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El-Sehemy A, Martins Melo I, Pecaku A, Zajner C, Naidu S, Motekalem Y, Muni RH. POSTOPERATIVE PHOTORECEPTOR INTEGRITY AND ANATOMICAL OUTCOMES BASED ON PRESENTING MORPHOLOGIC STAGE OF RHEGMATOGENOUS RETINAL DETACHMENT. Retina 2024; 44:756-763. [PMID: 38207330 DOI: 10.1097/iae.0000000000004034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
PURPOSE To evaluate outer retinal recovery on postoperative optical coherence tomography (OCT) based on presenting morphologic stage of rhegmatogenous retinal detachment (RRD). METHODS Retrospective cohort of consecutive primary fovea-involving RRDs, referred from January 2012 to September 2022. Baseline OCTs were assessed for morphologic stage of RRD. Postoperative OCT scans were graded at 3, 6, and 12 months for external limiting membrane, ellipsoid zone and interdigitation zone discontinuity, epiretinal membrane formation and severity, and residual subfoveal fluid. RESULTS Three hundred and fifty-one patients were included. Increasing baseline morphologic stage of RRD was significantly associated with external limiting membrane, ellipsoid zone, and interdigitation zone discontinuity at all time points postoperatively ( P < 0.001) and was shown to be an independent predictor of foveal photoreceptor integrity after adjusting for height of detachment, time to surgery, and duration of fovea involvement ( P < 0.001). Earlier stages were associated with residual subfoveal fluid ( P < 0.001). There was no association between the stages of RRD and epiretinal membrane severity. However, late stages presented with earlier development of epiretinal membrane ( P = 0.012). CONCLUSION Increasing morphologic stage of RRD is associated with delayed recovery of outer retinal bands in the first year and faster development of epiretinal membrane after RRD repair. The results of this study suggest that the stages may serve as a prognostic biomarker for postoperative photoreceptor recovery.
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Affiliation(s)
- Ahmed El-Sehemy
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Isabela Martins Melo
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Aurora Pecaku
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Chris Zajner
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada ; and
| | - Sumana Naidu
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Yasmin Motekalem
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Institute, Toronto, Ontario, Canada
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2
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Okamoto F. Changes in Metamorphopsia in Patients Undergoing Treatment for Vitreoretinal Disorders. J NIPPON MED SCH 2024; 91:28-36. [PMID: 38233125 DOI: 10.1272/jnms.jnms.2024_91-114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE To quantify and compare the severity of metamorphopsia in patients undergoing vitrectomy for vitreoretinal disorders. METHODS Data were collected evaluated from 319 patients with vitreoretinal disorders, including epiretinal membrane (ERM), macular hole (MH), cystoid macular edema with branch retinal vein occlusion (BRVO-CME), CME with central retinal vein occlusion (CRVO), diabetic macular edema (DME), macula-off rhegmatogenous retinal detachment (M-off RD), and macula-on RD (M-on RD). Metamorphopsia was recorded with the M-CHARTS preoperatively and at 3 and 6 months postoperatively. RESULTS Preoperative and 6-month postoperative metamorphopsia scores were 0.69 ± 0.50 and 0.50 ± 0.52, respectively. Before surgery, 94% of patients presented with metamorphopsia (score ≥0.2). Preoperative metamorphopsia scores were significantly correlated with postoperative metamorphopsia scores (r = 0.378, p < 0.0001). Preoperative metamorphopsia score was significantly higher for ERM (0.89) than for DME (0.51). Vitrectomy significantly improved metamorphopsia in ERM and MH but not in the other disorders. In contrast, treatment improved visual acuity for all disorders except CRVO-CME and M-on RD. CONCLUSION This quantitative study indicated that metamorphopsia is present in most patients undergoing surgery for vitreoretinal diseases and is most severe in ERM. In these patients, vitrectomy improved visual acuity but not metamorphopsia.
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Affiliation(s)
- Fumiki Okamoto
- Department of Ophthalmology, Graduate School of Medicine, Nippon Medical School
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3
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Sharma A, Wu L, Bloom S, Stanga P, Agrawal R, Downes RA, Rachitskaya AV, Ghalibafan S, Cai LZ, Yannuzzi NA, Shanmugam PM, Wakabayashi T, Avci R, Rezaei KA. RWC Update: Unstapling the Retina From a Firecracker Injury; Macula-On Retinal Detachment: When To Operate?; Choroidal Coloboma. Ophthalmic Surg Lasers Imaging Retina 2024; 55:125-128. [PMID: 38466966 DOI: 10.3928/23258160-20240212-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
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McKay BR, Bansal A, Kryshtalskyj M, Wong DT, Berger AR, Muni RH. Two-year outcomes of different subretinal fluid drainage techniques during vitrectomy for fovea-off rhegmatogenous retinal detachments: ELLIPSOID-2 Study. Br J Ophthalmol 2024:bjo-2023-323879. [PMID: 38290803 DOI: 10.1136/bjo-2023-323879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND The purpose of the study is to compare visual acuity, complications and outer retinal integrity following subretinal fluid (SRF) drainage from the peripheral retinal breaks (PRBs) versus posterior retinotomy (PR) versus perfluorocarbon liquid (PFCL) for macula-off rhegmatogenous retinal detachments (RRDs) at 2 years post-surgery. METHODS Retrospective analysis of 300 consecutive patients with primary RRD undergoing 23-gauge pars plana vitrectomy with SRF drainage through (1) PRB (n=100), (2) PR (n=100) or (3) with PFCL (n=100). Primary outcomes were visual acuity (best-corrected visual acuity (BCVA)) and complications (cystoid macular oedema (CMO) and epiretinal membrane (ERM)). Secondary outcomes were discontinuity of the external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IDZ) at 2 years post-surgery. RESULTS Mean (±SD) logMAR BCVA at 24 months was better in the PRB compared with PR and PFCL, with PFCL having the worst BCVA (PRB 0.5±0.6; PR 0.7±0.5; PFCL 0.9±0.7, p=0.001). CMO was higher with PFCL (PRB 29.7%; PR 30.2%; PFCL 45.9%, p=0.0015) and ERM formation was higher in PR (PRB 62.6%; PR 93.0%; PFCL 68.9%, p=0.002). There were no differences in ELM or EZ discontinuity. However, IDZ discontinuity was higher in PFCL (PRB 34%; PR 27%; PFCL 46%, p=0.002) at 2 years. CONCLUSIONS Visual acuity was worse and discontinuity of the IDZ and CMO was greater in eyes with PFCL-assisted drainage compared with PRB or PR. Drainage technique may impact long-term visual acuity and photoreceptor integrity.
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Affiliation(s)
- Bryon R McKay
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Science, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Aditya Bansal
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Michael Kryshtalskyj
- Department of Ophthalmology and Vision Sciences, University of Calgary, Calgary, Alberta, Canada
| | - David T Wong
- VitreoRetina, St Michael's Hospital, Toronto, Ontario, Canada
| | - Alan R Berger
- VitreoRetina, St Michael's Hospital, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St Michael's Hospital, Toronto, Ontario, Canada
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Hassan A, Abdel-Radi M, Aly MOM, Alattar S. Correlation between multifocal electroretinogram and optical coherence tomography findings with visual acuity after vitrectomy surgery for retinal detachment: an observational study. Int J Retina Vitreous 2024; 10:10. [PMID: 38263142 PMCID: PMC10804544 DOI: 10.1186/s40942-024-00527-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Despite the marked increase in the anatomical success rates of macula-off rhegmatogenous retinal detachment (RRD) surgery, patients may still complain about unsatisfactory visual outcome. This study aims to correlate the postoperative corrected distance visual acuity (CDVA) with the mf-ERG (multifocal electroretinogram) and OCT (optical coherence tomography) findings following vitrectomy surgery for RRD. PATIENTS AND METHODS This retrospective observational study included 40 eyes of 40 patients who underwent successful vitrectomy surgery for macula-off RRD. CDVA, mf-ERG amplitudes, mf-ERG latencies, the central macular thickness (CMT) and the integrity of the inner segment/outer segment (IS/OS) junction assessed by OCT, were evaluated 6 months postoperatively. The correlations between CDVA with mf-ERG amplitudes, mf-ERG latencies, central macular thickness, and IS/OS junction integrity were analyzed. RESULTS There was a statistically significant moderate positive correlation between CDVA of the studied eyes with mf-ERG amplitudes of N1, P1 and N2 in ring 1 (P = 0.008; P < 0.001 and P = 0.004, respectively), CMT (P < 0.001), and the integrity of IS/OS junction (P < 0.001). There was no significant correlation between CDVA and mf-ERG latencies in ring 1 (P > 0.05). Linear regression analysis revealed that CDVA was significantly associated with mf-ERG amplitudes and the IS/OS junction integrity. In addition, there was a strong positive correlation between mf-ERG amplitudes in ring 1 and the IS/OS junction integrity. CONCLUSIONS The integrated interpretation of postoperative CDVA, multifocal ERG parameters, and OCT findings provides useful information about functional visual recovery and retinal microstructural changes following vitrectomy for macula-off RRD surgery. The positive correlation between the IS/OS junction integrity and the mf-ERG amplitudes was stronger than the correlation between the IS/OS junction integrity and CDVA suggesting that mf-ERG may be superior to CDVA in reflecting the extent of microstructural damage in the photoreceptor layer. TRIAL REGISTRATION Clinicaltrials.gov, NCT05993208. Registered 15 August 2023 - Retrospectively registered, https://classic. CLINICALTRIALS gov/ct2/show/NCT05993208 .
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Affiliation(s)
- Asmaa Hassan
- Department of Ophthalmology, New Valley University, New Valley, Egypt
| | | | | | - Sara Alattar
- Department of Ophthalmology, Assiut University, Assiut, Egypt
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Huvard MJ, Patnaik JL, Kleinman DM, Preston M, Zacks DN, Kocab AJ, van de Goor J, Wagner BD, Cho S, Lynch AM, Mandava N. An Evaluation of the Repeatability of Visual Function Following Surgical Repair of Macula-Off Rhegmatogenous Retinal Detachment. Transl Vis Sci Technol 2023; 12:35. [PMID: 38019499 PMCID: PMC10691393 DOI: 10.1167/tvst.12.11.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 10/21/2023] [Indexed: 11/30/2023] Open
Abstract
Purpose To evaluate the reliability and reproducibility of visual function assessments for patients with macula-off rhegmatogenous retinal detachment (RRD). Methods This prospective study included patients with unilateral macula-off RRD of <10-day duration successfully treated with a single, uncomplicated surgery at least 1 year following repair. Visual function assessments were performed at time of enrollment and 1 month later. Testing included Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), low-contrast visual acuity (VA) 2.5% and 5%, contrast sensitivity assessment with Mars and Gabor patches, reading speed (acuity, speed, and critical print size), color vision testing (protan, deutan, and tritan), and microperimetry. Spectral-domain ocular coherence tomography (SD-OCT) was performed. Paired t-statistics were used to compare values between visits and between the study and fellow eyes. Results Fourteen patients (9 male, 5 female) with a mean age of 69 years at time of surgery were evaluated. Correlation coefficients across the two visits were highest for ETDRS BCVA (0.97), tritan color vision testing (0.96), and low-contrast VA 5% (0.96), while the average t-statistic was largest for low-luminance deficit (4.2), ETDRS BCVA (4.1), and reading speed critical print size (3.7). ETDRS BCVA did not correlate with SD-OCT findings. Conclusions ETDRS BCVA can be considered a highly reliable and reproducible outcome measure. LLVA, protan color discrimination, contrast sensitivity, and reading speed may be useful secondary outcome measures. Translational Relevance This study provides guidance on the selection of visual function outcome measures for clinical trials of patients with macula-off RRD.
