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Hoyek S, Lu Y, Mukai S, Patel NA. Longitudinal Characteristics of Choroidal Neovascular Membrane in Pediatric Patients. Am J Ophthalmol 2024; 261:76-84. [PMID: 38195046 DOI: 10.1016/j.ajo.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/24/2023] [Accepted: 01/01/2024] [Indexed: 01/11/2024]
Abstract
PURPOSE To report the clinical and imaging characteristics, including optical coherence tomography angiography (OCTA), and treatment outcomes of choroidal neovascular membranes (CNVMs) in children. DESIGN Retrospective clinical cohort study. METHODS Thirty eyes from 25 children (56% girls) with CNVM from 2 centers were examined from 2005 to 2022. Clinical features, imaging findings, treatment regimens, and outcomes are described. RESULTS The most common causes of CNVM were idiopathic (48%) and inflammatory (20%). At diagnosis, most CNVMs were unilateral (80%), active (83.3%), and juxtafoveal (46.7%). Twenty-five eyes (83.3%) of 21 patients (84%) were treated. The most common first-line treatment was intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) (92%), with a retreatment rate of 52.2% at an average of 237 days. The average number of total injections per eye was 2.3. Injections were safely administered in the clinic (52.2%). A gain of 3 lines or 15 ETDRS (Early Treatment Diabetic Retinopathy Study) letters was observed at final visit. The average duration of follow-up was 56.46 ± 42.51 months. No ocular or systemic complication related to treatment was reported. Sixteen eyes (64%) had OCTA images at both presentation and final visit, which showed a decrease in CNVM vessel density and vessel-length density, and in the height of retinal pigment epithelium detachment (RPED). CONCLUSIONS There are a variety of underlying etiologies for pediatric CNVMs, which are most often unilateral. Treatment with intravitreal anti-VEGF can be beneficial and does not often require frequent or chronic dosing. OCTA demonstrated a decrease in the CNVM vessel density and vessel-length density as well as in the height of RPED.
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Affiliation(s)
- Sandra Hoyek
- From the Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Yifan Lu
- From the Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Shizuo Mukai
- From the Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Nimesh A Patel
- From the Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
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2
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Li H, Li Z, Mao A, Dong P, Wang W. A case report: co-occurrence of probable Vogt-Koyanagi-Harada disease and diabetic retinopathy. BMC Ophthalmol 2024; 24:148. [PMID: 38566041 PMCID: PMC10985950 DOI: 10.1186/s12886-024-03410-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/24/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Bilateral retinal detachment and choroidal detachment in a patient are rare occurrences. The presence of bilateral diabetic retinopathy (DR) in such a case is even rarer and complicates the condition. CASE PRESENTATION In this study, we document a case of unconventional VKH. Manifestations in this patient included intense peripheral retinal detachment and choroidal detachment, along with vitreous opacities akin to cotton wool spots, concurrent with DR. The diagnosis was considered as probable VKH with DR. Treatment according to VKH protocols, including high-dose corticosteroids, yielded positive results. CONCLUSIONS VKH can co-occurrence with DR. VKH manifestations vary, and early, aggressive, and long-term treatment is essential. The complexity of treatment increases with concurrent DR, necessitating the use of immunosuppressants.
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Affiliation(s)
- Huan Li
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China
| | - Zhiyong Li
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China
| | - Ailing Mao
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China
| | - Ping Dong
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China
| | - Wei Wang
- Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, No.399, Quanbei East Street, 54000, Xingtai, Hebei Province, China.
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3
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Chang YC, Tsao YT, Wang CT, Hwang YS, Chou HD. Concomitant methicillin-resistant Staphylococcus aureus scleral buckle infection and acute retinal necrosis: A case report. J Fr Ophtalmol 2024; 47:104110. [PMID: 38431518 DOI: 10.1016/j.jfo.2024.104110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/24/2023] [Accepted: 12/12/2023] [Indexed: 03/05/2024]
Affiliation(s)
- Y-C Chang
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing St., Gueishan Dist., Taoyuan City 333, Taiwan
| | - Y-T Tsao
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing St., Gueishan Dist., Taoyuan City 333, Taiwan
| | - C-T Wang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing St., Gueishan Dist., Taoyuan City 333, Taiwan
| | - Y-S Hwang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing St., Gueishan Dist., Taoyuan City 333, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - H-D Chou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing St., Gueishan Dist., Taoyuan City 333, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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4
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Ouonnébo L, Nouira C, Jean-Charles A, Bonnafous M, Merle H. [Spontaneously reattached bilateral retinal detachment in Stickler syndrome]. J Fr Ophtalmol 2024; 47:104047. [PMID: 38387391 DOI: 10.1016/j.jfo.2023.104047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/09/2023] [Indexed: 02/24/2024]
Affiliation(s)
- L Ouonnébo
- Service d'ophtalmologie, centre hospitalier universitaire de Martinique, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort de France cedex, Martinique, France.
| | - C Nouira
- Service d'ophtalmologie, centre hospitalier universitaire de Martinique, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort de France cedex, Martinique, France
| | - A Jean-Charles
- Service d'ophtalmologie, centre hospitalier universitaire de Martinique, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort de France cedex, Martinique, France
| | - M Bonnafous
- Service d'ophtalmologie, centre hospitalier universitaire de Martinique, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort de France cedex, Martinique, France
| | - H Merle
- Service d'ophtalmologie, centre hospitalier universitaire de Martinique, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort de France cedex, Martinique, France
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Choi G, An SH, Choi JW, Rho MS, Park WC, Jeong WJ, Cha HJ. Injectable alginate-based in situ self-healable transparent hydrogel as a vitreous substitute with a tamponading function. Biomaterials 2024; 305:122459. [PMID: 38199216 DOI: 10.1016/j.biomaterials.2023.122459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/24/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024]
Abstract
Retinal detachment and other vision-threatening disorders often necessitate vitreous body removal and tamponade injection for retina stabilization. Current clinical tamponades such as silicone oil and expansile gases have drawbacks, including patient discomfort and the need for secondary surgery. We introduce a transparent alginate-phenylboronic acid/polyvinyl alcohol composite hydrogel (TALPPH) as a novel vitreous substitute with tamponading capabilities. In vitro physicochemical, rheological, and optical characterization of in situ self-healable TALPPH was performed, and long-term biocompatibility was assessed in a rabbit model of vitrectomy retinal detachment. In vivo evaluations confirmed TALPPH's ability to inhibit retinal detachment recurrence and preserve rabbit vision without adverse effects. TALPPH's close resemblance to the natural vitreous body suggests potential as a vitreous tamponade substitute for future ophthalmological applications.
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Affiliation(s)
- Geunho Choi
- Department of Chemical Engineering, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Seoung Hyun An
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Jae-Won Choi
- Department of Ophthalmology, Sungmo Eye Hospital, Busan 48064, Republic of Korea
| | - Mee Sook Rho
- Department of Pathology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Woo Chan Park
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Woo Jin Jeong
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea.
| | - Hyung Joon Cha
- Department of Chemical Engineering, Pohang University of Science and Technology, Pohang 37673, Republic of Korea; Medical Science and Engineering, School of Convergence Science and Technology, Pohang University of Science and Technology, Pohang 37673, Republic of Korea.
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6
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Bayraktar S, Acar A, Şekeroğlu MA. A Rare Association: Neovascular Glaucoma Accompanying Anterior Chamber Synchysis Scintillans. Turk J Ophthalmol 2024; 54:49-51. [PMID: 38008935 PMCID: PMC10895167 DOI: 10.4274/tjo.galenos.2023.39016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023] Open
Abstract
Synchysis scintillans, also known as cholesterolosis bulbi, is a degenerative eye pathology characterized by the accumulation of cholesterol crystals in the vitreous. It is typically observed bilaterally but can rarely be unilateral. It can be triggered by severe trauma, chronic inflammation, chronic retinal detachment, hyphema, vitreous hemorrhage, Coats’ disease, and retinoblastoma. In this report, we present a case with an uncommon association of anterior chamber synchysis scintillans and neovascular glaucoma.
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Affiliation(s)
| | - Atakan Acar
- Etlik City Hospital, Clinic of Ophthalmology, Ankara, Türkiye
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7
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Casswell EJ, Cro S, Cornelius VR, Banerjee PJ, Zvobgo TM, Tudor Edwards R, Ezeofor V, Anthony B, Shahid SM, Bunce C, Kelly J, Murphy C, Robertson E, Charteris D. Randomised controlled trial of adjunctive triamcinolone acetonide in eyes undergoing vitreoretinal surgery following open globe trauma: The ASCOT study. Br J Ophthalmol 2024; 108:440-448. [PMID: 36849205 DOI: 10.1136/bjo-2022-322787] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND/AIMS To investigate the clinical effectiveness of adjunctive triamcinolone acetonide (TA) given at the time of vitreoretinal surgery following open globe trauma (OGT). METHODS A phase 3, multicentre, double-masked randomised controlled trial of patients undergoing vitrectomy following OGT comparing adjunctive TA (intravitreal and subtenons) against standard care (2014-2020). The primary outcome was the proportion of patients with at least 10 Early Treatment Diabetic Retinopathy Study (ETDRS) letter improvement in corrected visual acuity (VA) at 6 months. Secondary outcomes included: change in ETDRS, retinal detachment (RD) secondary to PVR, retinal reattachment, macular reattachment, tractional RD, number of operations, hypotony, elevated intraocular pressure and quality of life. RESULTS 280 patients were randomised over 75 months, of which 259 completed the study. 46.9% (n=61/130) of patients in the treatment group had a 10-letter improvement in VA compared with 43.4% (n=56/129) of the control group (difference 3.5% (95% CI -8.6% to 15.6%), OR=1.03 (95% CI 0.61 to 1.75), p=0.908)). Secondary outcome measures also failed to show any treatment benefit. For two of the secondary outcome measures, stable complete retinal and macular reattachment, outcomes were worse in the treatment group compared with controls, respectively, 51.6% (n=65/126) vs 64.2% (n=79/123), OR=0.59 (95% CI 0.36 to 0.99), and 54.0% (n=68/126) vs 66.7% (n=82/123), OR=0.59 (95% CI 0.35 to 0.98), for TA vs control. CONCLUSION The use of combined intraocular and sub-Tenons capsule TA is not recommended as an adjunct to vitrectomy surgery following OGT. TRIAL REGISTRATION NUMBER NCT02873026.
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Affiliation(s)
- Edward J Casswell
- Sussex Eye Hospital, Brighton, UK
- Ophthalmology, University Hospitals Sussex NHS Foundation Trust, Worthing, UK
- Vitreoretinal Department, Moorfields Eye Hospital, London, UK
| | - Suzie Cro
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | | | - Philip J Banerjee
- Vitreoretinal Department, Moorfields Eye Hospital, London, UK
- Ophthalmology, Frimley Health NHS Foundation Trust, Frimley, UK
| | - Tapiwa M Zvobgo
- Vitreoretinal Department, Moorfields Eye Hospital, London, UK
- NIHR Moorfields Biomedical Research Centre, London, UK
| | | | - Victory Ezeofor
- Centre for Health Economics & Medicines Evaluation, Bangor University, Bangor, UK
| | - Bethany Anthony
- Centre for Health Economics & Medicines Evaluation, Bangor University, Bangor, UK
| | - Syed Mohammed Shahid
- Vitreoretinal Department, Moorfields Eye Hospital, London, UK
- Ophthalmology, William Harvey Hospital, East Kent University Hospitals NHS Trust, UK
| | - Catey Bunce
- RM CTU, Royal Marsden Hospital NHS Trust, London, UK
| | - Joanna Kelly
- King's Clinical Trials Unit, King's College London, London, UK
| | - Caroline Murphy
- King's Clinical Trials Unit, King's College London, London, UK
| | | | - David Charteris
- Vitreoretinal Department, Moorfields Eye Hospital, London, UK
- NIHR Moorfields Biomedical Research Centre, London, UK
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Govetto A, Sebag J, Lucchini S, Ballabio C, Matteucci M, Ranno S, Carini E, Virgili G, Bacherini D, Radice P. IMAGING RHEGMATOGENOUS RETINAL LESIONS AND PERIPHERAL VITREORETINAL INTERFACE WITH WIDEFIELD OPTICAL COHERENCE TOMOGRAPHY. Retina 2024; 44:269-279. [PMID: 37856780 DOI: 10.1097/iae.0000000000003946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
PURPOSE Analyze the peripheral vitreoretinal interface with widefield optical coherence tomography. METHODS Retrospective chart analysis and widefield optical coherence tomography in 120 consecutive cases of rhegmatogenous pathology. RESULTS There were 166 lesions in 120 eyes, including 106 horseshoe tears, 22 operculated holes, 30 nonoperculated holes, six giant tears, and two peripheral lamellar defects followed for 6.1 ± 1.2 months. Posterior vitreous detachment was present in all eyes (101/101, 100%) with tears and operculated holes, but only in 5/19 eyes (26.3%) with nonoperculated holes ( P < 0.001). Axial vitreous traction was evident at the anterior edge of horseshoe tears (106/106, 100%), but not the posterior border (18/106, 17%, P < 0.001). Operculated holes located posterior to the vitreous base were free from vitreous traction, displaying a morphology similar to the macular hole. Nonoperculated holes were farther anterior with signs of tangential traction in 23/30 (76.7%) cases. Peripheral vitreoschisis was more often associated with nonoperculated holes (25/30, 83.3%), than horseshoe tears (17/106, 16%; P < 0.001). Horseshoe tears and nonoperculated holes were more often associated with retinal detachment (58/106 [54.7%] and 15/30 [50%], respectively) than operculated holes (5/22, 22.7%), P = 0.023. CONCLUSION Peripheral vitreoretinal interactions are similar to vitreomaculopathies, with axial and vitreoschisis-related tangential traction playing different roles in different rhegmatogenous pathologies. Peripheral optical coherence tomography improves understanding of pathophysiology and risks of retinal detachment.
