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Baltă G, Tofolean IT, Tiu T, Dinu V, Alexandrescu CM, Baltă F, Voinea LM. SEQUENTIAL PARS PLANA VITRECTOMY AND INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR RHEGMATOGENOUS RETINAL DETACHMENTS WITH PERIPHERAL BREAKS AND CONCOMITANT NONCAUSATIVE MACULAR HOLE IN NONHIGHLY MYOPIC PATIENTS. Retina 2024; 44:1777-1784. [PMID: 39287540 PMCID: PMC11398291 DOI: 10.1097/iae.0000000000004180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
PURPOSE To present the anatomical and functional results of sequential pars plana vitrectomy for treating rhegmatogenous retinal detachment with peripheral breaks and concomitant noncausative macular holes (MHs) in nonhighly myopic patients. METHODS Medical records of patients who underwent rhegmatogenous retinal detachment surgical repair between 2017 and 2023 were reviewed. Of 980 patients with rhegmatogenous retinal detachment, 10 had concurrent MH and underwent sequential pars plana vitrectomy for rhegmatogenous retinal detachment repair and air endotamponade, followed by MH repair using the inverted internal limiting membrane flap technique and C2F6 endotamponade after a minimum of 1 week. The main outcomes measured were best-corrected visual acuity change, retinal reattachment rate, MH closure rate, and closure type. RESULTS The retinal reattachment rate was 90% after the primary surgery and 100% after subsequent surgery. Macular hole closure was achieved in all cases. Macular hole diameters ranged from 291 to 702 µm. Anatomical recovery showed mainly 1A closure types (90%). Functional recovery demonstrated significant best-corrected visual acuity improvement, with a mean visual acuity gain of 1.58 ± 0.41 the logarithm of the minimum angle of resolution. CONCLUSION For this infrequent pathology, sequential surgery using the inverted internal limiting membrane flap technique and air/gas endotamponade yielded favorable anatomical and functional outcomes. This controlled and standardized approach using sequential surgeries contributes to the achievement of consistent results.
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Affiliation(s)
- George Baltă
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Bucharest Emergency Eye Hospital, Bucharest, Romania
| | - Ioana Teodora Tofolean
- Bucharest Emergency Eye Hospital, Bucharest, Romania
- Department of Biophysics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Retina Clinic, Bucharest, Romania
| | | | - Valentin Dinu
- Bucharest Emergency Eye Hospital, Bucharest, Romania
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Cristina-Mihaela Alexandrescu
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania; and
| | - Florian Baltă
- Bucharest Emergency Eye Hospital, Bucharest, Romania
- Retina Clinic, Bucharest, Romania
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Academy of Romanian Scientists, Romania
| | - Liliana-Mary Voinea
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania; and
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Garcin T, Gaudric A, Sikorav A, Tadayoni R, Couturier A. Internal Limiting Membrane Peeling for Large Macular Holes Induces Only Structural Remodeling without Functional Impairment Over 12 Years. Ophthalmol Retina 2024:S2468-6530(24)00429-9. [PMID: 39276867 DOI: 10.1016/j.oret.2024.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 09/04/2024] [Accepted: 09/09/2024] [Indexed: 09/17/2024]
Abstract
PURPOSE To evaluate the very long-term functional and structural outcomes of internal limiting membrane (ILM) peeling for full-thickness macular holes (FTMH). DESIGN Observational case series nested within a multicenter, randomized, controlled clinical trial (RCT) (ClinicalTrials.gov: NCT00190190). SUBJECTS Patients who underwent vitrectomy with or without ILM peeling for an idiopathic large FTMH in a tertiary ophthalmology center, with a minimum follow-up of 10 years after surgery. METHODS Review of charts, spectral-domain OCT (SD-OCT) scans, OCT angiography (OCTA) scans, and microperimetry of patients originally enrolled in the RCT. MAIN OUTCOME MEASURES Primary outcome was functional assessment in both groups (ILM peeling or not) including the retinal sensitivity (RS), distance and near best-corrected visual acuity (BCVA), and number of eyes achieving ≥0.3 logarithm of the minimum angle of resolution >10 years after surgery. Secondary outcomes were structural assessment in the entire 3 × 3-mm and 6 × 6-mm areas, and regionally in the different areas of the ETDRS grid: OCT and OCTA biomarkers in both groups and fellow eyes. RESULTS Thirteen eyes of 13 patients with a mean follow-up of 12 ± 0.73 years were included. The mean RS and BCVA, or visual improvement did not differ between ILM peeling (n = 8) and no peeling (n = 5) (all P > 0.05). The dissociated optic nerve fiber layers on en face OCT were only observed in eyes with ILM peeling, predominantly in temporal parafoveal (20%) and perifoveal (19%) rings. The mean total retinal thickness and inner retinal thickness in the parafoveal ring were significantly lower in peeled eyes (309 ± 11 μm and 94 ± 9 μm respectively) versus nonpeeled eyes (330 ± 21 μm and 108 ± 11 μm respectively; P = 0.037 and P = 0.040), without significant difference in ganglion cell or retinal nerve fiber layers. Accordingly, the mean superficial capillary plexus density in the parafoveal ring was significantly lower in eyes with peeling versus without (39.65 ± 3.76 % versus 47.22 ± 4.00; P = 0.005). The mean foveal avascular zone area was smaller in eyes with peeling versus without (0.24 ± 0.05 mm2 vs. 0.42 ± 0.13 mm2, respectively, P = 0.005). CONCLUSIONS Despite persistent structural changes especially in the parafoveal ring, ILM peeling for idiopathic large FTMH did not seem to impact long-term RS or BCVA over 12 years. 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)
- Thibaud Garcin
- Ophthalmology Department, Hospital Lariboisiere and Fernand-Widal, Paris, France; Ophthalmology Department 5, National Hospital 15-20, Paris, France; University Jean Monnet, Saint-Etienne, France.
| | - Alain Gaudric
- Ophthalmology Department, Hospital Lariboisiere and Fernand-Widal, Paris, France
| | - Anne Sikorav
- Ophthalmology Department, Hospital Lariboisiere and Fernand-Widal, Paris, France
| | - Ramin Tadayoni
- Ophthalmology Department, Hospital Lariboisiere and Fernand-Widal, Paris, France
| | - Aude Couturier
- Ophthalmology Department, Hospital Lariboisiere and Fernand-Widal, Paris, France
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Ma X, Sun J, Liang Q, Kong Y, Yang H, Huang X. Comparative analysis of internal limiting membrane peeling versus internal limiting membrane flap insertion for treating idiopathic macular holes. Photodiagnosis Photodyn Ther 2024; 49:104311. [PMID: 39154923 DOI: 10.1016/j.pdpdt.2024.104311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/13/2024] [Accepted: 08/16/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVE To evaluate the clinical efficacy of internal limiting membrane (ILM) peeling combined with perimacular hole massage versus ILM flap insertion in the management of patients with idiopathic macular holes was conducted. METHODS 35 patients (total of 35 eyes) with idiopathic macular holes (with hole diameters ranging from 366 to 1430 μm) were divided into two groups-Group A consisted of 20 eyes that underwent pars plana vitrectomy (PPV) combined with ILM peeling and perimacular hole massage, while Group B comprised 15 eyes that underwent PPV combined with ILM flap insertion. Subsequent follow-up examinations were performed at 1 week, 1 month, and 3 months post-surgery. The study also involved a comparison of best corrected visual acuity (BCVA) and optical coherence tomography (OCT) classifications between both the patient groups. RESULTS The macular hole closure rates in Group A were 60 %, while in Group B, the closure rate was 93 %. There was significant difference in hiatus healing rate between the two groups (t = 4.843, p = 0.048). The difference in BCVA at 3 months post-operation between the two groups was statistically significant (t = 3.221, p = 0.003). Three months post-operatively, the BCVA in Group B demonstrated improvement compared to the pre-operative BCVA, with a statistically significant difference (p > 0.05). Three months post-operatively, the BCVA in Group A demonstrated improvement compared to the pre-operative BCVA, but this difference was not statistically significant (p > 0.05). CONCLUSION The combination of PPV with ILM flap insertion demonstrates favorable therapeutic efficacy in the treatment of idiopathic macular holes, leading to improved visual acuity.
