Pregnancy and retinal and retinal vascular complications

Pregnancy requires several changes in the body of the mother to successfully carry and deliver a child.Multiple alterations occur,including changes in cardiovascular system to meet the increased demands of the mother and placenta,the tilting of the hypercoagulable status to a more pro-coagulable state to prevent excessive blood loss post-delivery,and immunologic manipulations to protect the mother and fetus and decreasing the risk of a fatal immunologic response to the allogeneic fetus.These alterations are physiologically normal and expected,but can become pathologic when thresholds are crossed.Pregnancy may cause or exacerbate underlying retinal vascular diseases,a class of disorders compromised predominantly of retinal vein occlusion(RVO),retinal artery occlusion(RAO),central serous retinopathy(CSR),diabetic retinopathy,and hypertensive-related retinopathy,which includes pre-eclampsia,eclampsia,and hemolysis,elevated liver enzymes,and low platelets(HELLP)syndrome.The majority of the literature on retinal changes associated with pregnancy has focused on diabetic retinopathy,while the knowledge regarding the pathogenesis and treatment options of other pregnancy-related vascular diseases remains scarce.Understanding the implications pregnancy has on these rare,but severe,retinal vascular complications can help guide clinical management and potential treatment modalities.This paper aims to serve as a review of the retinal manifestations of diseases outside of diabetic retinopathy.

Efficacy of PC-PRL implantation in the treatment of high myopia and its complications

Objective: To study the effect of implantable posterior chamber phakic refractive lens (PC-PRL) in the treatment of high myopia and its effect on naked eye vision and retinal complications. Methods: A total of 110 patients (220 eyes) with high myopia admitted to our hospital from June 2017 to February 2019 were selected as subjects. All patients were treated with PC-PRL implantation. The UCVA, BCVA, intraocular pressure, corneal endothelial cell count and intraocular lens position (anterior chamber depth and arch height) were compared before and after the treatment. Results: 6 months after treatment, 68.18% of patients had UCVA between 0.6 and 0.9, 31.81% of patients had UCVA of more than 1.0, and 100.00% of patients had BCVA of more than1.0. The BCVA and UCVA values of patients at 1 week, 1 month, 3 months and 6 months after operation were significantly greater than those before surgery (P<0.05). There were no significant differences in BCVA and UCVA among 1 week, 1 month, 3 months and 6 months after operation (P>0.05). The intraocular pressure was significantly greater than that of the preoperative one week after operation (P<0.05). There was no significant difference between the intraocular pressure at 1 month, 3 months and 6 months after operation (P>0.05). There was no significant difference in corneal endothelial cell count and arch height before and after treatment (P>0.05). The depth of anterior chamber at 3 months and 6 months after operation was significantly less than that before operation (P<0.05). There was no significant difference in the anterior chamber depth between 3 months and 6 months after operation (P<0.05). There were 7 cases of corneal edema, 4 cases of high pressure eyes, 2 cases of refractive regression within 6 months, and 1 case of near-difficulty within 1 month. The total complication rate was 12.73%. Conclusion: PC-PRL implantation is effective in the treatment of high myopia, which can improve the naked eye and correct vision. At the same time, the incidence of retinal complications is low, which can be promoted and applied clinically.

Anatomical and functional outcomes after Densiron 68 heavy silicone oil tamponade for complicated retinal detachment in Chinese eyes

AIM:To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment(RD)in Chinese eyes.METHODS:Twenty-one eyes of 21 patients with complicated RD were included in this retrospective study.All patients underwent pars plana vitrectomy with an internal tamponade using Densiron 68 HSO.Anatomical and functional results and complications were evaluated,including retinal status,visual acuity(VA),intraocular pressure(IOP),intraocular inflammation,lens opacity,and HSO emulsification.RESULTS:Allthepatients were followed up for 3mo to1y(5.8±1.16mo).Retinal reattachment was achieved in 19of 21 patients(90.5%).VA improved in 18 of 21 patients(85.7%),from 1.93 logMAR(±0.48)to 1.52 logMAR(±0.45)(P=0.001).Postoperative complications included early dispersion of HSO in 7 eyes(38.8%),cataract in 10 of 18phakic eyes(55.5%),moderate postoperative inflammation reaction in 10 eyes(47.6%),and elevated IOP in 5 eyes(23.8%),all of which were controlled by medication or by surgery.CONCLUSION:Highanatomical and functional success rates can be achieved with primary vitrectomy for complicated RD by using Densiron 68 HSO;however,it should not be ignored that Densiron 68 HSO can cause some complications in the eye.

Study on Application of the Silicone Oil in the Reattachment of Complicated Retinal Detachment

Sixty eyes with complicated retinal detachment were treatedby vitrectomy combined with silicone oil tamponade (27 eyes of PMR gradeD,15 eyes of giant retinal tears with posterior flat folded-over,13 eyes ofposterior or macular hole,5 eyes of traumatic PVR).After 3-24 monthsfollow-up,the study showed retinal anatomic reattachment in 48 eyes inwhich the visual acuity of 32 eyes was 0.05 or better.The authorsconsider that vitrectomy and peeling make the silicone oil tamponadeperfect the vitreous surgery an...