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Affiliation(s)
- Andrea Govetto
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - J Sebag
- Doheny Eye Institute, UCLA, Pasadena, California
- Department of Ophthalmology, Geffen School of Medicine, UCLA, Los Angeles, California
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California; and
| | - Sara Lucchini
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
- Doheny Eye Institute, UCLA, Pasadena, California
- Department of Ophthalmology, Geffen School of Medicine, UCLA, Los Angeles, California
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California; and
- Ophthalmology Department, Careggi University Hospital, University of Florence, Florence, Italy
| | - Chiara Ballabio
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - Martina Matteucci
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - Stefano Ranno
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - Elisa Carini
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
| | - Gianni Virgili
- Ophthalmology Department, Careggi University Hospital, University of Florence, Florence, Italy
| | - Daniela Bacherini
- Ophthalmology Department, Careggi University Hospital, University of Florence, Florence, Italy
| | - Paolo Radice
- Department of Ophthalmology, VR Division, Circolo and Macchi Foundation Hospital, ASST-Settelaghi, Varese, Italy
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Bomdica PR, MacCumber MW, Abdel-Hadi S, Parker M, Minaker S. Surgical Outcomes of Rhegmatogenous Retinal Detachment and Fellow Eye Involvement in Adolescent and Young Adult Patients. Ophthalmol Retina 2024; 8:148-154. [PMID: 37716430 DOI: 10.1016/j.oret.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/30/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE To investigate the associations, fellow eye retinal tear or detachment, and surgical outcomes of rhegmatogenous retinal detachments (RRDs) in young adults. DESIGN Retrospective consecutive case series. SUBJECTS Patients aged ≤ 30 years who underwent surgical repair for RRD between 2014 and 2021 at a single practice. The mean age was 23.85 years (range, 12-30 years). METHODS Data collected included demographics, preoperative clinical features of the RRD, visual acuity (VA), type of surgery performed, anatomic outcomes, OCT findings, fellow eye retinal tear or detachment, and postoperative complications. MAIN OUTCOME MEASURES Postoperative VA and single-surgery anatomic success rate. RESULTS One hundred one patients (109 eyes) were included. Sixty-seven patients (74 eyes) and 17 patients (19 eyes) were followed for ≥ 1 year and 5 years, respectively. The most common associations were myopia (66 eyes, 60.6%), trauma (8 eyes, 7.3%), and prior ocular surgery (7 eyes, 6.4%). Median preoperative Snellen VA was 20/70. The macula was attached in 31 eyes. Scleral buckle (SB) alone was performed in 75 eyes, pars plana vitrectomy (PPV) + SB was performed in 27 eyes, PPV alone was performed in 6 eyes, and cryotherapy with pneumatic retinopexy was performed in 1 patient. Single-surgery anatomical success was 88.7% for SB, 89.7% for PPV + SB, and 75% for PPV. The median final postoperative Snellen VA was 20/50. Twelve patients presented with bilateral RRDs, and sequential surgery was performed in 8 patients, followed by 4 patients who underwent surgery with fellow eye laser barricade. Fourteen patients (13.9%) developed a retinal tear or detachment in the fellow eye, with a mean interval of 8 months from presentation. Of the 17 patients who were followed for ≥ 5 years, 3 patients (17.6%) developed a fellow eye retinal tear or detachment. After initial anatomical success, 6 eyes (5.5%) developed proliferative vitreoretinopathy. CONCLUSIONS The most common association of RRD in this study was myopia. Scleral buckle alone was the most common surgical intervention. However, outcomes were generally favorable with SB-only and PPV + SB. Surgeons and patients should be aware of the risk of bilateral retinal detachment and the risk of fellow eye retinal tear and detachment. These patients require long-term surveillance in both eyes. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Prithvi R Bomdica
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois
| | - Mathew W MacCumber
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois; Illinois Retina Associates, Chicago, Illinois
| | - Sarah Abdel-Hadi
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois
| | - Makena Parker
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois
| | - Samuel Minaker
- Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois; Illinois Retina Associates, Chicago, Illinois.
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Curran CD, Adams OE, Vagaggini T, Sodhi GS, Prairie ML, Baker MJ, Sastry A, Ryan EH, Parke DW, Mittra RA, Dev S, Tang PH. PROPHYLACTIC TREATMENT OF LATTICE DEGENERATION IN FELLOW EYES AFTER REPAIR OF UNCOMPLICATED PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT. Retina 2024; 44:63-70. [PMID: 37536462 DOI: 10.1097/iae.0000000000003908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
PURPOSE To evaluate prophylactic treatment (PTx) of lattice degeneration (LD) on retinal tear (RT) and rhegmatogenous retinal detachment (RRD) risk in fellow eyes of patients after primary RRD repair in the first eye. METHODS This was a consecutive case series with cohort control involving patients with RRD repair from January 1, 2013, through December 31, 2017. Patients received PTx (PTx cohort) or no PTx (No-PTx cohort) in fellow eye with 5-year follow-up. Primary outcome measure was proportion with new fellow eye RT/RRD. Secondary outcomes included logarithm of minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) and status of myopia, posterior vitreous detachment, and pseudophakia. RESULTS Four hundred ninety-eight patients were divided into 146 and 352 in PTx and No-PTx cohorts, respectively. PTx cohort developed significantly ( P < 0.05) fewer RT/RRD (17%) than No-PTx cohort (41%). PTx significantly ( P < 0.05) lowered RT/RRD irrespective of posterior vitreous detachment and myopia status. PTx patients undergoing phacoemulsification demonstrated significantly ( P < 0.05) less RT/RRD (22%) than No-PTx cohort (31%). There was no significant ( P = 0.96) final BCVA difference between PTx (median = 0 logMAR) and No-PTx (median = 0 logMAR) cohorts. CONCLUSION PTx of asymptomatic fellow eye LD reduced RT/RRD risk.
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Affiliation(s)
- Christian D Curran
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Olufemi E Adams
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | | | | | | | - Mikayla J Baker
- University of Minnesota Medical School, Minneapolis, Minnesota; and
| | - Ananth Sastry
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Edwin H Ryan
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota Medical School, Minneapolis, Minnesota
- Retina Consultants of Minnesota, Edina, Minnesota
| | - David Wilkin Parke
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota Medical School, Minneapolis, Minnesota
- Retina Consultants of Minnesota, Edina, Minnesota
| | - Robert A Mittra
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota Medical School, Minneapolis, Minnesota
- Retina Consultants of Minnesota, Edina, Minnesota
| | - Sundeep Dev
- Retina Consultants of Minnesota, Edina, Minnesota
| | - Peter H Tang
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota Medical School, Minneapolis, Minnesota
- Retina Consultants of Minnesota, Edina, Minnesota
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11
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Hsieh YT, Yang CM. Vitreomacular traction in diabetic retinopathy. Jpn J Ophthalmol 2024; 68:12-18. [PMID: 38001367 DOI: 10.1007/s10384-023-01034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/22/2023] [Indexed: 11/26/2023]
Abstract
PURPOSE Vitreomacular traction (VMT) has unique presentations in eyes with diabetic retinopathy (DR). This study aimed to investigate the characteristics and clinical course of VMT in DR. STUDY DESIGN A retrospective case series. METHODS Thirty eyes from 30 patients with DR and concurrent VMT were retrospectively enrolled. Baseline and final best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) characteristics were reported. Linear regression models were used to analyze the correlating factors for visual outcome. RESULTS Of the 30 eyes, a thickened posterior hyaloid membrane was noted in all cases and multi-layered traction from different directions in 14 eyes (46.7%). Twenty-one eyes (70%) had tractional macular retinoschisis, seven (23.3%) had foveal detachment, five (16.7%) had a lamellar macular hole, and three (10%) had a full-thickness macular hole, including two with macular hole retinal detachment. Three eyes had spontaneous release of the VMT within 3 months of observation. For the remaining 27 eyes receiving operations, the VMT, full-thickness macular hole, and serous foveal detachment all resolved postoperatively with residual macular schisis in 6 eyes (22.2%) only. None of the baseline OCT characteristics were associated with postoperative BCVA (P > .05). CONCLUSIONS VMT in DR had a thickened posterior hyaloid, and many of them had multi-layered traction and/or concurrent macular retinoschisis. Lamellar macular hole, full-thickness macular hole, or concurrent retinal detachment may also occur. Spontaneous resolution of VMT rarely occurred, and those who underwent operation for VMT had improved vision and macular structures with resolution of the macular hole and retinal detachment.
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Affiliation(s)
- Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, 7 Zhongshan S. Rd., Zhongzheng Dist., Taipei, 10002, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, 7 Zhongshan S. Rd., Zhongzheng Dist., Taipei, 10002, Taiwan.
- College of Medicine, National Taiwan University, Taipei, Taiwan.
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12
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Anjou M, Rothschild PR, Bernabei F, Azan F, Brezin AP, Lehmann M. MACULAR ATROPHY AFTER MACULAR HOLE SURGERY ASSISTED BY MEMBRANE BLUE DUAL: A CASE SERIES. Retin Cases Brief Rep 2024; 18:124-128. [PMID: 36007253 DOI: 10.1097/icb.0000000000001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE The aim of this study is to describe the clinical and multimodal imaging findings in patients with macular atrophy after macular hole surgery assisted by Membrane Blue Dual. METHOD This study is a monocenter, retrospective, observational case series that included patients who presented with macular atrophy following macular hole surgery. RESULTS Among the patients included in this study, four were operated for idiopathic macular hole and one for total retinal detachment associated with macular hole. In all patients, the internal limiting membrane was brittle and adherent, and multiple stains were required. One month postoperatively, all patients showed a reduced visual acuity except the patient with total retinal detachment. At fundus examination all patients showed patchy atrophy with a mottled hypopigmented and hyperpigmented appearance in the macular region. Optical coherence tomography scans demonstrated a closed macular hole with retinal thinning, disruption of the external retinal layers, and irregular retinal pigment epithelium thickening. Fundus autofluorescence showed a well-defined area of both hypoautofluorescence and hyperautofluorescence involving the macular area. CONCLUSION Macular atrophy after Membrane Blue Dual-assisted internal limiting membrane peeling represents a severe complication that vitreoretinal surgeons should be aware of and that should be taken into account in preoperative evaluation and surgical procedure planning. To reduce the risk of this complication, we recommend to ensure the best conditions of visibility, to reduce as much as possible the intensity and the distance of the endoillumination from the retina, and to use as little dye as possible.
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Affiliation(s)
- Mickael Anjou
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
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13
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Hsin-Pei L, Cherng-Ru H. Ultra-widefield fundus image of an oculocutaneous albinism patient with rhegmatogenous retinal detachment. J Fr Ophtalmol 2024; 47:103974. [PMID: 37845139 DOI: 10.1016/j.jfo.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 10/18/2023]
Affiliation(s)
- L Hsin-Pei
- Tri-Service General Hospital, Chenggong Rd, Neihu District, Taipei City 114, Taïwan
| | - H Cherng-Ru
- Tri-Service General Hospital, Chenggong Rd, Neihu District, Taipei City 114, Taïwan.
