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Detection of choroidal neovascularization using Optical Coherence Tomography Angiography compared to Traditional Angiography in Exudative Age-Related Macular Degeneration

SCIENTIFIC POSTER 2016_Detection of choroidal neovascularization using Optical Coherence Tomography Angiography compared to Traditional Angiography in Exudative Age-Related Macular Degeneration Purpose: To determine the sensitivity and specificity of optical coherence tomography angiography (OCTA) in detecting choroidal neovasculararization (CNV) compared to fluorescein angiography (FA) considered as the first choice technique. Methods: A...

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New Lutein-based Dyes vs Standard Synthetic Dyes in Vitreoretinal Interface Surgery

SCIENTIFIC POSTER 2016_New Lutein-based Dyes vs Standard Synthetic Dyes in Vitreoretinal Interface Surgery Purpose: To compare anatomic, functional, microperimetric and electrofunctional outcomes among patients affected by vitreoretinal interface-associated disorders undergoing vitrectomy + epiretinal membrane and/or internal limiting membrane peeling by using new lutein-based dyes or standard synthetic dyes. Materials and Methods: This is...

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You Have Got Endophthalmitis! What Next…???

The purpose of this presentation is to highlight significant worldwide issues in relation to Endophthalmitis management. It explores a detailed answer to this question – “What has changed since EVS?”; and highlights profound limitations of EVS, New evidences since EVS and Current Global Retina-Practice-Trends. The author unreservedly defends the role of early or primary vitrectomy in the management of most cases of Endophthalmitis;...

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Double Inverted Flap Technique for Stage IV MH

Aim: To present a modification of the conventional inverted flap technique in stage IV macular hole surgery. Technique: After a core vitrectomy and trypan blue-assisted ILM peeling. Two vertical tears were created, temporal and nasal, to the fovea. Boht flaps were folded over the fovea creating a large ILM peeling. Air fluid exchange was followed by SF6 25% injection. Results: Six eyes of 6 patients were treated with this technique and...

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My Way to Perform the Inverted Flap Technique for MH

Introduction: Full-thickness idiopathic macular holes are foveal anatomic defects with a complete interruption of all retinal layers. This results in a significant visual impact for the patient. Current surgical options are constantly under debate, particularly after the new International Vitreomacular Traction Study Group classification. Various surgical options have been proposed to boost the closure rates in this disorder, namely...

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Why Did I Choose the Inverted ILM Flap Technique?

Simple surgical maneouver. Better anatomical results. Earlier visual recovery. Large and difficult macular holes may be succesfully closed with this technique. No additional equipment/ dye etc. is necessary. Enables hole closure in different indications (traumatic, high myopia). It allows succesful treatment of myopic macular hole with retinal detachment. Reoperations are predictable, logic and easy to perform. Temporal inverted ILM...

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Clinical Experience of Ocriplasmin for Vitreomacular Traction and MH

Purpose: To evaluate the anatomical and functional results after ocriplasmin (JETREA, ThromboGenics NV, Iselin, NJ, USA) injection in patients with vitreomacular traction (VMT) with or without macular hole (MH). Methods: Fifteen prospective patients with VMT were treated with a single ocriplasmin injection and followed-up at baseline, 1 week, 1, 3 and 6 months. ETDRS best-corrected visual acuity (BCVA), intraocular pressure and...

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Morpho-functional Evaluation of the Ganglion Cell Complex After MH and ILM Peeled with Tano Diamond Scrapper

To evaluate the functionality and the thickness of the ganglion cell complex (GCC) in sixteen patients with full-thickness macular hole underwent ILM peeling and scraping with Tano Diamond Duster Membrane Scraper (DDMS). Three-port pars plana vitrectomy with a 23-gauge system was performed with ILM peeling. After Dual Blue staining, air was used as tamponade. Before performing fluid/air exchange, the hole edges were repeatetdly massaged...

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3 Cases of MH that Lately Closed when the Patient Respected his Positioning

Macular hole are frequently operated using gas tamponnade, requiring a face-down positioning. However, some suggest that this positioning is not so important whereas others consider that tamponnading is not necessary. In the EVRS MH study, we showed that 85% of macular holes would close; ranging from 95% in small holes to 40% in complex situations. However, patients are frequently complaining about the face-down positioning,...

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Advantages of ILM Blue

Before seeing the advantages of the ILM Blue in ERM surgery, compared to the other dyes, we must analyze what we want to dye: ERM is composed on a plaque of posterior hyaloid which is a collagen 2 structure responsible of reflection and metamorphopsia, the ILM (one micron collagen 4 structure) invaded by glial proliferation (astrocytes and Mueller cell end-feet filled with microfibrils of GFAP). ILM peeling works because, when we remove...

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My Way of Using the Coomasie Blue

Coumassie Blue or Brilliant Blue G (BBG) has been introduced as a surgical adjuvant for chromovitrectomy in 2006. This dye was reported to stain the ILM and to have no significant in vivo toxicity. In contrast Triamcinolone Acetonide produces a better vitreous visibility, the crystals of the steroid adhere to the acellular tissue, thereby enabling a clear contrast between the empty vitreous cavity compared to areas with the vitreous...

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Brillant Blue: An Excellent Dye to Peel the ILM

Purpose : To evaluate the potential of brillant blue g (BBG) for intraoperative staining of the inner limiting membrane (ILM) and to compare the different concentration of BBG showing the efficacy to stain. Methods: Review, interpretation and commentary regarding the most relevant stain, showing 2 different concentration of BBG. Results: The cases reviewed included the following diagnoses: epiretinal membrane (2), macular hole (5),...

