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Li QJ, Zhou SM, Zhang LY, Lin AN, Zhang Y, Jiang J, Che X, Qian YW, Liu Y, Wang ZL. Evaluation of retinal and choroidal thickness changes in overweight and obese adults without ocular symptoms by swept-source optical coherence tomography. Int J Ophthalmol 2024; 17:707-712. [PMID: 38638269 PMCID: PMC10988066 DOI: 10.18240/ijo.2024.04.15] [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: 05/16/2023] [Accepted: 12/01/2023] [Indexed: 04/20/2024] Open
Abstract
AIM To evaluate the relationship of overweight and obesity with retinal and choroidal thickness in adults without ocular symptoms by swept-source optical coherence tomography (SS-OCT). METHODS According to the body mass index (BMI) results, the adults enrolled in the cross-sectional study were divided into the normal group (18.50≤BMI<25.00 kg/m2), the overweight group (25.00≤BMI<30.00 kg/m2), and the obesity group (BMI≥30.00 kg/m2). The one-way ANOVA and the Chi-square test were used for comparisons. Pearson's correlation analysis was used to evaluate the relationships between the measured variables. RESULTS This research covered the left eyes of 3 groups of 434 age- and sex-matched subjects each: normal, overweight, and obesity. The mean BMI was 22.20±1.67, 26.82±1.38, and 32.21±2.35 kg/m2 in normal, overweight and obesity groups, respectively. The choroid was significantly thinner in both the overweight and obesity groups compared to the normal group (P<0.05 for all), while the retinal thickness of the three groups did not differ significantly. Pearson's correlation analysis showed that BMI was significantly negatively correlated with choroidal thickness, but no significant correlation was observed between BMI and retinal thickness. CONCLUSION Choroidal thickness is decreased in people with overweight or obesity. Research on changes in choroidal thickness contributes to the understanding of the mechanisms of certain ocular disorders in overweight and obese adults.
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Affiliation(s)
- Qing-Jian Li
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Sheng-Mei Zhou
- Eye Institute of Xiamen University, Xiamen University School of Medicine, Xiamen 361005, Fujian Province, China
| | - Ling-Yu Zhang
- Eye Institute of Xiamen University, Xiamen University School of Medicine, Xiamen 361005, Fujian Province, China
| | - An-Ni Lin
- Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yang Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jing Jiang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xin Che
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yi-Wen Qian
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yan Liu
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhi-Liang Wang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
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Muller YG, Lenoble P. [Clinical and pathophysiological contribution of OCT-angiography to epiretinal membranes]. J Fr Ophtalmol 2023; 46:776-790. [PMID: 37164872 DOI: 10.1016/j.jfo.2023.01.028] [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: 06/27/2022] [Accepted: 01/30/2023] [Indexed: 05/12/2023]
Abstract
Epiretinal membranes may lead to centripetal contraction forces on the retina and its vessels. OCT-Angiography (OCT-A) is a recent tool which permits a non-invasive understanding of these vascular changes. This review focuses on the OCT-A findings in idiopathic epiretinal membranes, before and after surgery, and the role of internal limiting membrane peeling. It appears that contraction of the epiretinal membrane is associated with both a reduction in the area and perimeter of the foveal avascular zone and alterations in the superficial and deep capillary plexuses. These changes mainly reflect a vascular shift from the perifoveal to the foveal region, increasing with retinal deformation, but also probable dynamic changes in vascular flow. Membrane peeling allows at least partial improvement of these microvascular parameters. Nevertheless, some limitations of OCT-A, such as segmentation errors on a retina with highly modified architecture, can lead to a selection bias in the studies and should call for caution in the interpretation of the results. Finally, internal limiting membrane peeling contributes to changes in the retinal architecture after surgery, in particular by causing a centripetal movement of the macular capillaries and a displacement of the fovea toward the optic nerve head. This role should be clarified in future studies.
