Retina San Diego

This patient presented with a central blind spot and significant distortions for couple weeks. He had a macular hole with a 20/80 vision. This video clip shows the most critical step in Macular Hole surgery. During this segment (which is at 2x speed on this video... I don’t move that swiftly!) the Internal Limiting Membrane (ILM) which has a thickness of 2.5 um and is transparent had already been stained with Indocyanine Green is peeled. (I now use Brilliant Blue). Our forc...eps have microscopic teeth created by laser ablation to allow for improved grasping of the ILM thus decreasing initial force exerted onto the retina. Once the ILM has been grasped, the goal is to remove it surrounding the macular hole gently in one piece to prevent touching the retina again and also preventing bleeding on the surface of the retina as fine retinal capillaries can be very superficial. Once intraocular gas resolved, this patient improved to 20/20 vision.

This patient presented with severe visual loss that started as a nasal veil associated with flashes and floaters which over 5 days progressed to affect her central vision. She presented with a Macula-OFF Retinal Detachment from a tear in an area of lattice degeneration superotemporally and a baseline vision of 20/150 that day. Given the superior location of her retinal tear, a Pneumatic Retinopexy with C3F8 was accomplished that same first day and patient was instructed to k...eep her head up and tilted to the left. Third image shows patient the following day with her retina completely reattached and C3F8 gas superiorly. Laser was applied to surround the retinal tear. Last image shows complete resorption of gas and retina completely attached with final vision of 20/20. Pneumatic Retinopexy is one of the most successful treatment modalities in the retina specialist’s armamentarium to repair retinal detachments. Patient selection and compliance with positioning are 2 key factors in Pneumatic Retinopexy. Patient Selection: - superior tear - preferably one tear (if multiple tears, they need to be within 1 clock hour) - size of tear less than 1 clock hour - no inferior pathology - no proliferative vitroretinopathy - patient’s compliance with positioning Principles of Pneumatic Retinopexy: The technique has now been perfected since Ohm attempted the first intravitreal air injection in 1911 with now expansile gases such as SF6 and C3F8. Here are the differences between the 2: - SF6: 0.5 mL is injected, reaches largest size by 36 hours, doubles in size and resolves in 12 days - C3F8: 0.3 mL is injected, reaches largest size by 3rd day, quadruples in size and resolves in 38 days The Buoyancy of the gas applies pressure superiorly and its surface tension closes the retinal tear. Once the tear is closed, fluid cannot pass through the tear and the Retinal Pigment Epithelium is now able to completely pump the subretinal fluid allowing the retina to reattach.

This patient who is also a doctor presented with a history of severe visual loss associated with flashes and floaters that worsened over 3 days. Upon presentation she had a Rhegmatogenous Retinal Detachment with a vision of Counting Fingers. Rhegmatogenous Retinal Detachment is the most common type of detachment. The term rhegma comes from Ancient Greek and means rupture as in this type of detachment, tractional forces from the vitreous gel undergoing liquefaction can crea...te a tear in the retina which allows the passage of liquefied vitreous underneath the retina. Major Factors that can affect visual prognosis are: 1) macular involvement, 2) duration of detachment, 3) presence of proliferative vitreoretinopathy Our patient had 3 horseshoe tears superotemporally, one operculated hole superiorly and 2 retinal holes inferotemporally. She underwent Pars Plana Vitrectomy, endolaser and C3F8 within 24 hours of presentation. Picture number 4 is a postop wide-field image and picture number 5 is an OCT, both showing reattachment of the retina with visual improvement to 20/20.

Today is a special day for us. It is Retina San Diego’s anniversary! 4 years ago, we started the journey with one clear mission in mind: to create a state of the art retina clinic where we would provide the most advanced care in San Diego and thus fulfill our lifelong passion of saving vision. We are humbled by the love and gratitude that our patients have provided, the awards we have received from our peers and the hard work of our team that have made this dream come true for our community. To many more years of saving vision!

Come join us Friday, September 15 at 9:00 am as Dr. Mozayan will talk about Eye Health & Aging.

If you or a loved one has suffered of a retinal vein occlusion or a "stroke of the eye", you can read Dr. Mozayan's article on the subject. http://www.coavision.org/i4a/pages/index.cfm?pageID=4317

Great article on Floaters in the New York Times. New onset of floaters should be evaluated within 24 hours to rule out a retinal tear.

Many of you have asked us for a list of foods that are beneficial to your eyes. Here is a poster of "Eye Healthy Foods" that you can place in your kitchen. You can also visit www.retinasd.com for more information.

Thank you to the amazing crowd that attended Dr. Mozayan's lecture yesterday. Please don't hesitate to visit our website at www.retinasd.com. You can also direct your questions to Dr. Mozayan at [email protected]

You can now learn more on Macular Degeneration and its treatments on our website. www.retinasd.com

Visit www.retinasd.com for more information on retinal diseases and our state-of-the-art center.

Thank you to everyone who attended Dr. Mozayan's community lecture on "Eye Health & Aging" on 9/18/15. It was a great turnout! Please feel free to send further questions to [email protected]

Spreading the love one eyeball cupcake at a time! Thank you everyone for an amazing event!

Retina San Diego has now joined Twitter! Follow us to stay up to date on news to keep you and your eyes healthy!

This NYT article nicely describes some of the main retinal diseases and the necessity to seek prompt evaluation to decrease risks of irreversibe damage to the retina.

Retina San Diego recently wrote an article in a local journal where we also discussed the same subject of the "rise of myopia" or nearsightedness that is covered in this article of the Wall Street Journal. High myopia increases your risks of retinal degeneration and retinal detachment. Our recommendation to all parents is to spend as much time as possible with their kids in the outdoors and to limit the time spent on their iPads.