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Paniagua-Diaz AM, Nguyen JH, Artal P, Gui W, Sebag J. Light Scattering by Vitreous of Humans With Vision Degrading Myodesopsia From Floaters. Invest Ophthalmol Vis Sci 2024; 65:20. [PMID: 38727692 PMCID: PMC11095561 DOI: 10.1167/iovs.65.5.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose Vision-degrading myodesopsia (VDM) from vitreous floaters significantly degrades vision and impacts visual quality of life (VQOL), but the relationship to light scattering is poorly understood. This study compared in vitro measures of light scatter and transmission in surgically excised human vitreous to preoperative indexes of vitreous structure, visual function, and VQOL. Methods Pure vitreous collected during vitrectomy from 8 patients with VDM had wide-angle straylight measurements and dark-field imaging, performed within 36 hours of vitrectomy. Preoperative VQOL assessment with VFQ-25, contrast sensitivity (CS) measurements with Freiburg acuity contrast testing, and quantitative ultrasonography were compared to light scattering and transmission in vitro. Results All indices of vitreous echodensity in vivo correlated positively with straylight at 0.5° (R = 0.708 to 0.775, P = 0.049 and 0.024, respectively). Straylight mean scatter index correlated with echodensity (R = 0.71, P = 0.04) and VQOL (R = -0.82, P = 0.0075). Dark-field measures in vitro correlated with degraded CS in vivo (R = -0.69, P = 0.04). VQOL correlated with straylight mean scatter index (R = -0.823, P = 0.012). Conclusions Increased vitreous echodensity in vivo is associated with more straylight scattering in vitro, validating ultrasonography as a clinical surrogate for light scattering. Contrast sensitivity in vivo is more degraded in the presence of dark-field scattering in vitro and VQOL is decreased in patients whose vitreous has increased light scattering. These findings could form the basis for the development of optical corrections for VDM or support new laser treatments, as well as novel pharmacotherapy.
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Affiliation(s)
| | - Justin H. Nguyen
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California, United States
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain
| | - Wei Gui
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California, United States
| | - J. Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California, United States
- Doheny Eye Institute, University of California–Los Angeles, Pasadena, California, United States
- Department of Ophthalmology, Geffen School of Medicine, University of California–Los Angeles, Los Angeles, California, United States
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Lin T, Zhang M, Wu B, An Y, Pazo EE, Li R, Shen L. No side effects on rabbit retina or vitreous microenvironment by nd:YAG laser vitreolysis. BMC Ophthalmol 2024; 24:171. [PMID: 38627705 PMCID: PMC11020201 DOI: 10.1186/s12886-024-03406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND To explore the safety of Neodymium:Yttrium-aluminum-garnet (Nd:YAG) laser vitreolysis based on the histological examination of the retina and the alteration of vitreous cytokines in the rabbits. METHODS Nine male New Zealand rabbits underwent Nd:YAG laser vitreolysis of 10 mJ x 500 pulses in the left eyes, while the right eyes were used as controls. Intraocular pressure, color fundus photography, and ultrasound B scan were measured before, as well as 1 day, 4 weeks, and 12 weeks after Nd:YAG laser vitreolysis. Three rabbits were euthanized 1 day, 4 weeks, and 12 weeks after treatment, respectively. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining and hematoxylin-eosin (H&E) staining were used to look for pathological changes in the retina. An enzyme-linked immunosorbent assay (ELISA) was utilized to detect the expression of vascular endothelial growth factor (VEGF) and some inflammatory cytokines, including interferon inducible protein 10 (IP-10), monocyte chemoattractant protein 1 (MCP-1) and interlenkin 6 (IL-6) in the vitreous humor. The ascorbic acid (AsA) and total reactive antioxidant potential (TRAP) in the vitreous humor were also measured. RESULTS Following Nd:YAG laser vitreolysis, the levels of VEGF, IP-10, MCP-1, IL6, AsA, and TRAP in the vitreous humor did not change substantially (P > 0.05). There were no detectable pathological changes in the retinal tissues, and no apoptotic signal was found. CONCLUSIONS Rabbits tolerate Nd:YAG laser vitreolysis without observable impact on retinal tissue or the microenvironment of the vitreous.
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Affiliation(s)
- Tiezhu Lin
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People' Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310000, China
| | - Mingqin Zhang
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Bing Wu
- He Eye Specialist Hospital, Shenyang, Liaoning Province, China
- Dalian Medical University, Dalian, Liaoning Province, China
| | - Yuanlong An
- The School of Pharmacy, He University, Shenyang, Liaoning Province, China
| | | | - Rong Li
- Department of Ophthalmology, the First Affiliated Hospital, Xi'an Medical University, Xi'an, Shanxi Province, China
| | - Lijun Shen
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People' Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310000, China.
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Hangshuai Z, Yanhua J, Yao Z, Guangjin Z, Hongyan W, Fanlian C. Efficacy and safety of early YAG laser vitreolysis for symptomatic vitreous floaters: the study protocol for a randomized clinical trial. Trials 2024; 25:48. [PMID: 38218919 PMCID: PMC10787457 DOI: 10.1186/s13063-024-07924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/10/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Vitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair visual acuity and quality of life. Laser vitreolysis, which uses an Nd: YAG laser to vaporize collagenous vitreous opacities, is increasingly being used as a treatment option. However, there is currently a lack of evidence regarding its efficacy and the appropriate timing of its application. This study aims to evaluate the efficacy and safety of early intervention with YAG laser vitreolysis in treating symptomatic vitreous floaters. METHODS The present study is a randomized, controlled, double-blind clinical trial. A total of 70 participants with symptomatic floaters for 1 month were prospectively recruited. These participants will be randomly assigned to two groups, with 35 individuals in each group: the early treatment group and the delayed treatment group. Participants assigned to the early treatment group will undergo YAG laser vitreolysis immediately, followed by a sham laser treatment 3 months later. On the other hand, participants assigned to the delayed treatment group will receive a sham laser treatment and then undergo YAG laser vitreolysis 3 months later. The follow-up time points will be 1, 3, 6, and 12 months from randomization. Primary outcomes will be participants' self-reported improvement in visual disturbance on a scale of 1 to 10 and their scores on the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes will be an objective evaluation of the effectiveness of the treatment in reducing vitreous floaters through OCT and fundus photography and tracking any adverse events related to the eyes or overall health. DISCUSSION This clinical trial aims to evaluate the effectiveness of YAG laser vitreolysis in treating symptomatic vitreous floaters and assess the safety of performing early intervention with YAG laser vitreolysis. TRIAL REGISTRATION ClinicalTrials.gov NCT05800353 . Registered on 10 March 2023.