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Affiliation(s)
- Y-G Muller
- Université Louis-Pasteur, 67000 Strasbourg, France.
| | - P Lenoble
- Hôpital Pasteur, 68000 Colmar, France
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Gong J, Gong Y, Zou T, Zeng Y, Yang C, Mo L, Kang J, Fan X, Xu H, Yang J. A controllable perfusion microfluidic chip for facilitating the development of retinal ganglion cells in human retinal organoids. LAB ON A CHIP 2023; 23:3820-3836. [PMID: 37496497 DOI: 10.1039/d3lc00054k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Retinal organoids (ROs) derived from human pluripotent stem cells (hPSCs) have become a promising model in vitro to recapitulate human retinal development, which can be further employed to explore the mechanisms of retinal diseases. However, the current culture systems for ROs lack physiologically relevant microenvironments, such as controllable mechano-physiological cues and dynamic feedback between cells and the extracellular matrix (ECM), which limits the accurate control of RO development. Therefore, we designed a controllable perfusion microfluidic chip (CPMC) with the advantages of precisely controlling fluidic shear stress (FSS) and oxygen concentration distribution in a human embryonic stem cell (hESC)-derived RO culture system. We found that ROs cultured under this system allow for expanding the retinal progenitor cell (RPC) pool, orchestrating the retinal ganglion cell (RGC) specification, and axon growth without disturbing the spatial and temporal patterning events at the early stage of RO development. Furthermore, RNA sequencing data revealed that the activation of voltage-gated ion channels and the increased expression of ECM components synergistically improve the growth of ROs and facilitate the differentiation of RGCs. This study elaborates on the advantages of the designed CPMC to promote RO growth and provide a controllable and reliable platform for the efficient maturity of RGCs in the ROs, promising applications in modeling RGC-related disorders, drug screening, and cell transplantation.
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Affiliation(s)
- Jing Gong
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China.
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Yu Gong
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Ting Zou
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Yuxiao Zeng
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Cao Yang
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Lingyue Mo
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Jiahui Kang
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, 40038, China.
| | - Haiwei Xu
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Jun Yang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China.
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Liu Y, Zhang JY, Ding X, He FL, Lu LN, Fu Y. Choroidal structural changes following vitrectomy performed with phacoemulsification in unilateral idiopathic epiretinal membrane. BMC Ophthalmol 2023; 23:52. [PMID: 36747177 PMCID: PMC9901130 DOI: 10.1186/s12886-023-02803-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study aims to determine the influence of vitrectomy combined with macular epiretinal membrane dissection and internal limiting membrane (ILM) peeling and phacoemulsification on choroidal vasculature in patients with unilateral idiopathic epiretinal membrane (IERM) and concurrent cataract using optical coherence tomography (OCT). METHODS This retrospective study included 26 eyes of 26 patients (8 males and 18 females) with unilateral IERM without vitreomacular traction (VMT) (group 1) and the patients' fellow eyes (n = 26, group 2). Three-port 25-G pars plana vitrectomy (PPV) combined with macular epiretinal membrane dissection and ILM peeling and phacoemulsification was performed on all patients. The comprehensive ophthalmologic examinations of all patients involved OCT measurements at every visit before and after surgery, and the choroidal thickness (CT), central macular thickness (CMT) and choroidal vascularity index (CVI) were calculated. RESULTS The mean age of the IERM patients was 66.58 ± 7.06 years. Postoperatively, best corrected visual acuity (BCVA) was significantly greater than baseline (P = 0.023). The CVI of the IERM eyes was significantly lower (P < 0.01) than that of the fellow eyes at baseline. The subfoveal CT in the IERM eyes was lower than that in the fellow eyes (P = 0.023), but there was, no significant difference in the average CT between the two groups at baseline (P = 0.071). In eyes with IERM, the CVI significantly increased at 1 week, 1 month (P < 0.001), and 3 months (P = 0.049) postoperatively, the subfoveal CT was markedly thickened 1 month after surgery (P = 0.001), the temporal 3 mm and nasal CT significantly increased at 1 week and 1 month postoperatively (P = 0.041, P = 0.022 for temporal 3 mm; P < 0.001, P = 0.047 for nasal 1.5 mm; P = 0.01, P = 0.001 for nasal 3 mm), and only the temporal 3 mm CT increased significantly at 3 months postoperatively (P = 0.017). The baseline CMT of the IERM eyes was significantly thicker than that of the fellow eyes (P < 0.001). CMT significantly decreased at 3 months postoperatively in IERM eyes(P = 0.033). CONCLUSIONS The increase in the CVI in the IERM eyes without VMT after combined PPV with ILM peeling and phacoemulsification persists for at least 3 months.
