due to Neovascular ARMD

This is a video of a patient with age related macular degeneration who had a macular scar in his right eye and a new subretinal massive hemorrhage causing hemorrhagic retinal detachment in his left eye which used to be his better eye. A cataract surgery combined with pars plana vitrectomy with 360 retinotomy, removal of subretinal hemorrhage, clots and choroidal neovascular membrane, and choroid-retina pigment epithelial patch graft was...

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Terminologic Confusion in DME

Background: Genuine confusion in the terminology of diabetic macular edema (DME) classification has existed for a long time. Only the definitions: focal versus diffuse DME and clinically significant macular edema (CSME) have been available since the ETDRS study. This is a far from satisfactory way to define many types of DME in the era of spectral OCT. Methods: OCT records of all DME cases in a university retina clinic were reviewed to...

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What Happens to the Macula Following ERM Surgery: OCT and Visual Changes

Purpose: To understand the postoperative behaviour of the macula after ERM surgery. Methods: Retrospective analysis of functional (visual) and anatomical (OCT) changes of cases with epimacular membrane following surgery was performed in long term. Anatomical changes for each individual case were followed with OCT. The percentage of cases getting normal foveal configuration and time needed for recovery were determined. The effect of...

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Do Neovascular AMD Lesions Associated with PED Behave Differently to Anti-VEGF Treatment?

Purpose: To document the prognosis of eyes with neovascular AMD associated with any pigment epithelial detachment (PED) during the course of anti VEGF treatment. Methods: The medical records of 331 eyes with neovascular AMD treated with intravitreal anti VEGFs were retrospectively errate for the presence of PED. The visual and anatomical (OCT) prognosis of the cases and complication rates after treatment were determined. Results: PED was...

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Treatment of Optic Pit Related Macular Detachment

Sengul Ozdek (Ankara, Turkey) Advantages: PPV with ILM peeling +/- laser for the treatment of optic pit related macular serous detachment. Effectiveness / Safety: Case 1 is a 68y old female with optic pit related macular detachment. Ophthalmic examination revealed a visual acuity (VA) of CF at 3m. Following PPV with ILM peeling and SF6 (20%) gas tamponade, serous detachment persisted during 2 wk post-op visit, which was totally resolved...

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Passive Removal of Silicone Oil with 23 G Transconjunctival System

Sengul Ozdek, Fulya Yaylacioglu (Ankara, Turkey) Advantages: Passive removal of 1000cs silicone oil with 23-G transconjunctival system is an easy and cheap method, which also allows additional vitreoretinal, maneuvers after removal. Methods: 91 eyes of 91 patients, enrolled in our clinic between January 2008 and April 2011, were studied retrospectively. After placing the 23 G infusion cannula, 23G trockars & cannulas were placed in...

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Chorioretinectomy for Perforating Eye Injuries

Sengul Ozdek*, Erdem Yuksel (Ankara, Turkey) Advantages: Early chorioretinectomy in eyes with perforating eye injury may increase the globe survival rate. Methods: Reports of consecutive eyes with severe perforating injuries treated with chorioretinectomy were examined for surgical technique, VA, formation of postoperative proliferative tissue, PVR, and tractional retinal detachment rate. Effectiveness / Safety: Results of 15 eyes of 15...

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RPE Tears and Relation with Anti-VEGF Therapies

http://www.evrs.eu/medias/2010/congress/Age-Related-Macular-Degeneration.flv Sengul C. Ozdek, Sibel Eryigit, Berati Hasanreisoglu (Ankara, Turkey) Purpose: To document the incidence of RPE tears after anti-VEGF therapy. Methods: The reports of patients with wet ARMD treated with anti-VEGFs were reviewed for occurrence of RPE tears. Lesion type, the type of anti-VEGF used and prognosis after RPE tear were analyzed. Results: A total of...

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Loading with Lucentis, Maintenance with Avastin: Can we Maintain the VA?

http://www.evrs.eu/medias/2010/congress/Age-Related-Macular-Degeneration.flv Sengul C. Ozdek, Sibel Eryigit, Berati Hasanreisoglu (Ankara, Turkey) Purpose: To determine if PRN Bevacizumab can maintain the visual acuity (VA) gained with loading Ranibizumab for wet ARMD. Methods: The reports of patients with wet ARMD treated with 3 monthly Ranibizumab followed by PRN Bevacizumab were reviewed retrospectively. VA and central foveal thickness...

