Management of persistent loculated subretinal fluid after pneumatic retinopexy

AIM: To report on the incidence and management of a unique and troublesome complication of pneumatic retinopexy-localised, delayed subretinal fluid absorption (DSRFA). METHODS: A retrospective chart review was done for all patients who underwent pneumatic retinopexy for retinal detachment over a 5 year period to identify the patients with DSRFA. RESULTS: Seven phakic patients (five females, two males, age range 26-87 years) were identified with the phenomenon of delayed resolution of subretinal fluid after pneumatic retinopexy and cryotherapy. In four patients the subretinal fluid involved the macula. Time taken to complete absorption of the subretinal fluid ranged from 10 to 26 months. In one patient there was still residual fluid inferiorly at 18 months of follow up. During the follow up period additional procedures were performed--scleral buckling (five eyes), pars plana vitrectomy (one eye), and mild laser scatter to extramacular areas of shallow subretinal fluid (four eyes). None of these procedures appeared to influence the rate of fluid absorption. CONCLUSIONS: Loculated subretinal fluid following pneumatic retinopexy may persist for very long periods, extending up to more than 2 years. Additional surgical procedures or laser photocoagulation do not affect the rate of subretinal fluid absorption. Spontaneous reattachment eventually occurs in most eyes, and conservative management is indicated.     

Pneumocystis carinii pneumonia studied by gallium-67 scanning

The validity and reliability of gallium-67 (Ga-67) scanning for diagnosis and follow-up of Pneumocystis carinii pneumonia (PCP) were assessed in 34 patients thought to have pulmonary complications of acquired immunodeficiency syndrome (AIDS). Overall sensitivity was 94% and specificity 74%. Among patients with normal or equivocal chest radiographs at the time of admission, sensitivity was 86% and specificity 85%. The authors consider Ga-67 scanning a valid and reliable adjunct in the diagnosis of PCP in AIDS patients with respiratory symptoms when the chest radiograph is normal or equivocal.     

The prevalence of diabetic retinopathy: effect of sex, age, duration of disease and mode of therapy

Studying 445 diabetic patients, we investigated the effects of sex, age, duration of disease, and mode of diabetes therapy on the prevalence of diabetic retinopathy. Of the study participants, 193 were treated with insulin injections, 164 took oral antidiabetic medications, and 88 were managed on diet alone. The prevalence of diabetic retinopathy was highest among insulin-treated patients (64%), while in the oral medication and diet groups, it was 36% and 12%, respectively. Diabetic retinopathy was more prevalent among patients with prolonged duration of disease. Sex and age did not seem to affect the prevalence of diabetic retinopathy when adjustments were made for the duration of disease.