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Affiliation(s)
- Yan Liu
- grid.16821.3c0000 0004 0368 8293Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, 639 Zhizaoju Road, Shanghai, 200011 China
| | - Jia Ying Zhang
- grid.16821.3c0000 0004 0368 8293Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, 639 Zhizaoju Road, Shanghai, 200011 China
| | - Xia Ding
- grid.16821.3c0000 0004 0368 8293Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, 639 Zhizaoju Road, Shanghai, 200011 China
| | - Fang Lin He
- grid.16821.3c0000 0004 0368 8293Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, 639 Zhizaoju Road, Shanghai, 200011 China
| | - Lin Na Lu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China. .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Yao Fu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China. .,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, 639 Zhizaoju Road, Shanghai, 200011, China.
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Wang X, Yang J, Wang C, Li X. Choroidal morphologic and vascular features in patients with unilateral idiopathic epiretinal membranes: An optical coherence tomography analysis integrated with assessment of retinal layers. Front Med (Lausanne) 2023; 9:1083601. [PMID: 36687460 PMCID: PMC9853170 DOI: 10.3389/fmed.2022.1083601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/16/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction Integrated analysis of retinal and choroidal morphologic and vascular features is urgently needed to examine whether and how these two elements interact with each other, thus contributing to visual impairment in patients with idiopathic epiretinal membranes (iERMs). Methods An observational retrospective study consisting of 181 patients diagnosed with unilateral iERM between August 2019 and July 2022 was carried out at Peking University Third Hospital. All patients underwent a standardized set of ophthalmologic examinations, including EDI-OCT and OCTA scanning, and were subsequently categorized into four stages according to current classification schemes based on their OCT findings. Altogether, 15 qualitative and quantitative parameters of both the retina (full-layer, inner and outer layers) and choroid were identified. Results The results revealed variations in the choroidal vascularity index (CVI) among different stages of iERMs (p < 0.001) for the first time. Distributions of retinal parameters across four stages of iERMs were validated. Correlation analysis between choroidal and retinal parameters showed that the CVI was associated with both inner and outer retinal morphologic biomarkers. Functional damage to retinal integrity was determined to be a strong contributor to visual acuity reduction in iERMs. Discussion This study complemented our present understanding of posterior segment structural and vascular alterations in iERMs.