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Surgical Treatment of Exudative Retinal Detachment in Eyes with Nanophthalmus

http://www.evrs.eu/medias/2010/congress/Vascular-Pathologies-in-Young-Patients.flv Sengul Ozdek (Ankara, Turkey) Advantages: Sclerectomy surgery is easy and effective in eyes with exudative RD secondary to nanophthalmos. Methods: Four quadrant deep sclerectomy and sclerostomy with mitomycin C was applied to 6 eyes of 3 patients with exudative RD secondary to nanophthalmos. Effectiveness / Safety: Exudative RD resolved quickly in 4 eyes...

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Assessment of CNV Activity with a New Activity

http://www.evrs.eu/medias/2009/congress/When-Re-Treating.flv Authors: Sengul Ozdek, Cuneyt Ozmen, Berati Hasanreisoglu, Ankara, Turkey Advantages: A new activity scoring (AS) for assessment of the neovascular ARMD activity is defined. AS supplies standardization for the assessment of the lesion activity after anti-VEGF therapy. Methods: 52 eyes with neovascular ARMD treated with anti- VEGF agents were involved. The AS is based on 1) fluid...

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Definition and Management of Non-Responders to Anti-VEGF for CNV

http://www.evrs.eu/medias/2009/congress/When-Re-Treating.flv Authors: Sengul Ozdek, Cuneyt Ozmen, Berati Hasanreisoglu, Ankara, Turkey Advantages: To define the nonresponders of CNV to anti-VEGF treatment clearly so that unnecessary treatments with a costly agent can be prevented. Methods: A mini questionnaire with 7 items was send to the retina specialist in Turkey via e-mail. The questions were related with the definition of...

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My Way of Assessment of Neovascular ARMD Avtivity

http://www.evrs.eu/medias/2008/congress/My-Way-of-Assessment-of-Neovascular-ARMD-Avtivity.flv Sengul Ozdek Advantages: In the era of anti-VEGF treatment of choroidal neovascular lesions (CNV) it is becoming more and more important to assess the activity of the lesion to decide for additional treatments. Here I present an activity scoring system which can easily be applied to all of the CNV lesions. Methods: I use 5 parameters to decide on...

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My Silicone Oil Removal Technique Both in Phakic and Aphakic Patients and in Patients with Cataract

http://www.evrs.eu/medias/2008/congress/My-Silicone-Oil-Removal-Technique-Both-in-Phakic-and-Aphakic-Patients-and-in-Patients-with-Cataract.flv Sengul Ozdek Advantages: These sutureless techniques are easy to perform for the surgeons and comfortable for the patients Methods: In pkakic patients: After a 23G 3-port pars plana entry silicone oil is drained passively from the superior trockars. It takes 5 minutes. You can also continue with...

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Vitrectomy Session – IOFB

http://www.evrs.eu/medias/2007/videos/vitrectomysession-iofb.flv

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Posterior Subtenon and Intravitreal Triamcinolone Acetonide for Diabetic Macular Edema

Sengül Özdek, Umut Bahçeci, Gökhan Gürelik, Bahri Aydın, Berati Hasanreisoglu Aim: To evaluate prospectively the results of posterior subtenon (PSTT) and intravitreal (IVT) triamcinolone injections in diabetic macular edema refractory to conventional grid laser photocoagulation. Material and methods: Eyes with resistant clinically significant macular edema had complete ophthalmic examination including FA and OCT before and 1st, 3rd...

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Optical Coherence Tomographic (OCT) Assessment of Diabetic Macular Edema: Comparison with Fluorescein Angiographic and Clinical Findings

Alper Erdinç, MD, Sengül Özdek, MD, Gökhan Gürelik, MD, Bahri Aydın, MD, Umut Bahçeci, MD, Berati Hasanreisoglu, MD, Gazi University, School of Medicine, Ophthalmology Department, Ankara, Turkey Purpose: To compare the optical coherence tomographic (OCT) features with clinical and fluorescein angiographic (FA) findings in patients with diabetic retinopathy. Methods: In a retrospective study ophthalmologic examination together with...

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