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Affiliation(s)
- Zhou Hangshuai
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China.
| | - Jin Yanhua
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
| | - Zhou Yao
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
| | - Zhao Guangjin
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
| | - Wu Hongyan
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
| | - Chen Fanlian
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
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Takahashi H, Uramoto K, Ohno-Matsui K. NEODYMIUM-DOPED YTTRIUM ALUMINUM GARNET LASER ABLATION OF INTERNAL LIMITING MEMBRANE TO TREAT MYOPIC MACULAR RETINOSCHISIS: CASE SERIES. Retin Cases Brief Rep 2024; 18:24-28. [PMID: 36007186 DOI: 10.1097/icb.0000000000001311] [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: 03/25/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of neodymium-doped yttrium aluminum garnet laser ablation of the internal limiting membrane (ILM) to treat myopic macular retinoschisis. METHODS Four patients with myopic myopic macular retinoschisis that extended out of the macular area were studied. All patients underwent yttrium aluminum garnet laser ablation of the detached ILM in the paramacular area, and the eyes were examined by ultra-widefield optical coherence tomography at the baseline and 6 months after the treatment. The measured outcomes were the foveal retinal thickness and the best-corrected visual acuity. RESULTS Neodymium-doped yttrium aluminum garnet laser was applied to the paramacular ILM in all four eyes. In each eye, the procedure failed to disrupt the ILM, and no significant changes were observed in foveal retinal thickness or best-corrected visual acuity subsequently. No serious adverse event occurred in all eyes. A transient intraretinal hemorrhage developed at the site of the application in two eyes but resolved within a week after the treatment. CONCLUSION Neodymium-doped yttrium aluminum garnet laser was applied to ILM in the peripheral macula in eyes with myopic macular retinoschisis. However, the lack of a reduction of the foveal thickness and improvement of the best-corrected visual acuity indicate that accurate focusing system is needed to treat eyes with myopic macular retinoschisis.
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Affiliation(s)
- Hiroyuki Takahashi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University (TMDU) Graduate School of Medical and Dental Sciences, Tokyo, Japan
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Lin T, Shi C, Wu B, Pazo EE, Shen L. Vision degrading myodesopsia assessed with optos ultra-widefield scanning laser ophthalmoscope. BMC Ophthalmol 2023; 23:425. [PMID: 37864149 PMCID: PMC10588225 DOI: 10.1186/s12886-023-03166-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND To investigate the diagnostic sensitivity of Optos imaging for vision degrading myodesopsia (VDM). METHODS A total of 420 eyes from 345 patients with VDM were collected in this cross-sectional study. All eyes were classified as having posterior vitreous detachment (PVD) or not having PVD. The sensitivity of Optos imaging for the visibility of vitreous floaters was evaluated. The associated factors with the visibility of vitreous floaters on Optos images were analyzed in univariate and multivariate logistic regression analyses. RESULTS The mean age of all patients was 56.19 ± 13.89 years old, and 66.67% of patients were female. The vitreous floaters were visible on the ultrasound B scan in all eyes, but only in 47.62% of Optos images (55.29% in eyes with PVD and 15% in eyes without PVD). In the multiple binary logistic regression analysis, age (OR = 1.094, 95%CI = 1.063-1.125, P < 0.001), spherical equivalent (OR = 0.869, 95%CI = 0.791-0.955, P = 0.004) and the distance of the floaters from the retina (OR = 1.191, 95%CI = 1.059-1.339, P = 0.003) were significantly correlated with the visibility of vitreous floaters on Optos images. On Optos images, 25.71% of VDM eyes presented additional retinal abnormalities. CONCLUSIONS Optos imaging has a low sensitivity for vitreous floaters, particularly in eyes without PVD. On Optos imaging, floaters were more visible in older patients, eyes with greater myopia, and floaters that were further from the retina.
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Affiliation(s)
- Tiezhu Lin
- Ophthalmology Department, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China
- He Eye Specialist Hospital, Shenyang, Liaoning, China
| | - Cheng Shi
- He Eye Specialist Hospital, Shenyang, Liaoning, China
- Dalian Medical University, Dalian, Liaoning Province, China
| | - Bing Wu
- He Eye Specialist Hospital, Shenyang, Liaoning, China
- Dalian Medical University, Dalian, Liaoning Province, China
| | | | - Lijun Shen
- Ophthalmology Department, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China.
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Jiang S, Golding J, Choudhry N. Practical applications of vitreous imaging for the treatment of vitreous opacities with YAG vitreolysis. Int Ophthalmol 2023; 43:3587-3594. [PMID: 37402010 DOI: 10.1007/s10792-023-02765-4] [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: 01/30/2022] [Accepted: 06/08/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE To demonstrate the methodology and efficacy of using scanning laser ophthalmoscopy (SLO) and dynamic optical coherence tomography (OCT) to identify and treat symptomatic vitreous floaters using yttrium-aluminum garnet laser vitreolysis (YLV). METHODS This is a case series highlighted from a cross sectional retrospective study conducted at the Vitreous Retina Macula Specialists of Toronto. Forty eyes from thirty-five patients were treated with YLV between November 2018 and December 2020 for symptomatic floaters and imaged with SLO and dynamic OCT. Patients were re-treated with YLV if they reported ongoing significant vision symptoms during follow-up which correlated to visible opacities on exam and or imaging. Three cases will be highlighted to present the practical applications of SLO and dynamic OCT imaging for YLV treatment. RESULTS Forty treated eyes were enrolled in this study, with twenty-six eyes (65%) requiring at least one repeat YLV treatment following the first treatment due to ongoing symptomatic floaters. Following the first YLV, there was a significant improvement in overall mean best corrected visual acuity compared to before treatment (0.11 ± 0.20 LogMAR units vs. 0.14 ± 0.20 LogMAR units, p = 0.02 (paired t test)). Case 1 demonstrates a dense, solitary vitreous opacity that has been localized with dynamic OCT imaging to track its movements and retinal shadowing with the patient's eye movements. Case 2 shows the utility of adjusting the fixation target to monitor the movement of vitreous opacities in real-time. Case 3 exhibits an association between decreased symptom burden and vitreous opacity density after YLV. CONCLUSION Image-guided YLV facilitates the localization and confirmation of vitreous opacities. SLO and dynamic OCT of the vitreous can provide a real-time evaluation of floater size, movement, and morphology, to help clinicians target treatment and monitoring of symptomatic floaters.
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Affiliation(s)
- Shangjun Jiang
- Section of Ophthalmology, Department of Surgery, Cumming School of Medicine, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada.
| | - John Golding
- Vitreous Retina Macula Specialists of Toronto, 3280 Bloor Street West, Suite 310, Etobicoke, ON, M8X 2X3, Canada
| | - Netan Choudhry
- Vitreous Retina Macula Specialists of Toronto, 3280 Bloor Street West, Suite 310, Etobicoke, ON, M8X 2X3, Canada.
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Hoerig C, Nguyen JH, Mamou J, Venuat C, Sebag J, Ketterling JA. Machine Independence of Ultrasound-Based Quantification of Vitreous Echodensities. Transl Vis Sci Technol 2023; 12:21. [PMID: 37750745 PMCID: PMC10540872 DOI: 10.1167/tvst.12.9.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/29/2023] [Indexed: 09/27/2023] Open
Abstract
Purpose Quantitative ultrasound (QUS) provides objective indices of Vision Degrading Myodesopsia (VDM) that correlate with contrast sensitivity (CS). To date, QUS methods were only tested on a single ultrasound machine. Here, we evaluate whether QUS measurements are machine independent. Methods In this cross-sectional study, 47 eyes (24 subjects; age = 53.2 ± 14.4 years) were evaluated with Freiburg acuity contrast testing (%Weber), and ultrasonography using 2 machines: one with a 15-MHz single-element transducer and one with a 5-ring, 20-MHz annular-array. Images were acquired from each system in sequential scans. Artifact-free, log-compressed envelope data were processed to yield three parameters (mean amplitude, M; energy, E; and percentage filled by echodensities, P50) and a composite score (C). A B-mode normalization method was applied to the 20-MHz datasets to match QUS parameters at both frequencies. Statistical analyses were performed to evaluate correlations among CS, E, M, P50, and C for both machines. Results QUS parameters from each machine correlated with CS (R ≥ 0.57, P < 0.001) and there was correlation between machines (R ≥ 0.84, P < 0.001). Correlations between CS and QUS parameters were statistically similar for both machines (P ≥ 0.14) except when the 20-MHz data were normalized (P = 0.04). Reproducibility of QUS parameters computed from 20-MHz data were satisfactory (52.3%-96.3%) with intraclass correlation values exceeding 0.80 (P < 0.001). Conclusions The high correlation between QUS parameters from both machines combined with a statistically similar correlation to CS suggests QUS is an effective, machine-independent, quantitative measure of vitreous echodensities. Translational Relevance QUS may be applied across clinical ophthalmic ultrasound scanners and imaging frequencies to effectively evaluate VDM.