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Affiliation(s)
- Xinglin Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Jiarui Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Changguan Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China,Changguan Wang,
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China,*Correspondence: Xuemin Li,
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Wang X, Yang J, Li Z, Hou Q, Wang C, Li X. Insights into the underlying choroid in different stages of idiopathic epiretinal membranes after Viteromacular surgery. Acta Ophthalmol 2022; 101:403-412. [PMID: 36408816 DOI: 10.1111/aos.15295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/22/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE The purpose of the study was to longitudinally investigate the correlation between choroidal morphologic and vascular parameters and postoperative visual outcome in different stages of idiopathic epiretinal membranes (iERMs). METHODS A prospective, observational, institutional case series of 102 consecutive patients diagnosed with unilateral iERMs were recruited at Peking University Third Hospital and were followed up for 12 months after surgical treatment with vitrectomy. Participants were classified into four stages according to current staging scheme. All eligible subjects underwent standardized imaging evaluation of choroidal parameters including subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), and choroidal capillary perfusion (CCP) at baseline and each follow-up by enhanced depth optical coherence tomography (EDI-OCT) and OCT angiography (OCTA). Longitudinal follow-up of choroidal parameters over 12 months was analysed, and their correlations with best-corrected visual acuity (BCVA) were also assessed for predictive prognostic value. RESULTS CVI and CCP were significantly correlated with BCVA at each follow-up examination (all p < 0.05). However, SFCT exhibited no variation among different stages of iERMs at baseline (p = 0.981) or during follow-up (p = 0.520). The preoperative CVI correlated with 12-month postoperative BCVA (p < 0.001) and its predictive prognostic effect on BCVA was validated in multiple regression analysis (p = 0.006). CONCLUSION CVI varied among different stages of iERM and was significantly correlated with visual outcomes after the surgery. CVI could serve as a predictive prognostic marker in iERMs, which further indicates the underlying choroid should be taken into consideration in clinical evaluation of iERMs.
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Affiliation(s)
- Xinglin Wang
- Department of Ophthalmology Peking University Third Hospital Beijing China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve Beijing China
| | - Jiarui Yang
- Department of Ophthalmology Peking University Third Hospital Beijing China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve Beijing China
| | - Zihan Li
- Department of Ophthalmology Peking University Third Hospital Beijing China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve Beijing China
| | - Qingyi Hou
- Department of Ophthalmology Peking University Third Hospital Beijing China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve Beijing China
| | - Changguan Wang
- Department of Ophthalmology Peking University Third Hospital Beijing China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve Beijing China
| | - Xuemin Li
- Department of Ophthalmology Peking University Third Hospital Beijing China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve Beijing China
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Brinkmann MP, Kibele NX, Prasuhn M, Kakkassery V, Toro MD, Ranjbar M, Grisanti S, Becker M, Rommel F. Evaluating Retinal and Choroidal Perfusion Changes after Isometric and Dynamic Activity Using Optical Coherence Tomography Angiography. Diagnostics (Basel) 2021; 11:diagnostics11050808. [PMID: 33947000 PMCID: PMC8146969 DOI: 10.3390/diagnostics11050808] [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: 03/30/2021] [Revised: 04/25/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
Optical coherence tomography angiography (OCTA) is a non-invasive tool for imaging and quantifying the retinal and choroidal perfusion state in vivo. This study aimed to evaluate the acute effects of isometric and dynamic exercise on retinal and choroidal sublayer perfusion using OCTA. A pilot study was conducted on young, healthy participants, each of whom performed a specific isometric exercise on the first day and a dynamic exercise the day after. At baseline and immediately after the exercise, heart rate (HR), mean arterial pressure (MAP), superficial capillary plexus perfusion (SCPP), deep capillary plexus perfusion (DCPP), choriocapillaris perfusion (CCP), Sattlers’s layer perfusion (SLP), and Haller’s layer perfusion (HLP) were recorded. A total of 34 eyes of 34 subjects with a mean age of 32.35 ± 7.87 years were included. HR as well as MAP increased significantly after both types of exercise. Both SCPP and DCPP did not show any significant alteration due to isometric or dynamic exercise. After performing dynamic exercise, CCP, SLP, as well as HLP significantly increased. Changes in MAP correlated significantly with changes in HLP after the dynamic activity. OCTA-based analysis in healthy adults following physical activity demonstrated a constant retinal perfusion, supporting the theory of autoregulatory mechanisms. Dynamic exercise, as opposed to isometric activity, significantly changed choroidal perfusion. OCTA imaging may represent a novel and sensitive tool to expand the diagnostic spectrum in the field of sports medicine.