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14
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Teng Y, Zhang X. Temporal inverted internal limiting membrane flap technique for myopic macular hole retinal detachment reconstruction. J Int Med Res 2024; 52:3000605231223635. [PMID: 38235655 PMCID: PMC10798096 DOI: 10.1177/03000605231223635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE To examine the effects of the temporal inverted internal limiting membrane (ILM) flap technique for foveal reconstruction in patients with highly myopic macular hole-associated retinal detachment (MHRD). METHODS A retrospective case series analysis of four patients (four eyes) with MHRD was conducted. The foveal optical coherence tomography changes following treatment using the temporal inverted ILM flap technique were evaluated. RESULTS In Patient 1, the ILM bridged the macular hole and residual subretinal fluid on postoperative day 6, and complete retinal reattachment was achieved at 19 months. Patient 2 exhibited reduced retinal detachment, with visible ILM inversion and macular hole closure after 14 days. In Patient 3, macular hole closure and fovea formation had occurred by day 25, and the ILM flap was visible. At 2 months, the outer collagenous layer connection in the central fovea and recovery of the external limiting membrane and ellipsoid zone were observed. Patient 4 had a "white hole" MHRD, with macular hole closure achieved on postoperative day 20, albeit with a suboptimal foveal shape. CONCLUSION The temporal inverted ILM flap technique in conjunction with vitrectomy facilitates foveal reconstruction in patients with successful treatment of MHRD, and this reconstruction process can be observed by optical coherence tomography.
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Affiliation(s)
- Yan Teng
- Department of Ophthalmology, Harbin Bright Eye Hospital, Harbin, China
| | - Xiaoyu Zhang
- Department of Ophthalmology, Harbin Bright Eye Hospital, Harbin, China
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15
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Stanbury K, Stavinohova R, Pettitt L, Dixon C, Schofield EC, Mclaughlin B, Pettinen I, Lohi H, Ricketts SL, Oliver JA, Mellersh CS. Multiocular defect in the Old English Sheepdog: A canine form of Stickler syndrome type II associated with a missense variant in the collagen-type gene COL11A1. PLoS One 2023; 18:e0295851. [PMID: 38153936 PMCID: PMC10754463 DOI: 10.1371/journal.pone.0295851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
Multiocular defect has been described in different canine breeds, including the Old English Sheepdog. Affected dogs typically present with multiple and various ocular abnormalities. We carried out whole genome sequencing on an Old English Sheepdog that had been diagnosed with hereditary cataracts at the age of five and then referred to a board-certified veterinary ophthalmologist due to owner-reported visual deterioration. An ophthalmic assessment revealed that there was bilateral vitreal degeneration, macrophthalmos, and spherophakia in addition to cataracts. Follow-up consultations revealed cataract progression, retinal detachment, uveitis and secondary glaucoma. Whole genome sequence filtered variants private to the case, shared with another Old English Sheepdog genome and predicted to be deleterious were genotyped in an initial cohort of six Old English Sheepdogs (three affected by multiocular defect and three control dogs without evidence of inherited eye disease). Only one of the twenty-two variants segregated correctly with multiocular defect. The variant is a single nucleotide substitution, located in the collagen-type gene COL11A1, c.1775T>C, that causes an amino acid change, p.Phe1592Ser. Genotyping of an additional 14 Old English Sheepdogs affected by multiocular defect revealed a dominant mode of inheritance with four cases heterozygous for the variant. Further genotyping of hereditary cataract-affected Old English Sheepdogs revealed segregation of the variant in eight out of nine dogs. In humans, variants in the COL11A1 gene are associated with Stickler syndrome type II, also dominantly inherited.
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Affiliation(s)
- Katherine Stanbury
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Louise Pettitt
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Ellen C. Schofield
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Bryan Mclaughlin
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Inka Pettinen
- Department of Veterinary Biosciences, Department of Medical and Clinical Genetics, University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - Hannes Lohi
- Department of Veterinary Biosciences, Department of Medical and Clinical Genetics, University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - Sally L. Ricketts
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Cathryn S. Mellersh
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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16
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Kao CC, Chen KJ, Cheng KC. Application of intravitreal aflibercept to treat bilateral exudative retinal detachment secondary to retinitis pigmentosa: Case report and review of literature. Medicine (Baltimore) 2023; 102:e36589. [PMID: 38134121 PMCID: PMC10735078 DOI: 10.1097/md.0000000000036589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/21/2023] [Indexed: 12/24/2023] Open
Abstract
RATIONALE Exudative retinal detachment with macular edema is one of the complications of retinitis pigmentosa (RP). In this report, we present a case who treated with intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) in RP-related exudative retinal detachment and subsequently improved with favorable outcome. PATIENT CONCERN A 49-year-old man, with a history of RP, had persistent blurred vision and was newly diagnosed with bilateral shallow exudative retinal detachment and macular edema. DIAGNOSIS Fluorescein angiography showed bilateral diffuse dye leakage with macular pooling, and systemic survey excluded the possibility of infection or autoimmune disease. INTERVENTIONS The patient was treated with intravitreal injection of aflibercept, one of the anti-VEGF agents, for bilateral eyes. Recurrent exudative retinal detachment and macular edema were noted, and repeated intravitreal injections of aflibercept in bilateral eyes were then arranged. Subsequently, bilateral macular edema and exudative retinal detachment subsided again, and the treatment course lasted for approximately 1 year. OUTCOMES After 1 year, the exudative retinal detachment with macular edema was much improved. In the meanwhile, visual functional improvement was also achieved. LESSONS This case illustrated the possibility of intravitreal injection of anti-VEGF therapy for the treatment of this rare complication of RP, and it may be a newly explored alternative treatment.
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Affiliation(s)
- Chia-Chen Kao
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuo-Jen Chen
- Department of Ophthalmology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Kai-Chun Cheng
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Ophthalmology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
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17
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Voide N, Kaeser PF. [Outbreak of myopia in pediatrics : management, prevention and treatment]. Rev Med Suisse 2023; 19:2407-2411. [PMID: 38117111 DOI: 10.53738/revmed.2023.19.855.2407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
The worldwide incidence and prevalence of myopia has increased. The age of onset of this refractive disorder has inversely decreased. In addition to genetic and familial factors, environmental factors related to a sedentary lifestyle and activities in highly solicited near vision seem to have an impact on the development of axial myopia, that is an early and non-reversible elongation of the eyeball. Prevention of the development of myopia in pediatrics through simple daily measures plays therefore a fundamental role. In addition, pharmacological treatments, and specific optical treatments for controlling myopia have shown encouraging results in reducing the risk of long-term complications of progressive myopia, that is increased risk of developing cataract, glaucoma, retinal detachment, or maculopathy.
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Affiliation(s)
- Nathalie Voide
- MER, Unité de strabologie et d'ophtalmologie pédiatrique, Service d'ophtalmologie, Université de Lausanne, Hôpital ophtalmique Jules-Gonin, 1002 Lausanne
| | - Pierre-François Kaeser
- PD, MER, Unité de strabologie et d'ophtalmologie pédiatrique, Service d'ophtalmologie, Université de Lausanne, Hôpital ophtalmique Jules-Gonin, 1002 Lausanne
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18
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Drača N, Orešković EG, Lazić R, Vukojević M, Radolović Bertetić A, Vukojević N. Management of Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP)-A Case Report. Medicina (Kaunas) 2023; 59:2158. [PMID: 38138261 PMCID: PMC10745080 DOI: 10.3390/medicina59122158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/27/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: This study reports a case of a 62-year-old patient experiencing a significant decline in vision over the past three months. The initial best-corrected visual acuity (BCVA) of 20/20 in both eyes diminished to 20/200 in the right eye (RE) and counting fingers (CF) in the left eye (LE) within this timeframe. The patient was diagnosed with stage 4 ovarian cancer just one month before the significant vision deterioration. Materials and Methods: A thorough ophthalmologic examination revealed a notable progression of cataracts and the presence of subretinal fluid on the posterior pole, accompanied by choroidal thickening. The right eye exhibited multifocal, orange-pigmented, and elevated choroidal lesions, while the left eye's fundus examination was impeded by dense cataracts. Optical coherence tomography (OCT) revealed bilateral choroidal thickening with overlying folds and subretinal fluid, and ultrasound imaging of the choroidal lesions indicated moderate homogenous internal reflectivity. Results: The patient received a diagnosis of BDUMP (bilateral diffuse uveal melanocytic proliferation), a paraneoplastic syndrome marked by simultaneous, bilateral, painless vision loss and the rapid onset of bilateral cataracts with serous retinal detachments. Despite cataract extraction, the expected visual recovery was not achieved (RE: CF; LE: 2/200, respectively). Plasmapheresis showed some success in stabilizing vision loss attributed to serous retinal detachments. Conclusions: BDUMP necessitates addressing the underlying malignancy for effective treatment. Left untreated, it can lead to near blindness within a year. The prognosis remains grim, with an average survival time ranging from 12 to 15.7 months from the time of diagnosis. Considering this case report, it is crucial to establish effective management plans and further investigate potential treatment methods and predictive markers centered around BDUMP. Collaboration between healthcare professionals and researchers is crucial in addressing the complexities of BDUMP, as the timely diagnosis and treatment of the disease remains a top priority.
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Affiliation(s)
- Nataša Drača
- Svjetlost Eye Clinic and University Hospital, 10000 Zagreb, Croatia; (E.G.O.); (R.L.)
| | - Emma Grace Orešković
- Svjetlost Eye Clinic and University Hospital, 10000 Zagreb, Croatia; (E.G.O.); (R.L.)
| | - Ratimir Lazić
- Svjetlost Eye Clinic and University Hospital, 10000 Zagreb, Croatia; (E.G.O.); (R.L.)
| | - Marija Vukojević
- Department of Ophthalmology, General Hospital Pula, 52100 Pula, Croatia;
- Institute of Emergency Medicine of Sisak-Moslavina County, 44000 Sisak, Croatia
| | | | - Nenad Vukojević
- Department of Opthalmology, University Hospital Rebro, 10000 Zagreb, Croatia; (A.R.B.); (N.V.)
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19
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Karabaş L, Seyyar SA, Tokuç EÖ. Management of Retinal Detachment With a Coexistent Macular Hole: Submacular Placement of Retinal Autograft Through a Macular Hole. Retina 2023; 43:2199-2203. [PMID: 37671786 DOI: 10.1097/iae.0000000000003901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
PURPOSE In this article, a submacular autologous neurosensory retinal transplantation technique is presented in patients with large macular hole (MH) accompanying retinal detachment. METHODS In the surgical procedure, 23-G pars plana vitrectomy and peripheral vitrectomy were performed. An autologous neurosensory retinal patch, which should be larger than the diameter of the MH, was released from a suitable quadrant. The retinal patch was grasped using a 23 gauge microforceps and then passed through the MH and placed under the macula. Liquid perfluorocarbon (PFCL) was injected, and the retina was reattached. A subfoveal autologous neurosensory retinal patch was repositioned in the center of the MH with gentle manipulation under fluid perfluorocarbon, if necessary. Laser retinopexy was applied to peripheral tears under PFCL Subsequently, a 5,000-cSt silicone oil-PFCL exchange was also performed. RESULTS Four eyes of four patients were operated on using the technique described earlier. Silicone oil was removed from two patients, and the macular holes were closed in all patients at the last follow-up. CONCLUSION This technique has been beneficial in refractory MHs and can improve the visual potential in eyes with MHs.
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Affiliation(s)
- Levent Karabaş
- Department of Ophthalmology, Kocaeli University School of Medicine, İzmit, Kocaeli, Turkey; and
| | - Sevim Ayça Seyyar
- Department of Ophthalmology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Ecem Önder Tokuç
- Department of Ophthalmology, Kocaeli University School of Medicine, İzmit, Kocaeli, Turkey; and
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20
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Ishida Y, Saito S, Tsuboi K, Miki A, Kamei M, Wakabayashi T. Head-Tilt Perfluorocarbon-Air Exchange Technique With Heads-Up Surgery for Giant Retinal Tear-Associated Retinal Detachments to Prevent Retinal Slippage Without Using Silicone Oil. Retina 2023; 43:2189-2193. [PMID: 37399269 DOI: 10.1097/iae.0000000000003877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
PURPOSE To report the efficacy of the perfluorocarbon liquid-air exchange with a head tilt toward the area of the giant retinal tear (GRT) using the heads-up surgery system to prevent retinal slippage during vitrectomy for GRT-associated retinal detachments. METHODS Eyes with GRT-associated retinal detachments underwent vitrectomy using the heads-up surgery system and perfluorocarbon liquid-air exchange with a head tilt 45° toward the GRT to put the area of the tear in the most dependent position to drain fluid. This technique was evaluated to prevent retinal slippage. RESULTS Five consecutive cases were evaluated. The mean GRT size was 174° (range, 90-240°) and the GRT was located temporally in two eyes, nasally in two eyes, and superiorly in one eye. The tamponade types were air (1 eye), sulfur hexafluoride (3 eyes), and perfluoropropane (1 eye). Our technique was feasible and the slippage did not occur in any eyes. Although the microscope needed to be tilted for optimal fundus visualization, heads-up surgery allowed surgeons to maintain ergonomic postures. Retinal reattachment was achieved with a single surgery in all eyes. CONCLUSION The head-tilt perfluorocarbon liquid-air exchange with heads-up surgery is useful in preventing retinal slippage in eyes with GRT.