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Affiliation(s)
- Michael J. Huvard
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA
| | - Jennifer L. Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - David M. Kleinman
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Mary Preston
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - David N. Zacks
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA
| | | | | | | | - Steve Cho
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Anne M. Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Naresh Mandava
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
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Barequet D, Shemesh R, Zvi D, Cohen R, Trivizki O, Schwartz S, Barak A, Loewenstein A, Rabina G. Functional and anatomical outcomes of fovea on, fovea off and fovea-splitting rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol 2023; 261:3187-3192. [PMID: 37477738 DOI: 10.1007/s00417-023-06169-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 06/12/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023] Open
Abstract
PURPOSE To compare the anatomical and functional outcomes of fovea-on, fovea-off, and fovea-split rhegmatogenous retinal detachment (RRD). METHODS Retrospective case series of consecutive patients diagnosed with RRD and treated with only pars plana vitrectomy (PPV). Preoperative and postoperative optical coherence tomography (OCT) and functional outcomes were obtained prior to and 6 months after surgery. RRD extending to the edge of the fovea on OCT was termed fovea-split RRD. RESULTS A total of 152 eyes were included, out of which 89 eyes presented with a fovea-off, 36 with a fovea-on, and 27 with a fovea-split RRD. The mean visual acuity (VA) preoperatively was 1.32 ± 0.58 logMAR (20/400 equivalent on Snellen chart), 0.19 ± 0.20 (20/30), and 0.71 ± 0.56 (20/100) for the fovea-off, fovea-on, and fovea-split groups, respectively (p < 0.001). The mean VA at 6 months of follow-up significantly improved for the fovea-split and fovea-off groups to 0.54 ± 0.79 (20/70) (p < 0.001) and 0.45 ± 0.29 (20/50) (p = 0.01), respectively, and remained stable for the fovea-on group 0.24 ± 0.20 (20/30) (p = 0.25). Differences in alterations of the outer retinal layers (p < 0.001) and in the in-segment/outer-segment ratio (p < 0.001) were found between the groups. CONCLUSION Eyes with fovea-split RRD had both a preoperative and a final postoperative VA between those of fovea-on and fovea-off eyes and different anatomical changes on OCT. This new entity warrants different patient expectations for postoperative outcomes.
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Affiliation(s)
- Dana Barequet
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Rachel Shemesh
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Dana Zvi
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ram Cohen
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Omer Trivizki
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shulamit Schwartz
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Adiel Barak
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gilad Rabina
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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8
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Anguita R, Charteris D. Visual loss in surgical retinal disease: retinal imaging and photoreceptor cell counts. Br J Ophthalmol 2023; 107:1583-1589. [PMID: 36396343 DOI: 10.1136/bjo-2022-321845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 11/02/2022] [Indexed: 11/18/2022]
Abstract
Vision loss after detachment of the neurosensory retina is a complex process which is not fully understood. Clinical factors have been identified which contribute to loss of macular function after retinal detachment and laboratory studies have played an important role in understanding the cellular and subcellular pathological processes which underlie the loss of visual function. As clinical imaging has advanced, multiple studies have focused on identifying and correlating clinicopathological features with visual outcomes in patients with rhegmatogenous retinal detachment. Optical coherence tomography, fundus autofluorescence, optical coherence tomography angiography and adaptive optics studies have contributed to the understanding of the anatomical changes in relation to clinical outcomes. A clear understanding of the macular pathology of retinal detachment is fundamental to develop strategies to improve outcomes in patients with rhegmatogenous retinal detachment and analogous retinal diseases where macular neurosensory retinal detachment is part of the pathology. This review assesses the evidence from experimental and pathological studies together with clinical imaging analyses (optical coherence tomography, fundus autofluorescence, optical coherence tomography angiography and adaptive optics) and the contribution of these studies to our understanding of visual outcomes.
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Affiliation(s)
- Rodrigo Anguita
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - David Charteris
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, London, UK
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9
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Fricke TR, Sankaridurg P, Naduvilath T, Resnikoff S, Tahhan N, He M, Frick KD. Establishing a method to estimate the effect of antimyopia management options on lifetime cost of myopia. Br J Ophthalmol 2023; 107:1043-1050. [PMID: 35264328 PMCID: PMC10359589 DOI: 10.1136/bjophthalmol-2021-320318] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/21/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Informed decisions on myopia management require an understanding of financial impact. We describe methodology for estimating lifetime myopia costs, with comparison across management options, using exemplars in Australia and China. METHODS We demonstrate a process for modelling lifetime costs of traditional myopia management (TMM=full, single-vision correction) and active myopia management (AMM) options with clinically meaningful treatment efficacy. Evidence-based, location-specific and ethnicity-specific progression data determined the likelihood of all possible refractive outcomes. Myopia care costs were collected from published sources and key informants. Refractive and ocular health decisions were based on standard clinical protocols that responded to the speed of progression, level of myopia, and associated risks of pathology and vision impairment. We used the progressions, costs, protocols and risks to estimate and compare lifetime cost of myopia under each scenario and tested the effect of 0%, 3% and 5% annual discounting, where discounting adjusts future costs to 2020 value. RESULTS Low-dose atropine, antimyopia spectacles, antimyopia multifocal soft contact lenses and orthokeratology met our AMM inclusion criteria. Lifetime cost for TMM with 3% discounting was US$7437 (CI US$4953 to US$10 740) in Australia and US$8006 (CI US$3026 to US$13 707) in China. The lowest lifetime cost options with 3% discounting were antimyopia spectacles (US$7280, CI US$5246 to US$9888) in Australia and low-dose atropine (US$4453, CI US$2136 to US$9115) in China. CONCLUSIONS Financial investment in AMM during childhood may be balanced or exceeded across a lifetime by reduced refractive progression, simpler lenses, and reduced risk of pathology and vision loss. Our methodology can be applied to estimate cost in comparable scenarios.
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Affiliation(s)
- Tim R Fricke
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas Naduvilath
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Nina Tahhan
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Mingguang He
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Kevin D Frick
- Johns Hopkins Carey Business School, Baltimore, Maryland, USA
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10
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Iannetti L, Scarinci F, Alisi L, Armentano M, Sampalmieri L, La Cava M, Gharbiya M. Correlation between Morphological Characteristics of Macular Edema and Visual Acuity in Young Patients with Idiopathic Intermediate Uveitis. Medicina (B Aires) 2023; 59:medicina59030529. [PMID: 36984530 PMCID: PMC10054752 DOI: 10.3390/medicina59030529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/12/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Background and Objectives: Macular edema (ME) is a common complication of intermediate uveitis (IU). It is often responsible for a decrease in visual acuity (VA). Three distinct patterns of macular edema have been described in intermediate uveitis, namely, cystoid macular edema (CME), diffuse macular edema (DME), and serous retinal detachment (SRD). The current study aims to describe the characteristics of macular edema in young patients with idiopathic intermediate uveitis and to correlate its features with VA using spectral domain optical coherence tomography (SD-OCT). Materials and Methods: A total of 27 eyes from 18 patients with idiopathic IU complicated by ME were included in this retrospective study. All patients underwent SD-OCT; data were gathered at the onset of ME. Best-corrected VA (BCVA) was correlated with the morphological features of ME. Results: BCVA was negatively correlated with Ellipsoid Zone (EZ) disruption (p = 0.00021), cystoid pattern (p = 0.00021), central subfield thickness (CST) (p < 0.001), and serous retinal detachment (0.037). Conclusions: In ME secondary to idiopathic IU, VA negatively correlates with Ellipsoid Zone disruption and increases in CST. Moreover, vision is influenced by the presence of cysts in the inner nuclear and outer nuclear layers and by the neuroepithelium detachment.
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Affiliation(s)
- Ludovico Iannetti
- Ophthalmology Unit, Head and Neck Department, Policlinico Umberto I University Hospital, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence: ; Tel.: +39-3388635417
| | | | - Ludovico Alisi
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
| | - Marta Armentano
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Maurizio La Cava
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
| | - Magda Gharbiya
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
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11
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Martis RM, Knight LJ, Acosta ML, Black J, Ng R, Ji LCL, Donaldson PJ, Lim JCH. Early onset of age-related changes in the retina of cystine/glutamate antiporter knockout mice. Exp Eye Res 2023; 227:109364. [PMID: 36586548 DOI: 10.1016/j.exer.2022.109364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/13/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
To determine the role of the cystine/glutamate antiporter on retinal structure and function, retinas of C57Bl/6J wild-type and xCT knockout mice, lacking the xCT subunit of the cystine/glutamate antiporter were examined from 6 weeks to 12 months of age. Fundoscopy, optical coherence tomography (OCT), and whole mount retinal autofluorescence imaging were used to visualise age-related retinal spots. Glial fibrillary acidic protein (GFAP) immunolabelling was used to assess retinal stress. Retinal function was evaluated using full-field and focal electroretinograms. Examinations revealed retinal spots in both wild-type and xCT knockout mice with the number of spots greater at 9 months in the knockout compared to wild-type. OCT confirmed these discrete spots were located at the retinal pigment epithelium (RPE)-photoreceptor junction and did not label with drusen markers. Whole mount lambda scans of the 9 month xCT knockout retinas revealed that the photoreceptor autofluorescence matched the spots, suggesting these spots were retinal debris. GFAP labelling was increased in knockout retinas compared to wild-type indicative of retinal stress, and the discrete spots were associated with migration of microglia/macrophages to the RPE-retina intersection. OCT revealed that the superior retina was thinner at 9 months in knockout compared to wild-type mice due to changes to the outer nuclear and photoreceptor layers. While global retinal function was not affected by loss of xCT, focal changes in retinal function were detected in areas where spots were present. Tother these results suggest that the xCT KO mice exhibit features of accelerated ageing and suggests that this mouse model may be useful for studying the underlying cellular pathways in retinal ageing.
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Affiliation(s)
- Renita Maria Martis
- Dept. Physiology, School of Medical Sciences, University of Auckland, New Zealand; School of Optometry and Vision Science, University of Auckland, New Zealand; New Zealand National Eye Centre, University of Auckland, New Zealand
| | - Luis James Knight
- Dept. Physiology, School of Medical Sciences, University of Auckland, New Zealand; New Zealand National Eye Centre, University of Auckland, New Zealand
| | - Monica L Acosta
- School of Optometry and Vision Science, University of Auckland, New Zealand; New Zealand National Eye Centre, University of Auckland, New Zealand; Centre for Brain Research, University of Auckland, New Zealand
| | - Joanna Black
- School of Optometry and Vision Science, University of Auckland, New Zealand; New Zealand National Eye Centre, University of Auckland, New Zealand
| | - Robert Ng
- School of Optometry and Vision Science, University of Auckland, New Zealand; New Zealand National Eye Centre, University of Auckland, New Zealand
| | | | - Paul James Donaldson
- Dept. Physiology, School of Medical Sciences, University of Auckland, New Zealand; New Zealand National Eye Centre, University of Auckland, New Zealand
| | - Julie Ching-Hsia Lim
- Dept. Physiology, School of Medical Sciences, University of Auckland, New Zealand; New Zealand National Eye Centre, University of Auckland, New Zealand.
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12
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Thomseth VM, Lindtjørn B, Ushakova A, Forsaa VA. LONG-TERM CHANGES IN VISUAL FUNCTION AND EN FACE OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN FOVEA-OFF RETINAL DETACHMENT: A 2-Year Prospective Study. Retina 2023; 43:330-337. [PMID: 36695802 DOI: 10.1097/iae.0000000000003670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate the long-term changes in visual function and outer retinal abnormalities on en face optical coherence tomography after fovea-off rhegmatogenous retinal detachment and to assess associations between functional outcomes and outer retinal abnormalities. METHODS Prospective, observational study. The following data were collected at 1, 3, 6, 12, and 24 months after retinal reattachment: Best-corrected visual acuity, metamorphopsia (M-CHARTS), aniseikonia (New Aniseikonia Test), altered ellipsoid zone reflectivity, outer retinal folds, macular detachment demarcation, and subfoveal fluid. RESULTS Thirty-eight patients were included. Best-corrected visual acuity improved significantly from 1 to 12 months and from 12 to 24 months (P < 0.001; P = 0.022). Vertical and horizontal metamorphopsia improved significantly from 1 to 12 months (P < 0.001; P = 0.002), and at 24 months, scores of ≥0.2° were present in 54% and 42% of patients, respectively. The degree of aniseikonia did not change. Best-corrected visual acuity and aniseikonia scores were positively associated with outer retinal fold (r 0.4, P = 0.009; r 0.4, P = 0.048). A gradual normalization of outer retinal reflectivity took place during 24 months. CONCLUSION Visual acuity improved significantly during the second year after reattachment surgery for fovea-off rhegmatogenous retinal detachment, in parallel with normalization of outer retinal abnormalities on en face optical coherence tomography. Metamorphopsia did not improve after 12 months, and aniseikonia remained unchanged.
