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Surgical Treatment of Retinal Vasculitis with Occlusion, Neovascularization or Traction

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Surgical Management of Inflammatory Eye Disease

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Abstract

■ Fluorescein angiography should be performed in any case of retinal vasculitis as soon as the media are transparent enough to allow it.

■ The affected area revealed by fluorescein angiography is usually greater than what is suspected by ophthalmoscopy.

■ We must pay special attention to the retina distal to the area affected by vasculitis: this will frequently be affected by ischemia.

■ Treatment should be started as soon as possible in ischemic cases in order to prevent neovascularization.

■ Concomitant steroidal therapy and adequate dosage are of utmost importance in order to control vasculitis.

■ The ischemic area should be treated by laser ablation under topical anesthesia in order to prevent neovascularization or to reduce it.

■ Posterior three-port vitrectomy should be performed in case of recurrent or persistent vitreous hemorrhage, vitreoretinal traction with macular distortion, or tractional retinal detachment.

■ Posterior three-port vitrectomy is useful to remove hemorrhages, perform resection of new vessels and associated traction and perform endophotocoagulation.

■ New technology such as 25-gauge vitrectomy should be considered in order to reduce surgical trauma.

■ The development of new antiangiogenic drugs (anti- VEGF) may offer a new therapeutic alternative to these cases.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Castilla La Mancha University School of Medicine, Albacete, Spain

    Jose M. Ruiz-Moreno

  2. Instituto Oftalmológico de Alicante, VISSUM, Pio del Rio Hortega University Hospital, Valladolid, Spain

    Javier A. Montero

Authors
  1. Jose M. Ruiz-Moreno
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  2. Javier A. Montero
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Editors and Affiliations

  1. Universitäts-Augenklinik Heidelberg, Interdisziplinäres Uveitiszentrum, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Matthias Becker

  2. Dept. of Ophthalmology, Triemli Hospital Zürich, Birmensdorfer Straße 497, 8063, Zürich, Switzerland

    Matthias Becker

  3. Ophthalmology, Univ. of Miami Bascom Palmer, 900 NW 17th Street, 33136, Miami, FL, FL, USA

    Janet Davis

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Ruiz-Moreno, J., Montero, J. (2008). Surgical Treatment of Retinal Vasculitis with Occlusion, Neovascularization or Traction. In: Becker, M., Davis, J. (eds) Surgical Management of Inflammatory Eye Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33862-8_19

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  • DOI: https://doi.org/10.1007/978-3-540-33862-8_19

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33861-1

  • Online ISBN: 978-3-540-33862-8

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