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Affiliation(s)
- Yuichiro Ishida
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Seiya Saito
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Kotaro Tsuboi
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Atsuya Miki
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Motohiro Kamei
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Taku Wakabayashi
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania; and
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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21
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Mueller A, Chang TCP. Serous Retinal Detachment in a Patient With a Port-Wine Birthmark Associated With Prostaglandin Analog Therapy. Ophthalmic Surg Lasers Imaging Retina 2023; 54:723-729. [PMID: 38113361 DOI: 10.3928/23258160-20231019-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
An 11-year-old girl with a port-wine birthmark (PWB), diffuse choroid hemangioma (DCH), and glaucoma experienced decreased vision upon starting treatment with bimatoprost. The patient was switched to latanoprostene bunod. Her vision remained reduced. Shortly after, she was diagnosed with serous retinal detachment (SRD). Both SRD and vision improved following prostaglandin analog (PGA) cessation. Patients with PWB are likely to have DCH and glaucoma. DCH itself poses a risk factor for SRD. Certain glaucoma management modalities may further increase this risk. This report highlights the importance of regular surveillance for SRD in patients with DCH who are receiving PGA. [Ophthalmic Surg Lasers Imaging Retina 2023;54:723-729.].
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22
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Di Bernardo J, Newkirk K, Hendrix D. Retinoschisis: a retrospective study of an uncommon retinal change in cats and dogs. J Comp Pathol 2023; 207:30-32. [PMID: 37925755 DOI: 10.1016/j.jcpa.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/23/2023] [Accepted: 10/01/2023] [Indexed: 11/07/2023]
Abstract
Retinoschisis is a poorly documented form of retinal degeneration characterized by cyst-like splitting that occurs between the inner nuclear and outer plexiform layers. The pathogenesis of retinoschisis is incompletely understood, but congenital, acquired and secondary aetiologies (glaucoma, inflammation, neoplasia) are described in humans. This retrospective study investigated the prevalence and associated histological and clinical features of retinoschisis in cats and dogs submitted for biopsy over a 10-year period. Of 140 samples with documented 'retinal vacuolation', four out of 120 (3%) canine samples and one out of 20 (5%) feline samples had changes consistent with retinoschisis. In most cases (80%), there was concurrent retinal detachment. In cases with available histories, increased intraocular pressure, proptosis and retinal detachment were reported clinical findings. In cats and dogs, retinoschisis is a retinal change that is generally secondary to other ocular lesions.
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Affiliation(s)
- Joel Di Bernardo
- Department of Biomedical and Diagnostic Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA.
| | - Kim Newkirk
- Department of Biomedical and Diagnostic Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Diane Hendrix
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
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23
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Salabati M, Massenzio E, Kim J, Awh K, Anderson H, Mahmoudzadeh R, Wakabayashi T, Hsu J, Garg S, Ho AC, Khan MA. Primary Retinal Detachment Repair in Eyes Deemed High Risk for Proliferative Vitreoretinopathy: Surgical Outcomes in 389 Eyes. Ophthalmol Retina 2023; 7:954-958. [PMID: 37453482 DOI: 10.1016/j.oret.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To evaluate surgical outcomes in eyes with primary rhegmatogenous retinal detachment (RRD) deemed at high risk for postoperative proliferative vitreoretinopathy (PVR). DESIGN Retrospective, consecutive case cohort study. PARTICIPANTS Eyes undergoing primary RRD repair with pars plana vitrectomy (PPV) or combined PPV with scleral buckling (PPV/SB) between January 1, 2016, and December 30, 2017, at Wills Eye Hospital. METHODS Eyes were defined as "high risk" if ≥ 1 of the following risk factors for PVR was present on preoperative examination: preoperative PVR grade A or B, vitreous hemorrhage, RRD involving ≥ 50% of retinal area, presence of ≥ 3 retinal breaks, history of prior cryotherapy, presence of choroidal detachment, or duration of RRD > 2 weeks. Surgical failure was defined as an additional intervention required for the retinal reattachment. MAIN OUTCOMES MEASURES Single surgery attachment success (SSAS) rate 3 months after first surgical intervention for primary RRD. RESULTS Of 2053 reviewed charts, a total of 389 eyes (18.9%) met the definition of high risk and were included in the analysis. Mean patient age was 63.5 years. PPV/SB was performed in 125 (32.1%) eyes and PPV alone in 264 (67.9%) eyes. SSAS rate of the overall cohort was 71.5% at 3 months. SSAS rate was significantly higher in eyes treated with PPV/SB compared with PPV (80.8% vs. 67%, respectively, P = 0.006). On multivariate analysis, use of PPV/SB was the only feature associated with SSAS (odds ratio, 2.04; 95% confidence interval, 1.12-3.69, P = 0.019). CONCLUSION In eyes with primary RRD and risk factors for PVR, overall SSAS was 71.5% after primary repair. In this cohort, use of PPV/SB was associated with a significantly higher SSAS compared with PPV alone. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
| | - Erik Massenzio
- The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Julie Kim
- The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Katherine Awh
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Hannah Anderson
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Taku Wakabayashi
- The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Jason Hsu
- The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sunir Garg
- The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Allen C Ho
- The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - M Ali Khan
- The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Shields RA, Mahmoud TH. MANAGEMENT OF AUTOLOGUS RETINAL TRANSPLANT COMPLICATIONS: A CASE SERIES. Retina 2023; 43:2030-2033. [PMID: 34723900 DOI: 10.1097/iae.0000000000003329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To present representative cases of the most common complications associated with an autologous retinal transplant (ART) for macular hole repair. METHODS A retrospective, consecutive case series on patients who underwent an ART by a single provider (Tamer H. Mahmoud). RESULTS Four cases were included in this review. Each suffered an ART-specific complication, including graft displacement and dislocation, sub-ART perfluoron, and a delayed proliferative vitreoretinopathy-associated retinal detachment. CONCLUSION Because more surgeons use ART to treat atypical macular holes, an adequate understanding of surgery-specific complications and techniques to treat those complications is increasingly necessary.
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Affiliation(s)
- Ryan A Shields
- Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan; and
| | - Tamer H Mahmoud
- Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan; and
- Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, Michigan
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Price P, Klobukowska HJ, Castillo-Alcala F, Foxwell JA, Orbell G, Brown S, Irving AC. Protothecosis in four dogs in New Zealand. N Z Vet J 2023; 71:321-328. [PMID: 37584100 DOI: 10.1080/00480169.2023.2248066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/06/2023] [Indexed: 08/17/2023]
Abstract
CASE HISTORIES Medical records of four dogs diagnosed with protothecosis in New Zealand were reviewed. The dogs were aged between 4 and 9 years and three of the four dogs were female. Breeds were one Labrador, one Miniature Schnauzer and two crossbreeds. The reasons for initial veterinary evaluation were a cough and opaque appearance of the right eye (Case 1), diarrhoea (Cases 2 and 3), and cutaneous disease (Case 4). CLINICAL FINDINGS The ocular signs were characterised by panuveitis, retinal detachment and secondary glaucoma. Gastrointestinal signs included chronic haemorrhagic diarrhoea due to colitis. Three cases had disseminated infection and developed both bilateral, blinding, ocular disease and chronic gastrointestinal disease. Cutaneous signs consisted of draining fistulae over the olecranon, multifocal cutaneous nodules, and ulceration and tracts of the foot pads. Disseminated protothecosis was confirmed by histopathology of biopsied ocular tissues in Cases 1 and 2 and by gastrointestinal biopsies in Case 3. Prototheca spp. were also identified in cytological specimens from Cases 1 and 4 and recovered by culture in Cases 2 and 4. Cutaneous protothecosis was diagnosed in Case 4 initially by cytology and histopathology of skin lesions, and Prototheca zopfii was confirmed by PCR of cultured organisms. TREATMENT AND OUTCOME Prior to diagnosis of protothecosis, a variety of treatments were prescribed to treat the gastrointestinal and ocular signs. After diagnosis, only Cases 2 and 4 received medication aimed at treating the protothecal infection, which was itraconazole in both cases. Following the progression of clinical signs and concerns about quality of life, all four dogs were euthanised. DIAGNOSIS Disseminated protothecosis in three dogs, cutaneous protothecosis in one dog. CLINICAL RELEVANCE Canine protothecosis is rarely reported, despite the ubiquity of the causal algae, and the disease usually carries an extremely grave prognosis when infection is generalised. In New Zealand, protothecosis should be considered as a differential diagnosis in dogs with panuveitis, chorioretinitis or retinal detachment, colitis, or nodular, ulcerative or fistulating cutaneous lesions.
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Affiliation(s)
- Psa Price
- Eyevet Services Ltd., Feilding, New Zealand
| | - H J Klobukowska
- New Zealand Veterinary Pathology, Palmerston North, New Zealand
| | - F Castillo-Alcala
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - J A Foxwell
- Animal Health Laboratory, Ministry for Primary Industries, Upper Hutt, New Zealand
| | - Gmb Orbell
- New Zealand Veterinary Pathology, Palmerston North, New Zealand
| | - S Brown
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - A C Irving
- Eyevet Services Ltd., Feilding, New Zealand
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Williamson RC, Selvam A, Sant V, Patel M, Bollepalli SC, Vupparaboina KK, Sahel JA, Chhablani J. Radiomics-Based Prediction of Anti-VEGF Treatment Response in Neovascular Age-Related Macular Degeneration With Pigment Epithelial Detachment. Transl Vis Sci Technol 2023; 12:3. [PMID: 37792693 PMCID: PMC10565708 DOI: 10.1167/tvst.12.10.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/01/2023] [Indexed: 10/06/2023] Open
Abstract
Purpose Machine learning models based on radiomic feature extraction from clinical imaging data provide effective and interpretable means for clinical decision making. This pilot study evaluated whether radiomics features in baseline optical coherence tomography (OCT) images of eyes with pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration (nAMD) can predict treatment response to as-needed anti-vascular endothelial growth factor (VEGF) therapy. Methods Thirty-nine eyes of patients with PED undergoing anti-VEGF therapy were included. All eyes underwent a loading dose followed by as-needed therapy. OCT images at baseline, month 3, and month 6 were analyzed. Images were manually separated into non-responding, recurring, and responding eyes based on the presence or absence of subretinal fluid at month 6. PED radiomics features were then extracted from each image and images were classified as responding or recurring using a machine learning classifier applied to the radiomics features. Results Linear discriminant analysis classification of baseline features as responsive versus recurring resulted in classification performance of 64.0% (95% confidence interval [CI] = 0.63-0.65), area under the curve (AUC = 0.78, 95% CI = 0.72-0.82), sensitivity 0.79 (95% CI = 0.63-0.87), and specificity 0.58 (95% CI = 0.50-0.67). Further analysis of features in recurring eyes identified a significant shift toward non-responding mean feature values over 6 months. Conclusions Our results demonstrate the use of radiomics features as predictors for treatment response to as-needed anti-VEGF therapy. Our study demonstrates the potential for radiomics feature in clinical decision support for personalizing anti-VEGF therapy. Translational Relevance The ability to use PED texture features to predict treatment response facilitates personalized clinical decision making.
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Affiliation(s)
- Ryan Chace Williamson
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Amrish Selvam
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Manan Patel
- BJ Medical College, Ahmedabad, Gujarat, India
| | | | | | - Jose-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
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Schott KD, Kriebel D, Sama SR, Buchholz BO, Järvholm B, Wahlström J. A cohort study of retinal detachment among Swedish construction workers. Scand J Work Environ Health 2023; 49:518-525. [PMID: 37530817 PMCID: PMC10837844 DOI: 10.5271/sjweh.4100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE Retinal detachment (RD) has been associated with exposure to heavy lifting. Many occupations within the construction industry are likely to involve lifting tasks. We investigated the association between occupational heavy lifting and rhegmatogenous RD in a retrospective cohort study of Swedish construction workers. METHODS We studied Swedish construction workers who participated in an industry-wide health and safety program from 1971 to 1993. Individual occupation codes were linked to a job exposure matrix, assigning intensity of exposure to heavy lifting to each worker. The Swedish National Patient Register was used to identify cases of RD that occurred during follow-up through the end of 2012. We used Poisson regression modeling to calculate incidence rates of RD associated with heavy lifting, age and other covariates. A subcohort of those age ≤25 years at enrollment was studied to reduce bias from missing exposure information from work prior to enrollment. RESULTS Of 256 241 construction workers, 17% were classified with high exposure to heavy lifting in their occupation. Within the cohort, 1588 cases of RD were identified. Average exposure intensity of heavy lifting was not associated with risk of RD. However, RD risk increased with increasing cumulative exposure to heavy lifting, both in the full cohort and subcohort of those who were ≤25 years old at entry into the construction-worker cohort. CONCLUSION Construction workers' risk of RD appeared to increase with time spent exposed to heavy lifting.