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Affiliation(s)
- Vilde M Thomseth
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway.,Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
| | - Birger Lindtjørn
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; and
| | - Anastasia Ushakova
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Vegard A Forsaa
- Department of Ophthalmology, Stavanger University Hospital, Stavanger, Norway.,Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
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13
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Guner ME, Guner MK, Cebeci Z, Kır N. Preoperative and Postoperative Factors Affecting Functional Success in Anatomically Successful Retinal Detachment Surgery. KOREAN JOURNAL OF OPHTHALMOLOGY 2022; 36:477-485. [PMID: 36220639 DOI: 10.3341/kjo.2022.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/24/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To investigate preoperative and postoperative factors affecting functional success in anatomically successful retinal detachment surgery. METHODS Seventy-five eyes of 75 patients with rhegmatogenous retinal detachment who underwent anatomically successful surgery from 2014 to 2019 with more than 1 year follow-up were included in the study. Demographic characteristics, ocular examination findings, preoperative and postoperative spectral domain optic coherence tomography images were retrospectively evaluated. RESULTS The mean age was 53.9 ± 17 years (range, 11-85 years). The mean follow-up period was 36.7 ± 16 months (range, 14-72 months). The mean best-corrected visual acuity of the patients before surgery was 1.35 ± 1.24 and at postoperative 12 months was 0.66 ± 0.5 logarithm of the minimum angle of resolution. Patients who were operated in 7 days of visual symptoms onset were found to have better visual acuity at the first and subsequent postoperative exams. Preoperative proliferative vitreoretinopathy, vitreous hemorrhage, and extent of retinal detachment were found to have a negative effect on functional success at 12 months. Regeneration of the outer retinal layers had a positive effect on visual acuity at 12 months but did not significantly increase visual acuity after 12 months. Multivariate analysis showed that preoperative external limiting membrane integrity was significantly associated with better functional outcomes. CONCLUSIONS Early intervention, presence of preoperative external limiting membrane integrity, and restoration of postoperative outer retinal layers positively affected functional success. The presence of preoperative vitreous hemorrhage, preoperative proliferative vitreoretinopathy, and the extent of retinal detachment had a negative effect on prognosis at 12 months.
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Affiliation(s)
- Mehmet Eren Guner
- Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA
| | | | - Zafer Cebeci
- Department of Ophthalmology, Istanbul University, Istanbul, Turkey
| | - Nur Kır
- Department of Ophthalmology, Istanbul University, Istanbul, Turkey
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14
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Komiya Y, Takeyama A, Shibata M, Imamura Y, Ishida M. Outer retinal microstructure and visual function after macular hole surgery with and without Brilliant Blue G. Jpn J Ophthalmol 2022; 66:534-540. [PMID: 36181645 DOI: 10.1007/s10384-022-00942-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/21/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the outer retinal microstructure and visual function after idiopathic macular hole (MH) surgery using internal limiting membrane (ILM) peeling with and without Brilliant Blue G (BBG) staining. STUDY DESIGN Retrospective, consecutive case series. METHODS A total of 49 eyes of 47 patients were enrolled: 23 eyes of 23 patients with MH who underwent ILM peeling without dyes (control group) and 26 eyes of 26 patients who underwent BBG staining (BBG group). The lengths of defects of the photoreceptor ellipsoid zone (EZ), external limiting membrane (ELM), and interdigitation zone (IZ) were measured. RESULTS The rate of MH closure after initial surgery was 95.6% (22/23 eyes) for the control group versus 100% (26/26 eyes) for the BBG group. In the 48 eyes with MH closure, the recovery rate of ELM deficiency and change in IZ deficiency showed no difference between the groups. The changes in EZ deficiency at 1 and 12 months were greater in the BBG group than in the control group. (P = 0.047 and 0.031). Visual acuity was better in the BBG group than in the control group during 12 months postoperatively (P < 0.001-0.038). CONCLUSION Eyes undergoing BBG-assisted MH surgery achieved faster recovery of the outer retinal structures and greater visual improvement than those of eyes without BBG.
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Affiliation(s)
- Yuko Komiya
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1, Futago, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan
| | - Asuka Takeyama
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1, Futago, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan. .,Department of Ophthalmology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
| | - Masaki Shibata
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1, Futago, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan
| | - Yutaka Imamura
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1, Futago, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan
| | - Masahiro Ishida
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, 5-1-1, Futago, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan.,Department of Ophthalmology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan
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15
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Muni RH, Lee WW, Bansal A, Ramachandran A, Hillier RJ. A paradigm shift in retinal detachment repair: The concept of integrity. Prog Retin Eye Res 2022; 91:101079. [DOI: 10.1016/j.preteyeres.2022.101079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/09/2022]
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16
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Moos WH, Faller DV, Glavas IP, Harpp DN, Kamperi N, Kanara I, Kodukula K, Mavrakis AN, Pernokas J, Pernokas M, Pinkert CA, Powers WR, Sampani K, Steliou K, Tamvakopoulos C, Vavvas DG, Zamboni RJ, Chen X. Treatment and prevention of pathological mitochondrial dysfunction in retinal degeneration and in photoreceptor injury. Biochem Pharmacol 2022; 203:115168. [PMID: 35835206 DOI: 10.1016/j.bcp.2022.115168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/19/2022]
Abstract
Pathological deterioration of mitochondrial function is increasingly linked with multiple degenerative illnesses as a mediator of a wide range of neurologic and age-related chronic diseases, including those of genetic origin. Several of these diseases are rare, typically defined in the United States as an illness affecting fewer than 200,000 people in the U.S. population, or about one in 1600 individuals. Vision impairment due to mitochondrial dysfunction in the eye is a prominent feature evident in numerous primary mitochondrial diseases and is common to the pathophysiology of many of the familiar ophthalmic disorders, including age-related macular degeneration, diabetic retinopathy, glaucoma and retinopathy of prematurity - a collection of syndromes, diseases and disorders with significant unmet medical needs. Focusing on metabolic mitochondrial pathway mechanisms, including the possible roles of cuproptosis and ferroptosis in retinal mitochondrial dysfunction, we shed light on the potential of α-lipoyl-L-carnitine in treating eye diseases. α-Lipoyl-L-carnitine is a bioavailable mitochondria-targeting lipoic acid prodrug that has shown potential in protecting against retinal degeneration and photoreceptor cell loss in ophthalmic indications.
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Affiliation(s)
- Walter H Moos
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of California San Francisco, San Francisco, CA, USA.
| | - Douglas V Faller
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA; Cancer Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Ioannis P Glavas
- Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - David N Harpp
- Department of Chemistry, McGill University, Montreal, QC, Canada
| | - Natalia Kamperi
- Center for Clinical, Experimental Surgery and Translational Research Pharmacology-Pharmacotechnology, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | | | | | - Anastasios N Mavrakis
- Department of Medicine, Tufts University School of Medicine, St. Elizabeth's Medical Center, Boston, MA, USA
| | - Julie Pernokas
- Advanced Dental Associates of New England, Woburn, MA, USA
| | - Mark Pernokas
- Advanced Dental Associates of New England, Woburn, MA, USA
| | - Carl A Pinkert
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Whitney R Powers
- Department of Health Sciences, Boston University, Boston, MA, USA; Department of Anatomy, Boston University School of Medicine, Boston, MA, USA
| | - Konstantina Sampani
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
| | - Kosta Steliou
- Cancer Research Center, Boston University School of Medicine, Boston, MA, USA; PhenoMatriX, Inc., Natick, MA, USA
| | - Constantin Tamvakopoulos
- Center for Clinical, Experimental Surgery and Translational Research Pharmacology-Pharmacotechnology, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Demetrios G Vavvas
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Robert J Zamboni
- Department of Chemistry, McGill University, Montreal, QC, Canada
| | - Xiaohong Chen
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA, USA; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.
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17
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Bodhankar PU, Joshi AK, Dronadula M, Patil AN. Postoperative microstructural re-modelling and functional outcomes in idiopathic full thickness macular hole. Indian J Ophthalmol 2022; 70:2077-2083. [PMID: 35647986 PMCID: PMC9359227 DOI: 10.4103/ijo.ijo_192_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: To analyze the effect of various macular hole indices and postoperative microstructural changes of all retinal layers on postoperative functional outcomes in patients with idiopathic full-thickness macular hole (FTMH). Methods: In this prospective study, pre and post-operative optical coherence tomography (OCT) scans of 36 eyes with idiopathic FTMH were analyzed. Hole indices and microstructural changes of all retinal layers such as ellipsoid zone (EZ), external limiting membrane (ELM) integrity, outer and inner retinal defects, and cystoid resolution were studied on follow-up visits. Results: Out of 36 eyes, type-1 closure was achieved in 23 eyes (65.7%) and type-2 closure in 11 eyes (31.42%), one eye showed persistent hole, and one eye was lost to follow-up. The mean minimum diameter of hole (P = 0.026), mean MHI (P = 0.001), DHI (P = 0.158), THI (P = 0.001), and HFF (P < 0.001) showed statistical significance with the type of hole closure. Postoperatively, eyes with intact ELM and EZ had better BCVA at the final visit. The BCVA was better by logMAR 0.73 ± 0.38 (P < 0.001) in patients with absent outer retinal defects. There was a significant difference in BCVA of 0.52 ± 0.35 at 1 month and 0.64 ± 0.34 at 6 months in eyes without inner retinal defects (P < 0.001). At 6 months, cystoid resolution was observed in 28 (80%) eyes. BCVA was significantly better at 1 month (P < 0.001) and at 6 months (P = 0.001) in eyes with no DONFL. Conclusion: Macular hole indices determine the closure type. Postoperative regeneration of outer retinal layers and resolution of retinal defects significantly influence the final visual outcomes. ELM recovery is seen as a prerequisite for EZ regeneration with no new IRD after a period of 3 months.
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Affiliation(s)
- Paurnima U Bodhankar
- Department of Ophthalmology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra; Department of Vitreo-Retina, Emerald Eye Hospital, Pune, Maharashtra, India
| | - Ajit K Joshi
- Department of Ophthalmology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India
| | - Meghana Dronadula
- Department of Ophthalmology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India
| | - Abhinandan N Patil
- Department of Ophthalmology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India
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18
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Pradhan D, Agarwal L, Joshi I, Kushwaha A, Aditya K, Kumari A. Internal limiting membrane peeling in macular hole surgery. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2022; 20:Doc07. [PMID: 35813123 PMCID: PMC9204259 DOI: 10.3205/000309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/23/2021] [Indexed: 11/18/2022]
Abstract
Since the era when macular hole was considered untreatable, macular hole surgery has come a long way to being one of the most successful surgeries. Internal limiting membrane (ILM) peeling has been an essential step of macular hole surgery since the establishment of the role of ILM in the aetiopathogenesis and progression of macular hole. However, the novel technique was not all virtuous. It had some vices which were not evident immediately. With the advent of spectral domain optical coherence tomography, short- and long-term effects of ILM peeling on macular structures were known; and with microperimetry, its effect on the function of macula could be evaluated. The technique has evolved with time from total peeling to inverted flap to just temporal peeling and temporal flap in an attempt to mitigate its adverse effects and to improve its surgical outcome. ILM abrasion technique and Ocriplasmin may eliminate the need of ILM peeling in selected cases, but they have their own limitations. We here discuss the role of ILM in the pathogenesis of macular hole, the benefits and adverse effects of ILM peeling, and the various modifications of the procedure, to then explore the alternatives.