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Vitrectomy Dyes: The Blues of Vitrectomy !

Many surgeons use dyes during vitrectomy surgery to enhance visualization of intraocular structures such as vitreous, epiretinal membranes and internal limiting (ILM). Several dyes are employed for this purpose including trypan blue, brilliant peel, indocyanin green and some newer Lutein based dyes. Triamcinolone is also used to improve the visualization of the vitreous gel and the posterior hyaloid. In this presentation, we aim to...

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Advantages of Membrane Blue / Membrane Blue Dual

I use routinely trypan blue since 2002 and operated more than 5000 cases during that time. Trypan blue is a non- specific dye. It stains vitreous, epiretinal membranes and ILM and I find it advantageous to improve visualization of all the tissue with a single dye. Trypan blue is non-toxic. Trypan blue is approved for vitreoretinal surgery. The effectiveness of staining depends on the observation system Different cases. Contact...

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EVRS Floaters Study – The EVRS Floaters Study Results

Contact Details: Email: parolinibarbara@gmail.com  

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EVRS Floaters Study – Review of Literature

Contact Details: Email: ron.adelman@yale.edu  

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Comparison of the Effect of Ranibizumab and Aflibercept for Choroidal Thickness Changes in Wet AMD

SCIENTIFIC POSTER 2016_Comparison of the Effect of Ranibizumab and Aflibercept for Choroidal Thickness Changes in Wet AMD Hee Seong Yoon Purpose: To compare the changes in subfoveal choroidal thickness (SFCT) after intravitreal ranibizumab or aflibercept injections for neovascular age-related macular degeneration (nAMD). Methods: Medical records of 67 treatment-naive patients (69 eyes) who were diagnosed with neovascular AMD (nAMD) and...

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New Findings in En-face OCT for the Diagnosis of CSCR

SCIENTIFIC POSTER 2016_New Findings in En-face OCT for the Diagnosis of CSCR Patricia Udaondo Purpose: To analyze the advantages and findings of en face OCT in the diagnosis of central serous corioretinopathy (CSC) cases. Methods: Both fluorescein angiography (FA), a gold standard test for diagnosis in CSC and en face/enhanced depth OCT images were obtained in 30 patients with CSC, analysed and compared. Results: In all patients with CSC...

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Efficacy and Safety of Subthreshold Laser in Refractory DME Demostrated by Swept Source OCT and Microperimetry

SCIENTIFIC POSTER 2016_Efficacy and Safety of Subthreshold Laser in Refractory DME Demostrated by Swept Source OCT and Microperimetry Patricia Udaondo Purpose: To demostrate de efficacy and safety of subthreshold laser therapy in the management of refractory diabetic macular edema cases. Methods: Patients with persistent macular edema despite several intravitreal injections with antiVEGF and/or steroids were treated with the new streamline...

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Clinical Outcomes and Safety of Nd-YAG Laser Vitreolysis for Symptomatic Vitreous Floaters

SCIENTIFIC POSTER 2016_Clinical Outcomes and Safety of Nd-YAG Laser Vitreolysis for Symptomatic Vitreous Floaters Seong Joo Shin Purpose: To evaluate the clinical outcomes and safety of Nd:YAG laser vitreolysis for symptomatic vitreous floaters. Methods: This was prospective interventional study of 42 eyes of 42 patients with symptomatic floaters lasting more than 6 months. The vitreous floaters were photodisrupted with Ultra Q Reflex...

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Tomographic and Angiographic Changes in Egyptian Patients with Behcet Posterior Uveitis

SCIENTIFIC POSTER 2016_Tomographic and Angiographic Changes in Egyptian Patients with Behcet Posterior Uveitis Maha Shahin Purpose: To evaluate different tomographic and angiographic changes occurring in Egyptian Behcet’s disease patients diagnosed with posterior uveitis using optical coherence tomography (OCT) and fundus fluorescein angiography. Patients and Methods: The study included 20 Egyptian Behcet’s patients with clinical...

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A Wrong Decision: Surgery of Lamellar Retinal Hole (A Case Report)

SCIENTIFIC POSTER 2016_A Wrong Decision Surgery of Lamellar Retinal Hole (A Case Report) Lidmila Prochazkova Objective: Our case report presents the course of a lamellar hole surgery and subsequent macular hole surgeries in a female patient aged 56 years. Introduction: Macular hole is a fovea defect in full thickness. It is caused by both tangential and saggital traction of posterior hyaloid in macular area. Macular hole progressively...

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A Case of Ocular Toxoplasmosis Presenting as Unilateral Papillitis and Juxtapapillary Retinitis

SCIENTIFIC POSTER 2016_A Case of Ocular Toxoplasmosis Presenting as Unilateral Papillitis and Juxtapapillary Retinitis Kuihyung Mun Purpose: Toxoplasmic retinochoroiditis is the most common form of posterior uveitis in otherwise healthy individuals. Papillitis and complicating acute juxtapapillary retinitis, are unusual and atypical features of ocular toxoplasmosis. This report presents an atypical case of ocular toxoplasmosis presenting as...

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Air Endotamponade Application in Patients with Rhegmatogenous RD

SCIENTIFIC POSTER 2016_Air Endotamponade Application in Patients with Rhegmatogenous RD Katarzyna Michalska-Malecka Introduction: The aim of this research was to evaluate the results of retinal detachment treatment with pars plana vitrectomy using air endotamponade. Methods: The research was conducted among 23 patients aged from 43 to 74 years old, 9 women (39.1%) and 14 man (60.9%). All patients underwent the treatment using pars plana...

