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Sherif NA, Hoyek S, Wai K, Makhoul KG, Bitar R, Teiger M, Lorch AC, Patel NA, Armstrong GW. Recovery of Vision in Open Globe Injury Patients with Initial No Light Perception Vision. Ophthalmol Retina 2024:S2468-6530(24)00185-4. [PMID: 38636901 DOI: 10.1016/j.oret.2024.04.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/31/2024] [Accepted: 04/08/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE OR PURPOSE To identify clinical characteristics of injured eyes associated with visual recovery in patients with open globe injuries (OGI) and presenting with no light perception (NLP) vision. DESIGN Retrospective chart review. SUBJECTS, PARTICIPANTS, AND/OR CONTROLS All patients presenting to Massachusetts Eye and Ear with OGI and NLP vision from January 1999 to March 2022. METHODS, INTERVENTION, OR TESTING Manual data extraction to collect patient demographic characteristics, pre-operative, intraoperative, and post-operative characteristics of OGI injury, laceration versus rupture, history of intraocular surgery, time from injury to repair, timing of vitrectomy, lensectomy, choroidal drainage, and silicone oil placement, visual acuity (VA) at last follow-up, and subsequent B-scan ultrasound findings of retinal detachment, choroidal hemorrhage, vitreous hemorrhage, and disorganized intraocular contents. Patients with more than one week of follow-up and a documented VA at most recent follow-up were included. Exclusion criteria included age less than 10 years. Multivariable regression was performed. MAIN OUTCOMES VA recovery defined as light perception or better in patients with OGI and initial NLP vision. RESULTS 147 eyes with NLP vision after OGI were included. 25 (17%) eyes regained vision at last follow-up. The majority of patients recovered light perception vision (n=15, 60%) followed by 20/500 or better (n=5, 20%), hand motion (n=3, 12%), and count fingers (n=2, 8%). Most injuries were zone III (n=102, 69%) and presented with rupture (n=127, 86%). The mean time from OGI to surgical repair was 0.85 ± 1.7 days. B-scan was obtained in 104 (71%) cases. Pars plana vitrectomy was performed in 9 eyes (6%) with NLP at time of vitrectomy. Disorganized intraocular contents on B-scan (OR=0.170, 95%CI: 0.042-0.681, P=0.012) was the only clinical variable significantly associated with visual recovery, corresponding to a lack of visual improvement. CONCLUSION Recovery of vision in OGI with NLP vision at presentation cannot be predicted based on presenting clinical features. B-scan findings of disorganized intraocular contents after initial OGI repair was the only factor negatively associated with vision recovery in this patient population. Therefore, all eyes presenting with an OGI and NLP vision should undergo primary repair in hopes of subsequent visual recovery.
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Affiliation(s)
- Noha A Sherif
- Department of Ophthalmology, New England Eye Center, Tufts University, Boston, MA, USA
| | - Sandra Hoyek
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Karen Wai
- Department of Ophthalmology, Byers Eye Institute, Stanford University, San Francisco, CA, USA
| | - Kevin G Makhoul
- Department of Ophthalmology, University of Kansas School of Medicine, Prairie Village, KS, USA
| | - Racquel Bitar
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Marisa Teiger
- Department of Ophthalmology, New England Eye Center, Tufts University, Boston, MA, USA
| | - Alice C Lorch
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Nimesh A Patel
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Grayson W Armstrong
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
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2
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Chalam KV, Akanda M, Subramanian M. Successful closure of a refractory giant (15 sq mm) macular hole with amniotic membrane graft. J Surg Case Rep 2024; 2024:rjae013. [PMID: 38304310 PMCID: PMC10832604 DOI: 10.1093/jscr/rjae013] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024] Open
Abstract
The management of macular hole defects has undergone a significant transformation with the advent of advanced diagnostic tools and surgical techniques. These developments have enabled the effective treatment of macular holes that were previously considered untreatable. Although the majority of patients exhibit a positive response to initial treatment, a subset of patients may develop refractory macular holes that necessitate multiple surgeries for closure. In these instances, the utilization of amniotic membrane grafts to aid in the closure of large retinal holes presents a promising alternative. This report details the successful closure of a refractory giant macular hole (15 sq. mm) in a patient using an amniotic membrane graft, with improvement in visual acuity.