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Affiliation(s)
- Deepti Pradhan
- Kirtipur Eye Hospital, Department of Vitreoretinal Services, Kirtipur, Nepal,*To whom correspondence should be addressed: Deepti Pradhan, Kirtipur Eye Hospital, Department of Vitreoretinal Services, Tahalcha, Tinkune, 44618 Kirtipur-10, Nepal, Phone: +977 9808119112, E-mail:
| | - Lalit Agarwal
- Biratnagar Eye Hospital, Department of Vitreoretinal Services, Biratnagar, Nepal
| | - Ichhya Joshi
- Biratnagar Eye Hospital, Department of Vitreoretinal Services, Biratnagar, Nepal
| | - Anamika Kushwaha
- Biratnagar Eye Hospital, Department of Vitreoretinal Services, Biratnagar, Nepal
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19
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Gopal AD, Starr MR, Obeid A, Ryan EH, Ryan C, Ammar M, Patel LG, Forbes NJ, Capone A, Emerson GG, Joseph DP, Eliott D, Regillo CD, Hsu J, Gupta OP, Kuriyan AE, Yonekawa Y. Predictors of Vision Loss after Surgery for Macula-Sparing Rhegmatogenous Retinal Detachment. Curr Eye Res 2022; 47:1209-1217. [PMID: 35608082 DOI: 10.1080/02713683.2022.2081980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine factors associated with loss of good vision (defined as Snellen visual acuity [VA] < 20/40) after surgery among eyes presenting with macula-on primary rhegmatogenous retinal detachment (RRD) with initial VA ≥20/40. MATERIALS AND METHODS Multicenter, retrospective, cohort study of eyes undergoing scleral buckle (SB), pars plana vitrectomy (PPV), or combined pars plana vitrectomy/scleral buckle (PPV/SB) for non-complex macula-on RRD with initial VA ≥20/40. RESULTS Among 646 eyes with macula-on RRDs with initial VA ≥20/40, 106 (16.4%) had VA <20/40 (i.e. lost good vision) at final follow-up. Eyes losing good vision had slightly worse pre-operative logMAR VA (mean 0.15 ± 0.10 [20/28]) compared to eyes that preserved good vision (mean 0.11 ± 0.10 [20/26]) (p = 0.004). RRDs extending greater than 6 clock-hours were more likely to lose good vision than smaller detachments (multivariate OR 4.57 [95% CI 1.44-14.51]; p = 0.0099). Compared to eyes repaired with SB alone, eyes undergoing PPV (multivariate OR 7.22 [95% CI 2.10-24.90]; p = 0.0017) or PPV/SB (multivariate OR 10.74 [95% CI 3.20-36.11]; p = 0.0001) were each more likely to lose good vision. Eyes requiring further RRD-related (multivariate OR 8.64 [95% CI 1.47-50.66]; p < 0.017) and non-RRD related vitreoretinal surgery (multivariate OR 14.35 [95% CI 5.39-38.21]; p <0.0001) were more likely to lose good vision. CONCLUSION Among macula-on RRDs, loss of good vision was associated with worse vision on presentation, vitrectomy-based procedures, greater extent of detachment, and lack of single surgery success. Understanding predictors of visual outcome in macula-on RRD repair may guide pre-operative counseling regarding visual prognosis.
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Affiliation(s)
- Anand D Gopal
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Matthew R Starr
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Anthony Obeid
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | | | | | - Michael Ammar
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Luv G Patel
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | | | - Antonio Capone
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, MI
| | | | | | - Dean Eliott
- Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Carl D Regillo
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Jason Hsu
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Omesh P Gupta
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Ajay E Kuriyan
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
| | - Yoshihiro Yonekawa
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA
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20
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McKay BR, Bansal A, Kryshtalskyj M, Wong DT, Berger A, Muni RH. Evaluation of Subretinal fluid Drainage Techniques during Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment - ELLIPSOID study. Am J Ophthalmol 2022; 241:227-237. [PMID: 35597323 DOI: 10.1016/j.ajo.2022.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare visual acuity and photoreceptor integrity following vitrectomy (PPV) with drainage from the peripheral retinal break(s) (PRB) vs. posterior retinotomy (PR) vs. perfluorocarbon liquid (PFCL) for macula-off rhegmatogenous retinal detachment (RRD). DESIGN Retrospective consecutive interventional comparative clinical study. METHODS 300 consecutive patients (300 eyes) with primary macula-off RRD underwent 23-gauge PPV with SRF drainage through 1) PRB (n=100), 2) PR (n=100), or 3) with PFCL (n=100). Visual acuity and SD-OCT were performed preoperatively and at 3, 6, and 12 months postoperatively. Primary outcomes were visual acuity and discontinuity of the external limiting membrane, ELM; ellipsoid zone, EZ; interdigitation zone, IDZ; and retinal pigment epithelium, RPE at 1-year. RESULTS Baseline characteristics were similar. Single-operation reattachment rates were: PRB 86%; PR 85%; PFCL 83%,p=0.9. Mean(±SD) logMAR visual acuity at 1-year was greater with PRB and PR compared to PFCL (PRB=0.6±0.5;PR=0.7±0.6;PFCL=0.9±0.6,p=0.002). There was an association between drainage technique and discontinuity of the ELM (PRB 26%,PR 24%,PFCL 44%,p=0.001), EZ (PRB 29%,PR 31%,PFCL 49%,p<0.001) and IDZ (PRB 43%,PR 39%,PFCL 56%, p=0.004). There was an association between drainage technique and risk of cystoid macular edema (CME) (PRB 28%,PR 39%,PFCL 46%,p=0.003) and ERM (PRB 64%,PR 90%,PFCL 61%,P<0.001). CONCLUSIONS PFCL-assisted drainage is associated with worse visual acuity and greater risk of outer retinal band discontinuity and CME compared with PRB or PR. PR had a greater risk of ERM compared with PRB and PFCL. PRB had the best outcomes overall. Drainage technique may impact long-term anatomic and functional outcomes.
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21
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Gebler M, Pfeiffer S, Callizo J, Hoerauf H, Feltgen N, Bemme S. Incidence and risk factors for macular oedema after primary rhegmatogenous retinal detachment surgery: a prospective single-centre study. Acta Ophthalmol 2022; 100:295-301. [PMID: 34137182 DOI: 10.1111/aos.14940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/20/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the incidence of cystoid macular oedema (CME) diagnosed by spectral domain optical coherence tomography (SD-OCT) after primary rhegmatogenous retinal detachment (RRD) surgery. METHODS From April 2016 to October 2017, 150 eyes of 150 patients presenting with primary RRD were included consecutively in this prospective single-centre study. Patients with the following characteristics were excluded: previous vitreoretinal surgery, combined cataract surgery, preoperatively presentation with any intraocular or systemic inflammatory condition, visible macular oedema or epiretinal membrane (ERM) on funduscopy. SD-OCT (Spectralis, Heidelberg Engineering) was conducted 3 and 6 weeks after surgery. RESULTS One hundred and twenty-eight of the 150 patients completed the study, of whom 107 (age: 61.7 ± 11.5 years, mean ± SD) showed successful retinal attachment during follow-up visits. The most frequent operation method was scleral buckling (54.2%), followed by vitrectomy (25.2%) and the combination of both techniques (20.6%). Postoperative SD-OCT revealed CME, neurosensory detachment and ERM in 18.7, 31.8 and 32.7% of all cases, respectively. The risk of postoperative CME was significantly elevated in patients with ERM (42.9 versus 6.9%, p < 0.001). In addition, patients with initial detachment of the macula had more postoperative CME (26.5 versus 11.1%, p = 0.044). BCVA improvement was significantly lower in patients with CME compared to patients without 6 weeks after surgery for macula-on RRD. CONCLUSIONS This prospective study confirmed that postoperative CME is a frequent complication after RRD surgery; we identified ERM and macula-off RRD as potential risk factors. As CME potentially delays visual recovery, postoperative follow-ups should include SD-OCT.
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Affiliation(s)
- Marie Gebler
- Department of Ophthalmology University Medical Center Goettingen Goettingen Germany
| | - Sebastian Pfeiffer
- Department of Research, Teaching and Clinical Science University Medical Center Goettingen Goettingen Germany
| | - Josep Callizo
- Department of Ophthalmology University Medical Center Goettingen Goettingen Germany
| | - Hans Hoerauf
- Department of Ophthalmology University Medical Center Goettingen Goettingen Germany
| | - Nicolas Feltgen
- Department of Ophthalmology University Medical Center Goettingen Goettingen Germany
| | - Sebastian Bemme
- Department of Ophthalmology University Medical Center Goettingen Goettingen Germany
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22
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Figueiredo N, Sarraf D, Gunnemann F, Sadda SR, Bansal A, Berger AR, Wong DT, Kohly RP, Kertes PJ, Hillier RJ, Muni RH. Longitudinal Assessment of Ellipsoid Zone Recovery Using En Face Optical Coherence Tomography After Retinal Detachment Repair. Am J Ophthalmol 2022; 236:212-220. [PMID: 34695399 DOI: 10.1016/j.ajo.2021.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/03/2021] [Accepted: 10/12/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE Suboptimal functional outcomes after rhegmatogenous retinal detachment (RRD) repair may be related to photoreceptor abnormalities, including alterations of the ellipsoid zone (EZ) that may not be apparent on cross-sectional optical coherence tomography (OCT). This study assessed EZ recovery using en face OCT after RRD repair and its association with visual acuity. DESIGN Post hoc analysis of a randomized controlled trial. METHODS Patients with macula-off RRD were monitored at 3, 6, 12, and 24 months postoperatively and annually thereafter. En face OCT of the EZ slab were analyzed. Hyporeflective areas were colocalized with EZ abnormalities on cross-sectional OCT B-scans and measured by 2 masked graders. Primary outcome was change in area of EZ hyporeflectivity from 3 to 24 months, and its association with Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity recovery was also assessed. RESULTS In total, 271 images of 61 patients were assessed. Mean area of hyporeflectivity significantly decreased from 3 to 24 months (-2.98 mm2; 95% CI, 1.82-4.13 mm2; P < .0001), with further reductions up to 4 years. Linear regression revealed an association between change in hyporeflective area and change in the ETDRS letter score from 3 to 24 months (β = -0.31, P = .009, R2 = 14.8%) and between duration of macula-off and change in hyporeflective area from 3 to 24 months (β = -0.37, P = .018, R2 = 13.7%). CONCLUSIONS En face OCT provides a novel biomarker for visualizing and quantifying EZ recovery after RRD repair that is associated with ETDRS visual acuity recovery. A steady decline in the area of EZ hyporeflectivity was observed over many years with delayed recovery in patients with longer duration of macula-off.
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Shao I, Dhoot AS, Popovic MM, Oquendo PL, Hamli H, Kertes PJ, Muni RH. Pneumatic retinopexy: a review of an essential technique in vitreoretinal surgical care. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2022.2013817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ian Shao
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Arjan S. Dhoot
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Marko M. Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Paola L. Oquendo
- Department of Ophthalmology, St. Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - Hesham Hamli
- Department of Ophthalmology, St. Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - Peter J. Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
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Bonfiglio V, Ortisi E, Nebbioso M, Reibaldi M, Lupidi M, Russo A, Fallico M, Scollo D, Macchi I, Pizzo A, Panebianco R, Patanè C, Vadalà M, Toro MD, Rejdak R, Nowomiejska K, Avitabile T, Longo A. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY EVALUATION OF PERIPAPILLARY MICROVASCULAR CHANGES AFTER RHEGMATOGENOUS RETINAL DETACHMENT REPAIR. Retina 2021; 41:2540-2548. [PMID: 34851885 DOI: 10.1097/iae.0000000000003253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the radial peripapillary capillary plexus (RPCP) vessel density (VD) and the retinal nerve fiber layer (RNFL) thickness in eyes successfully treated with pars plana vitrectomy for primary rhegmatogenous retinal detachment. METHODS In this cross-sectional multicenter clinical study, eyes with a minimum 12-month follow-up were reexamined. The RPCP VD and RNFL thickness in the rhegmatogenous retinal detachment subfields of the affected eye (study group) were compared with the corresponding areas of the healthy fellow eyes (control group). RESULTS Fifty-three eyes were included in the study. A significantly lower RPCP VD and RNFL thickness were observed in those subfields affected by rhegmatogenous retinal detachment compared with those of the control group (P < 0.001). No statistically significant differences were observed between undetached subfields in the study group and their corresponding images in the control group. In the study group, a significant correlation was found between RPCP VD and RNFL thickness in subfields with detached retina (r = 0.393, P < 0.001) and undetached retina (r = 0.321, P < 0.001). CONCLUSION Radial peripapillary capillary plexus VD changes were found in the subfields of detached retina successfully treated with pars plana vitrectomy and they correlated with RNFL thinning. These data suggest a coexistence of neuronal and microvascular damage in patients affected by rhegmatogenous retinal detachment.