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Affiliation(s)
- Xueying Ma
- Department of Retina diseases, Lanzhou Prey Eye and Vision Hospital, Lanzhou 730030, Gansu Province,China.
| | - Jie Sun
- Department of Retina diseases, Lanzhou Prey Eye and Vision Hospital, Lanzhou 730030, Gansu Province,China
| | - Qiaohong Liang
- Department of Retina diseases, Lanzhou Prey Eye and Vision Hospital, Lanzhou 730030, Gansu Province,China
| | - Yuerong Kong
- Department of Retina diseases, Lanzhou Prey Eye and Vision Hospital, Lanzhou 730030, Gansu Province,China
| | - Hong Yang
- Department of Retina diseases, Lanzhou Prey Eye and Vision Hospital, Lanzhou 730030, Gansu Province,China
| | - Xiaogang Huang
- Department of Retina diseases, Lanzhou Prey Eye and Vision Hospital, Lanzhou 730030, Gansu Province,China
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Rueda-Latorre D, Sosa-Lockward JA, Abreu-Arbaje N. Presence of subfoveal hyperreflective dots as an anatomic and functional prognostic biomarker in macular holes. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024; 99:232-236. [PMID: 38663716 DOI: 10.1016/j.oftale.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/12/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To evaluate the presence of subfoveal hyperreflective dots (SfHD) using optical coherence tomography (OCT) in macular holes (MH) and establish whether there is a relationship with postoperative anatomical and functional outcomes. METHODS An observational cross-sectional study was conducted at the Dr. Elías Santana Hospital. Sixty-eight eyes of 67 patients with a tomographic diagnosis of full-thickness MH who underwent pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling were included. Preoperative and postoperative measurements were obtained using radial macular scans and HD raster scans with Optovue and Cirrus 5000 (Zeiss) OCT machines. The main outcome measures were anatomical closure by OCT and functional outcome through best-corrected visual acuity (BCVA). RESULTS The anatomical closure rate in our study was 63%. MHs that failed to achieve anatomical closure exhibited a higher number of hyperreflective dots and worse postoperative BCVA. A statistically significant association was found between exposed retinal pigment epithelium (RPE) in microns and the number of SfHD (P = .001). CONCLUSION SfHD is a common tomographic finding in MH, and the presence of a higher number of these points is associated with poorer anatomical and functional outcomes. This imaging finding is a potential prognostic biomarker in this pathology.
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Affiliation(s)
- D Rueda-Latorre
- Instituto Tecnológico de Santo Domingo (INTEC), Santo Domingo, República Dominicana; Servicio de Oftalmología, Centro Cristiano de Servicios Médicos, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana.
| | - J A Sosa-Lockward
- Instituto Tecnológico de Santo Domingo (INTEC), Santo Domingo, República Dominicana; Servicio de Oftalmología, Centro Cristiano de Servicios Médicos, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana; Departamento de Retina y Vítreo, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana
| | - N Abreu-Arbaje
- Instituto Tecnológico de Santo Domingo (INTEC), Santo Domingo, República Dominicana; Servicio de Oftalmología, Centro Cristiano de Servicios Médicos, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana; Departamento de Retina y Vítreo, Hospital Dr. Elías Santana, Santo Domingo, República Dominicana
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Fan Y, Wang J, Lei J, Ji J, Xie P, Hu Z. Biological ultrathin amniotic membrane flap to close refractory macular holes associated with high myopia. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06509-7. [PMID: 38805096 DOI: 10.1007/s00417-024-06509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
PURPOSE To propose an ultrathin biological amniotic membrane (btAM) thinner than 10 μm as the graft to treat highly myopic macular holes (MH). METHODS This pilot study included 14 patients affected by refractory macular holes associated with high myopia. btAM was used as a bandage covering the holes. The best-corrected visual acuity (BCVA), fundus photography, and optical coherence tomography (OCT) before and after surgery were compared. RESULTS The mean MH size was 865.93 ± 371.72 μm and all the MHs achieved anatomical closure. The btAM located centrally and fully on MHs from fundus photography yet no obvious visual masking was complained. The average BCVA 1 month, 3, and 6 months after surgery were 0.95 ± 0.24, 0.92 ± 0.23, 0.92 ± 0.23 logMAR, respectively, improved significantly compared to pre-operative BCVA (1.24 ± 0.42 logMAR, all P < 0.05). Ten out of 14 (71.4%) exhibited 2C closure patterns (formally closed and no bare RPE) on OCT. CONCLUSION The btAM thinner showed a favorable anatomical success with less risk of parafoveal atrophy or iatrogenic injuries and shortened the dissolving time.
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Affiliation(s)
- Yuanyuan Fan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Jiagui Wang
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Jie Lei
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Jiangdong Ji
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China
| | - Ping Xie
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China.
| | - Zizhong Hu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China.
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Pellegrini F, Barosco G, Trento B, Rapizzi E, Zemella N. Dexamethasone Intravitreal Implant to Treat Persistent Full-Thickness Macular Hole. JOURNAL OF VITREORETINAL DISEASES 2024; 8:312-316. [PMID: 38770064 PMCID: PMC11102733 DOI: 10.1177/24741264241238910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Purpose: To describe a new technique for the secondary repair of persistent full-thickness macular holes (FTMHs). Methods: This series evaluated 3 cases of a persistent FTMH after pars plana vitrectomy, internal limiting membrane peeling, and 20% sulfur hexafluoride gas tamponade. After at least 4 weeks (mean, 36.3; range, 32-40) of unsuccessful topical treatment with nonsteroidal anti-inflammatory drugs, an intravitreal dexamethasone implant was injected. Results: The intravitreal dexamethasone implant led to anatomic closure and visual improvement in all 3 cases over a 3-month follow-up. Conclusions: An intravitreal dexamethasone implant could be considered in the management of selected cases of persistent FTMH. Further studies and a consistent number of cases are needed to fully understand the role of intravitreal dexamethasone implants in persistent FTMHs.