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Affiliation(s)
- Cameron Hoerig
- Weill Cornell Medicine, Department of Radiology, New York, NY, USA
| | - Justin H. Nguyen
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
| | - Jonathan Mamou
- Weill Cornell Medicine, Department of Radiology, New York, NY, USA
| | | | - J. Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
- Doheny Eye Institute/Geffen School of Medicine/UCLA, Los Angeles, CA, USA
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Woudstra-de Jong JE, Manning-Charalampidou SS, Vingerling H, Busschbach JJ, Pesudovs K. Patient-reported outcomes in patients with vitreous floaters: A systematic literature review. Surv Ophthalmol 2023; 68:875-888. [PMID: 37315741 DOI: 10.1016/j.survophthal.2023.06.003] [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: 02/06/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
Seeking treatment for bothersome vitreous floaters is patient driven. To measure the impact of floaters and treatment on an individual's quality of life, patient-reported outcome measurements (PROMs) are essential. We review all studies using a PROM for patients with floaters. We evaluated content coverage against quality-of-life domains previously identified in other ophthalmic disorders, and against a qualitative study investigating quality-of-life issues in patients with floaters. We assessed measurement properties of PROMs using an extensive range of psychometric quality criteria. We identified 59 studies using 28 different PROMs. Many PROMs were not specifically developed for patients with floaters. Floater-specific PROMs were mostly based on content validation from an ophthalmologist or researcher perspective; two included a patient perspective. Using the outcomes of the qualitative study, we found that the floater-specific PROMs were narrow in their content coverage, with most items relating to visual symptoms and activity limitations. Testing the psychometric quality of PROMs was rare, and when employed mostly limited to responsiveness and known group validity. The remarkable high number of floater-specific PROMs reveals a need for such measurements in ophthalmology. Unfortunately, reporting on psychometric quality is limited, and content development is most often done without patient involvement.
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Affiliation(s)
- Jarinne E Woudstra-de Jong
- Rotterdam Ophthalmic Institute, Eye Hospital Rotterdam, Rotterdam, the Netherlands; Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, the Netherlands.
| | - Sonia S Manning-Charalampidou
- Rotterdam Ophthalmic Institute, Eye Hospital Rotterdam, Rotterdam, the Netherlands; Department of Vitreoretinal Surgery, Eye Hospital Rotterdam, Rotterdam, the Netherlands
| | - Hans Vingerling
- Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Jan J Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Konrad Pesudovs
- School of Optometry and Vision Science, Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
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Ngo WK, Keshet Y, Salcedo-Ledesma A, Walia J, Ledesma-Gil G, Spaide RF. THE WAY PATIENTS SEE FLOATERS: Widefield Dynamic Scanning Laser Ophthalmoscopy Imaging of Vitreous Abnormalities. Retina 2023; 43:1240-1245. [PMID: 36977315 DOI: 10.1097/iae.0000000000003786] [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: 03/30/2023]
Abstract
PURPOSE To investigate the use of dynamic widefield scanning laser ophthalmoscopy (SLO) and B-scan ultrasonography in imaging vitreous abnormalities in patients with complaints of floaters. METHODS Twenty-one patients underwent both dynamic SLO and B-scan ultrasonography to image their vitreous abnormalities. After reviewing these videos, patients graded each imaging technique on a scale of 1 to 10, based on how closely it represented their visual perception of floaters. RESULTS The mean age of the patients (12 women and nine men) was 47.7 ± 18.5 years. The patients graded a median score of nine for SLO imaging (mean = 8.43) compared with a median score of 5 (mean = 4.95) for ultrasound ( P = 0.001). Widefield SLO imaging demonstrated three-dimensional interconnectivity within the condensations of the formed vitreous that exhibited translational and rotational movements with eye saccades. CONCLUSION Floaters are a common complaint, but it is difficult to know whether imaging findings of the vitreous correlate to what patients perceive. Widefield SLO seems to image vitreous abnormalities related to how patients perceive their own floaters better than B-scan ultrasonography. Despite the term "floaters", the vitreous abnormalities in the videos seemed to be manifestations of a complex three-dimensional degeneration of the vitreous framework.
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Affiliation(s)
- Wei Kiong Ngo
- Vitreous Retina Macula Consultants of New York, New York, New York
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Boneva SK, Nguyen JH, Gui W, Hoerig C, Mamou J, Ketterling JA, Chong LP, Sebag J. RECURRENT FLOATERS AFTER LIMITED VITRECTOMY FOR VISION DEGRADING MYODESOPSIA. Retina 2023; 43:1114-1121. [PMID: 36940362 PMCID: PMC10293082 DOI: 10.1097/iae.0000000000003781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
PURPOSE Limited vitrectomy improves vision degrading myodesopsia, but the incidence of recurrent floaters postoperatively is not known. We studied patients with recurrent central floaters using ultrasonography and contrast sensitivity (CS) testing to characterize this subgroup and identify the clinical profile of patients at risk of recurrent floaters. METHODS A total of 286 eyes (203 patients, 60.6 ± 12.9 years) undergoing limited vitrectomy for vision degrading myodesopsia were studied retrospectively. Sutureless 25G vitrectomy was performed without intentional surgical posterior vitreous detachment (PVD) induction. CS (Freiburg Acuity Contrast test: Weber index, %W) and vitreous echodensity (quantitative ultrasonography) were assessed prospectively. RESULTS No eyes (0/179) with preoperative PVD experienced new floaters. Recurrent central floaters occurred in 14/99 eyes (14.1%) without complete preoperative PVD (mean follow-up = 39 months vs. 31 months in 85 eyes without recurrent floaters). Ultrasonography identified new-onset PVD in all 14 (100%) recurrent cases. Young (younger than 52 years; 71.4%), myopic (≥-3D; 85.7%), phakic (100%) men (92.9%) predominated. Reoperation was elected by 11 patients, who had partial PVD preoperatively in 5/11 (45.5%). At study entry, CS was degraded (3.55 ± 1.79 %W) but improved postoperatively by 45.6% (1.93 ± 0.86 %W, P = 0.033), while vitreous echodensity reduced by 86.6% ( P = 0.016). New-onset PVD postoperatively degraded CS anew, by 49.4% (3.28 ± 0.96 %W; P = 0.009) in patients electing reoperation. Repeat vitrectomy normalized CS to 2.00 ± 0.74%W ( P = 0.018). CONCLUSION Recurrent floaters after limited vitrectomy for vision degrading myodesopsia are caused by new-onset PVD, with younger age, male sex, myopia, and phakic status as risk factors. Inducing surgical PVD at the primary operation should be considered in these select patients to mitigate recurrent floaters.
