Journal article
Meniscus Micropyon: An Ophthalmoscopic Sign Possibly Associated with Epiretinal Proliferation After Retinal Surgery with Gas Tamponade
Retina (Philadelphia, Pa.), Vol.44(10), pp.1766-1776
06/04/2024
DOI: 10.1097/IAE.0000000000004176
Abstract
Purpose: To describe an ophthalmoscopic sign, termed a meniscus micropyon, and its possible association with proliferative vitreoretinopathy (PVR)/epiretinal membrane (ERM) formation after retinal surgery with gas tamponade. Methods: Patients with intravitreal gas were examined postoperatively by 1 of 6 vitreoretinal surgeons from 4 institutions. A micropyon was defined as a white-yellow, solid-appearing consolidation along the meniscus (i.e., the fluid-gas interface). Results: A micropyon was visualized and photographed in 49 patients who received intravitreal gas. Preoperatively, retinal breaks were present in all 49 eyes and rhegmatogenous retinal detachment (RRD) in 45 (92%). Postoperatively, 39 eyes (80%) developed epiretinal proliferation: 16 eyes (33%) developed recurrent RRD from PVR, 6 eyes (12%) re-detached without frank PVR, 9 eyes (18%) developed postoperative ERM/worsening and 8 eyes (16%) had postoperative ERM but no preoperative OCT to determine if the postoperative ERM was new or worsening. The single-operation anatomic success in eyes with a micropyon was 51%, which was lower than that of a contemporaneous RRD control group (91%) in which no micropyon was detected. In 2 patients, micropyons were biopsied during PPV and examined histopathologically; they consist predominantly of white blood cells (WBCs). Conclusions: The meniscus micropyon is an ophthalmoscopic sign that can occur after retinal surgery with gas tamponade. Features that distinguish a micropyon from post-vitrectomy fibrin/fibrinoid syndrome include delayed appearance, hyperautofluorescence, absence of translucent strands or sheets in the anterior chamber or vitreous cavity, and the histopathologic identification of WBCs. A clinically detectable micropyon may be a biomarker of PVR/ERM formation.
Details
- Title: Subtitle
- Meniscus Micropyon: An Ophthalmoscopic Sign Possibly Associated with Epiretinal Proliferation After Retinal Surgery with Gas Tamponade
- Creators
- Jonathan F. Russell - University of IowaBenjamin J. Fowler - University of Wisconsin–MadisonHasenin Al-Khersan - University of MiamiThomas A. Lazzarini - University of MiamiNimesh A. Patel - Massachusetts Eye and Ear InfirmaryNasreen A. Syed - University of IowaStephen R. Russell - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Retina (Philadelphia, Pa.), Vol.44(10), pp.1766-1776
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- DOI
- 10.1097/IAE.0000000000004176
- ISSN
- 0275-004X
- eISSN
- 1539-2864
- Grant note
The authors thank H. Culver Boldt, MD, D. Brice Critser, BS, CRA, Ian C. Han, MD (all at the University of Iowa), and Joseph E. Shepherd, PhD (California Institute of Technology) for helpful discussions.
- Language
- English
- Electronic publication date
- 06/04/2024
- Academic Unit
- Pathology; Ophthalmology and Visual Sciences
- Record Identifier
- 9984643659102771
Metrics
9 Record Views