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Affiliation(s)
- Kevin D Schott
- Department of Public Health University of Massachusetts, Lowell, Lowell, MA, USA.
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Abstract
PURPOSE To evaluate the characteristics of bacillary layer detachment (BALAD) in acute Vogt-Koyanagi-Harada (VKH) disease and determine its prognostic value. METHODS Seventy patients with acute VKH disease with a minimum follow-up of 6 months were studied. The primary outcomes were clinical characteristics associated with BALAD, including features on multimodal imaging at baseline and follow-up. The secondary outcomes included best-corrected visual acuity and VKH with recurrence features. RESULTS Of 70 eyes (36 patients), 41 (58.6%) showed BALAD. The mean baseline best-corrected visual acuity and mean best-corrected visual acuity after resolution of serous retinal detachment were significantly lower in the BALAD group than in the no-BALAD group (0.90 ± 0.49 vs. 0.35 ± 0.35 log minimum angle of resolution, P < 0.001 and 0.39 ± 0.27 vs. 0.20 ± 0.20 log minimum angle of resolution, P = 0.020). The loss of ellipsoid zone integrity at baseline, proportion of serous retinal detachment, duration of serous retinal detachment, loss of ellipsoid zone integrity at 1 month, and subfoveal choroidal thickness at baseline were significantly higher in the BALAD group ( P = 0.017, P = 0.006, P = 0.023, P = 0.002, and P = 0.046, respectively). The mean best-corrected visual acuity and subfoveal choroidal thickness did not differ between the two groups at 6 months ( P = 0.380 and P = 0.180, respectively). Bacillary layer detachment at baseline was found to be a significant prognostic factor for VKH with recurrence features ( P = 0.007). CONCLUSION Vogt-Koyanagi-Harada with BALAD featured more severe clinical characteristics than VKH without BALAD during the acute phase. Patients with baseline BALAD require more vigilant monitoring as they are more likely to show recurrence features within the first 6 months.
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Affiliation(s)
- Jay Jiyong Kwak
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; and
| | - Junwon Lee
- Department of Ophthalmology, Institute of Human Barrier Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; and
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Ibanga A, Okonkwo ON, Ovienria W, Oyekunle I, Akanbi T, Nkanga D, Agweye C, Adenuga O, Udoh M. The fellow eye of retinal detachment patients: Vision and clinical presentation. Niger J Clin Pract 2023; 26:1342-1347. [PMID: 37794548 DOI: 10.4103/njcp.njcp_101_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background The fellow eye of a retinal detachment is at risk of developing a retinal detachment and other visually debilitating disease. Aim To investigate the rate of bilaterality of retinal detachment (RD), the presenting visual acuity (VA), and the presence of ocular morbidity in the fellow eye of patients with RD. Patients and Methods A multicenter, prospective, cross-sectional study examining the fellow eye of consecutive patients who were diagnosed with different types of RD. The patients were seen within one year and examined in four Nigerian eye hospitals and clinics. Demographics, VA, and clinical findings at the presentation were reported on examination of the fellow eyes. Results Twenty-seven (11.4%) out of 237 patients (264 eyes) had an RD in the fellow eye. The mean age of all study patients was 46.2 ± 16.8 years, M/F: 161 (67.9%)/76 (32.1%). The rates of bilaterality for rhegmatogenous, exudative, and tractional RDs were 4.2%, 11.1%, and 31.1%, respectively. Diagnosis of RD in an eye was associated with a risk of developing fellow eye rhegmatogenous retinal detachment (RRD) (P < 0.001) and tractional RD (P < 0.001), respectively. RRD in an eye was associated with a 17% risk of developing RD in the fellow eye (β = -1.6, OR = 0.202, P < 0.001). The BCVA in the fellow eye of the three types of RD varied significantly (P < 0.001). The fellow eye was blind in 25.2% of RRD, 54.1% of tractional retinal detachment (TRD), and 11.1% of exudative retinal detachment (ERD). Bilateral RD eyes were blind in RRD (85.7%), TRD (71.1%), and ERD (50%). One hundred and seven eyes (40.5%) of the total 264 RD eyes studied had other fellow eye events at the presentation. Conclusion A patient with an RD in one eye is at significant risk of developing a blinding RD in the fellow eye. This risk varies with the type of RD and is highest with TRD. However, RRD, the commonest type of RD, can benefit from prophylactic treatment to the fellow eye RD predisposing lesions.
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Affiliation(s)
- A Ibanga
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - O N Okonkwo
- Department of Ophthalmology, Eye Foundation Hospital, Lagos, Nigeria
| | - W Ovienria
- Department of Ophthalmology, Irrua Specialist Hospital, Benin City, Nigeria
| | - I Oyekunle
- Department of Ophthalmology, Eye Foundation Hospital, Lagos, Nigeria
| | - T Akanbi
- Department of Ophthalmology, Eye Foundation Hospital, Lagos, Nigeria
| | - D Nkanga
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - C Agweye
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - O Adenuga
- Department of Ophthalmology, University of Jos Teaching Hospital, Jos, Plateau State, Nigeria
| | - M Udoh
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Nigeria
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Benlahbib M, Cohen SY, Torrell N, Colantuono D, Crincoli E, Amoroso F, Semoun O, Jung C, Souied EH. PHOTOBIOMODULATION THERAPY FOR LARGE SOFT DRUSEN AND DRUSENOID PIGMENT EPITHELIAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION: A Single-Center Prospective Pilot Study. Retina 2023; 43:1246-1254. [PMID: 37027819 DOI: 10.1097/iae.0000000000003805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
PURPOSE To evaluate visual acuity and morphologic changes after photobiomodulation (PBM) for patients affected with large soft drusen and/or drusenoid pigment epithelial detachment associated with dry age-related macular degeneration. METHOD Twenty eyes with large soft drusen and/or drusenoid pigment epithelial detachment age-related macular degeneration were included and treated using the LumiThera Valeda Light Delivery System. All patients underwent two treatments per week for 5 weeks. Outcome measures included best-corrected visual acuity, microperimetry-scotopic testing, drusen volume, central drusen thickness, and quality of life score at baseline and month 6 (M6) follow-up. Data of best-corrected visual acuity, drusen volume, and central drusen thickness were also recorded at week 5 (W5). RESULTS Best-corrected visual acuity significantly improved at M6 with a mean score gain of 5.5 letters ( P = 0.007). Retinal sensitivity decreased by 0.1 dB ( P = 0.17). The mean fixation stability increased by 0.45% ( P = 0.72). Drusen volume decreased by 0.11 mm 3 ( P = 0.03). Central drusen thickness was reduced by a mean of 17.05 µ m ( P = 0.01). Geographic atrophy area increased by 0.06 mm 2 ( P = 0.01) over a 6-month follow-up, and quality of life score increased by 3,07 points on average ( P = 0.05). One patient presented a drusenoid pigment epithelial detachment rupture at M6 after PBM treatment. CONCLUSION The visual and anatomical improvements in our patients support previous reports on PBM. PBM may provide a valid therapeutic option for large soft drusen and drusenoid pigment epithelial detachment age-related macular degeneration and may potentially slow the natural course of the disease.
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Affiliation(s)
- Manal Benlahbib
- Department of Ophthalmology, Department of Ophthalmology, Centre Hospitaliser Intercommunal de Creteil, University of Paris Est-Creteil, Creteil, France
| | - Salomon Yves Cohen
- Department of Ophthalmology, Department of Ophthalmology, Centre Hospitaliser Intercommunal de Creteil, University of Paris Est-Creteil, Creteil, France
- Ophthalmology Center for Imaging and Laser, Paris, France; and
| | - Nuria Torrell
- Department of Ophthalmology, Department of Ophthalmology, Centre Hospitaliser Intercommunal de Creteil, University of Paris Est-Creteil, Creteil, France
| | - Donato Colantuono
- Department of Ophthalmology, Department of Ophthalmology, Centre Hospitaliser Intercommunal de Creteil, University of Paris Est-Creteil, Creteil, France
| | - Emanuele Crincoli
- Department of Ophthalmology, Department of Ophthalmology, Centre Hospitaliser Intercommunal de Creteil, University of Paris Est-Creteil, Creteil, France
| | - Francesca Amoroso
- Department of Ophthalmology, Department of Ophthalmology, Centre Hospitaliser Intercommunal de Creteil, University of Paris Est-Creteil, Creteil, France
| | - Oudy Semoun
- Department of Ophthalmology, Department of Ophthalmology, Centre Hospitaliser Intercommunal de Creteil, University of Paris Est-Creteil, Creteil, France
| | - Camille Jung
- Clinical Research Center, Centre Hospitaliser Intercommunal de Creteil, Creteil, France
| | - Eric H Souied
- Department of Ophthalmology, Department of Ophthalmology, Centre Hospitaliser Intercommunal de Creteil, University of Paris Est-Creteil, Creteil, France
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Charteris DG, Cro S, Casswell E, Edwards RT, Ezeofor V, Anthony B, Bunce C, Robertson E, Kelly J, Murphy C, Banerjee P, Cornelius VR. A randomised controlled trial of adjunctive triamcinolone acetonide in eyes undergoing vitreoretinal surgery for open globe trauma - the ASCOT study. Health Technol Assess 2023; 27:1-50. [PMID: 37840322 PMCID: PMC10591211 DOI: 10.3310/gnbj1387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Background Eyes sustaining open globe trauma are at high risk of severe visual impairment. Proliferative vitreoretinopathy is the most common cause of retinal detachment and visual loss in eyes with open globe trauma. There is evidence from experimental studies and pilot clinical trials that the use of adjunctive steroid medication triamcinolone acetonide can reduce the incidence of proliferative vitreoretinopathy and improve outcomes of surgery for open globe trauma. Objective The Adjunctive Steroid Combination in Ocular Trauma or ASCOT study aimed to investigate the clinical effectiveness of adjunctive triamcinolone acetonide given at the time of vitreoretinal surgery for open globe trauma. Design A phase 3 multicentre double-masked randomised controlled trial randomising patients undergoing vitrectomy following open globe trauma to either adjunctive triamcinolone acetonide or standard care. Setting Hospital vitreoretinal surgical services dealing with open globe trauma. Participants Patients undergoing vitrectomy surgery who had sustained open globe trauma. Interventions Triamcinolone acetonide 4 mg/0.1 ml into the vitreous cavity and 40 mg/1 ml sub-Tenon's or standard vitreoretinal surgery and postoperative care. Main outcome measures The primary outcome was the proportion of patients with at least 10 letters of improvement in corrected visual acuity at six months. Secondary outcomes included retinal detachment secondary to proliferative vitreoretinopathy, retinal reattachment, macula reattachment, tractional retinal detachment, number of operations, hypotony, elevated intraocular pressure and quality of life. Health-related quality of life was assessed using the EuroQol Five Domain and Visual Function Questionnaire 25 questionnaires. Results A total of 280 patients were randomised; 129 were analysed from the control group and 130 from the treatment group. The treatment group appeared, by chance, to have more severe pathology on presentation. The primary outcome (improvement in visual acuity) and principal secondary outcome (change in visual acuity) did not demonstrate any treatment benefit for triamcinolone acetonide. The proportion of patients with improvement in visual acuity was 47% for triamcinolone acetonide and 43% for standard care (odds ratio 1.03, 95% confidence interval 0.61 to 1.75, p = 0.908); the baseline adjusted mean difference in the six-month change in visual acuity was -2.65 (95% confidence interval -9.22 to 3.92, p = 0.430) for triamcinolone acetonide relative to control. Similarly, the secondary outcome measures failed to show any treatment benefit. For two of the secondary outcome measures, stable complete retinal reattachment and stable macular retinal reattachment, outcomes for the treatment group were significantly worse for triamcinolone acetonide at the 5% level (respectively, odds ratio 0.59, 95% confidence interval 0.36 to 0.99, p = 0.044 and odds ratio 0.59, 95% confidence interval 0.35 to 0.98, p = 0.041) compared with control in favour of control. The cost of the intervention was £132 per patient. Health economics outcome measures (Early Treatment Diabetic Retinopathy Study, Visual Function Questionnaire 25 and EuroQol Five Dimensions) did not demonstrate any significant difference in quality-adjusted life-years. Conclusions The use of combined intraocular and sub-Tenon's capsule triamcinolone acetonide is not recommended as an adjunct to vitrectomy surgery for intraocular trauma. Secondary outcome measures are suggestive of a negative effect of the adjunct, although the treatment group appeared to have more severe pathology on presentation. Future work The use of alternative adjunctive medications in cases undergoing surgery for open globe trauma should be investigated. Refinement of clinical grading and case selection will enable better trail design for future studies. Trial registration This trial is registered as ISRCTN 30012492, EudraCT number 2014-002193-37, REC 14/LNO/1428, IRAS 156358, Local R&D registration CHAD 1031. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (12/35/64) and will be published in full in Health Technology Assessment; Vol. 27, No. 12. See the NIHR Journals Library website for further project information.