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Affiliation(s)
- Stefaniya K. Boneva
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
- Doheny Eye Institute, UCLA, Pasadena, CA, USA
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | - Justin H. Nguyen
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
| | - Wei Gui
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
| | - Cameron Hoerig
- Department of Radiology, Weill-Cornell Medicine, New York, NY, USA
| | - Jonathan Mamou
- Department of Radiology, Weill-Cornell Medicine, New York, NY, USA
| | | | - Lawrence P. Chong
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - J. Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
- Doheny Eye Institute, UCLA, Pasadena, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, CA
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Spontaneous remission of vision degrading myodesopsia of posterior vitreous detachment type. Graefes Arch Clin Exp Ophthalmol 2022; 261:1571-1577. [PMID: 36565330 DOI: 10.1007/s00417-022-05948-4] [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: 09/13/2022] [Revised: 11/21/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The study aims to observe the spontaneous remission of posterior vitreous detachment (PVD)-type vision degrading myodesopsia (VDM) during long-term follow-up. METHODS We retrospectively reviewed VDM patients with PVD type that refused any treatment. The ratio and time of significant spontaneous remission of floater symptoms occurring were described. The associated factors with significant remission of floater symptoms were analyzed in the univariate and multivariate logistic regression analyses. RESULTS In total, 179 patients with VDM were assessed. The mean age of all patients was 60.56 ± 0.47 years old, and the mean duration of follow-up was 23.89 ± 6.63 months. Of the patients, 40.78% have significant improvement in their floater symptoms after mean 16.55 ± 10.63-month follow-up. Myopia (OR = 0.280, 95% CI = 0.084-0.932, P = 0.038), the number of floaters > 3 (OR = 0.343, 95% CI = 0.172-0.683, P = 0.002), and floaters with string-like pattern (OR = 0.370, 95% CI = 0.166-0.824, P = 0.015) and blocky pattern (OR = 0.299, 95% CI = 0.090-0.993, P = 0.049) were negatively correlated with the significant spontaneous remission of VDM symptoms in the multiple binary logistic regression analysis. CONCLUSIONS Approximately 40% of VDM patients with PVD may experience significant spontaneous remission during long-term follow-up. Patients that are non-myopic and with fewer floaters are more likely to feel relief from VDM symptoms. Floaters with string-like or blocky patterns are less likely to undergo spontaneous remission.
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Nguyen JH, Yee KMP, Nguyen-Cuu J, Mamou J, Sebag J. Vitrectomy Improves Contrast Sensitivity in Multifocal Pseudophakia With Vision Degrading Myodesopsia. Am J Ophthalmol 2022; 244:196-204. [PMID: 35562070 DOI: 10.1016/j.ajo.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE Multifocal intraocular lenses (MFIOL) are associated with degradation in contrast sensitivity function (CSF); yet the contribution of vitreous is not known, nor is the benefit of vitrectomy. DESIGN Prospective, nonrandomized clinical study. METHODS A total of 180 eyes of 180 patients (55 MFIOL, 60 monofocal intraocular lenses [MIOL], 65 phakic) with symptomatic vitreous opacities were enrolled. Vitreous structure was assessed with quantitative ultrasonography (QUS). Vision was evaluated with visual acuity and CSF measurements. RESULTS Vitreous echodensity was the same in all lens cohorts, yet CSF was worse in MFIOL eyes (P < .001). In 86 patients who elected vitrectomy, there was 68% greater vitreous echodensity and 31% worse CSF than in observation controls (P < .0001 for each). Preoperatively, CSF was 25% worse in MFIOL than in MIOL (P = .014). Postoperatively, vitreous echodensity decreased by 55%, 51%, and 52%, whereas CSF improved by 37% 48% in and 43% in MFIOL, MIOL, and phakic eyes, respectively (P < .0001 for each). NEI Visual Function Questionnaire analyses showed improved visual well-being. CONCLUSIONS Patients with vision degrading myodesopsia who elected vitrectomy had greater vitreous echodensity and worse CSF than controls, but no other differences in age, sex, or myopia. MFIOL eyes had worse CSF than MIOL and phakic eyes, very possibly due to combined effects of the MFIOL and vitreous opacification. Limited vitrectomy reduced vitreous echodensity and improved CSF in all eyes. All patients with CSF-degrading vitreous opacities benefited from limited vitrectomy, including those with MFIOL. As MFIOL eyes had 37% improvement in CSF, patients with MFIOL and vision degrading myodesopsia merit consideration of vitrectomy.
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Affiliation(s)
- Justin H Nguyen
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA
| | - Kenneth M P Yee
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA
| | - Jeannie Nguyen-Cuu
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA; DeBusk College of Osteopathic Medicine at LMU-Knoxville, Knoxville (J.N.-C.), Tennessee, USA
| | - Jonathan Mamou
- Department of Radiology (J.M.), Weill Cornell Medicine, New York, New York, USA
| | - J Sebag
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA; Doheny Eye Institute/UCLA (J.S.), Pasadena, California, USA; Department of Ophthalmology (J.S.), Stein Eye Institute, Geffen School of Medicine, UCLA, Los Angeles, California.
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Krásný J, Šach J. LASER VITREOLYSIS IN PATIENTS WITH SYMPTOMATIC VITREOUS FLOATERS. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2022; 79:59-67. [PMID: 37072253 DOI: 10.31348/2022/28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIMS To examine the effectiveness and safety of Nd:YAG laser vitreolysis in patients with symptomatic vitreous floaters. MATERIAL AND METHODS This was a single-centre study of adult patients with symptomatic vitreous floaters who underwent laser vitreolysis. Patients treated between 1/2020 and 10/2021 were included. Intraocular pressure was measured by non-contact tonometry before and one month after treatment. Colour fundus photography, slit lamp examination in mydriasis, best corrected visual acuity, optical coherence tomography, and ultrasound examinations were performed before treatment. The patients completed a questionnaire to subjectively rank the degree of impairment associated with the floaters before and between 1 and 2 months after treatment. RESULTS 89 eyes from 84 patients were included in the study, with a slight predominance of women (53%). A Weiss ring was present in 46%, and other types of vitreous opacity were found in 54%. Before treatment, 69% evaluated floaters as very troublesome (i.e., a value of 4 or 5 on a 1-5 scale). After treatment, 42% indicated subjective improvement (9% viewed the treatment as a complete success and 33% as a significant success). In 33% of eyes there was a partial improvement, i.e., some floaters could still be seen, and in 17% there was no improvement; 8% of patients were dissatisfied with the treatment results. There was no statistically significant difference in improvement between the group with Weiss rings and the group with other types of floaters. The procedure itself and the subsequent observation period were without complications, i.e., no cases of intraocular pressure elevation, cataract formation or retinal complications. Intraocular pressure did not significantly change from the pre-procedure value (p = 0.29). Average best corrected visual acuity after treatment was 0.97, thus it did not differ significantly from the pre-treatment values (p = 0.82). CONCLUSION Nd:YAG laser vitreolysis subjectively improved floater-related symptoms in treated eyes. The lack of an objective measurement of treatment success is a limiting factor. Laser vitreolysis is more suitable for solitary than diffuse vitreous opacities.