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Affiliation(s)
- Vincenza Bonfiglio
- Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Palermo, Italy
| | - Elina Ortisi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | | | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, Turin, Italy
| | - Marco Lupidi
- Department of Surgical and Biochemical Sciences, Section of Ophthalmology, University of Perugia, Perugia, Italy; and
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Davide Scollo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Iacopo Macchi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Alessandra Pizzo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | | | - Clara Patanè
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Maria Vadalà
- Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Palermo, Italy
| | - Mario D Toro
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Robert Rejdak
- Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland
| | | | | | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, Italy
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25
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Baudin F, Deschasse C, Gabrielle P, Berrod JP, Le Mer Y, Arndt C, Tadayoni R, Delyfer MN, Weber M, Gaucher D, Saleh M, Chiquet C, Creuzot‐Garcher C. Functional and anatomical outcomes after successful repair of macula-off retinal detachment: a 12-month follow-up of the DOREFA study. Acta Ophthalmol 2021; 99:e1190-e1197. [PMID: 33576133 DOI: 10.1111/aos.14777] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 12/11/2020] [Accepted: 01/13/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To report visual and anatomical outcomes and determine predictors of good visual acuity (VA) recovery after macula-off rhegmatogenous retinal detachment (RD). METHODS Prospective multicentre study including 115 eyes from 115 patients successfully operated on for RD, with assessment of VA and spectral-domain optical coherence tomography (SD-OCT) macular images at 1, 3, 6 and 12 months after surgery. RESULTS Over the follow-up period, VA significantly improved from median [IQR] 62 [46; 72] ETDRS letters at 1 month to 75 [67; 80] ETDRS letters at 12 months (p < 0.001) with a concomitant decreased number of eyes with any SD-OCT lesions (p < 0.001). The presence of subretinal fluid (SRF) significantly decreased (p < 0.001), as did the number of photoreceptor (PR) layer lesions (p = 0.04). At 12 months, lesions in the PR layer and poor VA recovery were significantly associated with a longer time to surgery (p = 0.007 and p < 0.001, respectively). The rate of patients without PR lesions increased from 40.9% at 1 month to 60.0% at 6 months and 73.9% at 12 months (p < 0.001). The incidence of epiretinal membrane (ERM) significantly increased (p < 0.001), while cystoid macular oedema (CME) remained stable over time. Visual acuity (VA) at 3 months postoperatively was a good reflection of final VA recovery (p < 0.001). CONCLUSION Visual acuity (VA) improved in parallel with the decreasing number of eyes with SD-OCT lesions after macula-off rhegmatogenous RD. A long time to surgery was the only preoperative factor associated with poor VA recovery after retinal detachment surgery.
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Affiliation(s)
- Florian Baudin
- Department of Ophthalmology University Hospital Dijon France
- EA 7460 Pathophysiology and Epidemiology of Cerebro‐Cardiovascular Diseases (PEC2) University Hospital Dijon France
| | | | | | - Jean P. Berrod
- Department of Ophthalmology University Hospital Nancy France
| | - Yannick Le Mer
- Department of Ophthalmology Fondation A. de Rothschild Paris France
| | - Carl Arndt
- Department of Ophthalmology University Hospital Reims France
| | - Ramin Tadayoni
- Department of Ophthalmology Lariboisière Hospital Paris France
| | | | - Michel Weber
- Department of Ophthalmology University Hospital Nantes France
| | - David Gaucher
- Department of Ophthalmology University Hospital Strasbourg France
- Bacteriology institute, UR‐7290 Strasbourg University Strasbourg France
| | - Maher Saleh
- Department of Ophthalmology University Hospital Besançon France
| | | | - Catherine Creuzot‐Garcher
- Department of Ophthalmology University Hospital Dijon France
- Eye and Nutrition Research group GSGA UMR 1324 INRA 6265 CNRS Dijon France
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RELATIONSHIP BETWEEN PREOPERATIVE FOVEAL MICROSTRUCTURE AND VISUAL ACUITY IN MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT: Imaging Analysis by Swept Source Optical Coherence Tomography. Retina 2021; 40:1873-1880. [PMID: 31764614 DOI: 10.1097/iae.0000000000002687] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To visualize foveal microstructures in macula-off rhegmatogenous retinal detachment using swept source optical coherence tomography preoperatively and postoperatively and to investigate the relationship between foveal microstructures and postoperative visual acuity. METHODS We retrospectively analyzed 42 eyes of 42 consecutive patients diagnosed with macula-off rhegmatogenous retinal detachment who underwent anatomically successful repair surgery and were followed up for 6 months. We used swept source optical coherence tomography to investigate the relationship between preoperative and postoperative continuity of both the external limiting membrane (ELM) and ellipsoid zone (Ez) and preoperative and postoperative best-corrected visual acuity. RESULTS Both preoperative ELM and Ez were continuous in 9 eyes (21%; ELM+/Ez+ eyes), only the ELM was continuous in 25 eyes (60%; ELM+/Ez- eyes), and neither was continuous in 8 eyes (19%; ELM-/Ez- eyes). Postoperative best-corrected visual acuity in ELM+/Ez+ eyes (-0.05 ± 0.04 logarithm of the minimum angle of resolution units, Snellen equivalent 20/18) was significantly better than that in both ELM+/Ez- (0.16 ± 0.16, 20/29; P = 0.03) and ELM-/Ez- (0.86 ± 0.37, 20/145; P < 0.001) eyes. Postoperative best-corrected visual acuity was significantly better in ELM+/Ez- than in ELM-/Ez- eyes (P < 0.001). CONCLUSION In macula-off rhegmatogenous retinal detachment, preoperative continuity of the ELM and Ez may be a predictor of postoperative best-corrected visual acuity.
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27
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Yılmaz Tuğan B, Karabaş L, Yenihayat F, Subaşı S, Kesim E, Özkan B. Correlation of Visual Recovery and Increased Ellipsoid Zone Reflectivity After Successful Macular Hole Surgery. Turk J Ophthalmol 2021; 50:283-287. [PMID: 33342195 PMCID: PMC7610054 DOI: 10.4274/tjo.galenos.2020.21456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives: To assess changes in reflectivity of the retinal pigment epithelium (RPE), ellipsoid zone (EZ), and external limiting membrane (ELM) on spectral domain-optical coherence tomography (SD-OCT) images and the effects of reflectivity changes on visual acuity improvement after vitrectomy in macular hole patients. Materials and Methods: Twenty-four eyes of 24 patients with idiopathic full-thickness macular hole closed after vitrectomy were retrospectively reviewed. The “plot profile” function of the medical imaging software was used by a single masked physician to analyze RPE, EZ, and ELM reflectivity on OCT images at postoperative 1 month and 12 months. Results: Absolute and relative EZ reflectivity showed highly significant increases at postoperative 12 months compared to 1 month (p<0.001 and p<0.001, respectively). Absolute and relative EZ reflectivity changes from postoperative month 1 to month 12 after macular hole surgery were significantly correlated with best corrected visual acuity improvement (p=0.012 and p=0.020, respectively). Conclusion: EZ reflectivity can be a predictor of functional and anatomical improvement after macular hole surgery.
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Affiliation(s)
- Büşra Yılmaz Tuğan
- Kocaeli University Faculty of Medicine, Department of Ophthalmology, Kocaeli, Turkey
| | - Levent Karabaş
- Kocaeli University Faculty of Medicine, Department of Ophthalmology, Kocaeli, Turkey
| | - Fatih Yenihayat
- Dünyagöz Kocaeli Hospital, Clinic of Ophthalmology, Kocaeli, Turkey
| | - Sevgi Subaşı
- Kocaeli University Faculty of Medicine, Department of Ophthalmology, Kocaeli, Turkey
| | - Enes Kesim
- Tuzla State Hospital, Clinic of Ophthalmology, İstanbul, Turkey
| | - Berna Özkan
- Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
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28
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Er D, Öner H, Kaya M, Dönmez O. Evaluation of the Effects of Silicone Oil on the Macula with Optical Coherence Tomography in Patients with Rhegmatogenous Retinal Detachment. Turk J Ophthalmol 2021; 51:218-224. [PMID: 34461708 PMCID: PMC8411287 DOI: 10.4274/tjo.galenos.2020.48376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives: The effects of silicone endotamponade duration on the macula were evaluated in patients with rhegmatogenous retinal detachment. Materials and Methods: Sixty-five eyes of 65 cases with rhegmatogenous retinal detachment that underwent pars plana vitrectomy and silicone endotamponade were included in the study. All cases were classified in three groups according to duration of silicone tamponade: ≤3 months, 3-6 months, and ≥6 months. All cases were evaluated at 1 week, 1 month, and 3 months after silicone injection, just before and at 1 month after silicone removal in terms of intraretinal pathologies in the macula by using spectral-domain optical coherence tomography (SD-OCT). Results: Sixteen (26.6%) of the patients were female and 49 (75.4%) were male. The mean age of the patients was 58.1±12.1 years (18-82); the mean follow-up time was 12.4±4 months (6-20). The mean duration of silicone tamponade was 6.7±2.3 months (2-12). In 26.6% of patients with ellipsoid zone/outer limiting membrane defect, a statistically significant improvement in reflectivity was detected after silicone oil removal (p=0.016). There was a significant increase in central foveal thickness after silicone removal in eyes with duration of silicone more than 3 months (p=0.003 for 3-6 months, p=0.006 for ≥6 months). The prevalence of cystoid macular edema before and after silicone removal was also significantly higher in the eyes with silicone duration of 6 months or longer (p<0.001). Conclusion: In eyes with silicone endotamponade, structural changes in the macula may differ according to the duration of silicone oil in the eye.
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Affiliation(s)
- Duygu Er
- University of Health Sciences Turkey Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Hakan Öner
- Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Mahmut Kaya
- Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Oya Dönmez
- Private Tınaztepe Galen Hospital, İzmir, Turkey
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29
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Bansal A, Lee WW, Felfeli T, Muni RH. Real-Time In Vivo Assessment of Retinal Reattachment in Humans Using Swept-Source Optical Coherence Tomography. Am J Ophthalmol 2021; 227:265-274. [PMID: 33626363 DOI: 10.1016/j.ajo.2021.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To assess the in vivo physiology of retinal reattachment in humans using swept-source optical coherence tomography (SS-OCT) in real time. DESIGN Prospective case series. METHODS Fifteen consecutive patients with fovea-involving rhegmatogenous retinal detachment were undergoing pneumatic retinopexy. SS-OCT was performed at presentation and frequent intervals immediately after pneumatic retinopexy. The primary outcome was longitudinal assessment of early postoperative SS-OCT to establish stages of reattachment. RESULTS Most patients (93.3%, 14/15) achieved successful reattachment at the median follow-up duration of 13 weeks (interquartile range 7.5-18.0). Reattachment occurred in 5 specific stages: 1) redistribution of fluid and approach of the neurosensory retina toward the retinal pigment epithelium occurred in 100% (15/15); 2) reduction in cystoid macular edema and improvement of outer retinal corrugations was achieved in 100% (15/15); 3) initial contact of the neurosensory retina to the retinal pigment epithelium occurred completely in 66.7% (10/15); 4) deturgescence of the inner and outer segments of the photoreceptors occurred in 66.7% (10/15); and 5) recovery of photoreceptor integrity occurred in 3 specific substages: 5A) external limiting membrane recovery (10/15, 66.6%); 5B) ellipsoid zone recovery (9/15, 60%); and 5C) interdigitation zone/foveal bulge recovery (3/15, 20%). Twenty percent (3/15) had delayed progression through stage 2, characterized by formation of outer retinal folds. Similarly, 33.3% (5/15) developed residual subfoveal fluid blebs (delayed progression to stage 3). CONCLUSIONS This study characterizes the in vivo physiology of retinal reattachment in humans using high-resolution SS-OCT that occurs in 5 specific stages. Delayed progression through certain stages was characterized by postoperative anatomic abnormalities. Am J Ophthalmol 2021;221:•••-•••. © 2021 Elsevier Inc. All rights reserved.