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Affiliation(s)
| | - Guido Barosco
- Department of Ophthalmology, AULLS3 Serenissima, Ospedale dell’Angelo di Mestre, Italy
| | - Barbara Trento
- Department of Ophthalmology, AULLS3 Serenissima, Ospedale dell’Angelo di Mestre, Italy
| | - Emilio Rapizzi
- Department of Ophthalmology, AULLS3 Serenissima, Ospedale dell’Angelo di Mestre, Italy
| | - Nicola Zemella
- Department of Ophthalmology, AULSS2 Marca Trevigiana, Conegliano, Italy
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Kulyabin M, Zhdanov A, Nikiforova A, Stepichev A, Kuznetsova A, Ronkin M, Borisov V, Bogachev A, Korotkich S, Constable PA, Maier A. OCTDL: Optical Coherence Tomography Dataset for Image-Based Deep Learning Methods. Sci Data 2024; 11:365. [PMID: 38605088 PMCID: PMC11009408 DOI: 10.1038/s41597-024-03182-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/22/2024] [Indexed: 04/13/2024] Open
Abstract
Optical coherence tomography (OCT) is a non-invasive imaging technique with extensive clinical applications in ophthalmology. OCT enables the visualization of the retinal layers, playing a vital role in the early detection and monitoring of retinal diseases. OCT uses the principle of light wave interference to create detailed images of the retinal microstructures, making it a valuable tool for diagnosing ocular conditions. This work presents an open-access OCT dataset (OCTDL) comprising over 2000 OCT images labeled according to disease group and retinal pathology. The dataset consists of OCT records of patients with Age-related Macular Degeneration (AMD), Diabetic Macular Edema (DME), Epiretinal Membrane (ERM), Retinal Artery Occlusion (RAO), Retinal Vein Occlusion (RVO), and Vitreomacular Interface Disease (VID). The images were acquired with an Optovue Avanti RTVue XR using raster scanning protocols with dynamic scan length and image resolution. Each retinal b-scan was acquired by centering on the fovea and interpreted and cataloged by an experienced retinal specialist. In this work, we applied Deep Learning classification techniques to this new open-access dataset.
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Affiliation(s)
- Mikhail Kulyabin
- Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Martensstr. 3, 91058, Erlangen, Germany.
| | - Aleksei Zhdanov
- Engineering School of Information Technologies, Telecommunications and Control Systems, Ural Federal University Named after the First President of Russia B. N. Yeltsin, Mira, 32, Yekaterinburg, 620078, Russia
| | - Anastasia Nikiforova
- Ophthalmosurgery Clinic "Professorskaya Plus", Vostochnaya, 30, Yekaterinburg, 620075, Russia
- Ural State Medical University, Repina, 3, Yekaterinburg, 620028, Russia
| | - Andrey Stepichev
- Ophthalmosurgery Clinic "Professorskaya Plus", Vostochnaya, 30, Yekaterinburg, 620075, Russia
| | - Anna Kuznetsova
- Ophthalmosurgery Clinic "Professorskaya Plus", Vostochnaya, 30, Yekaterinburg, 620075, Russia
| | - Mikhail Ronkin
- Engineering School of Information Technologies, Telecommunications and Control Systems, Ural Federal University Named after the First President of Russia B. N. Yeltsin, Mira, 32, Yekaterinburg, 620078, Russia
| | - Vasilii Borisov
- Engineering School of Information Technologies, Telecommunications and Control Systems, Ural Federal University Named after the First President of Russia B. N. Yeltsin, Mira, 32, Yekaterinburg, 620078, Russia
| | - Alexander Bogachev
- Ophthalmosurgery Clinic "Professorskaya Plus", Vostochnaya, 30, Yekaterinburg, 620075, Russia
- Ural State Medical University, Repina, 3, Yekaterinburg, 620028, Russia
| | - Sergey Korotkich
- Ophthalmosurgery Clinic "Professorskaya Plus", Vostochnaya, 30, Yekaterinburg, 620075, Russia
- Ural State Medical University, Repina, 3, Yekaterinburg, 620028, Russia
| | - Paul A Constable
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, SA 5042, Australia
| | - Andreas Maier
- Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Martensstr. 3, 91058, Erlangen, Germany
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Camenzind-Zuche H, Janeschitz-Kriegl L, Hasler PW, Prünte C. Autologous internal limiting membrane transplantation achieves anatomic closure and functional improvement in the treatment of large, persistent macular holes. Int J Retina Vitreous 2024; 10:7. [PMID: 38238805 PMCID: PMC10797851 DOI: 10.1186/s40942-023-00524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/21/2023] [Indexed: 01/22/2024] Open
Abstract
PURPOSE To evaluate the clinical outcome of subretinal autologous internal limiting membrane (ILM) transplantation during pars-plana vitrectomy for persistent full-thickness macular hole (FTMH) repair. METHODS Retrospective, consecutive case series of 13 eyes (13 patients) undergoing small-incision vitrectomy with ILM transplantation and air tamponade for large persistent FTMH after prior unsuccessful vitrectomy with posterior hyaloid detachment and ILM peeling. MAIN OUTCOME MEASUREMENTS For all eyes, high-definition spectral domain optical coherence tomography scans (SD-OCT Spectralis, Heidelberg Engineering GmbH, Germany) of the macula were routinely performed before surgery, 1 and 4 weeks after surgery, and at the final follow-up visit. Additionally, age, gender, axial length, macular hole diameter, biomicroscopic fundus evaluation and best-corrected visual acuity (BCVA) at baseline, 1 and 4 weeks after surgery, and at the final follow-up visit were analyzed. RESULTS Anatomic closure was achieved in all 13 cases (100% success rate). Closure pattern was classified in accordance with to Rossi et al. (Graefe's Arch Clin Exp Ophthalmol 258(12):2629-2638, 2020). Mean baseline BCVA logMAR was 0.93, mean postoperative BCVA logMAR was 0.66 with a mean postoperative follow-up period of 11.4 months. No re-opening occurred during the observation period. CONCLUSIONS Placing an autologous ILM-transplant in the subretinal space beneath the margin of the FTMH can support anatomic restauration and functional improvement in large, persistent FTMHs.
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Affiliation(s)
- Hanna Camenzind-Zuche
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland.
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland.
| | - Lucas Janeschitz-Kriegl
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | - Pascal W Hasler
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | - Christian Prünte
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
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Takáčová A, Kéri P, Krišková P, Majtánová N, Kolář P. Outcomes of 25-Gauge Pars Plana Vitrectomy in the Treatment of Idiopathic Macular Hole. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2024; 80:210-215. [PMID: 38925904 DOI: 10.31348/2024/20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
AIM The main aim of this study is to evaluate the anatomical and functional results of pars plana vitrectomy (PPV) with peeling of the internal limiting membrane (ILM), membrane blue staining and subsequent expansile gas tamponade (perfluoropropane) in the treatment of idiopathic macular hole (IMH). MATERIAL AND METHODS The retrospective analysis consisted of 100 eyes of a total of 100 patients (61 women and 39 men) with IMH, operated on at the Department of Ophthalmology of the Slovak Medical University and University Hospital Bratislava from 1 January 2021 to 1 January 2024, using 25-gauge PPV with ILM peeling and perfluoropropane tamponade (C3F8) of 15% concentration. After surgery, the patients were required to remain in a face-down position for at least one week. Best corrected visual acuity (BCVA), minimal linear diameter (MLD) on optic coherence tomography, macular hole closure type and occurrence of complications were evaluated. The obtained results were expressed with the use of arithmetic averages and displayed in graphs. RESULTS Primary closure of macular hole was achieved in 93 patients (93%). The most frequently occurring type of closure was 1A. After surgery, the BCVA of all patients improved, from an average value of 0.101 preoperatively to 0.300 one year after surgery. In all groups of patients (regardless of the size of the macular hole before surgery), during the one-year follow-up period there was a gradual increase in BCVA with its stabilization by 6 months. The main factors that influenced postoperative BCVA were the preoperative values of MLD and BCVA. CONCLUSION PPV with ILM peeling and perfluoropropane tamponade is an effective treatment for idiopathic macular holes with a success rate of more than 90%. This surgical procedure, associated with a relatively low number of complications, brings patients a definite improvement of BCVA.