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Design of a Functional Eye Dressing for Treatment of the Vitreous Floater. J Pers Med 2022; 12:jpm12101659. [PMID: 36294798 PMCID: PMC9604789 DOI: 10.3390/jpm12101659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/20/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Abstract
With the rapid development of display technology, related diseases of the human eye are also increasing day by day. Eye floaters are one of the diseases that affect humans. Herein, we present a functional ophthalmic dressing that can permeate the skin tissues of the eyes through oxygen and hydrogen to improve the symptoms of floaters. In clinical tests, the symptoms of sensory floaters improved in 28 patients, and the recovery rates of mild, moderate, and severe floaters were about 70%, 66.7%, and 83.3%, respectively.
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15
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Visualization and Grading of Vitreous Floaters Using Dynamic Ultra-Widefield Infrared Confocal Scanning Laser Ophthalmoscopy: A Pilot Study. J Clin Med 2022; 11:jcm11195502. [PMID: 36233369 PMCID: PMC9571201 DOI: 10.3390/jcm11195502] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose: To describe the appearance of vitreous opacities using dynamic ultra-widefield infrared confocal scanning laser ophthalmoscopy (IRcSLO). Design: Retrospective case series. Methods: Eyes of patients complaining of myodesopsia were analyzed using dynamic ultra-widefield IRcSLO imaging (Nidek Mirante, Nidek Co., Ltd., Gamagori, Japan), and classified according to a vitreous opacity severity scale. Results: Thirty eyes of 21 patients were included in this study. The average age was 56 years. Symptom duration ranged from 1 to more than 365 days. The most common cause of vitreous floaters was posterior vitreous detachment (63.3%), followed by vitreous syneresis (23.3%), asteroid hyalosis (10%) and vitreous hemorrhage (3.3%). Opacities were classified as Grade 1 in three eyes (10%), Grade 2 in 10 eyes (33.3%), Grade 3 in 11 eyes (36.6%), Grade 4 in two eyes (6.6%) and Grade 5 in four eyes (13.3%). Patients with Grade 1 opacities were younger than patients with opacities Grade 2 or greater. A visible Weiss ring could be identified in 0% of eyes with Grade 1 opacities, 40% of eyes with Grade 2 opacities, 100% of eyes with Grade 3 opacities, and 100% of eyes with Grade 4 opacities. In patients with Grade 5 opacities, a Weiss ring could not be identified. Conclusion: Dynamic ultra-widefield IRcSLO imaging is a useful tool to evaluate patients with vitreous floaters. It allows for accurate visualization of the number, density, and behavior of the shadows that vitreous opacities project over a very wide area of the retina, which has a positive correlation with patient perception of floaters.
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16
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Goh WN, Mustapha M, Zakaria SZS, Bastion MLC. The effectiveness of laser vitreolysis for vitreous floaters in posterior vitreous detachment. Indian J Ophthalmol 2022; 70:3026-3032. [PMID: 35918966 DOI: 10.4103/ijo.ijo_3198_21] [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: 11/05/2022] Open
Abstract
Purpose To determine the effectiveness of laser vitreolysis in terms of contrast sensitivity function (CSF) and vision-related quality of life (VRQol) for symptomatic floaters due to posterior vitreous detachment (PVD). Materials This is an interventional study that involved 57 eyes of 45 patients with symptomatic floaters for more than 3 months. Patients underwent one to three sessions of vitreolysis via Neodymiun-doped Yttrium Aluminum Garnet (Nd:YAG) laser. We examined the CSF using the computer programs Freiburg Acuity and Contrast Test (FrACT) and VRQoL survey using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) before, and 1 month after, vitreolysis. Results Twelve patients had both eyes lasered and 33 patients had one eye lasered. The mean CSF improved from 3.20 ± 0.85%W to 2.64 ± 0.63%W 1 month after vitreolysis. Each use of the laser showed a significant mean difference in CSF (%W) as analyzed by paired t-test before and after the first laser (0.29 ± 0.49%W [P ≤ 0.001]); after the first and second laser (0.35 ± 0.53%W [P = 0.01]); and after second and third laser (0.21 ± 0.31%W [P = 0.02]). There was improvement in the median of four subscales in NEI VFQ-25 scores post treatment: general vision (z = -3.30, P = 0.001), near activity (z = 3.396, P = 0.001, distance activity (z = -2.788, P = 0.005), and mental health (z = -2.219, P = 0.026). The mean scores increased to 79.55 ± 9.45 from the baseline 75.06 ± 9.69 (P ≤ 0.001). No adverse events were recorded 1 month after the laser treatments. Conclusion Vitreolysis by Nd:YAG laser improved the CFS and VRQoL in symptomatic PVD patients.
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Affiliation(s)
- Wan Ni Goh
- Department of Ophthalmology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Mushawiahti Mustapha
- Department of Ophthalmology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Syed Z S Zakaria
- Department of Paediatrics, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mae-Lynn C Bastion
- Department of Ophthalmology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
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Cai F, Wang X, Deng Z, Bai L. Exploration of the Visual Function after the Implantation of Continuous Visual Range Human Cocrystal Micromonocular Vision in Both Eyes of the Patient. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6000977. [PMID: 35295177 PMCID: PMC8920647 DOI: 10.1155/2022/6000977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/03/2022] [Accepted: 02/14/2022] [Indexed: 11/17/2022]
Abstract
Eye diseases such as myopia, hyperopia, astigmatism, and cataract are have affected most people at home and abroad for many years. With the development of science and technology, people who wear glasses are now younger, and they are on the rise over time. This paper is to explore the visual function after the implantation of continuous visual range human cocrystal micromonocular vision in both eyes of the patient. On this basis, the latest visual sensor technology is used to conduct clinical research on the operation, a case-control study is performed on the patient's eyes, followed by intraocular lens insertion surgery, one eye is hemitrope and the other eye has a certain degree of intraocular lens inserted, and it is recorded within a period of time after the operation. According to the analysis of the experimental results, the patient's naked eye and corrected distance vision is (t = 2.102, P = 0.049), middle distance vision (t = 1.403, P = 0.200), and near vision (t = 1.463, P = 0.216). After the operation, the ratio of patients taking off glasses 91.8%. After the continuous visual range intraocular lens micromonocular vision design, it can well correct the patient's near and far vision of the naked eye of both eyes.