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Affiliation(s)
- Kakarla Venkata Chalam
- Department of Ophthalmology, Loma Linda University School of Medicine, 11370 Anderson St., Suite 1800, Loma Linda, CA 92354, United States
| | - Marib Akanda
- Department of Ophthalmology, Loma Linda University School of Medicine, 11370 Anderson St., Suite 1800, Loma Linda, CA 92354, United States
| | - Meenakshi Subramanian
- Department of Ophthalmology, Loma Linda University School of Medicine, 11370 Anderson St., Suite 1800, Loma Linda, CA 92354, United States
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Tilak A, Dora J, Tudu KC, Hota G, Behera S. A Comprehensive Investigation Into the Outcomes of Descemet's Stripping Endothelial Keratoplasty (DSEK) as a Treatment for Corneal Endothelial Disorders. Cureus 2023; 15:e46076. [PMID: 37900453 PMCID: PMC10610307 DOI: 10.7759/cureus.46076] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Descemet's stripping endothelial keratoplasty (DSEK) has emerged as the preferred method for posterior lamellar keratoplasty, as it enables the replacement of the compromised host endothelium with a viable donor lamella. The objective of this study was to assess the impact of DSEK on surgical outcomes and visual acuity. METHODS The research was carried out from November 2019 to October 2021, encompassing a sample of 18 patients (18 eyes) who satisfied the inclusion criteria for DSEK. The pre-operative evaluation was performed once before the surgery, while post-operative evaluations were conducted at one, three, and six months after the surgical intervention. The main variables assessed in this study encompassed demographic characteristics, visual acuity, surgical techniques, and surgical complications employed during the surgical procedure. The collected data were statistically analyzed using IBM SPSS software version 21 (IBM Corp., Armonk, NY, USA). RESULTS Patients in the study ranged in age from 25 to 70, with a mean age of 53.16 ± 14.19 years. The participants were 61% male and 39% female. The main reasons for DSEK use were pseudophakic bullous keratopathy (61%) and post-penetrating keratoplasty (PK) graft failure (17%). The other indications were aphakic bullous keratopathy (11%), bullous keratopathy with cataracts (5%), and Fuchs's endothelial dystrophy (5%). The study included 18 eyes: 14 eyes underwent DSEK, two underwent DSEK with small-incision cataract surgery (SICS) and posterior chamber intraocular lens (PCIOL) implantation, and two underwent DSEK with scleral-fixated FIL. A significant improvement in best-corrected visual acuity (BCVA) was observed at six-month follow-up (0.73 ± 0.37 vs. 1.73 ± 0.59 logMAR pre-operatively). During donor cornea dissection, buttonholing was the main concern, occurring 11% of the time. Descemet's perforation and donor preparation thickness variations were also observed. Reverse donor unfolding, incomplete DM stripping, and donor button displacement were quickly addressed and managed. Post-operative graft failure occurred in 22% of cases, while acute graft rejection occurred in 11%. Graft dislocation, pupillary block, and secondary glaucoma each had a 5% prevalence. CONCLUSION Descemet's stripping endothelial keratoplasty is a safe and effective treatment for corneal endothelial disorders, particularly in cases where scarring is not present. Surgical skills are essential to achieving the desired results. Descemet's stripping endothelial keratoplasty is favored over conventional keratoplasty for endothelial dysfunction due to its technical advantages and manageable risks. Our research demonstrates a significant improvement in visual acuity through DSEK. Despite manageable post-operative complications, it is vital to educate patients and medical professionals on surgical complexities. Descemet's stripping endothelial keratoplasty appears promising for the treatment of endothelial disorders, but its long-term implications must be studied.