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Measurement of Retinal Layer Thickness Using Spectral Domain OCT After Macula off RD Surgery

SCIENTIFIC POSTER 2016_Measurement of Retinal Layer Thickness Using Spectral Domain OCT After Macula off RD Surgery Younghoon Lee Purpose: To investigate visual prognosis and the thicknesses of various retinal layers using spectral domain-optical coherence tomography (SD-OCT) following successful macula-off retinal detachment surgery. Methods: A retrospective study of 25 eyes of 25 patients who successfully reattached macula-off retinal...

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Surgical Management of Multiple Anterior Segment Malformations with RD in a 3 Year Old Boy

SCIENTIFIC POSTER 2016_Surgical Management of Multiple Anterior Segment Malformations with RD in a 3 Year Old Boy Patrycja Krzyzanowska-Berkowska Objective: To present major challenges of complicated congenital bilateral cataract surgery and pediatric pars plana vitrectomy in eyes with anterior proliferative vitreo-retinopathy (PVR). Case Report: We present a 3-year-old boy with bilateral congenital cataract, subluxated lens, iris coloboma...

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Atypical Case of Persistant Subretinal Fluid, Mimicking Acute Exudative Polymorphous Vitelliform Maculopathy or CSC

SCIENTIFIC POSTER 2016_Atypical Case of Persistant Subretinal Fluid, Mimicking Acute Exudative Polymorphous Vitelliform Maculopathy or CSC Philippe Koch Introduction: To describe the case of an atypical persistent subretinal fluid presentation following a macula on retinal detachment (R.D). Results: A 64 y.o woman developed a macula on RD extending from 5 to 11 o’clock, a retinal break at 10 o’clock with the RD threatening the macular...

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Early PPV versus Delayed PPV for Spontaneous Fundus Obscuring Vitreous Hemorrhage

SCIENTIFIC POSTER 2016_Early PPV versus Delayed PPV for Spontaneous Fundus Obscuring Vitreous Hemorrhage Joo Yeon Kim Purpose: To compare the visual outcomes of early versus delayed intervention in the setting of fundus-obscuring vitreous hemorrhage (VH) presumed to be due to posterior vitreous detachment. Methods: All eyes that presented with a fundus-obscuring VH defined as vision of 20/400 or worse, and requiring a B-scan at presentation...

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Full Thickness MH After ND-YAG Laser Posterior Capsulotomy: The Importance of Evaluation of Vitreoretinal Interface

SCIENTIFIC POSTER 2016_Full Thickness MH After ND-YAG Laser Posterior Capsulotomy The Importance of Evaluation of Vitreoretinal Interface Umut Karaca Purpose: To present a case of full-thickness macular hole (FTMH) formation after Nd-YAG laser posterior capsulotomy, and discuss the underlying pathology. Case Report: A 60-year-old male patient followed for dry age related macular degeneration underwent Nd-YAG laser posterior capsulotomy for...

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Outer Retinal Layers Alterations in Chronic CSCR: OCT Images and Fundus Autofluorescence Findings

SCIENTIFIC POSTER 2016_Outer Retinal Layers Alterations in Chronic CSCR OCT Images and Fundus Autofluorescence Findings Ji-Hye Jang Purpose: To document the alteration of the outer retinal layers and fundus autofluorescence (FAF) change in eyes with chronic central serous chorioretinopathy (CSCR). Methods: Seventeen eyes of fifteen patients with chronic CSCR from January of 2014 to March of 2015 with at least 6 months of follow-up with...

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Spontaneous Suprachoroidal Hemorrhage

SCIENTIFIC POSTER 2016_Spontaneous Suprachoroidal Hemorrhage Maha M. Elshafei We present a 52-year-old diabetic and hypertensive patient, for the past five years for which is well controlled on oral medications. The patient presented himself to Emergency on 21 June 2015 complaining of sudden loss of vision in the right eye after waking up from sleep. He was found to have vision of light perception in the right eye; IOP 8mmHg, quiet anterior...

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Idiopathic Neuro-retinitis with Retinal Vasculitis

SCIENTIFIC POSTER 2016_Idiopathic Neuro-retinitis with Retinal Vasculitis Maha M. Elshafei Twenty-eight-year old lady presented with chronic headache and decreased vision on the right eye. No history of systemic illnesses; she was only taking oral contraceptive for six months. Examination showed bilateral papilledema with right macular edema. Systemic work-up was normal. She was diagnosed a case of benign intracranial hypertension. Later on...

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Choroidal Neovascular Membrane in Children

SCIENTIFIC POSTER 2016_Choroidal Neovascular Membrane in Children Maha M. Elshafei Case 1: A case of seven-year-old girl who presented to the eye clinic complaining of decreased vision in both eyes. Examination showed bilateral active choroidal neovascular membrane in the macular area, which was, treated with multiple intravitreal injections of Ranibizumab. Screening of the family showed bilateral Vitilliform maculopathy in the younger...

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Outcome of IVT of Ocriplasmin for Symptomatic Vitreomacular Adhesion

SCIENTIFIC POSTER 2016_Outcome of IVTY of Ocriplasmin for Symptomatic Vitreomacular Adhesion Mostafa Elgohary Purpose: To evaluate the rate of release of vitreomacular adhesion (VMA), anatomical changes and visual outcome following intravitreal ocriplasmin injection for the treatment of symptomatic VMA with and without full-thickness macular hole (FTMH). Methods: This is a retrospective, interventional, case-series of 12 eyes of 11...