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Saxena S, Singh S, Meyer CH. Pathoanatomical aspects of macular hole closure: Emerging concepts. Indian J Ophthalmol 2024; 72:136-138. [PMID: 38131588 PMCID: PMC10841804 DOI: 10.4103/ijo.ijo_1763_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Sandeep Saxena
- Department of Ophthalmology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Samya Singh
- Department of Ophthalmology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Carsten H Meyer
- Department of Ophthalmology, Eye Centre Grischun, Chur, Switzerland, Augenklinik, Davos, Switzerland
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Lamas-Francis D, Rodríguez-Fernández CA, Bande M, Blanco-Teijeiro MJ. Foveal microvascular features following inverted flap technique for closure of large macular holes. Eur J Ophthalmol 2024; 34:260-266. [PMID: 37122260 DOI: 10.1177/11206721231173004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE To describe the anatomical and functional outcomes following use of the inverted flap technique (IFT) to close idiopathic macular holes (MH) of diameter greater than 400 μm. To compare the changes in the macular microvascularization following surgery in operated and healthy fellow eyes. METHODS Retrospective study of 24 patients who underwent vitrectomy and IFT for large MH closure. The main variables were closure pattern, best corrected visual acuity (BCVA) and recovery of the external limiting membrane (ELM) and ellipsoid zone (EZ). Foveal avascular zones (FAZ) and vessel and perfusion densities, obtained by OCT angiography scans, were compared with those in healthy fellow eyes. RESULTS Complete MH closure was achieved in 95.8% (23/24) of patients 6 months after surgery. There was a significant improvement in postoperative BCVA, from 1.0 to 0.4 logMAR (p < 0.001). The most frequent closure pattern was 1a (62.5%, 15/24), followed by 2c (12.5%, 3/24). The closure pattern was not correlated with height, minimum or maximum diameters or macular hole index (MHI) (p > 0.05). ELM and EZ recovery occurred in 87.5% and 83.3% of cases, respectively. FAZ were smaller in operated eyes than in the fellow eyes (p = 0.012). There were no differences in the vessel or perfusion densities between the operated and fellow eyes (p > 0.05). CONCLUSIONS Use of the inverted flap technique for large MH closure provides a high rate of functional and anatomical recovery. We observed a reduction in the FAZ following surgery, with no differences in the macular microvascularization parameters, suggesting that the technique is safe.
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Affiliation(s)
- David Lamas-Francis
- Department of Ophthalmology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Manuel Bande
- Department of Ophthalmology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - María José Blanco-Teijeiro
- Department of Ophthalmology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
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12
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Yagura T, Nishida K, Hirokazu S, Nishida K. A Case of Closure of Recurrent Full-Thickness Macular Hole by Spontaneous Retinal Detachment around the Macular Hole and Gas Tamponade. Case Rep Ophthalmol 2024; 15:150-156. [PMID: 38357213 PMCID: PMC10866610 DOI: 10.1159/000536338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Here, we present a case of full-thickness macular hole (FTMH) recurrence following two vitrectomies, accompanied by additional internal limiting membrane (ILM) peeling and gas tamponade. Ultimately, FTMH closure was accomplished by spontaneous retinal detachment around the macular hole and gas tamponade alone. Case Presentation The patient, a 54-year-old woman with a lamellar macular hole, had a visual acuity of 20/100 in her left eye. The treatment regimen included cataract surgery, a 25-gauge pars plana vitrectomy involving ILM peeling, application of the lamellar hole epiretinal proliferation embedding technique, and subsequent gas tamponade. Closure of the lamellar macular hole was observed a month post-surgery, improving visual acuity to 20/40. However, FTMH developed 3 months after the initial surgery, resulting in visual acuity decline to 20/100. A 25-gauge pars plana vitrectomy was performed with extensive ILM peeling and 20% sulfur hexafluoride gas tamponade. FTMH closure was noted within 19 days after reoperation, enhancing visual acuity to 20/66. Approximately 1.5 months after reoperation, a pinhole-shaped macular hole was identified, and the patient opted for follow-up observation due to her refusal to undergo additional surgery. As the macular hole gradually enlarged resembling retinal detachment, outpatient fluid-gas exchange with 14% perfluoropropane was performed 3.5 months after reoperation. The FTMH closed within a week post-gas injection and remained closed for more than 1 year. Consequently, visual acuity in the left eye was sustained at 20/50. Conclusion We encountered a case that might highlight the significance of releasing subretinal adhesions surrounding a FTMH for successful closure.
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Affiliation(s)
- Tatsuya Yagura
- Department of Ophthalmology, Kinan Hospital, Wakayama, Japan
| | - Kentaro Nishida
- Department of Advanced Device Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Sakaguchi Hirokazu
- Department of Advanced Device Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Ophthalmology, Gifu University School of Medicine, Gifu, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Osaka, Japan
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13
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Camenzind-Zuche H, Janeschitz-Kriegl L, Hasler P, Prünte C. Relaxing radial retinal incisions for the treatment of persistent macular holes. Eur J Ophthalmol 2024; 34:292-299. [PMID: 37700600 DOI: 10.1177/11206721231201662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
PURPOSE Various surgical techniques have been described for managing persistent macular holes after an unsuccessful vitrectomy with internal limiting membrane (ILM) peeling. However, the closure and functional improvement rates after these procedures are limited. Therefore, the aim of this study was to evaluate the usefulness of radial retinal incisions (retinotomies) in eyes with persistent large macula holes despite previous vitrectomy with ILM peeling. DESIGN In a retrospective case series, closure rate and best-corrected visual acuity (BCVA) were evaluated in eyes with persistent macular holes after an unsuccessful vitrectomy that included posterior vitreous detachment and ILM peeling. SUBJECTS 22 eyes of 22 patients (10 men and 12 women) underwent re-vitrectomy with radial retinal incisions. All the patients had undergone an unsuccessful surgery before. METHODS Small-incision re-vitrectomy with radial retinal incisions (retinotomies) and air tamponade was performed. MAIN OUTCOME MEASUREMENTS For all eyes, high-definition SD-OCT scans (SD-OCT Spectralis, Heidelberg Engineering GmbH, Germany) of the macula were routinely performed before surgery; 1 week and 1 month after surgery; and at final follow-up. Additionally, age, gender, axial length, macular hole diameter, biomicroscopic fundus evaluation and best-corrected visual acuity (BCVA) in logMAR and Snellen at baseline, 1 and 4 months after operation, and at the final follow-up visit were analyzed. RESULTS The mean baseline macular hole diameter was 668.5 ± 226.8 μm. At the final examination, 16 (72.72%) of the 22 macula holes were closed. Visual acuity increased in 17 eyes, was stable in 3 eyes, and decreased in 2 eyes owing to central retinal atrophy in both. The mean BCVA increased from logMAR 1.04 ± 0.29 at baseline to 0.57 ± 0.31 (Snellen 0.11 ± 0.05 to 0.33 ± 0.18). In all successful cases, macula hole closure was attained after 3 days, and none of the eyes showed macula hole recurrence. CONCLUSION The results of this limited case series suggest that radial retinal incisions of the rim in persistent macula holes after initial surgery with ILM peeling increase the success rate of macula hole closure and results in a relevant increase in BCVA. However, as the number of eyes included in this series is limited, the results must be confirmed in a study with a larger sample size.