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Affiliation(s)
- Amritha Tilak
- Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, IND
| | - Jayashree Dora
- Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, IND
| | - Kanhei C Tudu
- Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, IND
| | - Gopeswari Hota
- Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, IND
| | - Sharmistha Behera
- Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, IND
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Zhang Y, Chen C, Huang W, Teng Y, Shu X, Zhao F, Xu J, Zhang L. Preoperative volume of the optic chiasm is an easily obtained predictor for visual recovery of pituitary adenoma patients following endoscopic endonasal transsphenoidal surgery: a cohort study. Int J Surg 2023; 109:896-904. [PMID: 36999782 PMCID: PMC10389445 DOI: 10.1097/js9.0000000000000357] [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: 12/28/2022] [Accepted: 03/13/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Predicting the postoperative visual outcome of pituitary adenoma patients is important but remains challenging. This study aimed to identify a novel prognostic predictor which can be automatically obtained from routine MRI using a deep learning approach. MATERIALS AND METHODS A total of 220 pituitary adenoma patients were prospectively enrolled and stratified into the recovery and nonrecovery groups according to the visual outcome at 6 months after endoscopic endonasal transsphenoidal surgery. The optic chiasm was manually segmented on preoperative coronal T2WI, and its morphometric parameters were measured, including suprasellar extension distance, chiasmal thickness, and chiasmal volume. Univariate and multivariate analyses were conducted on clinical and morphometric parameters to identify predictors for visual recovery. Additionally, a deep learning model for automated segmentation and volumetric measurement of optic chiasm was developed with nnU-Net architecture and evaluated in a multicenter data set covering 1026 pituitary adenoma patients from four institutions. RESULTS Larger preoperative chiasmal volume was significantly associated with better visual outcomes ( P =0.001). Multivariate logistic regression suggested it could be taken as the independent predictor for visual recovery (odds ratio=2.838, P <0.001). The auto-segmentation model represented good performances and generalizability in internal (Dice=0.813) and three independent external test sets (Dice=0.786, 0.818, and 0.808, respectively). Moreover, the model achieved accurate volumetric evaluation of the optic chiasm with an intraclass correlation coefficient of more than 0.83 in both internal and external test sets. CONCLUSION The preoperative volume of the optic chiasm could be utilized as the prognostic predictor for visual recovery of pituitary adenoma patients after surgery. Moreover, the proposed deep learning-based model allowed for automated segmentation and volumetric measurement of the optic chiasm on routine MRI.
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Affiliation(s)
- Yang Zhang
- Department of Neurosurgery, West China Hospital, Sichuan University
- Department of Radiology, West China Hospital, Sichuan University
| | - Chaoyue Chen
- Department of Neurosurgery, West China Hospital, Sichuan University
- Department of Radiology, West China Hospital, Sichuan University
| | - Wei Huang
- College of Computer Science, Sichuan University
| | - Yuen Teng
- Department of Neurosurgery, West China Hospital, Sichuan University
- Department of Radiology, West China Hospital, Sichuan University
| | - Xin Shu
- College of Computer Science, Sichuan University
| | - Fumin Zhao
- Department of Radiology, West China Second University Hospital, Sichuan University
| | - Jianguo Xu
- Department of Neurosurgery, West China Hospital, Sichuan University
- Department of Radiology, West China Hospital, Sichuan University
| | - Lei Zhang
- College of Computer Science, Sichuan University
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5
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Srithawatpong S, Chaitanuwong P, Yospaiboon Y. Factors Affecting Visual Recovery in Patients with Ethambutol-Induced Optic Neuropathy. Clin Ophthalmol 2023; 17:545-554. [PMID: 36798797 PMCID: PMC9925387 DOI: 10.2147/opth.s401916] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
Purpose To study visual recovery and identify the factors that may affect it in patients with ethambutol-induced optic neuropathy (EON). Patients and Methods Medical charts of patients who developed optic neuropathy after ethambutol (EMB) treatment for tuberculosis infection were retrospectively reviewed. Demographic details and clinical data were examined to assess visual recovery after discontinuation of ethambutol treatment. The univariate and multivariate relationships between various factors and visual recovery were evaluated using regression analysis. Results Of 5394 patients diagnosed with tuberculosis infection and treated with EMB, 23 patients (0.43%) were diagnosed with EON. Logistic regression analysis found that female sex was the categorical factor significantly associated with good visual recovery with an odds ratio of 12.0 (95% confidence interval 1.56, 92.29; p = 0.02), while linear regression analysis identified good initial visual acuity as the numerical factor significantly related with it (p < 0.001). After adjustment with multivariate analysis, initial visual acuity was found to be the only significant factor associated with visual recovery. All patients with initial visual acuity of better than 20/200 at first visit achieved good visual recovery. Conclusion The incidence of EON in patients treated with EMB was 0.43% in this hospital-based study. Good visual recovery was noted in 39.13% of these patients, and initial visual acuity was the factor that affected visual recovery. It is recommended that patients on EMB have regular screening by an ophthalmologist for early detection of the disease, and if it is discovered, that the use of the drug be immediately discontinued in order to prevent potentially devastating visual loss.