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Outcome of Vitreomacular Traction Syndrome: Natural Course vs Vitrectomy vs Ocriplasmin

SCIENTIFIC POSTER 2016_Outcome of Vitreomacular Traction Syndrome Natural Course vs Vitrectomy vs Ocriplasmin Constantinos Demosthenous Purpose: Posterior Vitreous Detachment (PVD) is a common eye condition related with the normal aging of vitreous gel. However, the presence of persistent vitreomacular adhesions exerting tractional forces may be associated with the disruption of foveal anatomy thereby causing symptoms of visual...

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Magnet-assisted Removal of IOFB

Purpose: To evaluate the efficacy of our technique in achieving safe and atraumatic removal of posterior segment magnetic intraocular foreign bodies. Methods: A prospective study carried out at the ophthalmology department, Zagazig university hospitals, Zagazig, Egypt. The study included 45 eyes of 45 patients with posterior segment magnetic intraocular foreign bodies. Eight patients had already undergone primary surgical repair before....

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Three Monthly Ranibizumab for ME Secondary to BRVO: 12-month Outcomes

Purpose: To assess 12-month efficacy of the three monthly intravitreal injections of ranibizumab for the treatment of macular oedema (MO) secondary to branch retinal vein occlusion (BRVO) in comparison with combined treatment (a single intravitreal injection of ranibizumab followed by grid laser treatment). Methods: Subjects were 19 patients (19 eyes) with unilateral vision loss attributable to macular oedema following BRVO. Duration of the...

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Residual Vitreous Cortex at the Fovea During Vitrectomy for Primary Rhegmatogenous RD Repair

SCIENTIFIC POSTER 2016_Residual Vitreous Cortex at the Fovea During Vitrectomy for Primary Rhegmatogenous RD Repair Eun Hyung Cho Purpose: We investigated the effectiveness of the removal of the residual vitreous cortex in the fovea during vitrectomy for primary rhegmatogenous retinal detachment repair. Method: We retrospectively reviewed the chart and the operation video of the 50 patients (50 eyes) who underwent vitrectomy for retinal...

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Response of Pigment Epithelial Detachment to Anti-VEGF Treatment in AMD

SCIENTIFIC POSTER 2016_Response of Pigment Epithelial Detachment to Anti-VEGF Treatment in AMD Han Joo Cho Objective: To evaluate the therapeutic response of pigment epithelial detachment (PED) to anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (nAMD), and identify predictive factors for PED resolution after treatment. Methods: A total of 202 treatment-naive nAMD eyes presenting PED...

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Idiopathic ERM and Metamorphopsia: A New Tool for Pre- and Post-operative Evaluation

SCIENTIFIC POSTER 2016_Idiopathic ERM and Metamorphopsia A New Tool for Pre- and Post-operative Evaluation Elisa Buschini Idiopathic epiretinal membrane (IERM) is defined as an avascular proliferation of different types of cells between the posterior vitreous cortex (PVC) and the internal limiting membrane (ILM). A premacular membrane can remain asymptomatic for much time or it can cause blurred vision. Furthermore, IERM can contract...

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Results of Intravitreal Aflibercept in Insufficient Responders to Prior Anti-VEGF Therapy in Neovascular AMD

SCIENTIFIC POSTER 2016_Results of Intravitreal Aflibercept in Insufficient Responders to Prior Anti-VEGF Therapy in Neovascular AMD Zeynep Alkin Purpose: To report the outcomes of intravitreal aflibercept therapy in eyes with refractory neovascular age-related macular degeneration (AMD) switched from intravitreal bevacizumab or ranibizumab. Methods: This is a retrospective review of eyes with neovascular AMD switched to intravitreal...

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Macular Changes After Uneventful Phaco in Diabetic Patients and Risk Factors Contributing to Increase Retina Thickness

SCIENTIFIC POSTER 2016_Macular Changes After Uneventful Phaco in Diabetic Patients and Risk Factors Contributing to Increase Retina Thickness Maaly Abdel Fattah Introduction: The incidence of subclinical macular edema after uneventful phacoemulsification has become an issue of safety for this frequently performed operation. Advances in phacoemulsification techniques and intraocular lens design have led to improved outcomes following...

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Giant Tears with Vitrectomy Technique

The management of retinal detachment associated with giant tear present a unique and formidable challenge, even for experienced vitreoretinal surgeons, beyond a common rhegmatogenous detachment. Giant retinal tears are associated with hereditary conditions,like Stickler´s, Marfan´s, axial myopia, extensive lattice degeneration, multiples holes and trauma. My Sugery: Lensectomy for optimal removal of the basal vitreous. Conventional 3-...

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My Strategy for Floaters

People know that. I’m the first to fight against vitrectomy in a detachment without PVD, to fight against combined surgery when we can avoid it, or to call for a minimal vitrectomy in macular surgery as my concern is always to provoke the minimum trauma; but I am performing 10 to 15 vitrectomies per year for floaters and this can appear paradoxical. I have 2 indications Professional indications: a commercial traveler who cannot drive his...

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Our Experience in Treating Floaters

Treatment for symptomatic floaters range from floater reduction using laser strategies to full vitrectomy necessitating a surgical PVD. Furthermore, patient’s individual perceptions of vitreous opacities differ significantly, and therefore treatment strategies must respect their expectations. A subgroup of patients suffers heavily and is almost not able to continue normal daily life or work, although floaters are hardly detectable by...