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Affiliation(s)
- Max Philipp Brinkmann
- Department of Ophthalmology, Stadtspital Waid und Triemli Zürich, 8063 Zürich, Switzerland; (M.P.B.); (N.X.K.); (M.B.)
- Department of Ophthalmology, Klinikum Klagenfurt, A-9020 Klagenfurt, Austria
| | - Nikolas Xavier Kibele
- Department of Ophthalmology, Stadtspital Waid und Triemli Zürich, 8063 Zürich, Switzerland; (M.P.B.); (N.X.K.); (M.B.)
| | - Michelle Prasuhn
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
| | - Vinodh Kakkassery
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
| | - Mario Damiano Toro
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, 01815 Warsaw, Poland
- Correspondence: (M.D.T.); (F.R.); Tel.: +49-451-500-43952 (F.R.)
| | - Mahdy Ranjbar
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
| | - Salvatore Grisanti
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
| | - Matthias Becker
- Department of Ophthalmology, Stadtspital Waid und Triemli Zürich, 8063 Zürich, Switzerland; (M.P.B.); (N.X.K.); (M.B.)
- Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Felix Rommel
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
- Correspondence: (M.D.T.); (F.R.); Tel.: +49-451-500-43952 (F.R.)
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Bair H, Kung WH, Lai CT, Lin CJ, Chen HS, Chang CH, Lin JM, Hsia NY, Chen WL, Tien PT, Wu WC, Tsai YY. Preoperative Vision, Gender, and Operation Time Predict Visual Improvement After Epiretinal Membrane Vitrectomy: A Retrospective Study. Clin Ophthalmol 2021; 15:807-814. [PMID: 33658756 PMCID: PMC7917339 DOI: 10.2147/opth.s294690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/21/2021] [Indexed: 11/23/2022] Open
Abstract
Background To evaluate the efficacy of micro-incision vitrectomy surgery using a non-contact wide-angle viewing system for fovea-attached type epiretinal membrane, and to report the factors influencing the outcome. Methods A retrospective, comparative case series that included 50 patients with fovea-attached type epiretinal membrane who received micro-incision vitrectomy surgery using a non-contact wide-angle viewing system. Results All patients were followed-up for a minimum of 12 months. Seven cases were classified as group 1A (mainly outer retinal thickening), 17 were group 1B (more tenting of outer retina and distorted inner retina), and 26 were group 1C (prominent inner retina thickening and inward tenting of outer retina). Outcome measures included operation time, recurrent rate, postoperative BCVA, and CRT. The mean operative time was 26.2 minutes. The mean change of BCVA (LogMAR) was −0.43 (p< 0.001). The mean change of CRT was 135.3 μm (p< 0.001). The mean change of CRT was significantly higher in group 1C. Worse preoperative BCVA, male gender, and longer operative time can predict better postoperative BCVA found by multivariate logistic regression and multiple regression models. Conclusion Significant improvement in BCVA and CRT is noted after micro-incision vitrectomy surgery to operate fovea-attached type epiretinal membranes. Worse preoperative BCVA, male, and longer operation time could predict better improvement. These findings may assist surgeons in better evaluating the potential of this method to help their patients with epiretinal membranes.