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Affiliation(s)
- Supaporn Srithawatpong
- Department of Ophthalmology, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand,Department of Ophthalmology, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Pareena Chaitanuwong
- Department of Ophthalmology, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand,Department of Ophthalmology, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Yosanan Yospaiboon
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand,Correspondence: Yosanan Yospaiboon, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, 123 Mitraparb Highway, Khon Kaen, 40002, Thailand, Tel +66-4336-3010, Fax +66-4334-8383, Email
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6
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Shah S, Shah M, Purohit A, Khanguda V. Perceptual learning with hand - eye coordination as an effective tool for managing amblyopia: A prospective study. Indian J Ophthalmol 2022; 70:3630-3633. [PMID: 36190061 PMCID: PMC9789846 DOI: 10.4103/ijo.ijo_852_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Amblyopia is a serious condition resulting in monocular impairment of vision. Although traditional treatment improves vision, we attempted to explore the results of perceptual learning in this study. Methods This prospective cohort study included all patients with amblyopia who were subjected to perceptual learning. The presenting data on vision, stereopsis and contrast sensitivity were documented in a pretested online format, and the pre- and post-treatment information was compared using descriptive, cross-tabulation and comparative methods on SPSS 2.2. The mean values were obtained, and P < 0.05 was considered statistically significant. Results The cohort consisted of 47 patients (23 females and 24 males) with a mean age of 14.11 ± 7.13 years. A statistically significant improvement was detected in visual acuity after the perceptual learning session, and the median follow-up period was 17 days. Also, significant improvements were observed in stereopsis but not in the visual outcomes among the age groups. Conclusion Perceptual learning with hand-eye coordination is an effective method for managing amblyopia. This approach can improve vision in all age groups. However, visual improvement is significantly influenced by ocular alignment.
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Affiliation(s)
| | - Mehul Shah
- Drashti Netralaya, Dahod, Gujarat, India,Correspondence to: Dr. Mehul Shah, Drashti Netralaya, Chakalia Road, Dahod, Gujarat, India. E-mail:
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7
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Balasubramaniam S, Sreenivasan J, Dhawan A, Agarwal A. A case of central retinal artery occlusion due to atrial myxoma with excellent visual recovery. Indian J Ophthalmol 2022; 70:2698-2700. [PMID: 35791211 PMCID: PMC9426161 DOI: 10.4103/ijo.ijo_239_22] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | | | - Atul Dhawan
- Dr. Agarwal's Eye Hospital, Chennai, Tamil Nadu, India
| | - Amar Agarwal
- Dr. Agarwal's Eye Hospital, Chennai, Tamil Nadu, India
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8
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Ain-Nasyrah AS, Majid NA, Shatriah I. Transient cortical blindness secondary to hepatic encephalopathy in a pediatric patient: A case report and literature review. Taiwan J Ophthalmol 2021; 11:413-416. [PMID: 35070675 PMCID: PMC8757512 DOI: 10.4103/tjo.tjo_43_20] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022] Open
Abstract
Cortical blindness, also known as cerebral visual impairment, may occur in pediatric patients. Hepatic encephalopathy is a rare cause of cortical blindness in children. This report describes a girl with underlying type 1 autoimmune hepatitis, who complained of sudden-onset, painless visual loss in both eyes, which was associated with generalized headache and altered mental status. She was treated with intravenous antibiotics and syrup lactulose. The patient regained full visual recovery after 1 week. Prompt diagnosis and treatment are mandatory in such uncommon instances.