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30
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Mete M, Maggio E, Ramanzini F, Guerriero M, Airaghi G, Pertile G. Microstructural macular changes after pars plana vitrectomy for primary rhegmatogenous retinal detachment. Ophthalmologica 2021; 244:551-559. [PMID: 34167115 DOI: 10.1159/000517880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/06/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Maurizio Mete
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - Emilia Maggio
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - Francesca Ramanzini
- Eye Clinic, Department of Neuroscience and Sensory Organs, Policlinico San Martino Hospital IRCCS Hospital-University San Martino, University of Genoa, Genoa, Italy
| | | | - Giulia Airaghi
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
- Department of Ophthalmology, ASST Valle Olona, Varese, Italy
| | - Grazia Pertile
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
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31
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Kaderli ST, Karalezli A, Sul S. Microvascular retinal alterations in rhegmatogenous retinal detachment after pneumatic retinopexy. Acta Ophthalmol 2021; 99:383-389. [PMID: 33191599 DOI: 10.1111/aos.14624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/23/2020] [Accepted: 08/28/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the macular microvascularity with optical coherence tomography angiography (OCTA) in rhegmatogenous retinal detachment (RRD) which were successfully treated with pneumatic retinopexy (PR). METHODS Thirty eyes of thirty patients who were treated with PR (12 eyes with macula-off RRD and 18 eyes with macula-on RRD) were included in this prospective study. OCTA was used to evaluate the macular perfusion changes postoperatively at 1 and 3 months. The fellow eyes (30 eyes) were used as control for comparison. Parafoveal retinal thickness (RT) and best-corrected visual acuity (BCVA) were evaluated. RESULTS Vessel density (VD) in SCP, DCP and choriocapillaris plexus (CCP) flow area was significantly lower in the macula-off group one month after the PR (p < 0.001). In the macula-off group, VD in SCP, DCP and CCP flow area significantly increased at months 3 (p < 0.001, p < 0.001, p = 0.009). The inner RT, RT and FAZ decreased three months after PR (p < 0.001, p = 0.001, <0.001). The FAZ was significantly larger in the macula-off group at third months after PR (p < 0.001). The inner RT was higher in the macula-off group at third month (p = 0.012). There was no significant difference between the groups in means of final VD, CCP flow area and RT. There was also a negative correlation between the final BCVA (logMAR) and FAZ at month 3 (r = 0.776, p = 0.003). CONCLUSION Optical coherence tomography angiography evaluation of macular capillary plexuses may be useful for predicting vascular structural changes in patients undergoing PR.
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Affiliation(s)
- Sema Tamer Kaderli
- Department of Ophthalmology Mugla Sitki Kocman Education and Training Hospital Mugla Turkey
| | - Aylin Karalezli
- Department of Ophthalmology Mugla Sitki Kocman University School of Medicine Mugla Turkey
| | - Sabahattin Sul
- Department of Ophthalmology Mugla Sitki Kocman University School of Medicine Mugla Turkey
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32
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Muni RH, Felfeli T, Sadda SR, Juncal VR, Francisconi CLM, Nittala MG, Lindenberg S, Gunnemann F, Berger AR, Wong DT, Altomare F, Giavedoni LR, Kohly RP, Kertes PJ, Sarraf D, Hillier RJ. Postoperative Photoreceptor Integrity Following Pneumatic Retinopexy vs Pars Plana Vitrectomy for Retinal Detachment Repair: A Post Hoc Optical Coherence Tomography Analysis From the Pneumatic Retinopexy Versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial. JAMA Ophthalmol 2021; 139:620-627. [PMID: 33885738 DOI: 10.1001/jamaophthalmol.2021.0803] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Importance Pneumatic retinopexy (PnR) is associated with superior visual acuity and reduced vertical metamorphopsia compared with pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). It is important to determine postoperative photoreceptor integrity with both surgical techniques. Objective To compare photoreceptor integrity on spectral domain-optical coherence tomography (SD-OCT) between PnR and PPV at 12 months postoperatively. Design, Setting, and Participants Post hoc analysis of the Pneumatic Retinopexy Versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) conducted between August 2012 and May 2017 at St Michael's Hospital, Toronto, Ontario, Canada. Primary RRDs with specific criteria were included. Data were analyzed between April and August 2020. Intervention Randomization to PnR vs PPV stratified by macular status. Main Outcomes and Measures Difference in proportion of patients with discontinuity of the ellipsoid zone (EZ) and external limiting membrane (ELM) between groups assessed independently by 2 masked graders at an external masked image reading center. Results A total of 150 participants completed the 12-month follow-up visit. A total of 145 patients (72 PPV and 73 PnR) had gradable spectral-domain optical coherence tomography at 12 months. Analysis of the central 3-mm (foveal) scans found that 24% (n = 17 of 72) vs 7% (n = 5 of 73) displayed EZ discontinuity (difference, 17%; odds ratio [OR], 4.204; 95% CI, 1.458-12.116; P = .005) and 20% (n = 14 of 71) vs 6% (n = 4 of 73) displayed ELM discontinuity (difference, 14%; OR, 4.237; 95% CI, 1.321-13.587; P = .01) in the PPV and PnR groups, respectively. Analysis of the 6-mm (foveal and nonfoveal) scans revealed that EZ and ELM discontinuity was greater in the PPV vs PnR groups (EZ, 32% [n = 23 of 72] vs 11% [n = 8 of 73]; difference, 21%; OR, 3.814; 95% CI, 1.573-9.249; P = .002; ELM, 32% [n = 23 of 71] vs 18% [n = 13 of 73]; difference, 14%; OR, 2.211; 95% CI, 1.015-4.819; P = .04). Conclusions and Relevance Discontinuity of the EZ and ELM was more common at 12 months postoperatively following PPV vs PnR for RRD repair. The findings of this post hoc analysis suggest that less discontinuity of the EZ and ELM may provide an anatomic basis for the previously reported superior functional outcomes with PnR, although the analysis does not prove a cause-and-effect relationship. Trial Registration ClinicalTrials.gov Identifier: NCT01639209.
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Affiliation(s)
- Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.,Kensington Vision and Research Centre, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre for Biomedical Science/Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
| | - Tina Felfeli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Srinivas R Sadda
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California.,Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles
| | - Verena R Juncal
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Carolina L M Francisconi
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | - Frederic Gunnemann
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California.,Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles
| | - Alan R Berger
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - David T Wong
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Filiberto Altomare
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Louis R Giavedoni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Radha P Kohly
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Kensington Vision and Research Centre, University of Toronto, Toronto, Ontario, Canada.,The John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Kensington Vision and Research Centre, University of Toronto, Toronto, Ontario, Canada.,The John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - David Sarraf
- Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles
| | - Roxane J Hillier
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, England.,Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, England
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Baseline Optical Coherence Tomography Parameters That May Influence 6 Months Treatment Outcome of Polypoidal Choroidal Vasculopathy Eyes with Combination Therapy: A Short-Term Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105378. [PMID: 34070071 PMCID: PMC8158141 DOI: 10.3390/ijerph18105378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022]
Abstract
Although optical coherence tomography (OCT) parameters have assisted in the diagnosis of polypoidal choroidal vasculopathy (PCV), its potential to evaluate treatment outcomes has not been established. The purpose of this pilot study was to evaluate baseline OCT parameters that may influence treatment outcome in PCV eyes with combination therapy. In this single-centered, prospective study, patients were recruited with at least one treatment-naïve PCV eye and treated with combination therapy of intravitreal anti-vascular endothelial growth factor and photodynamic therapy. Best-corrected distance and near visual acuity (DVA and NVA), and contrast sensitivity (CS) were recorded at baseline and six months after treatment. OCT parameters were determined. Twenty-six eyes of 26 patients aged between 51 to 83 years were evaluated. In eyes that had disrupted external limiting membrane (ELM), photoreceptors inner and outer segment (IS-OS) junction at 1000 micron of fovea at baseline showed low mean visual functions after 6 months of treatment. Eyes with foveal sub-retinal fluid (SRF) and polyp at central 1000 micron of fovea at baseline showed significantly worse DVA and CS after six months. Thus, the presence of foveal SRF, foveal polyp, disrupted ELM, and IS-OS junction at baseline significantly influenced the six months' visual outcome in PCV eyes treated with combination therapy.
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Change in retinal and choroidal microvascular structures after rhegmatogenous retinal detachment surgery and effects on visual recovery. J Fr Ophtalmol 2021; 44:804-812. [PMID: 33994048 DOI: 10.1016/j.jfo.2020.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/14/2020] [Accepted: 11/12/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE To investigate changes in retinal and choroidal microvascular structures in the macular region after surgery for rhegmatogenous retinal detachment (RRD) and their relationship to visual function at 3months. METHODS This prospective, cross-sectional study included 37 eyes of 37 patients who underwent surgery for RRD (pneumatic retinopexy and/or pars plana vitrectomy). All patients underwent a comprehensive ophthalmologic examination, including measurement of best-corrected visual acuity (BCVA, logMAR), anterior segment and fundus examination, and optical coherence tomography angiography (OCTA) imaging 3months postoperatively. The healthy fellow eyes formed the control group. OCTA was used for the assessment of macular vessel density (VD), foveal avascular zone (FAZ), central macular thickness, and choroidal and outer retinal flow rates. RESULTS The findings showed that the VD of the superficial and deep capillary plexuses were lower in the RRD group compared to the control group (P=0.012; P<0.001). The FAZ was larger in the RRD group (P=0.035). The choroidal flows in the 1 and 3mm2 were lower in the RRD group (P<0.001). Superficial FAZ area and choroidal flow rate (1 and 3mm2 areas) were moderately negatively correlated with BCVA (P=0.008; P=0.035; P=0.008). CONCLUSIONS Our study demonstrated that the FAZ was larger, and the choroidal flow rate was lower, in the RRD group compared to the control group. Choroidal flow rate was negatively correlated with postoperative BCVA. Ischemic events resulting from the RRD were likely the reason for these changes.
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Angermann R, Mosböck S, Palme C, Ulmer H, Rauchegger T, Nowosielski Y, Bechrakis NE, Zehetner C. Impact of submacular fluid volume on visual outcome in macula-off rhegmatogenous retinal detachment using automated optical coherence tomography volumetric quantification. Clin Exp Ophthalmol 2021; 49:439-447. [PMID: 33864341 PMCID: PMC8360107 DOI: 10.1111/ceo.13929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/19/2021] [Accepted: 04/13/2021] [Indexed: 01/04/2023]
Abstract
Background We investigated effects of submacular fluid volume (SMFV) on visual outcomes following surgery for macula‐off primary rhegmatogenous retinal detachment (RRD) using automated fluid volumetric quantification with optical coherence tomography (OCT). Methods We analysed 127 eyes that were surgically treated for macula‐off RRDs. We obtained preoperative images following the spectral domain (SD)‐OCT dense volume protocol, applied automated retinal segmentation and used an automated algorithm to quantify each eye's SMFV. We used multivariate models to identify various risk factors for impaired visual outcome. Results Linear regression showed that preoperative SMFV (ß = 0.013; P = .005) was significantly associated with a reduced visual outcome 12 months after the treatment of macula‐off RRDs. SMFV was negatively correlated with 12‐month postoperative (r = .311; P = .001) visual acuity (VA). The group with low preoperative SMFV (≤9.0 mm3) showed an increasing VA up to 12 months postoperatively (P < .001), while the VA did not increase in the group with high SMFV (>9.0 mm3) beyond 3 months of follow‐up. Patients with a high SMFV were 8.0 times more likely to have worse visual outcomes after 12 months of follow‐up (P = .018). Conclusions SMFV was negatively correlated with visual outcomes after the surgical treatment of macula‐off RRDs. Patients with SMFV <9.0 mm3 12 months after surgery had an 8.0 times greater chance for better visual recovery than patients with high preoperative SMFV. Our findings highlight the efficacy of automated SMFV quantification in predicting surgical outcomes in patients with RRDs, which could be useful in future clinical practice and the development of research models.
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Affiliation(s)
- Reinhard Angermann
- Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria.,Department of Ophthalmology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Stefan Mosböck
- Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria
| | - Christoph Palme
- Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria
| | - Hanno Ulmer
- Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria
| | - Teresa Rauchegger
- Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria
| | - Yvonne Nowosielski
- Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Claus Zehetner
- Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria
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BOZALİ E, ERDOĞAN H, DURSUN A, VURAL ÖZEÇ A, TOKER İ, ARICI M. Evaluation Of Foveal Thickness And Macular Choroidal Thickness With Optical Coherence Tomography in Behçet's Disease. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.764833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Grzybowski A, Shtayer C, Schwartz SG, Moisseiev E. The 100 most cited papers on retinal detachment: a bibliographic perspective. Br J Ophthalmol 2021; 106:305-311. [PMID: 33785506 DOI: 10.1136/bjophthalmol-2020-318015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/27/2021] [Accepted: 03/12/2021] [Indexed: 11/04/2022]
Abstract
The 100 most cited papers on retinal detachment (RD) were analysed using a bibliographic study. The bibliographic databases of the ISI Web of Knowledge were searched, limited to research articles published between 1965 and 2020 in peer-reviewed journals. The papers were ranked in order of number of citations since publication. Ninety of the 100 most cited papers on RD were published in 12 ophthalmology journals, with 74 of them published in American Journal of Ophthalmology (n=31), Ophthalmology (n=23), Archives of Ophthalmology (n=10) and Investigative Ophthalmology and Visual Science (n=10); the remaining 10 papers were published in 8 journals from other fields of medical research. All papers in the top 100 were published in English. The 100 most cited papers on RD originated from 12 different countries, with the majority (72 papers) originating from the USA. The 100 identified papers represent a mix of clinical trials and animal/laboratory studies. This bibliographic study provides a unique perspective and insight into some of the most influential contributions in RD understanding and management over the last 55 years.