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Affiliation(s)
- Henry Bair
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Stanford University School of Medicine, Stanford, CA, USA
| | - Wei-Hsun Kung
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Optometry, Asia University, Taichung, Taiwan
| | - Huan-Sheng Chen
- An-Shin Dialysis Center, NephroCare Ltd., Fresenius Medical Care, Taichung, Taiwan
| | - Cheng-Hsien Chang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Jane-Ming Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wen-Lu Chen
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Peng-Tai Tien
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Wen-Chuan Wu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Optometry, Asia University, Taichung, Taiwan
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9
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Influences of Central Bouquet Alterations on the Visual Outcome in Eyes Receiving Epiretinal Membrane Surgery. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11030926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Previous studies have shown that epiretinal membranes (ERMs) may be associated with abnormal outer retinal anatomy. However, long-term morphological and functional results of pars plana vitrectomy (PPV) with ERM and internal limiting membrane (ILM) peeling in eyes with central bouquet (CB) alterations have not yet been investigated. Methods: In a retrospective, consecutive study all patients underwent best corrected visual acuity (BCVA) testing and spectral domain optical coherence tomography (SD-OCT) before and after a mean of 20 months (range 3–70 months) postoperatively. CB abnormalities and ERMs were classified according to Govetto’s staging systems. Results: Of the 67 eyes, 22 (34%) showed CB abnormalities at baseline. The mean BCVA increased from 0.42 at baseline to 0.20 LogMAR at final follow-up (p < 0.001). Neither ERM stage (p = 0.06) nor CB stage (p = 0.939) at baseline were significant predictors of vision improvement following surgery. Conclusions: Our results show that baseline BCVA, but not classification of CB changes and ERM at baseline, seems to be a useful predictor for functional outcomes following PPV with ERM and ILM peeling in the long-term.
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Cacciamani A, Cosimi P, Ripandelli G, Di Nicola M, Scarinci F. Epiretinal Membrane Surgery: Structural Retinal Changes Correlate with the Improvement of Visual Function. J Clin Med 2020; 10:jcm10010090. [PMID: 33383922 PMCID: PMC7795238 DOI: 10.3390/jcm10010090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/22/2020] [Accepted: 12/25/2020] [Indexed: 12/02/2022] Open
Abstract
Several parameters have been studied for identifying the visual outcomes after pars plana vitrectomy (PPV) for epiretinal membrane (ERM) peeling. This retrospective study aimed to analyze structural retinal changes with spectral domain-optical coherence tomography (SD-OCT) and their correlations with visual acuity improvement in patients with ERM undergoing PPV. Twenty-one pseudophakic eyes were enrolled in the study. Ophthalmic evaluations included best corrected visual acuity (BCVA) and retinal layer thickness measurements with SD-OCT. The segmentation of the retina was divided into four parts: the inner retinal layer (IRL), composed of an internal limiting membrane, retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer; inner nuclear layer (INL); outer plexiform layer (OPL); and outer nuclear layer (ONL). Correlations between changes in retinal layer thicknesses and BCVA were explored over a 6 month follow-up period. The postoperative thickness decrease of the INL was significantly correlated with thickness changes in all other measured retinal layers (p < 0.001). Non-parametric linear regression showed that postoperative improvement in BCVA was associated with a postoperatively decreased thickness in the IRL (p = 0.021), INL (p = 0.039), and OPL (p = 0.021). In eyes undergoing PPV, postoperative thickness decreases of the IRL, INL, and OPL were correlated with visual acuity improvements. Re-compaction of these retinal layers after relieving ERM-induced traction may be an important factor in postoperative visual function improvement.
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Affiliation(s)
- Andrea Cacciamani
- IRCCS Fondazione Bietti, Via Livenza 3/5, 00198 Rome, Italy; (A.C.); (P.C.); (G.R.)
| | - Pamela Cosimi
- IRCCS Fondazione Bietti, Via Livenza 3/5, 00198 Rome, Italy; (A.C.); (P.C.); (G.R.)
| | - Guido Ripandelli
- IRCCS Fondazione Bietti, Via Livenza 3/5, 00198 Rome, Italy; (A.C.); (P.C.); (G.R.)
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy;
| | - Fabio Scarinci
- IRCCS Fondazione Bietti, Via Livenza 3/5, 00198 Rome, Italy; (A.C.); (P.C.); (G.R.)
