Tatiana Tanaka

Case report: pneumatic retinopexy for the treatment of progressive retinal detachment in senile retinoschisis.

Retinoschisis is an abnormal separation of the retinal layers and is asymptomatic in most cases. Enlargement of the area of retinoschisis and retinal tear and detachment are possible complications of the disease, and the treatment of retinoschisis is controversial. In this case report, we present a case of retinal detachment associated with senile retinoschisis in which pneumatic retinopexy was chosen as the treatment of choice and was performed successfully in one of the eyes. After a literature review on retinoschisis and pneumatic retinopexy for the treatment of associated retinal detachment, we found only one case that was successfully treated without drainage of subretinal fluid, using air as the filler. However, no previous reports have been found in the literature on the effectiveness of pneumatic retinopexy using C3F8 as the sole treatment for progressive retinal detachment in senile retinoschisis.

Bactec™ blood culture bottles allied to MALDI-TOF mass spectrometry: rapid etiologic diagnosis of bacterial endophthalmitis

Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) has been used for direct identification of pathogens from blood-inoculated blood culture bottles (BCBs). We showed that MALDI-TOF MS is an useful technique for rapid identification of the causative agents of endophthalmitis from vitreous humor-inoculated BCBs with a simple protocol.

Intraoperative Infusion-related Jet Stream Enlargement of Macular Hole.

This photo essay shows two surgical frames 1 second apart (Figure 1, A and B). A 51-year-old phakic woman with full-thickness macular hole was submitted to pars plana vitrectomy using a 23-gauge nonvalved Accurus system (Alcon, Fort Worth, TX). Vented gas forced infusion was set at 35 mmHg, and aspiration was set at proportional vacuum vitrectomy with a maximum power of 400 mmHg. During the surgery, the cutter was disabled and a high aspiration was applied next to the optic nerve, to double check the posterior vitreous detachment that had already been achieved. At that moment, a sudden increase at the macular hole diameter was noted (see Video, Supplemental Digital Content 1, http://links.lww.com/IAE/A406). We believe that a jet stream directed to the posterior pole associated to a sudden intraocular pressure decrease caused the occurrence. The surgery continued with internal limiting peeling and C3F8 tamponade, and after 3 months, anatomical success was achieved and the best-corrected visual acuity was 20/30. A jet stream of fluid from the infusion cannula through an air-filled eye can produce a water-cannon effect and cause mechanical damage to the retina. In our case, a subtle decompression generated by high aspiration allowed the water-cannon effect even in a fluid-filled eye. The use of valved cannulas should not avoid this complication, as the decompression was not related to leaking sclerotomies. Integrated pressurized infusion with intraocular pressure compensation should protect against the water-cannon effect, as it decreases intraocular pressure fluctuations. However, superonasal midperiphery retinal breaks (on the route of the infusion flow) have been recently described in 25-gauge vitrectomies using the Constellation system (Alcon), in what seems to be the same mechanism related to the macular hole enlargement observed in our case. In conclusion, in cases of macular hole, the infusion should not point to the posterior pole, as a direct flow damage may occur.

Necrose retiniana aguda por presumível etiologia viral por herpes simples resultando em endoftalmite: relato de caso

The acute retinal necrosis is a rare and devastating necrotizing retinitis, which can be caused by the herpes simplex virus type 1 or 2. It typically affects healthy patients of all ages. This study report a case of 18 year-old healthy male patient, with the the diagnosis of the acute retinal necrosis due to herpes simplex, and presents its clinical and ultrassonographic features. The acute retinal necrosis results in endofthalmitis because of lack of early diagnosis and therapy.