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Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury in Olsztyn School of Medicine, Olsztyn, Poland
| | - Chen Shtayer
- Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Stephen G Schwartz
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA .,Institute for Research in Ophthalmology, Poznan, Poland
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Epiretinal Membrane Surgery after Retinal Detachment Repair: Visual Acuity Outcomes and OCT Analysis. Ophthalmol Retina 2021; 6:49-57. [PMID: 33794391 DOI: 10.1016/j.oret.2021.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To assess visual acuity (VA) outcomes of epiretinal membrane (ERM) surgery following primary rhegmatogenous retinal detachment (RD) repair and to identify OCT features predictive of visual outcomes. DESIGN Retrospective, consecutive case series. SUBJECTS Eyes undergoing pars plana vitrectomy (PPV) with membrane peel (MP) surgery for ERM following primary RD repair (PPV with or without scleral buckle (SB) and gas tamponade). METHODS Retrospective chart review from 2015 to 2018. A previously described ERM grading scale was utilized for OCT structural analysis. MAIN OUTCOME MEASURES Visual acuity (VA) and change in VA from pre- MP to 6 months and final follow-up. Secondary outcomes included RD and OCT features predictive of VA, as well as RD factors associated with need for subsequent MP surgery. RESULTS 53 eyes of 53 patients underwent MP following RD repair. VA improved significantly from logMAR 1.00 ± 0.51 (Snellen 20/200) pre-MP to 0.45 ± 0.41 (20/56) at 6 months and 0.42 ± 0.41 (20/53) at final follow-up, (p<0.001) for each respectively. Macula on eyes had better 6 month [0.29 ± 0.18 (20/39) vs. 0.51 ± 0.46 (20/65), p=0.02] and final VA [0.29 ± 0.14 (20/39) vs. 0.46 ± 0.47 (20/58), p=0.04] after MP surgery. VA improved significantly from pre-MP to 6 months and final follow-up regardless of macula status. MP occurring ≤180 days from RD repair and IS/OS loss were associated with worse pre-MP VA [1.13 ± 0.09 (20/270) vs. 0.82 ± 0.07(20/132), p=0.01 and 1.21 ± 0.07 (20/324) vs. 0.74 ± 0.09 (20/110) p=0.0003, respectively]. IS/OS loss [adjusted means 0.54 ± 0.07 (20/69) vs. 0.25 ± 0.08 (20/36) at final visit, p=0.006] and RD repair with PPV/SB [0.53 ± 0.08 (20/68) vs. 0.31 ±0.07 (20/41) at final visit, p=0.03] were significantly associated with worse VA at both 6 months and final follow-up. CONCLUSIONS Eyes undergoing MP after RD repair have significant visual acuity gains independent of macula-status at time of RD repair. Pre-operative IS/OS disruption was the OCT feature best predictive of visual acuity.
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The urgency of surgical treatment for rhegmatogenous retinal detachment. Ophthalmologe 2021; 118:160-165. [PMID: 33751188 DOI: 10.1007/s00347-021-01364-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 10/21/2022]
Abstract
The ideal timing of surgery in patients with rhegmatogenous retinal detachment has been discussed for decades. The study situation has improved in recent years so that recommendations can now be made. When the macula is detached, surgical treatment of the retinal detachment should be undertaken within a few days. When the macula is still attached, the near fovea and bullous superotemporal detachment should be classified as an emergency. When planning the operation environmental factors must also be considered, meaning that the performance of the intervention by an experienced surgical team is usually more important for the final result than the retinal condition alone. Influencing factors are discussed in this article and recommendations for dealing with these emergency patients are discussed.
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Christou EE, Kalogeropoulos C, Georgalas I, Stavrakas P, Christodoulou E, Batsos G, Stefaniotou M. Assessment of Anatomical and Functional Macular Changes with Optical Coherence Tomography Angiography After Macula-Off Rhegmatogenous Retinal Detachment Repair. Semin Ophthalmol 2021; 36:119-127. [PMID: 33656959 DOI: 10.1080/08820538.2021.1889618] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: To evaluate macular capillary plexus changes with OCT-angiography with regard to macular detachment duration in macula-off rhegmatogenous retinal detachment (RRD).Methods: 23 eyes of 23 patients were included in this retrospective case-control study and were divided into 2 groups. Group-A had a macular detachment duration of 0 to 10 days and group-B of 11 to 30 days. All eyes underwent a single successful pars plana vitrectomy (PPV) and gas tamponade. We analysed the OCT-A characteristics and visual outcomes at 12 weeks postoperatively in the 2 groups. The fellow eye was used as control.Results: Vessel density (VD) and flow density (FD) in the superficial capillary plexus (SCP) were significantly lower in group-B (p < .01) than in group-A and control. FAZ SCP in both groups was significantly larger than the control (p < .01), although it did not differ significantly between the two groups (p = 1.000). BCVA was significantly lower in group-B compared to group-A (p < .01). BCVA was positively correlated with VD SCP in group B (p = .015), but not in group-A. Postoperative BCVA had no correlation with FAZ SCP in both groups.Conclusions: The macular detachment duration could be a predicting factor of flow density in macular capillary plexus which in turn might be an indicator of visual outcomes in chronic cases.
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Affiliation(s)
- Evita Evangelia Christou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Christos Kalogeropoulos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ilias Georgalas
- First Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Greece
| | - Panagiotis Stavrakas
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Eleni Christodoulou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Georgios Batsos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Stefaniotou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Chatziralli I, Chatzirallis A, Kazantzis D, Dimitriou E, Machairoudia G, Theodossiadis G, Parikakis E, Theodossiadis P. Predictive Factors for Long-Term Postoperative Visual Outcome in Patients with Macula-Off Rhegmatogenous Retinal Detachment Treated with Vitrectomy. Ophthalmologica 2021; 244:213-217. [PMID: 33465770 DOI: 10.1159/000514538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 01/11/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this prospective study was to evaluate potential predictive factors of long-term postoperative outcomes in patients with macula-off rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV). METHODS Participants in this study were 86 patients diagnosed with macula-off RRD, who underwent PPV. Demographic characteristics and preoperative characteristics of RRD were recorded, while best corrected visual acuity (BCVA) was measured preoperatively and at specific postoperative time points (6 weeks and 6, 12, and 24 months). In addition, spectral domain-optical coherence tomography (SD-OCT) characteristics at postoperative week 6 were assessed as potential factors affecting the long-term postoperative visual outcome 24 months after PPV for RRD. RESULTS Increasing age, duration of RD of more than 1 week, presence of proliferative vitreoretinopathy, increasing central retinal thickness, ellipsoid zone disruption, and external limiting membrane disruption were significantly associated with a worse BVCA. BCVA was not associated with gender, lens status, the location of breaks, the gas tamponade agent used in PPV, the presence of subretinal fluid, and intraretinal fluid. CONCLUSIONS It is important to determine predictive factors for visual outcomes in order to inform patients about their prognosis and help in the decision-making process for patient management.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, University of Athens, Athens, Greece
| | | | | | - Eleni Dimitriou
- 2nd Department of Ophthalmology, University of Athens, Athens, Greece
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Effects of different tamponade materials on macular segmentation after retinal detachment repair. Jpn J Ophthalmol 2021; 65:227-236. [PMID: 33420541 DOI: 10.1007/s10384-020-00800-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/25/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This study used spectral domain-optical coherence tomography (SD-OCT) to evaluate individual retinal layer thickness in eyes with macula-off rhegmatogenous retinal detachment (RRD) treated with silicone oil (SiO) or gas endotamponades. STUDY DESIGN This was a retrospective, interventional, comparative study. METHODS The study included 86 eyes of 43 patients who were divided into 3 groups according to endotamponades: SiO, perfluoropropane (C3F8), and sulfur hexafluoride (SF6). The affected eyes were compared with the fellow eyes of the same patient via SD-OCT automated segmentation analysis. Patients with a follow-up of at least 6 months were included in the final analysis. Macular segmentation including the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), inner retinal layers (IRLs), and outer retinal layers (ORLs) was analyzed. RESULTS In the SiO group, the mean thickness of each retinal layer including the RNFL, GCL, IPL, ONL, and IRLs within a 1-mm ETDRS subfield of the affected eyes was significantly lower than that of the fellow eyes (P = 0.036, P = 0.028, P = 0.003, P < 0.001, P = 0.013, respectively). There was no significant difference in the C3F8 and SF6 groups (all P > 0.05). The difference between the ONL and IRLs in the SiO-treated eyes differed significantly from that of the gas groups (P = 0.001 and P = 0.045, respectively) The difference in the GCL thickness of the affected eyes and healthy eyes showed a significant correlation with postoperative BCVA changes in the SiO, C3F8, and SF6 groups (P = 0.041, P = 0.048, and P = 0.045, respectively). CONCLUSION The findings of our study show that endotamponades used in RRD surgery may have different effects on retinal layers. In addition, SiO may cause undesirable effects on the retinal layers.
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Bacherini D, Mastropasqua R, Borrelli E, Capuano V, Iovino C, Dragotto F, Caporossi T, Rizzo S, Giansanti F. OCT-A in the Management of Vitreoretinal Diseases and Surgery. Asia Pac J Ophthalmol (Phila) 2021; 10:12-19. [PMID: 33512825 DOI: 10.1097/apo.0000000000000373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Optical coherence tomography angiography is a relatively new noninvasive technique that is changing our approach in the management of several retinal diseases such as neovascular age-related macular degeneration, occlusive retinal diseases, or diabetic retinopathy, but it could also be useful in nonprimary vascular retinal pathologies such as vitreoretinal interface surgical disorders.In idiopathic vitreoretinal interface disorders and surgical retinal diseases, the study of vascular involvement, not commonly assessed by invasive methods, could be useful to reveal specific vascular abnormalities. Such information may be useful for a more detailed phenotyping of each clinical picture before and after surgical treatment, providing potential new prognostic biomarkers.The review discusses the current and potential utility of optical coherence tomography angiography to study vitreoretinal pathologies of surgical interest.
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Affiliation(s)
- Daniela Bacherini
- Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, Florence, Italy
- YORIS, Young Ophthalmologists Retinal Imaging Society
| | - Rodolfo Mastropasqua
- YORIS, Young Ophthalmologists Retinal Imaging Society
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Borrelli
- YORIS, Young Ophthalmologists Retinal Imaging Society
- Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Vittorio Capuano
- YORIS, Young Ophthalmologists Retinal Imaging Society
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Claudio Iovino
- YORIS, Young Ophthalmologists Retinal Imaging Society
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Dragotto
- Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, Florence, Italy
| | - Tomaso Caporossi
- Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, Florence, Italy
| | - Stanislao Rizzo
- UOC Oculistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy; Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
| | - Fabrizio Giansanti
- Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, Florence, Italy
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SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY TO DETERMINE THE RECOVERY OF RETINAL LAYERS AFTER INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE: Correlation With Visual Acuity Improvement. Retina 2020; 39:2099-2106. [PMID: 30157112 DOI: 10.1097/iae.0000000000002297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyze the recovery of retinal lines using swept-source optical coherence tomography after inverted internal limiting membrane flap technique to treat full-thickness macular hole, and the relationship between best-corrected visual acuity and retinal line repair. METHODS Thirty-eight eyes were evaluated for recovery of the external limiting membrane, photoreceptor inner segment/outer segment junction line, and cone outer segment tips (COST) line. Correlation between the recovery of retinal lines and best-corrected visual acuity improvement was analyzed 6 months after surgery. RESULTS The closure rate of full-thickness macular hole was 97%. The best recovery rates were associated with external limiting membrane line recovery (25 eyes, 65.8%), followed by inner segment/outer segment line recovery (22 eyes, 57.9%), and less frequently, COST line recovery (9 eyes, 23.7%); moreover, recovery of the COST line was apparent only in eyes with recovered external limiting membrane and inner segment/outer segment lines. Mean postoperative visual acuity in the COST line recovery group (COST+) was 20/42 (0.48, 0.33 logarithm of the minimum angle of resolution), compared with 20/95 (0.21, 0.68 logarithm of the minimum angle of resolution) without COST line recovery (COST-). Final visual acuity was significantly better in the COST+ group compared with the COST- group (P = 0.002). CONCLUSION Cone outer segment tips line recovery is correlated with best-corrected visual acuity improvement for eyes treated with inverted internal limiting membrane flap technique for full-thickness macular hole.