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Affiliation(s)
| | - Norizan Abdul Majid
- Pediatrics Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Ismail Shatriah
- Ophthalmology Clinic, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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9
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Zhang Y, Chen C, Huang W, Cheng Y, Teng Y, Zhang L, Xu J. Machine Learning-Based Radiomics of the Optic Chiasm Predict Visual Outcome Following Pituitary Adenoma Surgery. J Pers Med 2021; 11:991. [PMID: 34683132 DOI: 10.3390/jpm11100991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023] Open
Abstract
Preoperative prediction of visual recovery after pituitary adenoma surgery remains a challenge. We aimed to investigate the value of MRI-based radiomics of the optic chiasm in predicting postoperative visual field outcome using machine learning technology. A total of 131 pituitary adenoma patients were retrospectively enrolled and divided into the recovery group (N = 79) and the non-recovery group (N = 52) according to visual field outcome following surgical chiasmal decompression. Radiomic features were extracted from the optic chiasm on preoperative coronal T2-weighted imaging. Least absolute shrinkage and selection operator regression were first used to select optimal features. Then, three machine learning algorithms were employed to develop radiomic models to predict visual recovery, including support vector machine (SVM), random forest and linear discriminant analysis. The prognostic performances of models were evaluated via five-fold cross-validation. The results showed that radiomic models using different machine learning algorithms all achieved area under the curve (AUC) over 0.750. The SVM-based model represented the best predictive performance for visual field recovery, with the highest AUC of 0.824. In conclusion, machine learning-based radiomics of the optic chiasm on routine MR imaging could potentially serve as a novel approach to preoperatively predict visual recovery and allow personalized counseling for individual pituitary adenoma patients.
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Oya S, Matsui T. Ultra-Early Optic Nerve Decompression for the Resection of Anterior Clinoidal Meningioma. J Neurol Surg B Skull Base 2018; 79:S231-S232. [PMID: 29770287 PMCID: PMC5954281 DOI: 10.1055/s-0038-1623521] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 12/07/2017] [Indexed: 11/10/2022] Open
Abstract
Improvement in vision is one of the main goals of surgery for anterior clinoidal meningiomas with visual deficits. Early optic nerve decompression surgery has been advocated in previous studies to achieve the best visual outcome. Through this video, the authors describe their surgical techniques to decompress the optic nerve at the very early stage of surgery. A 35-year-old patient presented with subjective blurry vision in the right eye over the last 8 months. Magnetic resonance images showed a 3.2-cm meningioma arising at the right anterior clinoid. Preoperative ophthalmological test was within the normal range, but the patient wished to have surgical resection after a detailed discussion of benefits and risks related to surgical resection. The surgical strategy consisted of the right lateral subfrontal approach that includes a standard right frontotemporal craniotomy, extradural anterior clinoidectomy, and early optic nerve decompression prior to tumor resection. The tumor was divided into compartments defined by the arteries and resected. Simpson grade II resection was achieved without complications. The patient's symptoms disappeared. In anterior clinoidal meningiomas that cause visual deficits, the optic nerve is assumed very vulnerable to any further injuries related to the operative maneuver. Ultra-early optic nerve decompression can be performed in anterior clinoidal meningiomas regardless of their size by extradural unroofing of the optic canal and sectioning of the optic canal sheath, which we believe contributes to better visual improvement.
The link to the video can be found at:
https://youtu.be/RIFi4ecWAhQ
.
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Affiliation(s)
- Soichi Oya
- Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Toru Matsui
- Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Emperador S, Vidal M, Hernández-Ainsa C, Ruiz-Ruiz C, Woods D, Morales-Becerra A, Arruga J, Artuch R, López-Gallardo E, Bayona-Bafaluy MP, Montoya J, Ruiz-Pesini E. The Decrease in Mitochondrial DNA Mutation Load Parallels Visual Recovery in a Leber Hereditary Optic Neuropathy Patient. Front Neurosci 2018; 12:61. [PMID: 29479304 PMCID: PMC5811516 DOI: 10.3389/fnins.2018.00061] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/24/2018] [Indexed: 11/13/2022] Open
Abstract
The onset of Leber hereditary optic neuropathy is relatively rare in childhood and, interestingly, the rate of spontaneous visual recovery is very high in this group of patients. Here, we report a child harboring a rare pathological mitochondrial DNA mutation, present in heteroplasmy, associated with the disease. A patient follow-up showed a rapid recovery of the vision accompanied by a decrease of the percentage of mutated mtDNA. A retrospective study on the age of recovery of all childhood-onset Leber hereditary optic neuropathy patients reported in the literature suggested that this process was probably related with pubertal changes.