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Vitrectomy for Floaters – Risks versus Benefits

Purpose: To review the outcome of small gauge vitrectomy for symptomatic floaters and compare risks versus benefits. Background: Floaters can be a symptomatic condition due to partial liquefaction of vitreous gel or accumulation of opacities in vitreous. Patients may complain of a variety of visual symptoms, which can be potentially disabling. This phenomenon may or may not be associated with posterior vitreous detachment (PVD) which is...

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My Strategy for Floaters

Pars plana vitrectomy (PPV) provides the most effective treatment for floaters as it offers a definitive cure with complete resolution of symptoms. However, this procedure is invasive with the possibility of complications such as endophthalmitis, retinal tears and detachments, cataract formation, glaucoma, vitreoretinal hemorrhage, and macular edema . Therefore, it is important to only advocate vitrectomy to cure floaters for patients who...

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Vitreous Floaters Not Only in Young Anxious Engineers

Advantages: 1. Vitrectomy helps in all kinds of vitreous opacities. 2. We broke the concept that the typical patient with vitreous floaters is a young anxious engineer. Methods: We analyzed 83 eyes of 63 patients who underwent vitrectomy for vitreous floaters (asteroid hyalosis, PVD, and floaters only) between 2010 and 2015. 47 were male, 36 female eyes. Their mean age was 60 years, ranging from 22 to 82; the median was 61. The mean...

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Floaters Surgery

Vitreous floaters could result from vitreous seneresis or as result of vitreoretinal diseases such as intraocular inflammation or vitreous haemorrhage. In the absence of associated vitreoretinal disease, most patients with vitreous seneresis- related floaters learn to live with their symptoms. However, surgery is justifiable in some patients whose quality of vision is compromised because of significant floaters. It is important to carefully...

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Photoreceptors Exhibit Optical Fiber Property Due to Physical Properties, Including Their Shapes, Diameters and Indices of Refraction

Photoreceptors exhibit optical fiber property due to physical properties, including their shapes, diameters and indices of refraction. Because of their wave-guiding properties, visual perception of light is weakened by the obliquity of the incident rays. Light rays passing through the centre of the pupil appear brighter than peripheral rays. This phenomenon is called the Stiles-Crawford effect. In an emmetropic eye, every wave front related...

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Alternative Diffuse DME Treatment: Laser Photostimulation versus Topical Medical Therapy

Introduction: The standard first-line treatment for diffuse diabetic macular edema (DDME) is intravitreal injections. Although considered safer and more effective than laser, these drugs may have serious ocular and systemic complications. Recent research of the pharmacological properties of Nepafenac, found that this drug could reach the retina in sufficient concentrations to produce beneficial effects. We evaluated the efficacy of...

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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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Micropulse Laser 577 nm: A Perfect « Second Line » Treatment for ME ?

Purpose: The authors report several tips and tricks increasing efficiency of 577 nm Micropulse Laser (MIP) in treatment of macular oedema recurrence in eyes with previous ILM peeling surgery. Methods: The study is a retrospective clinical study of sub threshold laser treatment as a tissue-sparing laser photocoagulation for ME. Eyes included underwent treatment for ME due different pathologies (Diabetic Retinopathy, branch or central...

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Micropulse Contiguous Grid Laser for Diffuse DME

Objective: To investigate micropulse contiguous grid laser in fovea involved DDME and to correlate SD-OCT structural changes with resolution target visual fields. Purpose: To investigate micropulse contiguous grid laser in the treatment of eyes with DDME involving the fovea, and second, to correlate OCT findings with resolution target visual field (RTVF) measurements of threshold acuity at fixation, best acuity measured at any...

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Safety and Efficacy of Intravitreal Preservative-free Triamcinolone for ME Secondary to Diabetes or Retinal Vein Occlusion

Purpose: To evaluate the efficacy and safety of preservative-free triamcinolone acetonide injectable suspension (Taioftal) for the treatment of macular edema secondary to diabetes or retinal vein occlusion. Design, Setting & Participants: From January 2015 to December 2015, at Ospedale Maggiore of Bologna, a retrospective study was conducted on patients suffering from macular edema secondary to diabetes or retinal vein occlusion....

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Combined Intravitreal Anti-VEGF & Subtenon Corticosteroids in AMD Reduces ME Recurrence and Increases Delay Between IVTs

Purpose:  To evaluate, with time, efficiency of combined treatment using Anti-VEGF & subtenon corticosteroids in ME recurrence in AMD Material and methods: All kinds of CNV in AMD were included in this retrospective study (classic, minimally classic, occult, PEDs…). Both Ranibizumab and Aflibercept were used and associated with subtenon corticosteroids. Corticosteroid was mostly bethamethasone acetate vs triamcinolone...

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Tractional RD of the Posterior Pole Related to a Multi Injected ERM

In a case of macular edema, is it reasonable to treat it with multiple injections without paying attention to the etiology? It is in this case an epiretinal membrane, which obviously should have been treated by surgery. Contact Details: Email: jeanpaul.amar@gmail.com Cell Phone:...

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New Sharing-economy in Ophthalmology : The Trojan Horse of Multiple IVTs with Easy Protocols Guidelines

Purpose: Report of some common attitudes in medical retinal practice with multiple IVTs, issues pertaining to high risk of over-standardization, lower necessity of an expert medical advice and short-time possibilities of low-cost evolution excluding ophthalmologists Methods: Protocols with IVTs required for AMD or ME treatments are analysed and we have pointed out several medical contestations of these protocols. Results: Nowadays...