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Ng H, La Heij EC, Andrinopoulou ER, van Meurs JC, Vermeer KA. Smaller Foveal Avascular Zone in Deep Capillary Plexus Is Associated with Better Visual Acuity in Patients after Macula-off Retinal Detachment Surgery. Transl Vis Sci Technol 2020; 9:25. [PMID: 33024618 PMCID: PMC7521173 DOI: 10.1167/tvst.9.10.25] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/26/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To associate the change in the foveal avascular zone (FAZ) and vessel density (VD) with final best corrected visual acuity (BCVA) in eyes after macula-off rhegmatogenous retinal detachment surgery, and to investigate the evolution of FAZ and VD during 12 months of follow-up. Methods We prospectively evaluated 47 patients with macula-off rhegmatogenous retinal detachment and healthy fellow eyes. At 1.5, 3.0, 6.0, and 12.0 months postoperatively, optical coherence tomography angiography scans were obtained from both eyes on a 3.0 × 3.0 mm macula-centered grid. En face images of the superficial vascular plexus, intermediate capillary plexus and deep capillary plexus were used to quantify FAZ and VD. BCVA was assessed with ETDRS-charts (logarithm of the minimal angle of resolution). At 12 months postoperatively, the association between the change in optical coherence tomography angiography parameters and visual function in study eyes was evaluated using the Spearman correlation coefficient. We calculated the BCVA difference and the percentage difference of FAZ and VD between the study and control eye. The evolution of FAZ and VD was investigated with linear mixed-effects models with nested random effects (eyes nested within patients). Results At 12 months postoperatively, FAZ difference of the deep capillary plexus and BCVA difference were correlated (P = 0.0004, rs = 0.5). Furthermore, there was no evidence that FAZ and VD changed during follow-up. Conclusions Although FAZ and VD remained stable during 12 months after surgery for macula-off rhegmatogenous retinal detachment, a smaller FAZ in the deep capillary plexus is associated with better BCVA. Translational relevance Reduction in FAZ area may be caused by angiogenesis to counteract ischemia, therefore therapeutic stimulation of angiogenesis could be beneficial to visual recovery.
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Affiliation(s)
- Heijan Ng
- Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands
| | - Ellen C La Heij
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, the Netherlands
| | | | - Jan C van Meurs
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, the Netherlands.,Erasmus Medical Center, Department of Ophthalmology, Rotterdam, the Netherlands
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Feltgen N, Callizo J, Hattenbach LO, Hoerauf H. Dringlichkeit der operativen Versorgung bei der rissbedingten Netzhautablösung. Ophthalmologe 2020; 117:858-865. [DOI: 10.1007/s00347-020-01191-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hung KC, Wang SW, Hsia Y, Chen MS, Tsai CY, Ho TC. Natural course of the intraretinal hyperreflective sign after macular haemorrhage absorption in eyes with pathologic myopia. Acta Ophthalmol 2020; 98:e631-e638. [PMID: 31808300 DOI: 10.1111/aos.14332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/18/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE We investigated the natural course of the intraretinal hyperreflective (IRH) sign after macular haemorrhage (MHE) absorption in eyes with pathologic myopia. METHODS This prospective observational cohort study evaluated 28 patients with pathologic myopia and MHE. The eyes were categorized into IRH and non-IRH sign groups according to IRH sign development. All eyes were evaluated; follow-up visits were scheduled at 1, 3, 6, 12 and 24 months after MHE absorption. RESULTS Of 28 patients (14 eyes each in the IRH and non-IRH groups), nine (32.1%) were men and 19 (67.9%) were women. The average age (mean ± SD) was 46.64 ± 11.92 versus 52.71 ± 12.19 years in the IRH and non-IRH groups. The IRH sign coincided with the MHE invasion site. The sign persisted for the entire follow-up period in all but two eyes, in which it disappeared at 12 and 24 months, respectively. Maximal MHE thickness was significantly greater in the IRH sign group (162.9 ± 67.84 versus 104.2 ± 32.34 μm, p = 0.013). The mean logarithm of the minimum angle of resolution visual acuity was significantly better in the non-IRH sign group at 12 (p = 0.029) and 24 (p = 0.033) months. The incidence of myopic traction maculopathies (MTM) was significantly higher in the IRH (57.1%) than in the non-IRH sign group (14.3%; p = 0.046). CONCLUSION The IRH sign can develop after MHE in pathologic myopia and can remain stable long after MHE absorption; furthermore, it is predictive of future MTM.
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Affiliation(s)
- Kuo-Chi Hung
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Ophthalmology, Sinying Hospital, Ministry of Health and Welfare, Taipei, Taiwan
| | - Shih-Wen Wang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yun Hsia
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Muh-Shy Chen
- Department of Ophthalmology, Cardinal Tien Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chia-Ying Tsai
- Department of Ophthalmology, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Tzyy-Chang Ho
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Zhou Y, Zhang S, Zhou H, Gao M, Liu H, Sun X. Comparison of fundus changes following silicone oil and sterilized air tamponade for macular-on retinal detachment patients. BMC Ophthalmol 2020; 20:249. [PMID: 32571251 PMCID: PMC7310510 DOI: 10.1186/s12886-020-01523-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/17/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To investigate different tamponade effects of intravitreal silicone oil (SO) and sterilized air on macular vasculature and structure after successful retinal repair for macular-on rhegmatogenous retinal detachment (RRD) patients. METHOD 21 eyes (21 patients) with macular-on RRD underwent single pars plana vitrectomy following intravitreal SO or sterilized air (Gas) tamponade. Optical Coherence Tomography (OCT) and angiography were used to evaluate retinal layer thickness and flow density (FD) changes throughout the observation period of 12 weeks. Retinal layers were segmented into 7 sets: NFL, GCL + IPL, INL, OPL, ONL + IS, OS+RPE and BRM. Macular perfusion system was segmented into superficial and deep capillary plexus flow density (SCPFD, DCPFD), and choriocapillaries plexus flow density (CCPFD). RESULT Compared to Gas tamponade, SO tamponade led to more decrease in both superficial and deep retinal blood flow during observation. NFL thickness was found to decrease in both Gas tamponade and SO tamponade eyes. SO tamponade resulted in more pronounced decrease which led to significant intergroup difference. Opposite changing trends were found in GCL + IPL and ONL + IS thicknesses due to different means of tamponade. SO tamponade caused thicknesses of these two segmented layers to decrease, which led to significant intergroup differences. SO tamponade also led to more decrease in INL, OPL thicknesses. No significant intergroup difference of choroidal thickness was observed. CONCLUSION Compared to gas, silicone oil could have more negative tamponade effects on both fundus vasculature and structure.
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Affiliation(s)
- Yifan Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Siqi Zhang
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Min Gao
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Haiyun Liu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China.
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China.
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
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Yu J, Ye X, Li L, Chang Q, Jiang C. Relationship between photoreceptor layer changes before half-dose photodynamic therapy and functional and anatomic outcomes in central serous chorioretinopathy. Eye (Lond) 2020; 35:1002-1010. [PMID: 32546748 DOI: 10.1038/s41433-020-1018-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To investigate the relationship between photoreceptor layer (PRL) changes before half-dose photodynamic therapy (PDT) and functional and anatomic outcomes in central serous chorioretinopathy (CSC). METHODS Baseline PRL changes were classified based on optical coherence tomography: (1) smooth PRL outer border without a foveal PRL defect; (2) smooth PRL outer border with a foveal PRL defect; (3) granulated PRL outer border and (4) scattered dots of PRL. The best-corrected visual acuity (BCVA), difference in the foveal outer nuclear layer (ONL) thickness between the CSC and normal contralateral eyes and ellipsoid zone (EZ) integrity 12 months after half-dose PDT were compared. RESULTS In total, 132 patients were included. Group 4 eyes had rather poor BCVA (20/2000-20/400) with little improvement (P = 0.088) at 1 year following half-dose PDT. In the other groups, the mean BCVA improved significantly to 20/25 or better (all P < 0.001). Group 1 eyes had the smallest foveal ONL thickness reduction (-5.12 ± 6.89 μm) and intact EZs (33/33), whereas Group 4 eyes had the largest foveal ONL thickness reduction (-70.00 ± 7.87 μm) and disrupted EZs (4/4). Group 2 and Group 3 eyes behaved similarly: they both had notable foveal ONL thickness reductions (-19.21 ± 18.53 and -20.75 ± 17.62 μm, respectively), but usually continuous EZs (18/19 and 69/76, respectively). CONCLUSIONS The PRL change category before half-dose PDT was closely related to functional and anatomic outcomes. This information could aid clinicians to better determine the timing of treatment with half-dose PDT in CSC.
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Affiliation(s)
- Jia Yu
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaofeng Ye
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Lei Li
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Qing Chang
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China. .,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. .,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China. .,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
| | - Chunhui Jiang
- Department of Ophthalmology, Eye and Ear Nose Throat Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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Reumueller A, Wassermann L, Salas M, Karantonis MG, Sacu S, Georgopoulos M, Drexler W, Pircher M, Pollreisz A, Schmidt-Erfurth U. Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry. Am J Ophthalmol 2020; 214:72-85. [PMID: 31883465 DOI: 10.1016/j.ajo.2019.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Limited information is available on morphologic and functional regeneration of photoreceptors after retinal detachment (RD) surgery. This observational clinical study compared morphologic and functional changes of cones after vitrectomy for macula-off retinal detachment. DESIGN Prospective, fellow-eye comparative case series. METHODS StudyPopulation: Five eyes after vitrectomy with gas for macula-off retinal detachment (retinal detachment eyes, RDE) and 5 healthy fellow eyes (HFE) of 5 patients (mean age 59.8 years, macula-off duration 0.5 days to 5.5 days). ObservationProcedures: Eyes were examined with adaptive-optics optical coherence tomography (AO-OCT), spectral-domain OCT (SDOCT), and microperimetry (MP) at 6 (baseline, BL) and 56 weeks (follow-up, FUP) after 23 gauge pars plana vitrectomy and SF6 gas tamponade. Eight corresponding regions at foveal eccentricities of 2.5° (ecc 2.5°) and 6.5° (ecc 6.5°) were analyzed in every eye. AO-OCT en face images and SD-OCT B-scans were graded regarding irregularity and loss of photoreceptor signals ranging from none to severe changes. The number of detectable cones at height of the inner-outer segment junction (IS/OS) and cone outer segment tips (COST) was counted manually in AO-OCT images. MP with a custom grid was used to assess retinal sensitivity at these locations. MainOutcomeMeasures: Cone density, cone pattern regularity and signal attenuation, retinal sensitivity. RESULTS In comparison to HFE, RDE showed highly irregular cone patterns in AO-OCT and irregular outer retinal bands in SDOCT. Despite significant improvement of cone pattern regularity compared to BL (P < .001), 63% of AO images showed remaining cone pattern irregularity and 45.5% of SDOCT B-scans showed severe signal reduction at FUP. In HFE, mean cone density retrieved from IS/OS and COST remained around 20,000/mm2 (ecc 2.5°) and 16,000/mm2 (ecc 6.5°) at BL and FUP. Cone density of RDE was significantly reduced and ranged between 200/mm2 and 15,600/mm2 (P < .001) at BL. Despite improvement at FUP (P < .001), mean cone density at IS/OS and COST was still lower compared to HFE and ranged between 7790 and 9555 cones/mm2 (P < .001). Mean retinal sensitivity of all measured locations remained 18 dB in HFE and was significantly lower in RDE, with 14.30 dB at BL and 14.64 dB at FUP. Both SDOCT grading and microperimetry sensitivity showed strong correlation with AO-OCT grading and cone density (rho values > 0.750). CONCLUSIONS The combination of AO-OCT, SDOCT, and microperimetry is a powerful tool to capture cone regeneration after vitreoretinal surgery. Our study shows that cone morphology and function improve within 56 weeks after RD surgery but structural and functional impairment is still present.
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Affiliation(s)
- Adrian Reumueller
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Lorenz Wassermann
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Matthias Salas
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | | | - Stefan Sacu
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Michael Georgopoulos
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Drexler
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Michael Pircher
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Andreas Pollreisz
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
| | - Ursula Schmidt-Erfurth
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
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