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Affiliation(s)
- Fangrong Cai
- Ophthalmology, Jianyang People's Hospital, Jianyang 641400, China
| | - Xiaoli Wang
- Ophthalmology, Jianyang People's Hospital, Jianyang 641400, China
| | - Zhihui Deng
- Ophthalmology, Jianyang People's Hospital, Jianyang 641400, China
| | - Lina Bai
- Ophthalmology, Jianyang People's Hospital, Jianyang 641400, China
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The Efficacy and Safety of YAG Laser Vitreolysis for Symptomatic Vitreous Floaters of Complete PVD or Non-PVD. Ophthalmol Ther 2021; 11:201-214. [PMID: 34778916 PMCID: PMC8770727 DOI: 10.1007/s40123-021-00422-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/01/2021] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION To evaluate and compare the efficacy and safety of YAG laser vitreolysis in treating symptomatic vitreous floaters of complete posterior vitreous detachment (PVD) and non-PVD. METHODS In this prospective cohort study, 51 eyes with symptomatic floaters were treated with YAG laser vitreolysis. Participants were divided into complete PVD and non-PVD groups. Objective visual quality measures including the Strehl ratio (SR), internal spherical aberration (SA), internal comatic aberration (CA), internal high-order aberration (HOA), area ratio of modulation transfer function (MTFa) and Vitreous Floaters Symptom Questionnaire (VFSQ-13) scores were used to compare the efficacy of YAG laser vitreolysis treatment between two groups. RESULTS The mean age of all patients was 56.80 ± 10.82 years old. In total, 36 of 51 (70.59%; 95% CI 58.10-83.10) patients reported their symptoms as significant or complete improvement after YAG laser vitreolysis treatment. Post-treatment MTFa, internal SA and internal HOA were significantly better compared to baseline (26.19 ± 14.73 vs. 29.19 ± 17.98, p = 0.013; 0.05 ± 0.05 vs. 0.04 ± 0.04, p = 0.031 and 0.23 ± 0.22 vs. 0.16 ± 0.07, p = 0.044; respectively) in all eyes. Twenty-nine of 51 (56.86%) eyes had floaters of non-PVD type. Significant or complete subjective improvements in the PVD group and non-PVD group were 72.73% and 68.97% (p = 0.344), respectively. CONCLUSIONS Improved subjective and objective visual quality in participants with symptomatic floaters following YAG laser vitreolysis was found in both groups. The efficacy of YAG laser vitreolysis was comparable in floaters of complete PVD and non-PVD types.
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Dai S, Sun W, Xu H, Wang Y, Liu Y, Han A, Han L, Wang J, Liao R, Liu S, Gao Y, Han H. Effect of Applying Binocular Visual Training after Slanted Lateral Rectus Recession on Orthophoric Rate and Binocular Visual Function Recovery on Patients with Convergence Insufficiency-Type Intermittent Exotropia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:7202319. [PMID: 34697548 PMCID: PMC8541848 DOI: 10.1155/2021/7202319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the effect of applying binocular visual training after slanted lateral rectus recession on orthophoric rate and binocular visual function recovery on patients with convergence insufficiency-type intermittent exotropia (CI-IXT). METHODS A total of 76 CI-IXT child patients treated at the Strabismus and Pediatric Ophthalmology Department of our hospital from June 2019 to June 2020 were selected as the research objects, and those who met the inclusion criteria were equally divided into group A (63 eyes) and group B (61 eyes) according to the sealed envelope randomization. All child patients accepted the slanted lateral rectus recession, and after that, those in group A accepted the binocular visual training and those in group B accepted the conventional visual function rehabilitation training, so as to compare their position of eye, the best corrected visual acuity, etc., after training for statistical analysis. RESULTS Compared with group B after one month of surgery, group A had significantly less patients with grade I binocular vision function (P < 0.001) and more patients with grade II and III vision function (P < 0.05); between group A and group B, after 3 months and 6 months of treatment, the number of eyes with normal stereoscopic vision was significantly higher in group A (P < 0.05); at 15 days, 1 month, 3 months, and 6 months of treatment, the visual strain scores of group A were significantly lower (P < 0.001); after treatment, the number of orthophoria eyes was significantly higher in group A (P < 0.001), while the numbers of overcorrected eyes and undercorrected eyes were significantly higher in group B (P < 0.001); and the total incidence rate of adverse reactions was significantly lower in group A (P < 0.05). CONCLUSION Applying binocular visual training to child patients with CI-IXT after slanted lateral rectus recession can promote the recovery of binocular vision and ensure higher safety, and further study will help to establish a better solution for the affected children.
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Affiliation(s)
- Shuying Dai
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Weifeng Sun
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Hongjia Xu
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Yanan Wang
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Yuan Liu
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Aijun Han
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Lixiao Han
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Juan Wang
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Rujuan Liao
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Sujiang Liu
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Yu Gao
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
| | - Huifang Han
- Department of Strabismus and Pediatric Ophthalmology, Hebei Eye Hospital, Xingtai 054000, Hebei Province, China
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Dani Nandiyanto AB, Kito Y, Hirano T, Ragadhita R, Le PH, Ogi T. Spherical submicron YAG:Ce particles with controllable particle outer diameters and crystallite sizes and their photoluminescence properties. RSC Adv 2021; 11:30305-30314. [PMID: 35480242 PMCID: PMC9041146 DOI: 10.1039/d1ra04800g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/03/2021] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study was to demonstrate the preparation of spherical submicron YAG:Ce particles with controllable particle outer diameters and crystallite sizes and their photoluminescence (PL) properties, which were produced using a flame-assisted spray-pyrolysis method followed by the annealing process. The correlation of particle outer diameter, crystallite size, and PL performance of the prepared particles was also investigated. Experimental results showed that the increases in the particle outer diameters have an impact on the obtainment of higher PL performance. Large particle outer diameters permitted the crystallites to grow more, whereas this is in contrast to the condition for small particle outer diameter having limitations in crystallite growth. This study also found that too large outer diameter (>557 nm) was not effective since crystallites cannot grow anymore and it permits possible scattering problems. This study provides significant information for optimizing synthesis parameters for controlling particle outer diameters and crystallite sizes, which could be relevant to other functional properties, especially for lens, solar cell, and LED applications. We demonstrate the synthesis of spherical submicron YAG:Ce particles with controllable particle outer diameters and crystallite sizes and their photoluminescence properties, produced by a flame-assisted spray-pyrolysis method with annealing process.![]()
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Affiliation(s)
- Asep Bayu Dani Nandiyanto
- Departemen Kimia, Universitas Pendidikan Indonesia Jl. Dr Setiabudhi No. 229 Bandung 40154 Indonesia
| | - Yusuke Kito
- Chemical Engineering Program, Graduate School of Advanced Science and Engineering, Hiroshima University 1-4-1 Kagamiyama Higashi-Hiroshima City Hiroshima 739-8527 Japan +81-82-424-3765 +81-82-424-3765
| | - Tomoyuki Hirano
- Chemical Engineering Program, Graduate School of Advanced Science and Engineering, Hiroshima University 1-4-1 Kagamiyama Higashi-Hiroshima City Hiroshima 739-8527 Japan +81-82-424-3765 +81-82-424-3765
| | - Risti Ragadhita
- Departemen Kimia, Universitas Pendidikan Indonesia Jl. Dr Setiabudhi No. 229 Bandung 40154 Indonesia
| | - Phong Hoai Le
- Chemical Engineering Program, Graduate School of Advanced Science and Engineering, Hiroshima University 1-4-1 Kagamiyama Higashi-Hiroshima City Hiroshima 739-8527 Japan +81-82-424-3765 +81-82-424-3765
| | - Takashi Ogi
- Chemical Engineering Program, Graduate School of Advanced Science and Engineering, Hiroshima University 1-4-1 Kagamiyama Higashi-Hiroshima City Hiroshima 739-8527 Japan +81-82-424-3765 +81-82-424-3765
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Barras A, Sauvage F, de Hoon I, Braeckmans K, Hua D, Buvat G, Fraire JC, Lethien C, Sebag J, Harrington M, Abderrahmani A, Boukherroub R, De Smedt S, Szunerits S. Carbon quantum dots as a dual platform for the inhibition and light-based destruction of collagen fibers: implications for the treatment of eye floaters. NANOSCALE HORIZONS 2021; 6:449-461. [PMID: 33903870 DOI: 10.1039/d1nh00157d] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Common in myopia and aging, vitreous opacities arise from clumped collagen fibers within the vitreous body that cast shadows on the retina, appearing as 'floaters' to the patient. Vitreous opacities degrade contrast sensitivity function and can cause significant impairment in vision-related quality-of-life, representing an unmet and underestimated medical need. One therapeutic approach could be the use of versatile light-responsive nanostructures which (i) interfere with the formation of collagen fibers and/or (ii) destroy aggregates of vitreous collagen upon pulsed-laser irradiation at low fluences. In this work, the potential of positively and negatively charged carbon quantum dots (CQDs) to interfere with the aggregation of type I collagen is investigated. We demonstrate that fibrillation of collagen I is prevented most strongly by positively charged CQDs (CQDs-2) and that pulsed-laser illumination allowed to destroy type I collagen aggregates and vitreous opacities (as obtained from patients after vitrectomy) treated with CQDs-2.