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Affiliation(s)
- Hanna Camenzind-Zuche
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | - Lucas Janeschitz-Kriegl
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | - Pascal Hasler
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | - Christian Prünte
- Department of Ophthalmology, University Hospital Basel, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
- Kantonsspital Baselland, Eye Clinic, Liestal, Switzerland
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14
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Ye X, Xu J, He S, Wang J, Yang J, Tao J, Chen Y, Shen L. Quantitative evaluation of dissociated optic nerve fibre layer (DONFL) following idiopathic macular hole surgery. Eye (Lond) 2023; 37:1451-1457. [PMID: 35778607 PMCID: PMC10170160 DOI: 10.1038/s41433-022-02150-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/24/2022] [Accepted: 06/14/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To quantitatively evaluate concentric macular dark spots (CMDS) on spectral-domain optical coherence tomography (SD-OCT) to determine the morphological characteristics of dissociated optic nerve fibre layer (DONFL) following the performance of internal limiting membrane (ILM) peeling in patients with full-thickness idiopathic macular hole (IMH) closure. METHODS Retrospective study on patients who underwent a vitrectomy with ILM peeling procedure. BCVA, cross-sectional OCT scans, and three-dimensional reconstructions of en face OCT scans were analysed preoperatively, at 2, 6, 12 months post-operatively. A novel image analysis technique was used to automatically measure DONFL logical properties through the radius, area, the nerve fibre layer dissociation index (NFLDI), and depth of the CMDS. RESULTS 53 eyes of 51 patients were included, and the mean follow-up was 11.53 ± 6.26 months. CMDS was found in 46 (86.79%) eyes within 2 months after ILM peeling and 50 (94.34%) eyes within 6 months after ILM peeling. CMDS concentrated on the temporal side of the macula in all 50 eyes (100%) at first detection. The area, NFLDI, and depth of CMDS in four quadrants developed significantly during the postoperative 6 months (p < 0.05), and then these changes slowed down and remained unchanged 12 months post-operatively. The morphological changes in the temporal quadrant were significantly greater than those in other quadrants at 2, 6, 12 months (all p < 0.05) post-operatively. CONCLUSIONS CMDS mostly appeared and concentrated on the temporal side of the macula in IMHs within two months after ILM peeling and progressed within 6 months and remained unchanged after 12 months.
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Affiliation(s)
- Xin Ye
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, China
| | - Jiahao Xu
- Department of Ophthalmology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing City, Zhejiang, 312000, China
| | - Shucheng He
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, China
| | - Jun Wang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, China
| | - Jinglei Yang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, China
| | - Jiwei Tao
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, China
| | - Yiqi Chen
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, China.
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, China.
| | - Lijun Shen
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, China.
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, China.
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15
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Garcin T, Gain P, Thuret G. Femtosecond laser-cut autologous anterior lens capsule transplantation to treat refractory macular holes. Eye (Lond) 2023; 37:1073-1079. [PMID: 35428868 PMCID: PMC10101960 DOI: 10.1038/s41433-022-02062-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To report the long-term outcomes of round autologous anterior lens capsules (ALCs) cut by a femtosecond laser (FSL) and transplanted onto refractory macular holes (MHs) in a prospective interventional study. METHODS Three eyes of three patients were included for persistent MH after reattached rhegmatogenous retinal detachment (RRD) (n = 2) or RRD recurrence by persistent MH (n = 1), in a university hospital. A 6 mm diameter ALC disc was carefully extracted during FSL-assisted lens extraction, stained with 0.06% trypan blue, decellularised, transplanted using a catheter and unfolded over the MH. Gas or silicone-oil tamponade was used. At 1 year, the main criterion was anatomic success, defined as complete MH closure. Secondary criteria were changes in best corrected visual acuity (BCVA), ellipsoid zone (EZ) and external limiting membrane (ELM) defects, complications. RESULTS Baseline data were: minimum and maximum diameters, respectively 887, 1079 and 1180 μm; 1260, 1213 and 1350 μm; central posterior staphyloma in two highly myopic eyes; number of prior surgeries 2 ± 1. At 1 year, the three MHs were closed with stable transplanted ALCs. Distant BCVA improved respectively from 3.0, 0.8, 3.0 to 1.0, 0.2, 0.7 logMAR, i.e. all eyes achieved ≥0.3 logMAR improvement. All patients had decreased EZ and ELM defects, without reaching normal profile. No adverse event occurred. CONCLUSIONS FSL-cut ALC helps standardise this challenging surgery: it prevents from tears and facilitates manipulation, so that the ALC disc is perfectly transparent and biocompatible, with a large MH overlap. One-year follow-up highlighted that this technique helps safely close refractory MHs with satisfactory visual recovery.
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Affiliation(s)
- Thibaud Garcin
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France.
- Ophthalmology Department, University Hospital, Saint-Etienne, France.
| | - Philippe Gain
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
- Ophthalmology Department, University Hospital, Saint-Etienne, France
| | - Gilles Thuret
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
- Ophthalmology Department, University Hospital, Saint-Etienne, France
- Institut Universitaire de France, Boulevard Saint-Michel, Paris, France
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16
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Buzzi M, Parisi G, Marolo P, Gelormini F, Ferrara M, Raimondi R, Allegrini D, Rossi T, Reibaldi M, Romano MR. The Short-Term Results of Autologous Platelet-Rich Plasma as an Adjuvant to Re-Intervention in the Treatment of Refractory Full-Thickness Macular Holes. J Clin Med 2023; 12:jcm12052050. [PMID: 36902837 PMCID: PMC10004127 DOI: 10.3390/jcm12052050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/24/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
The purpose of this study was to investigate the short-term efficacy and safety of autologous platelet-rich plasma (a-PRP) as an adjuvant to revisional vitrectomy for refractory full-thickness macular holes (rFTMHs). We conducted a prospective, non-randomized interventional study including patients with rFTMH after a pars plana vitrectomy (PPV) with internal limiting membrane peeling and gas tamponade. We included 28 eyes from 27 patients with rFTMHs: 12 rFTMHs in highly myopic eyes (axial length greater than 26.5 mm or a refractive error greater than -6D or both); 12 large rFTMHs (minimum hole width > 400 μm); and 4 rFTMHs secondary to the optic disc pit. All patients underwent 25-G PPV with a-PRP, a median time of 3.5 ± 1.8 months after the primary repair. At the six-month follow-up, the overall rFTMH closure rate was 92.9%, distributed as follows: 11 out of 12 eyes (91.7%) in the highly myopic group, 11 out of 12 eyes (91.7%) in the large rFTMH group, and 4 out of 4 eyes (100%) in the optic disc pit group. Median best-corrected visual acuity significantly improved in all groups, in particular from 1.00 (interquartile range: 0.85 to 1.30) to 0.70 (0.40 to 0.85) LogMAR in the highly myopic group (p = 0.016), from 0.90 (0.70 to 1.49) to 0.40 (0.35 to 0.70) LogMAR in the large rFTMH group (p = 0.005), and from 0.90 (0.75 to 1.00) to 0.50 (0.28 to 0.65) LogMAR in the optic disc pit group. No intraoperative or postoperative complications were reported. In conclusion, a-PRP can be an effective adjuvant to PPV in the management of rFTMHs.
