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      Retinal detachment repair with perfluoro-N-octane endotamponade in an infant with juvenile X-linked retinoschisis

      case-report

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          Abstract

          Purpose

          We present a case of successful surgical management of an infant with X-linked retinoschisis with a giant retinal tear and retinal detachment of the right eye.

          Observations

          A 10-month-old male presented with retinoschisis of both eyes and a retinal detachment of the right eye. The patient underwent two-stage pars plana vitrectomy utilizing perfluoro-N-octane to stabilize the detached retina and facilitate posterior hyaloid separation. Retained perfluoro-N-octane tamponade was later exchanged with silicone oil. The retina remained attached at last follow up.

          Conclusions and Importance

          Retinal detachment repair in infants presents unique challenges. This is a safe and effective strategy for complex retinal detachment repair in the infant population.

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          Most cited references8

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          X linked retinoschisis.

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            RETINAL DETACHMENT SURGERY IN A PEDIATRIC POPULATION

            Pediatric retinal detachments (RDs) are unique in etiology, anatomy, and prognosis compared with the adult population. The mechanisms of pediatric RD include tractional (TRD), rhegmatogenous retinal detachment, traumatic, and other types, such as exudative or hemorrhagic. This study examined visual and anatomical outcomes of pediatric RD undergoing surgical repair at a single university referral center.
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              Experimental studies of tolerance to intravitreal perfluoro-n-octane liquid.

              Low viscosity perfluorocarbon liquids are useful adjuncts during vitreoretinal surgery. This study evaluates perfluoro-n-octane (PFnO) for intraoperative use by examining ocular tolerance in rabbits and pigs. Rabbits were treated with intravitreal placement of PFnO for 48 hours and were examined during a period of 2 months following treatment. No clinical, electroretinographic, or light and electron microscopic evidence of adverse effects on the retina were observed. Small residual amounts of PFnO produced no adverse histologic changes 6 months after treatment. In pigs treated with mechanical vitrectomy and placement of PFnO for 3 hours, electron microscopic evaluation of the retina confirmed that the liquid had been well tolerated. These findings indicate that PFnO is safe for intraoperative use. When PFnO remained in the vitreous cavity of rabbits for longer than 1 week, varying degrees of globule dispersion occurred. Furthermore, histologic examination revealed changes in the inferior retina: photoreceptor outer segments were distorted, the outer plexiform layer was narrowed, and preretinal accumulation of macrophages had occurred.
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                Author and article information

                Contributors
                Journal
                Am J Ophthalmol Case Rep
                Am J Ophthalmol Case Rep
                American Journal of Ophthalmology Case Reports
                Elsevier
                2451-9936
                24 October 2020
                December 2020
                24 October 2020
                : 20
                : 100975
                Affiliations
                [a ]UT Health San Antonio, Department of Ophthalmology, 7703 Floyd Curl Dr. MSC 6230, San Antonio, TX, 78229, USA
                [b ]Retina and Vitreous of Texas, Houston, 2727, Gramercy Suite 200, Houston, TX, 77025, USA
                [c ]Austin Retina Associates, 801 W, 38th Street, Suite 200, Austin, TX, 78705, USA
                Author notes
                []Corresponding author. armieharper3@ 123456gmail.com
                Article
                S2451-9936(20)30290-5 100975
                10.1016/j.ajoc.2020.100975
                7670199
                7664a9b0-723d-4667-bc12-d3accdb59ed7
                © 2020 Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 27 August 2020
                : 7 October 2020
                : 18 October 2020
                Categories
                Case Report

                x-linked retinoschisis,retinal detachment,vitrectomy,perfluoro-n-octane,xlrs, x-linked retinoschisis,eua, exam under anesthesia,ppv, pars plana vitrectomy,pfo, perfluoro-n-octane,pvr, proliferative vitreoretinopathy

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