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Approach to Diabetic Epimacular Membranes in DME Surgery

Approach to Diabetic Epimacular membranes in Diabetic macular Edema surgery Risk of Diabetic Epimacular membranes (ERM) Peeling: These membranes are rather toughly adherent to an underlying fragile ischemic macula. Vascular connections may be present, in or around, the area of the membranes. This may elicit: iatrogenic retinal breaks, uncontrolled retinal bleeding. My Technique: I use Chandelier as the illumination tool, and an aspheric...

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Central Retinal Vein Occlusion: What`s New ?

Despite numerous studies describing predominantly its clinical course, many aspects of central retinal vein occlusion (CRVO) remain unclear. Hypotheses on the pathogenesis of CSCR have ranged from a basic alteration in the blood stream to an involvement of the blood vessel wall. We reviewed the different therapeutic approaches, including laser induced chorioretinal anastomosis (LICRA), vitrectomy (PPV) and intravitreal treatment (IVT)....

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Vitreo-retinal Interface in Non-tractional DME

Vitrectomy is a well-known technique for dealing with “tractional DME”. Most doctors however prefer medical treatment for “non-tractional” DME. Recently performed, ME EVRS study proved that vitrectomy may be a valuable treatment option for “non-tractional” DME. The aim of this presentation is to show the vitreo-retinal relationship in “nontractional DME” revealed during the surgery, pointing that in...

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Incidence and Risk Factors of Cystoid Macular Edema After Retinal Detachment Surgery

Purpose : To evaluate the incidence rate of cystoid macular edema (CME) after uncomplicated primary operation on retinal detachment (RD) and to identify risk factors associated with postoperative CME. Methods : Retrospective interventional case series of consecutive patients that underwent one RD repair either by primary vitrectomy or external procedure during a 3 years period starting on January 2012. Postoperative CME was defined as...

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Validity of Aqueous Flare Measurement in Predicting Proliferative Vitreoretinopathy in Patients with Rhegmatogenous Retinal Detachment

Purpose: To investigate aqueous flare as a preoperative predictor for later proliferative vitreoretinopathy (PVR) development in patients with rhegmatogenous retinal detachment (RD) and to determine the validity of this measurement in patients at low clinical risk for postoperative PVR. Methods: This study included 100 eyes of 100 patients who underwent surgery for primary RD. Aqueous flare was determined preoperatively with a laser...

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The Paradox of ILM Peeling: It Is Traumatic but it Works…Why ?

ILMP is challenged because it may injure the Retinal Fiber and the Retinal Ganglion cells layers. And indeed ILMP tears Muller Cells (MC) endfeet, and eventually retinal astrocytes, and endothelial cells. However numerous studies as well as routine clinical practice have long shown that well-conducted Vitrectomy-ILMP can reabsorb macular edema and improve visual acuity in the majority of cases. It is acknowledged today that EGFR (Epidermal...

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Advanced PVR in Single Eye with RD; Surgical Methods Maneuvers & Outcome

We are going to send video about two cases of surgical management with advanced PVR retinal detachment at the single eyes. The first clinical case is the patient 43 years old with posttraumatic anterior PVR and narrow funnel retinal detachment in subatrophy eye. The patient does have not any previously surgical treatment as long as three month after his injury. The retina was attached completely in during surgical maneuvers and 360-degree...

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Exo-resection of Iris-ciliary Body Melanoma After Failed Brachytherapy. Intra & Postoperative Complications. Five Year Follow-up

We present the case of a 37-year-old male with an iris-ciliary body melanoma. 2 years after brachytherapy, the tumor started to grow and we decided to perform a partial lamellar sclerouvectomy plus iridectomy, followed by phacoemulsification without intraocular lens and 23 g vitrectomy for the consequent retinal detachment, leaving 5000 cs silicone oil. 7 months later, because of extreme photophobia with intense anxiety and despite...

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Partial Lamellar Scleral Resection in a Choroidal Melanoma with Extraocular Extension

A 60-year-old male presenting with large sized melanoma with extraocualr extension. Management included partial lamellar resection, with full thickness eye wall resection around the extra ocular extension and scleral graft. Postoperative recovery was smooth and patient received adjuvant transpupillary thermotherapy. Five year follow up was uneventful. Contact Details: Email: ihabsaad@hotmail.com Cell Phone:...

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Entry-site Hemorrhage: When to Suspect and How to Manage it

Introduction: Vitreoretinal sutureless surgery has evolved in recent years into a safer, more effective group of procedures. It is, therefore, an unexpected sight to have a vitreous hemorrhage at the end of an otherwise uneventful vitrectomy. A possible cause of such a finding is an external hemorrhage that occurs immediatly after the removal of the trocars, that finds its way inside the vitreous cavity through the sclerotomy. Methods: The...

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A Retinal Detachment with Panuveitis and MH

Introduction: Any surgical pathology presenting with concomitant inflammation presents a dilemma to the eye surgeon, due to the increased risk of post-op complications. On the other hand, a retinal detachment presents an additional challenge to the vitreoretinal specialist in this situation. The authors present a clinical case with both these simultaneous conditions. Case Report: We present the case of a male 75 year-old patient, with a...

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Managing Optic Pit – The Right Stuff !

A video showing how the authors have used various techniques to manage optic pit with vitrectomy over the past 15 years. Surgical modifications to standard vitrectomy are shown and the authors comment on the various techniques used and the results obtained. They also refer to the literature, which prompted them to develop a new approach to treat the condition. The latest modification involves “stuffing” the optic pit – with...