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Affiliation(s)
- Sonia Emperador
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigaciones Biomédicas En Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Mariona Vidal
- Servicio de Oftalmología Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carmen Hernández-Ainsa
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Cristina Ruiz-Ruiz
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain
| | - Daniel Woods
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana Morales-Becerra
- Servicio de Oftalmología Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jorge Arruga
- Servicio de Oftalmología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Artuch
- Centro de Investigaciones Biomédicas En Red de Enfermedades Raras (CIBERER), Barcelona, Spain.,Servicio de Bioquímica, Hospital Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Ester López-Gallardo
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigaciones Biomédicas En Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - M Pilar Bayona-Bafaluy
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Julio Montoya
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigaciones Biomédicas En Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Eduardo Ruiz-Pesini
- Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigaciones Biomédicas En Red de Enfermedades Raras (CIBERER), Barcelona, Spain.,Fundación ARAID, Zaragoza, Spain
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Zhang J, Zhou YH, Zheng Y, Liu Q. Comparison of visual performance recovery after thin-flap LASIK with 4 femtosecond lasers. Int J Ophthalmol 2017; 10:1566-1572. [PMID: 29062777 DOI: 10.18240/ijo.2017.10.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 07/11/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the speed of visual recovery following myopic thin-flap LASIK with four femtosecond lasers. METHODS Eighty-eight eyes of 46 patients who were consecutively scheduled for bilateral LASIK with the IntraLase FS60 (Group 1), Femto LDV Crystal Line (Group 2), Wavelight FS200 (Group 3) and VisuMax (Group 4) femtosecond lasers were enrolled in. Monocular uncorrected distance visual acuity (UDVA), best-corrected distant visual acuity (CDVA), refraction, contrast sensitivity and higher-order aberrations (HOAs) were evaluated at 1, 3d, 1wk and 1mo postoperatively. RESULTS Sixteen eyes (72.7%) achieved 20/16 and 8 eyes (36.4%) were 20/12.5 at 1d in Group 2, which was significantly more than other 3 groups. At 1wk, 20 eyes (90.9%) achieved 20/16 in Groups 2 and 4. At 1mo, 20 eyes (90.9%) achieved 20/16 in Group 2 and Group 4, which were significantly more than other two groups. While by 1 mo, the difference of the residual spherical equivalent (SE) was not statistically significant among 4 groups (P=0.121). The induction of spherical aberration (SA) were significantly less for Groups 2, 3, 4 than for Group 1 one day after surgery (P=0.015). The differences among 4 groups were not statistically significant before and after surgery on every time points (all P>0.05). CONCLUSION The thin-flap LASIK procedure using the Femto LDV Crystal Line and VisuMax femtosecond laser show faster visual performance recovery.
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Affiliation(s)
- Jing Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yue-Hua Zhou
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yan Zheng
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Qian Liu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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Zhang J, Zhang S, Song Y, Zhu C, He M, Ren Q, Shan B, Wang Z, Zeng Y, Xu J. Predictive value of preoperative retinal nerve fiber layer thickness for postoperative visual recovery in patients with chiasmal compression. Oncotarget 2017; 8:59148-59155. [PMID: 28938625 PMCID: PMC5601721 DOI: 10.18632/oncotarget.19324] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/11/2017] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to evaluate the predictive role of preoperative retinal nerve fiber layer (RNFL) thickness for postoperative visual recovery in patients with chiasmal compression through performing a meta-analysis. PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure were searched for relevant studies. The study and patient characteristics were extracted. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to estimate the predictive value of RNFL thickness. Subgroup analyses were also performed. Four studies with 202 patients and 395 eyes were included. The pooled results showed that patients with normal RNFL thickness could achieve better visual recovery compared with those with thin RNFL with the OR of 15.61 (95% CI, 4.09-59.61). Significant heterogeneity was observed (I2 = 54.5%, P=0.086). Publication bias was not present. Normal preoperative RNFL thickness could predict better postoperative visual recovery than thin RNFL in patients with chiasmal compression.