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Affiliation(s)
| | - Suzie Cro
- Imperial College Clinical Trials Unit, Imperial College London, London, UK
| | | | - Rhiannon Tudor Edwards
- Centre for Health Economics and Medicines Evaluation, School of Medical and Health Sciences, Bangor University, Gwynedd, UK
| | - Victory Ezeofor
- Centre for Health Economics and Medicines Evaluation, School of Medical and Health Sciences, Bangor University, Gwynedd, UK
| | - Bethany Anthony
- Centre for Health Economics and Medicines Evaluation, School of Medical and Health Sciences, Bangor University, Gwynedd, UK
| | - Catey Bunce
- Research Data and Statistics Unit (RDSU), Royal Marsden NHS Foundation Trust, London, UK
| | | | - Joanna Kelly
- King's Clinical Trial Unit, Research Management and Innovation Directorate, Institute of Psychiatry, Kings College, London, UK
| | - Caroline Murphy
- King's Clinical Trial Unit, Research Management and Innovation Directorate, Institute of Psychiatry, Kings College, London, UK
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Jamil MU, Mahmood A, Rizvi SF. Optic Disc Pit Associated With Choroidal Coloboma: Case Report And Short Review. J Ayub Med Coll Abbottabad 2023; 35:507-509. [PMID: 38404105 DOI: 10.55519/jamc-03-11574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Optic disc pits are hypothesized to form because of failure of embryonic fissure closure, which can also present with congenital defects in the choroid, RPE, and neurosensory retina. It is also associated with serous macular detachment. We present a case report of a 32-year-old man with an optic disc pit and independent choroidal coloboma below the inferior peripapillary area in the left eye, associated with macular retinoschisis with serous detachment.
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Affiliation(s)
| | - Aysal Mahmood
- LRBT Tertiary Teaching Eye Hospital, Dow Medical College, Karachi, Pakistan
| | - Syed Fawad Rizvi
- LRBT Tertiary Teaching Eye Hospital, Dow Medical College, Karachi, Pakistan
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33
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Breazzano MP. Simultaneous macular hole with retinal and hemorrhagic choroidal detachments. J Fr Ophtalmol 2023; 46:679. [PMID: 37088631 DOI: 10.1016/j.jfo.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/27/2022] [Indexed: 04/25/2023]
Affiliation(s)
- M P Breazzano
- Retina-Vitreous Surgeons of Central New York, Department of Ophthalmology & Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY, United States.
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Li JQ, Pfeil JM, Stahl A, Krohne TU. [Late sequelae of retinopathy of prematurity in infancy]. Ophthalmologie 2023; 120:588-596. [PMID: 37221277 DOI: 10.1007/s00347-023-01876-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) is one of the most frequent causes of severe visual impairment or blindness in childhood and can lead to severe late complications in children even after the initial disease has resolved. PURPOSE The present study summarizes possible late effects in childhood after treated and untreated ROP. A special focus is on the development of myopia, retinal detachment, as well as neurological and pulmonary development after anti-vascular endothelial growth factor (VEGF) treatment. MATERIAL AND METHODS This work is based on a selective literature search on late effects in childhood of treated or untreated ROP. RESULTS Preterm infants have an increased risk of developing high-grade myopia. Interestingly, several studies indicate that the risk of myopia is reduced following anti-VEGF treatment. With anti-VEGF treatment, however, late recurrences after initial response are possible even after several months, making long-term and frequent follow-up examinations essential. Controversy exists regarding the possible negative effects of anti-VEGF treatment on neurological and pulmonary development. After both treated and untreated ROP, rhegmatogenous, tractional or exudative retinal detachment, vitreous hemorrhage, high myopia and strabismus are possible late complications. DISCUSSION Children with a history of ROP with or without treatment have an increased risk for late ocular sequelae, such as high myopia, retinal detachment, vitreous hemorrhage and strabismus. A seamless transition from ROP screening to pediatric and ophthalmological follow-up care is therefore essential for timely detection and treatment of possible refractive errors, strabismus, or other amblyogenic changes.
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Affiliation(s)
- Jeany Q Li
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Johanna M Pfeil
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Andreas Stahl
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Tim U Krohne
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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35
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Iannetti L, Scarinci F, Alisi L, Armentano M, Sampalmieri L, La Cava M, Gharbiya M. Correlation between Morphological Characteristics of Macular Edema and Visual Acuity in Young Patients with Idiopathic Intermediate Uveitis. Medicina (B Aires) 2023; 59:medicina59030529. [PMID: 36984530 PMCID: PMC10054752 DOI: 10.3390/medicina59030529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/12/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Background and Objectives: Macular edema (ME) is a common complication of intermediate uveitis (IU). It is often responsible for a decrease in visual acuity (VA). Three distinct patterns of macular edema have been described in intermediate uveitis, namely, cystoid macular edema (CME), diffuse macular edema (DME), and serous retinal detachment (SRD). The current study aims to describe the characteristics of macular edema in young patients with idiopathic intermediate uveitis and to correlate its features with VA using spectral domain optical coherence tomography (SD-OCT). Materials and Methods: A total of 27 eyes from 18 patients with idiopathic IU complicated by ME were included in this retrospective study. All patients underwent SD-OCT; data were gathered at the onset of ME. Best-corrected VA (BCVA) was correlated with the morphological features of ME. Results: BCVA was negatively correlated with Ellipsoid Zone (EZ) disruption (p = 0.00021), cystoid pattern (p = 0.00021), central subfield thickness (CST) (p < 0.001), and serous retinal detachment (0.037). Conclusions: In ME secondary to idiopathic IU, VA negatively correlates with Ellipsoid Zone disruption and increases in CST. Moreover, vision is influenced by the presence of cysts in the inner nuclear and outer nuclear layers and by the neuroepithelium detachment.
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Affiliation(s)
- Ludovico Iannetti
- Ophthalmology Unit, Head and Neck Department, Policlinico Umberto I University Hospital, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence: ; Tel.: +39-3388635417
| | | | - Ludovico Alisi
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
| | - Marta Armentano
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Maurizio La Cava
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
| | - Magda Gharbiya
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
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Mahmoudzadeh R, Mokhashi N, Anderson H, Patel S, Salabati M, Chiang A, Kuriyan AE, Gupta OP, Mehta S, Garg SJ, Hsu J. Outcomes of Retinectomy without Lensectomy in Rhegmatogenous Retinal Detachments with Proliferative Vitreoretinopathy. Ophthalmol Retina 2023; 7:52-58. [PMID: 35940476 DOI: 10.1016/j.oret.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To report the anatomic and functional outcomes of retinectomy without lensectomy in eyes with rhegmatogenous retinal detachment (RRD) and proliferative vitreoretinopathy (PVR). DESIGN Retrospective, noncomparative, and interventional case series. SUBJECTS One hundred twelve eyes of 112 patients with RRD complicated by PVR who underwent retinectomy without lensectomy. METHODS Retrospective review of patients treated with vitrectomy and retinectomy without lensectomy from January 1, 2015, to January 1, 2020. MAIN OUTCOME MEASURES The primary outcome was the final attachment rate and single surgery anatomic success (SSAS) at 3 and 6 months after retinectomy. Secondary outcomes included predictors of final visual acuity (VA), the mean number of subsequent operations required for complete retinal reattachment, cataract surgery, and the number of eyes that ultimately had successful silicone oil removal. RESULTS Complete final retinal reattachment was achieved in 111 of 112 (99.1%) patients, with a mean (standard deviation [SD]) follow-up of 29 (14) months (range, 8-62 months) after retinectomy. The SSAS was achieved in 84 of 112 (75%) patients at 3 months and 73 of 112 (65.2%) patients at 6 months. The final VA improved or stabilized in 76 of 112 (67.9%) eyes. Silicone oil removal was performed in 72 of 112 patients (64.3%) at a mean (SD) of 6.6 (3.3) months, and cataract surgery was performed on 101 (90.2%) eyes before the last follow-up visit. CONCLUSIONS Retinectomy without lensectomy to repair RRDs complicated by PVR showed acceptable anatomic and functional results. This study suggests that removing the lens when there is no significant cataract may not be necessary in these cases to obtain reasonable outcomes.
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Affiliation(s)
- Raziyeh Mahmoudzadeh
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Nikita Mokhashi
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Hannah Anderson
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Shail Patel
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mirataollah Salabati
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Allen Chiang
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ajay E Kuriyan
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Omesh P Gupta
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sonia Mehta
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sunir J Garg
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jason Hsu
- Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Arévalo Simental DE, Sepulveda Tinajero LH, Villarreal Contreras FA, Becerra Cota MG, Ingolotti M. MASSIVE BILATERAL SEROUS RETINAL DETACHMENT IN A YOUNG PATIENT WITH HYPERTENSIVE CHORIORETINOPATHY AND CHRONIC KIDNEY DISEASE. Retin Cases Brief Rep 2023; 17:33-36. [PMID: 36525246 DOI: 10.1097/icb.0000000000001103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Report a case of hypertensive chorioretinopathy with massive bilateral serous retinal detachment in a young patient with chronic kidney disease. METHODS Observational case report. RESULTS An 18-year-old man with Grade 5 chronic kidney disease, systemic high blood pressure, secondary acute pulmonary edema, and acute uremic syndrome was referred to our service complaining of bilateral decreased vision starting one week ago. The patient was treated at that moment with hemodialysis and losartan. At initial examination, the patient's blood pressure was 170/120 mmHg; dilated fundus examination evidenced optic disk edema, hypertensive chorioretinopathy, and massive serous retinal detachment with best-corrected visual acuity of hand motion in both eyes. The case was diagnosed as undertreated hypertension and was referred to the nephrologist for treatment adjustments. At 1-month follow-up, blood pressure was 160/90 mmHg; there was clinical improvement in both eyes but with ischemic sequelae. At the final follow-up 6 months later, blood pressure was 100/60 mmHg, best-corrected visual acuity was 20/80 in the right eye and count fingers at 2 min the left eye, and there was a complete resolution of the retinal serous detachment in both eyes. CONCLUSION Patients with massive serous detachments due to systemic hypertension are atypical so it is of immense importance for the ophthalmologists to recognize the ocular manifestations of systemic diseases that put the patient's life at risk as in this case.
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Linton E, Jalil A, Sergouniotis P, Moussa G, Black G, Charles S, Ivanova T. LASER PROPHYLAXIS IN STICKLER SYNDROME: The Manchester Protocol. Retina 2023; 43:88-93. [PMID: 36165842 DOI: 10.1097/iae.0000000000003634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/17/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Patients with Stickler syndrome are at high risk of giant retinal tears (GRTs) and detachments. Vitreoretinal interventions can reduce this risk, but there is presently no consensus about the optimal prophylactic approach. The aim of our study was to determine whether 360° laser prophylaxis is a safe and effective procedure to prevent GRT detachments in patients with Stickler syndrome. METHODS Study subjects were recruited retrospectively through the databases of the vitreoretinal and ophthalmic genetic tertiary services in Manchester, United Kingdom. Clinical data were collected including on prophylactic intervention, the occurrence of retinal detachment, and the presence/type of retinal breaks. RESULTS One hundred thirteen eyes from 63 patients with Stickler syndrome were studied; 72.6% (82/113) of these eyes received 360° laser prophylaxis. Of these, 9% had a retinal detachment, but no GRTs occurred. Among the 27.4% (31/113) of eyes that had no prophylactic treatment, 23% suffered a retinal detachment and 42.9% of these were associated with a GRT. CONCLUSION Patients who underwent laser prophylaxis had fewer retinal detachments and no GRTs during an average of 6.1 years of follow-up (median 5 years), suggesting that this is a safe and effective approach for individuals with Stickler syndrome.