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Affiliation(s)
- Matilde Buzzi
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
- Correspondence: (M.B.); (M.R.R.)
| | - Guglielmo Parisi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10124 Turin, Italy
| | - Paola Marolo
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10124 Turin, Italy
| | - Francesco Gelormini
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10124 Turin, Italy
| | - Mariantonia Ferrara
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| | - Raffaele Raimondi
- Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24125 Bergamo, Italy
| | - Davide Allegrini
- Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24125 Bergamo, Italy
| | | | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10124 Turin, Italy
| | - Mario R. Romano
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
- Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24125 Bergamo, Italy
- Correspondence: (M.B.); (M.R.R.)
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17
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EXCESSIVE GLIOSIS AFTER VITRECTOMY FOR THE HIGHLY MYOPIC MACULAR HOLE: A Spectral Domain Optical Coherence Tomography Study. Retina 2023; 43:200-208. [PMID: 36695791 DOI: 10.1097/iae.0000000000003657] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate different modes of foveal regeneration after the closure of idiopathic macular hole (IMH) or highly myopic macular hole (HMMH) by vitrectomy with internal limiting membranes peeling or flap techniques. METHODS This retrospective observational study followed 47 IMH and 50 HMMH eyes for at least 6 months. Twenty four IMH and 25 HMMH eyes underwent internal limiting membrane peeling, whereas 23 IMH and 25 HMMH eyes received inverted internal limiting membrane flap technique. Spectral domain optical coherence tomography was used to analyze macular hole closure, foveal microstructures, and excessive gliosis as a foveal "peak-like" protuberance. RESULTS A single procedure closed all IMH (n = 47). For HMMH, the inverted group (n = 25, 100%) closed more macular hole than the peeling group (n = 14, 56.00%) (P < 0.001). Excessive gliosis only occurred in the inverted group, and there was a significant difference (P = 0.005) in incidence between IMH (three in 23 eyes, 13.04%) and HMMH (13 in 25 eyes, 52.00%). The axial length more than 29.985 mm enhanced the risk of excessive gliosis. CONCLUSION The inverted internal limiting membrane flap efficiently treated refractory MHs but was prone to cause excessive gliosis in highly myopic eyes. Excessive elongation of the globe (axial length > 29.985 mm) was linked to excessive gliosis growth.
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18
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Analysis of Retinal Microstructure in Eyes with Dissociated Optic Nerve Fiber Layer (DONFL) Appearance following Idiopathic Macular Hole Surgery: An Optical Coherence Tomography Study. J Pers Med 2023; 13:jpm13020255. [PMID: 36836488 PMCID: PMC9963747 DOI: 10.3390/jpm13020255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/21/2023] [Accepted: 01/28/2023] [Indexed: 01/31/2023] Open
Abstract
(1) Purpose: This study aimed to evaluate morphological changes of the retina in eyes with dissociated optic nerve fiber layer (DONFL) appearance following internal limiting membrane (ILM) peeling for full-thickness idiopathic macular hole (IMH) on spectral-domain optical coherence tomography (SD-OCT). (2) Methods: We retrospectively analyzed 39 eyes of 39 patients with type 1 macular hole closure after a vitrectomy with ILM peeling procedure at a six-month minimum postoperative follow-up. The retinal thickness maps and cross-sectional OCT images were obtained from a clinical OCT device. The cross-sectional area of the retinal nerve fiber layer (RNFL) on cross-sectional OCT images was manually measured by ImageJ software. (3) Results: The inner retinal layers (IRLs) thickness thinned down much more in the temporal quadrant than in nasal quadrants at 2 and 6 months postoperatively (p < 0.001). However, the cross-sectional area of the RNFL did not change significantly at 2 and 6 months postoperatively (p > 0.05) when compared to preoperative data. In addition, the thinning of the IRL did not correlate with the best-corrected visual acuity (BCVA) at 6 months postoperatively. (4) Conclusions: The thickness of the IRL decreased in eyes with a DONFL appearance after ILM peeling for IMH. The thickness of the IRL decreased more in the temporal retina than in the nasal retina, but the change did not affect BCVA during the 6 months after surgery.
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Rezende FA, Ferreira BG, Rampakakis E, Steel DH, Koss MJ, Nawrocka ZA, Bacherini D, Rodrigues EB, Meyer CH, Caporossi T, Mahmoud TH, Rizzo S, Johnson MW, Duker JS. Surgical classification for large macular hole: based on different surgical techniques results: the CLOSE study group. Int J Retina Vitreous 2023; 9:4. [PMID: 36717928 PMCID: PMC9885593 DOI: 10.1186/s40942-022-00439-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/29/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The CLOSE study group proposes an updated surgical classification for large macular holes based on a systematic review of new treatments. Recently, many new techniques have been introduced to treat large full-thickness macular holes (FTMH); although the indications are not clear. An updated surgical classification is needed to help surgical decision-making. METHODS We gathered published series by the CLOSE Study Group members and from literature search until June 2021. Techniques included: internal limiting membrane peeling (ILM peeling), ILM flaps, macular hydrodissection (macular hydro), human amniotic membrane graft (hAM), and autologous retinal transplantation (ART). Within each technique, chi-square test assessed association between the minimal linear diameter (MLD) (in µm) and closure rate; the postoperative best-corrected visual acuity (BCVA) gains were compared among groups. RESULTS Data extraction included 31 published articles: total of 1135 eyes. Eyes were divided into the following groups: ILM peel (n: 683), ILM Flap (n: 233), macular hydrodissection (n: 64), hAM (n: 59), and ART (n: 96). The initial BCVA and size were heterogenous between the groups. ILM peel showed the best results in large FTMH ≤ 535 µm (closure rate 96.8%); adjusted mean BCVA: 0.49 (LogMAR) with a statistical difference among groups. Large FTMH between 535 and 799 µm: ILM flap technique showed better results (closure rate 99.0%); adjusted mean BCVA: 0.67(LogMAR); also with a statistical difference. For large FTMH ≥ 800 µm more invasive techniques are required. Use of hAM, macular hydrodissection and ART showed higher closure rates for this category (100%, 83.3% and 90.5% respectively), and adjusted mean BCVA varied from 0.76 to 0.89. Although there was no statistical difference between those techniques for this group due to the smaller number of cases. CONCLUSIONS The CLOSE study group demonstrated the potential usefulness of a new surgical classification for large FTMHs and propose OCT biomarkers for use in clinical practice and future research. This new classification demonstrated that Large (400-550 µm) and X-Large (550-800 µm) holes can be treated highly successfully with ILM peel and ILM flap techniques, respectively. Further studies are necessary for the larger FTMHs (XX-Large and Giant), using the CLOSE classification, in order to determine which technique is better suited for each hole size and characteristics.