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When a Funny Hyalitis is Hiding an Unusual Cause

Purpose: Endogenous endophthalmitis due to parasites is quite rare. We herein report an unusual case of degenerated intravitreal cysticercus cyst masquerading as a funny panuveitis with a good outcome after appropriate management. Methods: A retrospective interventional case report of an 38-year-old man who presented a loss of vision in the left eye. Visual acuity in the left eye at time of presentation was counting fingers near face....

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A Macula-on RD with Multiple Giant Tears

Introduction: Retinal detachments with giant retinal tears pose a significant challenge, even to the most experienced vitreoretinal specialists. The extent of the primary lesion complicates management and tamponade choices, carrying the risk of the flap folding over post-operatively and re-detaching the retina. The authors present one case of a macula-on retinal detachment with multiple giant tears. Case report: The authors present the...

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Vitrectomy for Rhegmatogenous Retinal Detachment Associated with Degenerative Retinoschisis

I will be presenting the technique of vitrectomy in a patient with rhegmatogenous retinal detachment associated with vitreous haemorrhage and degenerative retinoschisis. The technique involved 3-port pars plana vitrectomy, completion of posterior vitreous detachment, deroofing of the retinechisis area, fluid air exchange and cryotehrapy and laser retinopexy. Gas tamponade (C2F6) was used. The retina was successfully reattached and visual...

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Inverted ILM Flap Technique for MH in High Myopia: A Case Report

Purpose: To report the surgical technique and efficacy of the inverted internal limiting membrane (ILM) flap technique for an idiopathic macular hole (MH) in high myopia. Case presentation: A 47-year-old female with a full thickness macular hole with foveoschisis underwent pars plana vitrectomy with 23 gauge plus transconjunctival system, ILM peeling and SF6 gas tamponade. Axial length was 29.96mm and best corrected visual acuity was 0.06...

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An Unlikely Surgery in a Case of Macular Subretinal Hematoma

After several IVTs on a macular hemorrhage, after 2 months, a huge and calcified hematoma with a complete loss of vision was successfully operated with a trans-retinal extraction of the hematoma. The removal of the hematoma in the vitreous cavity was possible thanks to the use of an aspiration-flow control pump. The main secret of this surgery is to remove by aspiration all the blood above and under the retina. The surgery was ended by a...

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Role of Endo-diathermy Probe in PDR Surgery

I use the endodiathermy probe as one of two instruments for bimanual dissection of diabetic fibrovascular proliferations. It replaces either the forceps or the vitreous cutting probe and scissors. Forceps Replacement: I identify the surgical planes, by inserting the endodiathermy probe tip underneath the membranes; this allows me to dissect with the vitreous cutting probe under good visulaization. Probe/scissors Replacement: In the...

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Vitrectomy Under Air in Rhegmatogenous RD Surgery

After perfoming central vitrectomy, I inject perfluro-carbon liquid (PFCL) into the vitreous cavity, to re-attach retina, up to the level of the retinal breaks. If there are no detectable breaks, I inject the PFCL as peripheral as possible up to the level of the posterior border of the vitreous base. Subsequently, air is infused, to fill the anterior part of the vitreous cavity. At the air level: I perform meticulous shaving of the...

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Rhegmatogenous Retinal Detachment: Basic Concepts and Surgical Strategy for Primary Vitrectomy

Contrary to popular dogma, the most important element in the pathogenesis of a rhegmatogenous retinal detachment (RRD) is not the break but the vitreoretinal traction that causes the break (i.e., the RRD is a vitreogenic pathology). In the presence of vitreous degeneration (syneresis) such dynamic traction is inevitable if the eyeball and/or the head moves: this hypothesis is supported by the clinical observation that a RRD spontaneously...

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Management of Rhegmatogenous RD Associated with Giant Tear

Purpose: To investigate the anatomic and visual outcomes of pars plana vitrectomy in patients with rhegmatogenous retinal detachment (RRD) associated with giant tear. Associated procedures to vitrectomy were evaluated. Background: The incidence of retinal giant tear in RRD is very low. It represents 0.5% of all retinal detachments. The recurrence of RRD with gian tears is essentially due to the difficulties in re-attaching the posterior...

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Surgical PVD Induction Using Combined Sharp Pick and Active Aspiration

Some cases of retinal detachment particualry in young phakic patients, may not have posterior vitreous detachment (PVD). If operated by PPV, induction of PVD in these cases is mandatory. However, PVD induction by active aspiration of the vitreous cortex over the optic disc margin as usually employed in PPV surgery can be challenging in these eyes because of firmly adherent posterior hyaloid and the absence of counter traction from the...

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My Experience with PTFE Explants in the Last 15 Years (189 cases)

Expanded PTFE (e-PTFE) is a material derived from goretex, that has been used since the seventies for vascular surgery. Afterwards its utility was expanded to reconstructive and plastic surgery, and in the ophthalmological field  to oculoplastics, corneal surgery and scleral buckling. It is a smooth surfaced, resistant, permeable and highly biocompatible material that can be used as buckling element. In addition it is non elastic and...

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Slit Lamp Surgery for Uncomplicated RD

Despite the great evolution of pars plana vitrectomy for the treatment of retinal detachment in the last decade, accomplished by the development of better vitrectomy machines, smaller size of the instruments and better illumination options, there are still some cases in which external surgery is strongly advised and may have better results and lower complications rates than vitrectomy. In this sense, the possibility of examining the...