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Affiliation(s)
- Alexandre Barras
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - Félix Sauvage
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Inès de Hoon
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France. and Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Kevin Braeckmans
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Dawei Hua
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Gaëtan Buvat
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - Juan C Fraire
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Christophe Lethien
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - J Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California 92647, USA and Doheny Eye Institute/UCLA, Los Angeles, California 90033, USA
| | | | - Amar Abderrahmani
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - Rabah Boukherroub
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - Stefaan De Smedt
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Sabine Szunerits
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
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Ramovecchi P, Salati C, Zeppieri M. Spontaneous posterior vitreous detachment: A glance at the current literature. World J Exp Med 2021; 11:30-36. [PMID: 34141604 PMCID: PMC8188834 DOI: 10.5493/wjem.v11.i3.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 02/06/2023] Open
Abstract
Spontaneous posterior vitreous detachment (PVD) is a common age-related condition in which prevalence tends to increase with age. Acute PVD can cause the onset of symptoms that include visual disturbances, myodesopsia and photopsia. The goal of this short review was to provide a quick glance at the important factors related to PVD based on current literature in this field, which includes incidence, symptoms, diagnosis, risk factors, and education for patients with acute symptoms, and treatments. The take home message is that an ophthalmic examination at the onset of symptoms is of utmost importance, considering that irreversible sight-threatening complications can be prevented if diagnosed and treated promptly.
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Affiliation(s)
- Paola Ramovecchi
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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23
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Sebag J. Vitrectomy for Vision Degrading Myodesopsia. Ophthalmol Retina 2021; 5:1-3. [PMID: 33413791 DOI: 10.1016/j.oret.2020.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 11/16/2022]
Affiliation(s)
- J Sebag
- Doheny Eye Institute/UCLA, Los Angeles, California; Department of Ophthalmology, Geffen School of Medicine, UCLA, Los Angeles, California; VMR Institute for Vitreous Macula Retina, Huntington Beach, California.
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Vitreous Structure and Visual Function in Myopic Vitreopathy Causing Vision-Degrading Myodesopsia. Am J Ophthalmol 2021; 224:246-253. [PMID: 32950508 DOI: 10.1016/j.ajo.2020.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/29/2020] [Accepted: 09/10/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Myopic vitreopathy features precocious fibrous vitreous liquefaction and early posterior vitreous detachment (PVD). It is unclear whether visual function is affected by myopic vitreopathy and PVD. This study assessed the relationships among axial length, structural vitreous density, PVD, and visual function. DESIGN Retrospective case-control study. METHODS Ultrasonography measurements were made of axial length, logMAR VA, contrast sensitivity function (CSF [Freiburg acuity contrast test]), and quantitative B-scan ultrasonography. RESULTS Seventy-nine subjects (45 men and 34 women; mean age: 49 ± 14 years) were analyzed. Axial lengths ranged from 22 to 29.2 mm (mean: 24.9 ± 1.8 mm; myopic eyes: 26.35 ± 1.35 mm; and nonmyopic eyes: 23.45 ± 0.75 mm; P < .001). With increasing axial length there was greater vitreous echodensity (R: 0.573; P < .01) and degradation in CSF (R: 0.611; P < .01). Subgroup analyses found that myopic eyes (>- 3 diopters) had 37% more vitreous echodensity than nonmyopic eyes (762 ± 198 arbitrary units [AU] vs. 557 ± 171 AU, respectively; P < .001) and that CSF was 53% worse in myopic eyes (3.30 ± 1.24 Weber index [%W]) than in nonmyopic eyes (2.16 ± .59 %W; P < .001). Myopic eyes with PVD had 33% greater vitreous echodensity (815 ± 217 AU; P < .001) and 62% degradation in CSF (3.63 ± 2.99 %W) compared to nonmyopic eyes with PVD (613 ± 159 AU; 2.24 ± 0.69 %W; P < .001, each). Limited vitrectomy was performed in 11 of 40 cases (27.5%), normalizing vitreous echodensity and CSF in each case. CONCLUSIONS Axial myopia is associated with increased fibrous vitreous liquefaction and echodensity, as well as profound degradation of CSF. PVD in myopic eyes is associated with even more structural and functional abnormalities, normalized by limited vitrectomy. These findings may explain some common complaints of myopic patients with respect to vision and quality of life.
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Schrenk K, Khoramnia R, Feltgen N, Bachmann W, Ziemssen F, Rohrbach JM, Dimopoulos S. [Advertising or information in ophthalmology? : Scientific evaluation of a YouTube sample]. Ophthalmologe 2021; 118:30-41. [PMID: 32350611 PMCID: PMC7808978 DOI: 10.1007/s00347-020-01105-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hintergrund Trotz der Liberalisierung des Heilmittelwerbegesetzes ist anpreisende, irreführende oder vergleichende Werbung nach wie vor berufswidrig. Angesichts des zunehmenden Engagements von Finanzinvestoren und der Ökonomisierung in der Augenheilkunde sollte diese Arbeit prüfen, welche Aussagen in offen zugänglichen Videos der YouTube-Plattform getroffen werden. Methode Mit den Suchbegriffen „Augenarzt“, „Augenärztin“ und „Augenzentrum“ sowie vordefinierten Kriterien (deutsche Herkunft, Audiospur mit Text, Dauer >1 min) wurden Videos identifiziert und in eine anonymisierte Textform transkribiert. Mittels eines eigens entwickelten Fragebogens wurden die Einzelaussagen daraufhin einer kritischen Prüfung durch jeweils 3 Experten unterzogen sowie Klarheit, Relevanz und Vollständigkeit bewertet. Parallel wurden Laien abgefragt, wie überzeugend, verständlich und vollständig sie die Informationen bewerten und ob sie sich von den Ärzten behandeln lassen würden. Ergebnisse Von 68 Videos erfüllten 30 die definierten Einschlusskriterien; 46 % der Videos thematisierten Verfahren der refraktiven Chirurgie. Aus Sicht der Experten waren mindestens 11,8 % der Einzelaussagen vollständig falsch oder wenig korrekt. Über 80 % der Filme stellten Informationen unvollständig dar. So wurden z. B. peri- und postoperative Komplikationen nur von 3 Filmen angesprochen. Laien bewerteten die Texte recht uneinheitlich und konnten nicht die Videos identifizieren, die aus Sicht der ophthalmologischen Fachärzte problematische Aussagen enthielten. Es wurden Konflikte mit den rechtlichen Anforderungen an Werbung z. B. in der Verwendung entsprechender Superlative festgestellt. Eine ausgewogene Darstellung wie Alternativen zu den Behandlungsverfahren war kaum enthalten, die Verständlichkeit für Laien war verbesserungswürdig. Schlussfolgerungen Nur eine geringe Anzahl frei zugänglicher Videos bot aktuelle, wissenschaftlich fundierte und korrekte Informationen. Bisher berücksichtigen nur wenige Augenärzte die juristischen und moralischen Anforderungen an werbende Aussagen. Daher ergeben sich möglicherweise negative Auswirkungen auf das Berufsbild in der Öffentlichkeit, und Chancen zur Gesundheitsförderung bleiben ungenutzt.