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Affiliation(s)
- Emma Linton
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Assad Jalil
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Panagiotis Sergouniotis
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Division of Evolution, Infection & Genomics, School of Biological Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom; and
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - George Moussa
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Graeme Black
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Division of Evolution, Infection & Genomics, School of Biological Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom; and
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Stephen Charles
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Tsveta Ivanova
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Burgos-Blasco B, Güemes-Villahoz N, Hernández-Ruiz S, Donate-Lopez J, López-Guajardo L. Dexamethasone implant prior to anti-VEGF therapy in pigment epithelium detachments with high-risk rupture characteristics secondary to neovascular age-related macular degeneration. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:676-683. [PMID: 35879177 DOI: 10.1016/j.oftale.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Evaluate the incidence of pigment epithelial tear when intravitreal delayed-release dexamethasone implant is administered (off-label use) prior to antiangiogenic treatment in pigment epithelium detachments (PED) secondary to neovascular age-related macular degeneration (nAMD) with high-risk rupture characteristics and investigate if it causes a decrease in the PED size. METHODS Patients with nAMD, PED height >500 microns and Ozurdex implant prior to the antiangiogenic therapy were included. The presence of pigment epithelium rupture in optical coherence tomography scans, best-corrected visual acuity (BCVA) and PED measurements (maximum height and diameter) were registered. RESULTS The study included 14 eyes of 14 patients: mean age 77 ± 7 years, 11 (79%) females. 25 ± 13 days after the Ozurdex, patients started with at least 3 anti-VEGF monthly injections. BCVA improved from 64 ± 14-69 ± 11 letters after anti-VEGF therapy (p > 0.05). Mean baseline PED height was 817 ± 269 µm, being 639 ± 268 µm after Ozurdex and 370 ± 260 µm after anti-VEGF injections (p = 0.035 and p = 0.009). One retinal pigment epithelium tear occurred (7%). No other adverse effects were reported. CONCLUSIONS Dexamethasone implant prior to anti-VEGF therapy may represent a promising therapeutic modality for large PED in nAMD, reducing PED dimensions and the risk of pigment epithelium tears prior to anti VEGF therapy.
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Affiliation(s)
- B Burgos-Blasco
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - N Güemes-Villahoz
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - S Hernández-Ruiz
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - J Donate-Lopez
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - L López-Guajardo
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Gabrielle PH, Nguyen V, Arnould L, Viola F, Zarranz-Ventura J, Barthelmes D, Creuzot-Garcher C, Gillies M. Incidence, Risk Factors, and Outcomes of Rhegmatogenous Retinal Detachment after Intravitreal Injections of Anti-VEGF for Retinal Diseases: Data from the Fight Retinal Blindness! Registry. Ophthalmol Retina 2022; 6:1044-1053. [PMID: 35589075 DOI: 10.1016/j.oret.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To report the estimated incidence, probability, risk factors, and 1-year outcomes of rhegmatogenous retinal detachment (RRD) in eyes receiving intravitreal injections (IVTs) of VEGF inhibitors for various retinal conditions in routine clinical practice. DESIGN Retrospective analysis of data from a prospectively designed observational outcomes registry: the Fight Retinal Blindness! PARTICIPANTS Eyes of patients starting IVTs of VEGF inhibitors (ranibizumab, aflibercept, or bevacizumab) for neovascular age-related macular degeneration, diabetic macular edema, or retinal vein occlusion from January 1, 2006, to December 31, 2020. All eyes that developed RRD within 90 days of IVTs were defined as cases with RRD and were matched with control eyes. METHODS Estimated incidence, probability, and hazard ratios (HRs) of RRD were measured using Poisson regression, Kaplan-Meier survival curve, and Cox proportional hazards models. Locally weighted scatterplot smoothing curves were used to compare visual acuity (VA) between cases and matched controls. MAIN OUTCOME MEASURES Estimated incidence of RRD. RESULTS We identified 16 915 eyes of 13 792 patients who collectively received 265 781 IVTs over 14 years. Thirty-six eyes were reported to develop RRD over the study period. The estimated incidence (95% confidence interval [CI]) per year per 1000 patients and per 10 000 injections was 0.77 (0.54-1.07) and 1.36 (0.95-1.89), respectively. The probability of RRD did not significantly increase at each successive injection (P = 0.95) with the time of follow-up. Older patients (HR [95% CI] = 1.81 [1.21-3.62] for every decade increase in age, P < 0.01) were at a higher risk of RRD, whereas patients with good presenting VA (HR [95% CI] = 0.85 [0.70-0.98] for every 10-letter increase in VA, P = 0.02) were at a lower risk. Neither the type of retinal disease (P = 0.52) nor the VEGF inhibitor (P = 0.09) was significantly associated with RRD risk. Cases with RRD lost 3 lines of vision on average compared with the prior RRD VA and had significantly fewer injections than matched controls over the year after the RRD. CONCLUSIONS Rhegmatogenous retinal detachment is a rare complication of VEGF inhibitor IVT in routine clinical practice with poor visual outcomes at 1 year.
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Affiliation(s)
- Pierre-Henry Gabrielle
- Department of Ophthalmology, Dijon University Hospital, Dijon, France; The University of Sydney, Sydney Medical School, Discipline of Ophthalmology, Save Sight Institute, New South Wales, Australia.
| | - Vuong Nguyen
- The University of Sydney, Sydney Medical School, Discipline of Ophthalmology, Save Sight Institute, New South Wales, Australia
| | - Louis Arnould
- Department of Ophthalmology, Dijon University Hospital, Dijon, France
| | - Francesco Viola
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Javier Zarranz-Ventura
- Clinical Institute of Ophthalmology (ICOF), Hospital Clinic, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Daniel Barthelmes
- The University of Sydney, Sydney Medical School, Discipline of Ophthalmology, Save Sight Institute, New South Wales, Australia; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Mark Gillies
- The University of Sydney, Sydney Medical School, Discipline of Ophthalmology, Save Sight Institute, New South Wales, Australia
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Eshtiaghi A, Dhoot AS, Mihalache A, Popovic MM, Nichani PAH, Sayal AP, Yu HJ, Wykoff CC, Kertes PJ, Muni RH. Pars Plana Vitrectomy with and without Supplemental Scleral Buckle for the Repair of Rhegmatogenous Retinal Detachment: A Meta-analysis. Ophthalmol Retina 2022; 6:871-885. [PMID: 35227949 DOI: 10.1016/j.oret.2022.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/06/2022] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
TOPIC It is unclear whether there are differences in safety and efficacy between pars plana vitrectomy (PPV) alone and PPV with a supplemental scleral buckle (SB; PPV-SB) for the treatment of rhegmatogenous retinal detachment. CLINICAL RELEVANCE This meta-analysis aimed to compare the safety and efficacy of these surgical procedures. METHODS In this meta-analysis, Ovid MEDLINE, Embase, and Cochrane Library were systematically searched (January 2000-June 2021). The primary outcome was the final best corrected visual acuity (BCVA), whereas the secondary outcomes were reattachment rates and complications. The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions tool for nonrandomized studies. RESULTS This study included 15 661 eyes from 38 studies (32 observational studies and 6 RCTs). The median follow-up duration was 6 months. The final BCVA was similar between PPV and PPV-SB (weighted mean difference [WMD], -0.03 logarithm of the minimum angle of resolution [-0.14 to 0.07]; P = 0.55). There was a significant difference in the single-operation success rate (SOSR) (88.2% versus 86.3%; relative risk [RR], 0.97 [0.95-1.00]; P = 0.03), favoring PPV-SB; however, there was no significant difference in the final reattachment rate (RR, 1.00 [0.99-1.01]; P = 0.56). Pars plana vitrectomy required a significantly higher number of operations to achieve final anatomical reattachment (WMD, 0.13 [0.02-0.24]; P = 0.02). In terms of complications, PPV was significantly less likely to be associated with macular edema (RR, 0.47 [0.25-0.88]; P = 0.02) and epiretinal membrane formation (RR, 0.70 [0.52-0.94]; P = 0.02), but these differences were no longer significant in studies published after 2010 or in RCTs. Significant proliferative vitreoretinopathy, lens status, and macular attachment status did not mediate differences in these effects. CONCLUSIONS There were no significant differences in the final visual acuity outcomes between PPV and PPV-SB. Pars plana vitrectomy with supplemental SB was associated with a greater SOSR than standalone PPV, although the magnitude of the effect was small, with a high number needed to treat. The final reattachment rate was similar. In recent studies and in RCTs, the risk of complications was similar between the procedures.
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Affiliation(s)
- Arshia Eshtiaghi
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Arjan S Dhoot
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Prem A H Nichani
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Aman P Sayal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Hannah J Yu
- Retina Consultants of Texas, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Charles C Wykoff
- Retina Consultants of Texas, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada.
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Stappler T, Montesel A, Konstantinidis L, Wolfensberger TJ, Eandi CM. INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE COEXISTENT WITH RHEGMATOGENOUS RETINAL DETACHMENT. Retina 2022; 42:1491-1497. [PMID: 35439799 PMCID: PMC9301978 DOI: 10.1097/iae.0000000000003509] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the clinical features and treatment outcomes of patients with macular hole coexistent with rhegmatogenous retinal detachment surgically treated with pars plana vitrectomy and inverted internal limiting membrane flap technique. METHODS Eleven consecutive patients with rhegmatogenous retinal detachment and macular hole who underwent vitrectomy and internal limiting membrane peeling with the inverted flap technique between December 2017 and February 2021 were retrospectively evaluated. The main outcome measures were retinal reattachment rate, macular hole closure rate, and postoperative best-corrected visual acuity. A nonsystematic literature review was performed to compare the study outcomes with those previously reported. RESULTS The primary retinal reattachment rate was 90% (10/11) with one surgery and 100% with 2 surgical procedures. Macular hole closure was achieved in all patients (11/11). All patients showed an improvement in visual acuity at the final postoperative visit, and the mean postoperative best-corrected visual acuity was 0.60 ± 0.32 logarithm of the minimum angle of resolution (20/80 Snellen equivalent). CONCLUSION Vitrectomy with the inverted internal limiting membrane flap technique achieved not only favorable anatomical retinal reattachment rates but also an encouraging recovery of central macular anatomy and visual function in patients with macular hole coexistent with rhegmatogenous retinal detachment.
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Affiliation(s)
- Theodor Stappler
- Department of Ophthalmology, University of Lausanne, Fondation Asile des Aveugles, Jules Gonin Eye Hospital, Lausanne, Switzerland; and
| | - Andrea Montesel
- Department of Ophthalmology, University of Lausanne, Fondation Asile des Aveugles, Jules Gonin Eye Hospital, Lausanne, Switzerland; and
| | - Lazaros Konstantinidis
- Department of Ophthalmology, University of Lausanne, Fondation Asile des Aveugles, Jules Gonin Eye Hospital, Lausanne, Switzerland; and
| | - Thomas J. Wolfensberger
- Department of Ophthalmology, University of Lausanne, Fondation Asile des Aveugles, Jules Gonin Eye Hospital, Lausanne, Switzerland; and
| | - Chiara M. Eandi
- Department of Ophthalmology, University of Lausanne, Fondation Asile des Aveugles, Jules Gonin Eye Hospital, Lausanne, Switzerland; and
- Department of Surgical Sciences, University of Torino, Italy
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Xiong S, Xia X. Risk factors and surgical outcomes for the concurrence of intraocular lens dislocation with vitreoretinal diseases. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2022; 47:881-887. [PMID: 36039584 PMCID: PMC10930294 DOI: 10.11817/j.issn.1672-7347.2022.220264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The weakness and dialysis of lens zonule after cataract surgery may lead to dislocation of intraocular lens (IOL). It has been shown that cataract surgery could induce or aggravate posterior vitreous detachment (PVD) due to postoperative inflammation and increased volume of vitreous cavity. PVD is associated with the occurrence of several vitreoretinal diseases, such as rhegmatogenous retinal detachment and macular hole. This study aims to explore risk factors for dislocation of IOL concurring with vitreoretinal disease, such as retinal detachment and macular hole, and to evaluate the efficacy and complications of surgical intervention for these abnormalities concurrently. METHODS Ten patients (10 eyes) who diagnosed as rhegmatogenous retinal detachment, traumatic macular hole, high myopic macular hole, and combined with IOL dislocation at the Department of Ophthalmology of Xiangya Hospital from January 2004 to December 2020 were enrolled. The patients received vitreoretinal surgery and reposition of IOL by scleral suturing. Medical records were reviewed to figure out the time and type of IOL dislocation. Preoperative and 1 year of postoperative best corrected visual acuity, intraocular pressure, corneal endothelial density, and complications of surgical management were analyzed. RESULTS Ten patients including 4 high myopia, 4 ocular contusion, and 2 who experienced IOL dislocation during the posterior capsulotomy were included in this study. Coexistence of IOL dislocation and vitreoretinal abnormalities occurred in patients with high myopia, ocular contusion, and capsulotomy. IOL dislocation happened in the vitreoretinal surgery in patients with high myopia or intraoperative capsulotomy. IOL dislocation occurred preoperatively in patients with ocular contusion. IOL capsular bag complex dislocation and out-of-the-bag IOL dislocation were found in 4 and 6 patients, respectively. Surgical relocation of dropped IOL and repair of vitreoretinal disease improved the best corrected visual acuity from preoperative 1.79±0.39 to postoperative 1.13±0.45 (P<0.001). The density of corneal endothelial cells in patients was lower than that before surgery [(1 806.40±181.20) cells/mm2 vs (1 914.00±182.22) cells/mm2, P<0.001]. There was no significant difference in intraocular pressure before and after surgery (P=0.099). Postoperative complications included high intraocular pressure and recurrent retinal detachment. CONCLUSIONS Dislocation of IOL may be concurrent with vitreoretinal disease. High myopia, blunt contusion, and capsulectomy might be the risk factors for intraocular lens dislocation. The surgical technique used in the present study is successful in manipulating these disorders with optimal functional results and less severe complications.