- Correspondence: ; Tel.: +39-068-535-6727; Fax: +39-068-535-2333
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Rommel F, Lüken S, Prasuhn M, Kurz M, Kakkassery V, Grisanti S, Ranjbar M. Evaluating Retinal and Choroidal Perfusion Changes After Ocular Massage of Healthy Eyes Using Optical Coherence Tomography Angiography. ACTA ACUST UNITED AC 2020; 56:medicina56120645. [PMID: 33255873 PMCID: PMC7761025 DOI: 10.3390/medicina56120645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/08/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
Background and objectives: Ocular massage (OM) is used as a treatment option for acute retinal artery occlusion, under the assumption that it induces vessel dilatation and enhances perfusion. Since evidence of ocular perfusion alteration due to OM is lacking, we investigate the impact of OM on the hemodynamics of the posterior pole in healthy eyes in a noninvasive fashion by using optical coherence tomography angiography (OCTA). Materials and Methods: A prospective study was conducted on healthy volunteers, each of whom underwent measurements of intraocular pressure (IOP), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), radial peripapillary capillary perfusion (RPCP), superficial capillary plexus perfusion (SCPP), deep capillary plexus perfusion (DCPP), choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP) and Haller’s layer perfusion (HLP) before and after OM. OM was performed for 2 min, consisting of 10-s turns of compression and decompression of the globe. Results: A total of 21 eyes from 21 participants (median age 29) were included. After OM, IOP significantly declined (p < 0.001), while SFCT (p < 0.005), SCPP (p < 0.001), DCPP (p = 0.004) and CCP (p = 0.008) significantly increased. CMT, RPCP, SLP and HLP did not show any significant alteration due to OM. Changes in SCPP correlated positively with changes in CCP and vice versa. Conclusions: OCTA-based analysis in healthy adults following OM demonstrated a significant increase of retinal perfusion values, assumed to be due to failure of autoregulatory mechanisms. These findings may indicate a positive effect of OM as a treatment option for patients with acute retinal artery occlusion.
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Lin GC, Lin HS, Horng YH, Chu HC, Sheu SJ. Intraocular pressure might play a role in the surgical management of patients with epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2020; 258:2691-2699. [PMID: 32734468 DOI: 10.1007/s00417-020-04870-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] [Received: 04/21/2020] [Revised: 07/02/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To investigate the prognostic factors and visual outcomes for patients with epiretinal membrane after pars plana vitrectomy and possible interactions between multiple factors. METHODS A retrospective chart review of adult patients with epiretinal membrane treated with pars plana vitrectomy performed by a single surgeon between February 1, 2015, and January 31, 2017 was conducted. The surgical procedures included standard 25-gauge vitrectomy with peeling of the epiretinal membrane and internal limiting membrane (ILM). Factors including age, sex, vision, intraocular pressure (IOP), lens status, and baseline optical coherence tomography angiography were analyzed to determine any association with visual outcomes. IOP and lens status were evaluated at every visit point and were used for analysis. RESULTS Visual changes after pars plana vitrectomy in patients with epiretinal membrane were significantly associated with time, lens status, baseline ellipsoid zone integrity, baseline vision, baseline parafoveal vessel density of superficial capillary plexus (SPVD), and IOP. Further investigation using Johnson-Neyman analysis revealed that vision improved over time, especially in pseudophakic eyes. High IOP at baseline or during follow-up was identified as a significant factor associated with limited visual improvement. CONCLUSION Our study showed that vision improved over time after vitrectomy for patients with epiretinal membrane. The surgical outcomes are more stable in pseudophakic eyes, and vision improved after cataract extraction in phakic eyes. IOP should be managed and monitored closely to optimize surgical and visual outcomes in patients.
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Affiliation(s)
- Guan-Chyun Lin
- Department of Information Technology and Management, Fooyin University, Kaohsiung, Taiwan
| | - Huey-Shyan Lin
- Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan
| | - Yu-Harn Horng
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hui-Chen Chu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Rd., Sanmin District, Kaohsiung City, 80756, Taiwan
| | - Shwu-Jiuan Sheu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Rd., Sanmin District, Kaohsiung City, 80756, Taiwan. .,School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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