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Affiliation(s)
- Flavio A. Rezende
- grid.14848.310000 0001 2292 3357Department of Ophthalmology, Maisonneuve-Rosemont Hospital, CIUSSS de l’est d’ile de Montréal, University of Montreal, 801 Rue de la Commune est, ap 501, Montreal, QC H2V0A3 Canada
| | - Bruna G. Ferreira
- grid.14848.310000 0001 2292 3357Department of Ophthalmology, Maisonneuve-Rosemont Hospital, CIUSSS de l’est d’ile de Montréal, University of Montreal, 801 Rue de la Commune est, ap 501, Montreal, QC H2V0A3 Canada
| | - Emmanouil Rampakakis
- grid.14709.3b0000 0004 1936 8649Faculty of Medicine and Health Sciences, McGill University, Montreal, QC Canada
| | - David H. Steel
- grid.1006.70000 0001 0462 7212Sunderland Eye Infirmary, Sunderland, and Newcastle University, Newcastle-Upon-Tyne, UK
| | - Michael J. Koss
- Augenzentrum Nymphenburger Höfe/Augenklinik Herzog Carl Theodor, Munich, Germany
| | | | - Daniela Bacherini
- grid.8404.80000 0004 1757 2304Department of Neurosciences, Psychology, Drug Research and Child Health, Eye Clinic, University of Florence, Florence, Italy
| | - Eduardo B. Rodrigues
- grid.262962.b0000 0004 1936 9342Department of Ophthalmology, St. Louis University, St. Louis, MO USA
| | | | - Tomaso Caporossi
- grid.8142.f0000 0001 0941 3192Fondazione Policlínico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy ,grid.418879.b0000 0004 1758 9800Instituto di Neuroscienze - CNR, Pisa, Italy
| | - Tamer H. Mahmoud
- grid.261277.70000 0001 2219 916XAssociated Retinal Consultants, Beaumont Neuroscience Center, Oakland University William Beaumont School of Medicine, Royal Oak, MI USA
| | - Stanislao Rizzo
- grid.8142.f0000 0001 0941 3192Fondazione Policlínico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy ,grid.418879.b0000 0004 1758 9800Instituto di Neuroscienze - CNR, Pisa, Italy
| | - Mark W. Johnson
- grid.214458.e0000000086837370Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI USA
| | - Jay S. Duker
- grid.67033.310000 0000 8934 4045New England Eye Center, Tufts Medical Center, Boston, MA USA ,grid.67033.310000 0000 8934 4045Department of Ophthalmology, Tufts Medical Center, Boston, MA USA
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Sahoo NK, Suresh A, Patil A, Ong J, Kazi E, Tyagi M, Narayanan R, Nayak S, Jacob N, Venkatesh R, Chhablani J. Novel En Face OCT-Based Closure Patterns in Idiopathic Macular Holes. Ophthalmol Retina 2022:S2468-6530(22)00638-8. [PMID: 36584899 DOI: 10.1016/j.oret.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To determine the postoperative en face OCT pattern of closure in idiopathic macular holes (MHs). DESIGN Retrospective, multicentric, observational study. PARTICIPANTS Patients aged > 18 years with a diagnosis of idiopathic MH, with well documented en face OCT images. METHODS Baseline characteristics and preoperative OCT and en face OCT parameters like horizontal and vertical minimum linear diameter (MLD), horizontal and vertical basal hole diameter (BHD), hole height, acircularity index, and hole orientation were measured. MAIN OUTCOME MEASURE The type of hole closure on en face OCT, and a comparison of baseline parameters and final visual acuity among the en face closure types. RESULTS A total of 64 eyes of 62 patients (24 men and 40 women) with a mean age of 63.8 ± 12.4 years. The median duration of symptoms was 3 months (interquartile range, 1.75-10.5). The eyes had a mean baseline visual acuity of 0.97 ± 0.46 logarithm of minimum angle of resolution (logMAR). The baseline horizontal MLD was 591.7 ± 219.4 μm and the vertical MLD was 552.9 ± 198.2 μm. Baseline horizontal and vertical BHD were 1240.3 ± 521.1 μm and 1142.1 ± 478.1 μm, respectively. The mean hole height was 394.8 ± 123.2 μm. Two different patterns were noted on en face OCT: round, or linear. A total of 38 eyes had a round/centripetal closure and 26 eyes had a linear closure (17 eyes had a horizontal closure, 7 eyes had an oblique closure, while 2 eyes had a vertical closure). The mean final visual acuity was 0.80 ± 0.43 logMAR (Snellen equivalent of 20/125). Eyes with linear closure (0.76 ± 0.23 logMAR) had a significantly (P = 0.03) better visual acuity than the round closure group (1.07 ± 0.28 logMAR), only in eyes with horizontal MLD of > 650 μm, but not when other MLD cut-offs were used. CONCLUSION We describe 2 different patterns of hole closure (linear and round) on en face OCT. Further studies will be required to determine its functional significance. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Niroj Kumar Sahoo
- Anant Bajaj retina Institute, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, India.
| | - Anjali Suresh
- Anant Bajaj retina Institute, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, India
| | - Ashika Patil
- Anant Bajaj retina Institute, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, India
| | - Joshua Ong
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eman Kazi
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mudit Tyagi
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Raja Narayanan
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Sameera Nayak
- Anant Bajaj retina Institute, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, India
| | - Ninan Jacob
- Anant Bajaj retina Institute, Kode Venkatadri Chowdary Campus, L V Prasad Eye Institute, Vijayawada, India
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Benguluru, India
| | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, Pennsylvania
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Comparative Study of Conventional Inverted ILM Flap Covering and ILM Flap Filling Technique in Idiopathic Macular Hole Treatment: A Meta-Analysis and Systematic Review. J Ophthalmol 2022; 2022:4922616. [PMID: 36237559 PMCID: PMC9553370 DOI: 10.1155/2022/4922616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This meta-analysis was performed to evaluate the anatomical efficacy and functional improvement of the conventional inverted internal limiting membrane (ILM), flap covering technique, and ILM flap filling technique for patients with idiopathic macular hole (MH). Methods Literature from Pubmed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were comprehensively retrieved. The primary outcomes included the MH closure rate and postoperative best-corrected visual acuity (BCVA). The secondary outcomes were the proportion of external limiting membrane (ELM) and ellipsoid zone (EZ) defect recovery. Pooled odds ratios (ORs), weighted mean differences (WMDs), and 95% confidence intervals (CIs) were calculated using STATA 17.0 software. Results 7 studies that contained 139 eyes in the inverted ILM flap covering group and 121 eyes in the ILM flap filling group were selected. Pooled data suggested that the surgical treatment resulted in an overall MH closure rate of up to 97.12% (135/139 eyes) in the inverted ILM flap covering group and 99.17% (120/121 eyes) in the filling group, with no significant difference between the 2 groups (OR = 1.98, 95% CI: 0.55 to 7.09, and P=0.29). Similarly, the 2 techniques demonstrated equal effectiveness on the anatomical closure in MH with the average diameter smaller than 650 μm (OR = 2.17, 95% CI: 0.48 to 9.77, and P=0.31) and larger than 650 μm (OR = 1.58, 95% CI: 0.14 to 17.37, and P=0.71). However, compared with the filling technique, the inverted ILM flap covering technique was superior in postoperative BCVA (WMD = 0.11, 95% CI: 0.04 to 0.18, and P=0.0017) and presented a significantly higher proportion of reconstitution of ELM (OR = 0.02, 95% CI: 0.00 to 0.08, and P < 0.0001) and EZ (OR = 0.11, 95% CI: 0.04 to 0.32, and P=0.0001). Conclusion The inverted ILM flap covering technique was associated with the superior reconstitution of outer layers of the retina, including ELM and EZ, and more improvement in postoperative BCVA than the ILM flap filling technique.