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Affiliation(s)
- Kilian Schrenk
- Department für Augenheilkunde, Eberhard-Karl Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland
| | - Ramin Khoramnia
- Universitätsaugenklinik Heidelberg, 69120, Heidelberg, Deutschland
| | - Nicolas Feltgen
- Augenklinik der Universitätsmedizin Göttingen, Göttingen, Deutschland
| | | | - Focke Ziemssen
- Department für Augenheilkunde, Eberhard-Karl Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland.
| | - Jens Martin Rohrbach
- Department für Augenheilkunde, Eberhard-Karl Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland
| | - Spyridon Dimopoulos
- Department für Augenheilkunde, Eberhard-Karl Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland
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26
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Return to the Operating Room after Vitrectomy for Vitreous Opacities. ACTA ACUST UNITED AC 2021; 5:4-8. [DOI: 10.1016/j.oret.2020.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/22/2022]
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Sebag J. Vitreous and Vision Degrading Myodesopsia. Prog Retin Eye Res 2020; 79:100847. [PMID: 32151758 DOI: 10.1016/j.preteyeres.2020.100847] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 12/16/2022]
Abstract
Macromolecules comprise only 2% of vitreous, yet are responsible for its gel state, transparency, and physiologic function(s) within the eye. Myopia and aging alter collagen and hyaluronan association causing concurrent gel liquefaction and fibrous degeneration. The resulting vitreous opacities and collapse of the vitreous body during posterior vitreous detachment are the most common causes for the visual phenomenon of vitreous floaters. Previously considered innocuous, the vitreous opacities that cause floaters sometimes impact vision by profoundly degrading contrast sensitivity function and impairing quality-of-life. While many people adapt to vitreous floaters, clinically significant cases can be diagnosed with Vision Degrading Myodesopsia based upon echographic assessment of vitreous structure and by measuring contrast sensitivity function. Perhaps due to the ubiquity of floaters, the medical profession has to date largely ignored the plight of those with Vision Degrading Myodesopsia. Improved diagnostics will enable better disease staging and more accurate identification of severe cases that merit therapy. YAG laser treatments may occasionally be slightly effective, but vitrectomy is currently the definitive cure. Future developments will usher in more informative diagnostic approaches as well as safer and more effective therapeutic strategies. Improved laser treatments, new pharmacotherapies, and possibly non-invasive optical corrections are exciting new approaches to pursue. Ultimately, enhanced understanding of the underlying pathogenesis of Vision Degrading Myodesopsia should result in prevention, the ultimate goal of modern Medicine.
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Affiliation(s)
- J Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA; Doheny Eye Institute, Pasadena, CA, USA; Department of Ophthalmology, Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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Broadhead GK, Hong T, Chang AA. To Treat or Not to Treat: Management Options for Symptomatic Vitreous Floaters. Asia Pac J Ophthalmol (Phila) 2020; 9:96-103. [PMID: 32097127 DOI: 10.1097/apo.0000000000000276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Vitreous floaters are a common cause for presentation to ophthalmologists, and may significantly affect visual function. In the absence of some more serious underlying pathology such as uveitis, many patients may not experience significant persistent visual impairment from floaters. For some patients, the symptomatic effects of floaters may persist. For these patients, treatment options are available, of which the most commonly reported is vitrectomy. Other treatment modalities have also become more common, notably YAG vitreolysis. Selection of appropriate patients for surgery is often difficult, in part due to the relative lack of objective outcomes with which to measure both visual impairment and improvement post-procedure. Although well-tolerated, vitrectomy does carry with it risks, including iatrogenic retinal breaks, retinal detachment, and in phakic patients, subsequent cataract formation. Techniques such as small gauge vitrectomy, intraoperative examination and treatment of breaks or other worrying lesions, and careful consideration of the need for posterior vitreous detachment induction may help limit the incidence of these adverse events. For other treatment options such as YAG vitreolysis, research and clinical experience remain more limited, and as such the long-term efficacy and risks of these therapies are still unclear. Here, we review the evidence surrounding the role of vitrectomy and YAG vitreolysis in the treatment of vitreous floaters and potential means to minimize therapeutic complications.
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Affiliation(s)
- Geoffrey K Broadhead
- Save Sight Institute, The University of Sydney, Sydney, Australia
- Sydney Institute of Vision Science, Sydney, Australia
| | - Thomas Hong
- Sydney Institute of Vision Science, Sydney, Australia
- Sydney Retina Clinic & Day Surgery, Sydney, Australia
| | - Andrew A Chang
- Save Sight Institute, The University of Sydney, Sydney, Australia
- Sydney Institute of Vision Science, Sydney, Australia
- Sydney Retina Clinic & Day Surgery, Sydney, Australia
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Ankamah E, Sebag J, Ng E, Nolan JM. Vitreous Antioxidants, Degeneration, and Vitreo-Retinopathy: Exploring the Links. Antioxidants (Basel) 2019; 9:antiox9010007. [PMID: 31861871 PMCID: PMC7022282 DOI: 10.3390/antiox9010007] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 02/06/2023] Open
Abstract
The transparent vitreous body, which occupies about 80% of the eye’s volume, is laden with numerous enzymatic and non-enzymatic antioxidants that could protect the eye from oxidative stress and disease. Aging is associated with degeneration of vitreous structure as well as a reduction in its antioxidant capacity. A growing body of evidence suggests these age-related changes may be the precursor of numerous oxidative stress-induced vitreo-retinopathies, including vision degrading myodesopsia, the clinically significant entoptic phenomena that can result from advanced vitreous degeneration. Adequate intravitreal antioxidant levels may be protective against vitreous degeneration, possibly preventing and even improving vision degrading myodesopsia as well as mitigating various other vitreo-retinopathies. The present article is, therefore, a review of the different antioxidant molecules within vitreous and the inter-relationships between vitreous antioxidant capacity and degeneration.
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Affiliation(s)
- Emmanuel Ankamah
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Co., X91 K236 Waterford, Ireland;
- Institute of Eye Surgery, UPMC Whitfield, Buttlerstown, Co., X91 DH9W Waterford, Ireland
- Correspondence: (E.A.); (J.M.N.)
| | - J. Sebag
- VMR Consulting Inc., Huntington Beach, CA 92647, USA;
| | - Eugene Ng
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Co., X91 K236 Waterford, Ireland;
- Institute of Eye Surgery, UPMC Whitfield, Buttlerstown, Co., X91 DH9W Waterford, Ireland
| | - John M. Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Co., X91 K236 Waterford, Ireland;
- Correspondence: (E.A.); (J.M.N.)
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