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Affiliation(s)
- Jing Zhang
- Department of Neurosurgery, West China Hospital of Sichuan University, The First People's Hospital of Yibin, Sichuan, PR China
| | - Sunfu Zhang
- Department of Neurosurgery, West China Hospital of Sichuan University, The First People's Hospital of Yibin, Sichuan, PR China
| | - Yanlin Song
- West China School of Medicine, West China Hospital of Sichuan University, Sichuan, PR China
| | - Chenjing Zhu
- West China School of Medicine, West China Hospital of Sichuan University, Sichuan, PR China
| | - Min He
- Department of Neurosurgery, West China Hospital of Sichuan University, The First People's Hospital of Yibin, Sichuan, PR China
| | - Qingqing Ren
- Department of Neurosurgery, West China Hospital of Sichuan University, The First People's Hospital of Yibin, Sichuan, PR China
| | - Baoyin Shan
- Department of Neurosurgery, West China Hospital of Sichuan University, The First People's Hospital of Yibin, Sichuan, PR China
| | - Ziqiong Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, The First People's Hospital of Yibin, Sichuan, PR China
| | - Yunhui Zeng
- Department of Neurosurgery, West China Hospital of Sichuan University, The First People's Hospital of Yibin, Sichuan, PR China
| | - Jianguo Xu
- Department of Neurosurgery, West China Hospital of Sichuan University, The First People's Hospital of Yibin, Sichuan, PR China
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Abstract
Background The purpose of this study was to analyze eyes presenting with no light perception (NLP) after open globe injury (OGI) to determine visual outcomes and prognostic indicators for visual recovery. Methods The records of consecutive patients with at least 6 months of follow-up presenting with OGI and NLP to a single institution between January 1, 2003 and December 31, 2013 were reviewed for demographics, ophthalmic history, context and characteristics of injury, ocular examination findings, surgical interventions, and follow-up visual acuity. Unpaired t-tests and Fisher’s Exact tests were used for statistical analysis. Results Twenty-five patients met our inclusion criteria. The mean age was 50.4±25.5 (range 8–91) years. Four patients (16%) regained vision (hand motion in three patients and light perception in one patient) while 21 patients (84%) remained with NLP or had a prosthesis at final follow-up. Fourteen eyes (56%) were enucleated; nine (36%) were secondary enucleations. Although the sample sizes were small, neither ocular trauma score nor wound size was found to predict visual recovery. Conclusion Four patients regained some vision after presenting with NLP due to OGI. These findings suggest that, in select cases, physicians should discuss the possibility of regaining some vision.
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Affiliation(s)
- Yong S Han
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA
| | - Shaheen C Kavoussi
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA
| | - Ron A Adelman
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA
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Örnek K, Örnek N. Visual recovery from optic atrophy following acute optic neuropathy in the fellow eye. J Res Med Sci 2012; 17:582-3. [PMID: 23626640 PMCID: PMC3634301] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 05/03/2012] [Accepted: 05/16/2012] [Indexed: 12/02/2022]
Abstract
The left eye of a 65-year-old male was blind due to optic atrophy and only seeing eye had also dry type age-related macular degeneration. An anterior ischemic optic neuropathy developed in the better seeing eye. Vision recovered in the blind eye in a short time after losing the better eye. Gaining some vision in a blind eye may be an adaptation of visual pathway in such patients.
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Affiliation(s)
- Kemal Örnek
- Department of Ophthalmology, School of Medicine, Kirikkale University, Kirikkale, Turkey,Address for correspondence: Dr. Kemal Örnek, Associate Professor, 1465. Sokak, 16/31 Çukurambar, Çankaya, Ankara, Turkey. E-mail:
| | - Nurgül Örnek
- Department of Ophthalmology, School of Medicine, Kirikkale University, Kirikkale, Turkey
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