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External Surgery: A Simple Solution for First Hand Procedures Failures

Since the development of Ab interno surgery in the 2000s, surgeons have more surgical options for the treatment of retinal detachment (RD). While being currently set aside, ab externo scleral buckle (SB) surgery, still has a place for certain cases of RD. With or without pars plana vitrectomy (PPV), SB is also a useful option for surgical failures after PPV. Using surgical videos, I will illustrate SB surgery for RD with the objective of...

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Retinal Detachment: Try a Scleral Buckling First!

In this presentation, we will reflect on our experience in using scleral buckling procedure as the initial treatment modality for retinal detachment. Contact Details: Email: martiano.d@gmail.com Cell Phone: +33624122418  

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Scleral Buckling, PPV & Pneumatic Retinopexy: An Individualised Approach

The surgical approach to repairing retinal detachment (RD) has been a success story since Jules Gonin identified the retinal breaks to be the cause of retinal detachment. The techniques however have evolved over the years. Three techniques in particular, namely scleral buckling (SB), pars plana vitrectomy (PPV) and pneumatic retinopexy (PR), have been proved to be most successful and are therefore used around the world by almost all...

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Short-term Safety Profile of Intravitreal Ziv-aflibercept

Aim: To evaluate the safety of intravitreal ziv-aflibercept (Zaltrap®) in the treatment choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods: Eligible eyes with CNV secondary to AMD each received a single intravitreal injection of ziv-aflibercept. Comprehensive ophthalmic examinations and detailed systemic evaluations were performed at baseline, and days 1, 7, and 30 after injection, and...

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Effectiveness of Low-energy Light Irradiation for Exudative AMD After Anti-VEGF Therapy

Studied the effectiveness of low-energy light irradiation in patients with exudative form of age-related macular degeneration after anti-VEGF therapy. The main group included 62 patients (the 69 eyes), who received two courses of low-energy light radiation within 6 months after the anti-VEGF therapy. A control group of 41 patients (44 eyes) to the monitoring took place only anti-VEGF therapy. The total period of observation was 1 year....

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Eylea in the Treatment of Wet AMD : Comparison of Different Treating Regimens

Advantages: We compared different regimens of aflibercept (EYLEA) injections in patients with wet AMD. Methods: We analyzed 195 eyes of 186 patients with wet AMD, treated between 2013 and 2015 with aflibercept. We assessed BCVA and central retinal thickness and compared these parameters in four subgroups of patients treated using four different regimens: Only three monthly loading doses. Three loading doses followed with individual...

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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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Stargardt Color and Autofluorescence

              The image is a collage of the bilateral color and autofluorescence capture of a young boy with Stargardt disease stage 3a. Contact Details: Email: parolinibarbara@gmail.com Cell Phone:...

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Retinoschisis and Detachment in High Myopia

              Retinoschisis and detachment in high myopia: long scan with Optovue OCT. Contact Details: Email: parolinibarbara@gmail.com Cell Phone:...

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Retinal Teleangectasia

              Color and autofluorescence of retinal teleangectasia in a 30 yo boy, partially treated with laser. Contact Details: Email: parolinibarbara@gmail.com Cell Phone:...

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Macular Hole in RD PDR

          Giant macular hole in a 13 yo girl after surgery for retinal detachment. Subretinal strands are also visible. Tamponade is silicone oil. Contact Details: Email: parolinibarbara@gmail.com Cell Phone:...

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Pattern Choroidal Dystrophy

              Contact Details: Email: ihabsaad@hotmail.com Cell Phone:...

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Ocular Histoplasmosis, Retcam

              Contact Details: Email: ihabsaad@hotmail.com Cell Phone:...

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Insufficient Laser, Preretinal Hemorrhage

              Contact Details: Email: ihabsaad@hotmail.com Cell Phone:...

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An Atypical Case of Persistant Subretinal Fluid, Mimicking a Unilateral Acute Exudative Polymorphous Vitelliform Maculopathy or a CSC

                  Introduction: To describe the case of an atypical Persistent Subretinal Fluid presentation following a macula ON R.D. Results: A 64 y.o woman developed a Macula ON retinal detachment extending from 5 to 11 o’clock, with a unique retinal break at 10 o’clock but threatening the Macular area. For such reason, a vitrectomy was realised to drain the subretinal fluid...

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Scleral Buckling, Vitrectomy and Pneumatic Retinopexy: An Individualised Approach by Indication and Based on Evidence

The surgical approach to repairing retinal detachment (RD) has been a success story since Jules Gonin identified the retinal breaks to be the cause of retinal detachment. The techniques however have evolved over the years. Three techniques in particular, namely scleral buckling (SB), pars plana vitrectomy (PPV) and pneumatic retinopexy (PR), have been proved to be most successful and are therefore used around the world by almost all...

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Retinal Detachment Surgery Needs to Be Individualized – Vitrectomy Surgery Is Not the “One Size Fits All™” Treatment

Rhegmatogenous retinal detachment (RD) surgery is the most common indication for vitreoretinal surgery. Pars plana vitrectomy (PPV) and scleral buckle (SB) are the most commonly used techniques, with the proportion of patients undergoing SB significantly decreased over the last decade in the US and worldwide. There is agreement that PPV is the surgery of choice for complex RD and in pseudopakic eyes. However, SB remains a valid option for...

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Customized Approach in RD in High Myopia

Retinal detachment in high myopia is due to a combination of anteroposterior traction (due to the elongation of the sclera unmatched to the elongation of the retina) and of tangential tractions (due to the formation of epiretinal contraction. I will discuss why it is not possible to propose vitrectomy as the only choice, since vitrectomy is related to a high rate of retinal detachment relapse and since, in case of an associated macular...

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