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22
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Galletero Pandelo L, Olaso Fernández H, Sánchez Aparicio JA, Rodríguez Vidal C, Martínez-Alday N. Results of large macular hole surgery using different interposition techniques. A report on 9 cases. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:457-463. [PMID: 35331671 DOI: 10.1016/j.oftale.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To describe the long-term anatomical and functional restoration observed in patients operated on for a large macular hole (MH) using different macular interposition techniques. METHOD Retrospective analysis of the results obtained in a series of 9 patients undergoing large MH surgery (≥450μm) performing 4 different macular interposition techniques: inverted internal limiting membrane flap in 4 cases, autotransplantation of internal limiting membrane in 2, amniotic membrane graft in 2, and autologous anterior capsule graft in one. The mean follow-up time was 11 months. Anatomically, the outcome measures explored were the restoration of the outer layers of the retina and the pattern of MH closure. The final visual acuity and visual quality were functionally assessed. RESULTS The restoration of the outer layers was partial in 6 cases. The macular closure rate was 100%, showing an incomplete pattern in 4 cases. Visual acuity improved in 7 patients, remaining stable in 2. Three cases showed an eccentric fixation pattern and/or metamorphopsia. CONCLUSIONS The development of new surgical techniques has increased the rate of macular closure in large MHs. However, the anatomical and functional restoration remains unpredictable. In this work, macular closure was achieved in all patients and a higher rate of complete closure using inverted internal limiting membrane flap. The restoration of the outer layers was more favorable in the groups in which internal limiting membrane had been used. Functional recovery was independent of the technique used.
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Affiliation(s)
- L Galletero Pandelo
- Departamento de Oftalmología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain.
| | - H Olaso Fernández
- Departamento de Oftalmología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
| | - J A Sánchez Aparicio
- Departamento de Oftalmología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
| | - C Rodríguez Vidal
- Departamento de Oftalmología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
| | - N Martínez-Alday
- Departamento de Oftalmología, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
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Pradhan D, Agarwal L, Joshi I, Kushwaha A, Aditya K, Kumari A. Internal limiting membrane peeling in macular hole surgery. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2022; 20:Doc07. [PMID: 35813123 PMCID: PMC9204259 DOI: 10.3205/000309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/23/2021] [Indexed: 11/18/2022]
Abstract
Since the era when macular hole was considered untreatable, macular hole surgery has come a long way to being one of the most successful surgeries. Internal limiting membrane (ILM) peeling has been an essential step of macular hole surgery since the establishment of the role of ILM in the aetiopathogenesis and progression of macular hole. However, the novel technique was not all virtuous. It had some vices which were not evident immediately. With the advent of spectral domain optical coherence tomography, short- and long-term effects of ILM peeling on macular structures were known; and with microperimetry, its effect on the function of macula could be evaluated. The technique has evolved with time from total peeling to inverted flap to just temporal peeling and temporal flap in an attempt to mitigate its adverse effects and to improve its surgical outcome. ILM abrasion technique and Ocriplasmin may eliminate the need of ILM peeling in selected cases, but they have their own limitations. We here discuss the role of ILM in the pathogenesis of macular hole, the benefits and adverse effects of ILM peeling, and the various modifications of the procedure, to then explore the alternatives.
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Affiliation(s)
- Deepti Pradhan
- Kirtipur Eye Hospital, Department of Vitreoretinal Services, Kirtipur, Nepal,*To whom correspondence should be addressed: Deepti Pradhan, Kirtipur Eye Hospital, Department of Vitreoretinal Services, Tahalcha, Tinkune, 44618 Kirtipur-10, Nepal, Phone: +977 9808119112, E-mail:
| | - Lalit Agarwal
- Biratnagar Eye Hospital, Department of Vitreoretinal Services, Biratnagar, Nepal
| | - Ichhya Joshi
- Biratnagar Eye Hospital, Department of Vitreoretinal Services, Biratnagar, Nepal
| | - Anamika Kushwaha
- Biratnagar Eye Hospital, Department of Vitreoretinal Services, Biratnagar, Nepal
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Mansour HA, Uwaydat SH, Parodi M, Jürgens I, Smiddy W, Allabban AA, Schwartz SG, Foster RE, Ascaso J, Leoz MS, Belotto S, Mateo J, Olivier-Pascual N, Lima LH, Navea A, Neila EMR, Castillo RA, Alaman AS, Mansour AM. Recovery course of foveal microstructure in the nonsurgical resolution of full-thickness macular hole. Graefes Arch Clin Exp Ophthalmol 2022; 260:3173-3183. [DOI: 10.1007/s00417-022-05672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 11/04/2022] Open
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Romano MR, Rossi T, Borgia A, Catania F, Sorrentino T, Ferrara M. Management of refractory and recurrent macular holes: A comprehensive review. Surv Ophthalmol 2022; 67:908-931. [DOI: 10.1016/j.survophthal.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
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26
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Garcin T. Epiretinal scroll of lyophilized amniotic membrane used to close a large, long-standing, idiopathic, full-thickness macular hole. J Fr Ophtalmol 2021; 45:142-143. [PMID: 34949498 DOI: 10.1016/j.jfo.2021.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 11/17/2022]
Affiliation(s)
- T Garcin
- Service d'ophtalmologie, biologie, ingénierie et imagerie de la greffe de cornée, BiiGC, EA2521, faculté de médecine, centre hospitalier universitaire, université Jean-Monnet, avenue Albert-Raimond, 42000 Saint-Étienne, France.
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Gedik B, Suren E, Bulut M, Durmaz D, Erol MK. Changes in choroidal blood flow in patients with macular hole after surgery. Photodiagnosis Photodyn Ther 2021; 35:102428. [PMID: 34217870 DOI: 10.1016/j.pdpdt.2021.102428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/07/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION A macular hole (MH) is a defect that occurs in the retina and involves all layers. In this study, we aimed to investigate the preoperative and postoperative choriocapillaris blood flow (CBF) changes in patients with MH and the role of CBF in the pathogenesis of the disease using optical coherence tomography angiography (OCTA). MATERIAL METHOD This is a retrospective study examining eyes with MH. The study included 25 operated eyes of 25 patients and contralateral eyes of 18 patients. CBF and subfoveal choroidal thickness were examined using the OCTA images of the patients before surgery and at the first, third and sixth months after surgery. RESULTS The mean CBF value of the patients was 1.57±0.20 mm² preoperatively, 1.94±0.13 mm² at the postoperative first month, 1.98±0.12 mm² at the third month, and 2.00±0.10 mm² at the sixth month. The increases in the CBF values between the preoperative period and the postoperative measurements were statistically significant (p<0.0001 for all). In the preoperative period, the CBF value of the contralateral eyes was 2.07±0.10 mm². The preoperative CBF value of the contralateral eyes was higher compared to that of the eyes with MH (p<0.0001). There was no significant difference between the preoperative CBF value of the contralateral eyes and the postoperative sixth-month value of the eyes with MH (p = 0.065). CONCLUSION The preoperative and postoperative third-month CBF values of the eyes with MH were found to be lower than those of the contralateral eyes, but there was no difference between the postoperative sixth-month CBF value of the eyes with MH and the preoperative CBF value of the contralateral eyes. We consider that the eyes with MH achieve similar CBF values to the contralateral eyes in an average of six months after successful surgery.
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Affiliation(s)
- Birumut Gedik
- University of Health Sciences, Antalya Education and Research Hospital, Department of Ophthalmology, Antalya, Turkey.
| | - Elcin Suren
- University of Health Sciences, Antalya Education and Research Hospital, Department of Ophthalmology, Antalya, Turkey
| | - Mehmet Bulut
- University of Health Sciences, Antalya Education and Research Hospital, Department of Ophthalmology, Antalya, Turkey
| | - Doğan Durmaz
- University of Health Sciences, Antalya Education and Research Hospital, Department of Ophthalmology, Antalya, Turkey
| | - Muhammet Kazim Erol
- University of Health Sciences, Antalya Education and Research Hospital, Department of Ophthalmology, Antalya, Turkey
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