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Affiliation(s)
- Siqi Xiong
- Eye Center of Xiangya Hospital, Central South University, Changsha 410008.
- Hunan Key Laboratory of Ophthalmology, Changsha 410008, China.
| | - Xiaobo Xia
- Eye Center of Xiangya Hospital, Central South University, Changsha 410008.
- Hunan Key Laboratory of Ophthalmology, Changsha 410008, China.
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44
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Gündoğdu KÖ, Doğan E, Çelik E, Alagöz G. Effect of intravitreal ranibizumab on serous retinal detachment in diabetic macular edema. J Diabetes Complications 2022; 36:108228. [PMID: 35691875 DOI: 10.1016/j.jdiacomp.2022.108228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Kübra Özata Gündoğdu
- Sakarya University Education and Research Hospital, Department of Ophthalmology, Sakarya, Turkey.
| | - Emine Doğan
- Sakarya University Education and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
| | - Erkan Çelik
- Sakarya University Education and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
| | - Gürsoy Alagöz
- Sakarya University Education and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
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Abstract
PURPOSE OF REVIEW Despite advancement in the surgical instrumentation and techniques, proliferative vitreoretinopathy (PVR) remains the most common cause for failure of rhegmatogenous retinal detachment (RRD) repair. This review discusses ongoing translational and clinical advancements in PVR. RECENT FINDINGS PVR represents an exaggerated and protracted scarring process that can occur after RRD. The primary cell types involved are retinal pigment epithelium, glial, and inflammatory cells. They interact with growth factors and cytokines derived from the breakdown of the blood-retinal barrier that trigger a cascade of cellular processes, such as epithelial-mesenchymal transition, cell migration, chemotaxis, proliferation, elaboration of basement membrane and collagen and cellular contraction, leading to overt retinal pathology. Although there are currently no medical therapies proven to be effective against PVR in humans, increased understanding of the risks factors and pathophysiology have helped guide investigations for molecular targets of PVR. The leading therapeutic candidates are drugs that mitigate growth factors, inflammation, and proliferation are the leading therapeutic candidates. SUMMARY Although multiple molecular targets have been investigated to prevent and treat PVR, none have yet demonstrated substantial evidence of clinical benefit in humans though some show promise. Advancements in our understanding of the pathophysiology of PVR may help develop a multipronged approach for this condition.
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Affiliation(s)
- Abtin Shahlaee
- Mid Atlantic Retina, Retina Service of Wills Eye Hospital
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Collynn F Woeller
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Nancy J Philp
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ajay E Kuriyan
- Mid Atlantic Retina, Retina Service of Wills Eye Hospital
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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Abebe D, Tsegaw A. Pattern of vitreo-retinal diseases at University of Gondar tertiary eye care and training center, North-West Ethiopia. PLoS One 2022; 17:e0267425. [PMID: 35446916 PMCID: PMC9022795 DOI: 10.1371/journal.pone.0267425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/03/2021] [Indexed: 11/18/2022] Open
Abstract
Objective
Vitreoretinal diseases are common causes of ocular morbidities and blindness. Data on the spectrum of vitreoretinal diseases needs to be studied and known in order to establish appropriate vitreoretinal care setups. The aim of this study was to determine the patterns of vitreoretinal diseases among patients who visited the vitreoretina clinic of University of Gondar Tertiary Eye Care and Training Center, NW Ethiopia (UoG-TECTC).
Methodology
A hospital based cross sectional study was conducted from October/2017-September/2018. All patients who visited the vitreoretinal clinic for the first time during the study period were studied. Data were collected with standardized data extraction format entered into SPSS statistical package Version 20 and analyzed.
Result
A total of 739 new patients who visited the vitreoretinal clinic were included in the study. The mean age was 50.26 +/- 19 years. The age group between 21–60 years accounted for 59.7% of study patients. Male’s accounted for 63.1% and 58.7% of the participants were from urban areas. Bilateral disease was diagnosed in 504 (68.2%) of patients and 220 (29.7%) were bilaterally blind at presentation. Three hundred eighty nine (52.6%) of them had duration of illness six months and above.
Diabetic Retinopathy (DR), Age Related Macular Degeneration (AMD) and Rhegmatoginous Retinal Detachment (RRD) were the top three retinal diseases accounting for 21.3%(196), 17.3% (128) and 12.4% (92) of diagnoses respectively. Systemic comorbidities were found in 44% (325) of the patients with diabetes mellitus, hypertension and hyperlipidemia being the commonest, occurring in 27.8%, 6.3% and 2.8% of study patients respectively. Cataract was the commonest ocular comorbidity seen in 33.5% of study participants.
Conclusion
Vitreoretinal diseases affected a significant number of patients presented to our center and most of the study patients presented late with significant vision loss and blindness. Males were affected more than females and the age group between 21–60 years accounted nearly two-third of study patients. This is the working age group suffering from vision loss from vitreoretinal diseases. DR, AMD and RRD were the commonest retinal pathologies accounting for nearly half of the vitreoretinal diseases and these conditions are treatable either surgically or medically. However, available facilities for the management of these diseases are not adequate at the center. Strengthening the vitreoretinal services of UoG-TECTC with relevant equipment is recommended.
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Affiliation(s)
- Dagmawi Abebe
- Department of Ophthalmology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asamere Tsegaw
- Department of Ophthalmology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
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Cai Y, Yang Y, Zhong X. A Case Report of Intravitreal Dexamethasone Implant with Exudative Retinal Detachment for Ocular Toxocariasis Treatment. Korean J Parasitol 2022; 60:133-137. [PMID: 35500895 PMCID: PMC9058278 DOI: 10.3347/kjp.2022.60.2.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/21/2022] [Indexed: 11/23/2022]
Abstract
Toxocariasis is one of the most common geohelminth infections in several parts of the world. We describe a rare case of ocular toxocariasis with secondary exudative retinal detachment treated with albendazole and an intravitreal dexamethasone implant. A 13-year-old boy with counting finger vision was diagnosed with retinal vasculitis and exudative retinal detachment in his right eye. Fundoscopic examination revealed retinal hemorrhage, retinal vasculitis, and exudative retinal detachment. Serological test using serum and intraocular aqueous humor were positive for anti-Toxocara specific IgG antibodies. He received repeated doses of intravitreal dexamethasone implants combined with oral albendazole. A sequential follow-up optical coherence tomography revealed that the retina was successfully reattached. His visual acuity subsequently improved to 20/400.
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Cox JT, Miller JB. Retinal Detachment Associated With Acute Retinal Necrosis. Int Ophthalmol Clin 2022; 62:157-172. [PMID: 35325917 DOI: 10.1097/iio.0000000000000414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Feenstra HMA, Hahn LC, van Rijssen TJ, Tsonaka R, Breukink MB, Keunen JEE, Peters PJH, Dijkman G, Souied EH, MacLaren RE, Querques G, Downes SM, Fauser S, Hoyng CB, van Dijk EHC, Boon CJF. EFFICACY OF HALF-DOSE PHOTODYNAMIC THERAPY VERSUS HIGH-DENSITY SUBTHRESHOLD MICROPULSE LASER FOR TREATING PIGMENT EPITHELIAL DETACHMENTS IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY. Retina 2022; 42:721-729. [PMID: 34864802 DOI: 10.1097/iae.0000000000003363] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Comparing the effect of half-dose photodynamic therapy and high-density subthreshold micropulse laser treatment on retinal pigment epithelial detachments (PEDs) in chronic central serous chorioretinopathy. METHODS This study included data from the PLACE trial, a prospective randomized controlled trial comparing half-dose photodynamic therapy and high-density subthreshold micropulse laser treatment in chronic central serous chorioretinopathy. Main outcome measurements were changes in both the foveal PED and the highest PED within the macula at baseline compared with first and final evaluation visit. RESULTS At baseline, a macular PED was detected in 76.9% of patients (123/160), and a PED within 1,500 µm from the foveal center in 37.5% of patients (60/160). In the half-dose photodynamic therapy arm (61 patients), there was a significantly larger decrease in the highest macular PED compared with the high-density subthreshold micropulse laser treatment arm (62 patients) at both first and final evaluation visits (P < 0.001 and P = 0.012, respectively). The decrease of highest foveal PED was significant at first visit (P = 0.025). CONCLUSION Half-dose photodynamic therapy is superior to high-density subthreshold micropulse laser treatment with regard to a statistically significant reduction in the height of macular PEDs in active chronic central serous chorioretinopathy. These findings may also have implications for other diseases within the pachychoroid disease spectrum that can present with PEDs.
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Affiliation(s)
- Helena M A Feenstra
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Leo C Hahn
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Thomas J van Rijssen
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Roula Tsonaka
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Myrte B Breukink
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan E E Keunen
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Petrus J H Peters
- Department of Ophthalmology, Bergman Clinics B.V., Velp, the Netherlands
| | - Greet Dijkman
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Eric H Souied
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est, Creteil, France
| | - Robert E MacLaren
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Giuseppe Querques
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est, Creteil, France
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy
| | - Susan M Downes
- Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Sascha Fauser
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany; and
- F. Hoffmann-La Roche, Basel, Switzerland
| | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
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50
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Liu X, Huang J, Zhou R, Jiang Z, Chen H, Chen W, Ng TK, Wu Z, Zhang G. COMPARISON OF INTERNAL LIMITING MEMBRANE PEELING WITH THE INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR RHEGMATOGENOUS RETINAL DETACHMENT COEXISTING WITH MACULAR HOLE. Retina 2022; 42:697-703. [PMID: 35350048 DOI: 10.1097/iae.0000000000003370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To evaluate the anatomical and functional outcomes of internal limiting membrane (ILM) peeling and the inverted ILM flap technique for rhegmatogenous retinal detachment coexisting with macular hole. METHODS This retrospective study evaluated the medical records of 79 eyes with concurrent rhegmatogenous retinal detachment and macular hole received vitrectomy and silicone oil tamponade, with ILM peeling on 56 eyes and the inverted ILM flap technique on 23 eyes. RESULTS The Type 1 closure rate was greater in the inverted ILM flap group than the ILM peeling group (82.6% vs. 55.4%, P = 0.038). Lines of improvement were 7.8 ± 5.3 in the ILM peeling group and 8.9 ± 5.6 in the inverted ILM flap group. Postoperative epiretinal membrane and retinal reattachment rates were similar in two surgical groups (16.1% vs. 21.7%, P = 0.535 and 94.6% vs. 95.7%, P = 0.999, respectively). Type 1 closure was significantly correlated with the inverted ILM flap technique (OR = 5.568, P = 0.023). The inverted ILM flap technique showed no significant association with the final logarithm of the minimum angle of resolution best-corrected visual acuity in multivariate model analysis. CONCLUSION The inverted ILM flap technique was more effective in restoring the macular structure in patients with rhegmatogenous retinal detachment and coexisting macular hole, but the functional outcomes of the two strategies were comparable.
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Affiliation(s)
- Xujia Liu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
- Shantou University Medical College, Shantou, Shantou, Guangdong, China; and
| | - Jinqu Huang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Ruiqin Zhou
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
- Shantou University Medical College, Shantou, Shantou, Guangdong, China; and
| | - Zehua Jiang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
- Shantou University Medical College, Shantou, Shantou, Guangdong, China; and
| | - Haoyu Chen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Weiqi Chen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
- Shantou University Medical College, Shantou, Shantou, Guangdong, China; and
- Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Zhenggen Wu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Guihua Zhang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
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