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Cheng CY, Hsieh YT, Yang CM. BROAD VITREOMACULAR ATTACHMENT-INDUCED MACULAR HOLE: Structural Changes and Surgical Outcome. Retina 2024; 44:627-634. [PMID: 38064680 DOI: 10.1097/iae.0000000000004018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
PURPOSE This study aims to describe the structural changes and surgical outcomes of full-thickness macular holes (FTMHs) induced by vitreomacular traction with broad vitreomacular attachment (VMA). METHODS A retrospective analysis of idiopathic FTMHs from October 2010 to May 2022 was conducted. Patients with FTMHs and no retinal detachment (RD) induced by broad VMA (the study group) were compared with a control group consisting of typical FTMHs with focal VMA. RESULTS Thirty-one eyes had broad VMA-associated FTMH, among which seven eyes (22%) were with concurrent RD. Among the total of 24 cases without RD, 8 (33%) exhibited schisis. The incidence of lamellar holes associated epithelial proliferation and multiple membrane traction was significantly higher in the study group. One hundred percent FTMH closure was observed postoperatively in both groups. Although the postoperative visual acuity was not significantly different, the study group showed a greater ellipsoid zone disruption length. CONCLUSION Broad VMA-induced FTMHs are characterized by diverse macular structural changes, including schisis and macular detachment. These FTMHs are associated with a higher incidence of lamellar holes associated epithelial proliferation and multiple membrane traction. Surgical outcomes for FTMHs induced by broad VMA are similar to those induced by typical focal VMA, with both groups demonstrating a 100% hole-closure rate.
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Affiliation(s)
- Chia-Yi Cheng
- Department of Ophthalmology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; and
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; and
- College of Medicine, National Taiwan University, Taipei, Taiwan
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Ito Y, Takatsudo Y, Gehlbach PL, Mori K. Mechanistic Insights into the Pathogenesis of Proliferative and Nonproliferative Vitreomacular Traction. Am J Ophthalmol 2022; 238:1-9. [PMID: 34902326 DOI: 10.1016/j.ajo.2021.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/02/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe the vitreoretinal interface in vitreomacular traction (VMT) by using novel optical coherence tomography (OCT) methods; wide-angle montage, and pseudomotion OCT imaging systems. DESIGN Observational case series. METHODS Wide-angle montage OCT images of horizontal and vertical scans through the fovea were acquired in 50 eyes of 46 consecutive patients with VMT. Baseline fundus scans were obtained. These were followed by scans acquired with an eye-tracking system performed immediately after vertical and horizontal eye movements. Three scans were then superimposed to compare changes in the contour and position of the posterior vitreous. RESULTS The subjects were classified as VMT with ("proliferative"; 48.0%) and without ("nonproliferative"; 52.0%) thickened posterior vitreous. Epiretinal membrane was observed in 26.9% of nonproliferative and 95.8% of proliferative VMT eyes (P = 3.6 × 10-7). No eye of proliferative and 57.7% of nonproliferative VMT eyes had wavy contoured posterior vitreous (P = 4.0 × 10-6). None with proliferative VMT, but 91.7% of nonproliferative VMT eyes, showed motion induced changes of posterior vitreous following eye movement (P = 2.0 × 10-8). The posterior vitreous detachment extended beyond the scanned area in 34.6% of nonproliferative and 8.3% of proliferative VMT eyes (P = .040). CONCLUSIONS By dynamically evaluating the vitreoretinal interface of patients with VMT, the static contraction forces of a thickened posterior vitreous at the macula are implicated in proliferative VMT. This contractile force is not strongly implicated in the majority of VMT eyes with nontaut and more mobile vitreous (nonproliferative VMT). VMT and its associated complications are determined by at least 2 different pathophysiological mechanisms.
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Affiliation(s)
- Yoko Ito
- From the Department of Ophthalmology, International University of Health and Welfare, Nasu-shiobara, Tochigi, Japan (Y.I., Y.K., K.M.)
| | - Yuki Takatsudo
- From the Department of Ophthalmology, International University of Health and Welfare, Nasu-shiobara, Tochigi, Japan (Y.I., Y.K., K.M.)
| | - Peter L Gehlbach
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (P.L.G.)
| | - Keisuke Mori
- From the Department of Ophthalmology, International University of Health and Welfare, Nasu-shiobara, Tochigi, Japan (Y.I., Y.K., K.M.); Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan (K.M.).
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Liao DY, Liu JH, Zheng YP, Shiu HW, Wang JM, Chao HM. OCT proves that vitreomacular adhesion is significantly more likely to develop vision-threatening retinal complications than vitreomacular separation. BMC Ophthalmol 2020; 20:163. [PMID: 32321473 PMCID: PMC7178608 DOI: 10.1186/s12886-020-01416-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/31/2020] [Indexed: 11/23/2022] Open
Abstract
Background SD-OCT is becoming commonplace in everyday practice. Vitreomacular adhesions (VMAs) are being more routinely diagnosed. Predictive studies to the natural course of VMA are thus clinically significant. Spectral domain-optical coherence tomography (SD-OCT) was presently utilized to analyze the incidence of floaters, the complete vitreomacular separation or VMA, the VMA complication, the vitreomacular angle (VMAng), and the complication mechanism. Methods Monthly SD-OCT was performed on patients with/without symptomatic floaters. OCT allowed VMA and vitreomacular separation to be compared. The incidence was assessed applying one-tailed Fisher’s exact tests. The VMAngs between the inner retina and posterior hyaloid were measured, and the complication mechanism was studied using OCT image. For macular hole (MH), pre- and/or post-operative best corrected visual acuities (BCVAs; LogMAR), refractions and photoreceptor conditions were also evaluated. Results Totally, 124 eyes were included; there were 116 eyes with VMA and 8 eyes with vitreomacular separation. Considering the percentages over 124 eyes, floaters were present in 14.5% of enrolled eyes (=18/124), consisting of 12.9% of eyes with VMA (16/124) and 1.6% of eyes with vitreomacular separation (2/124). Moreover, there were twelve eyes (9.7%) with VMA-associated vision-threatening complications, including MH (n = 8; 6.5%), retinal detachment (RD; n = 2; 1.6%), vitreomacular traction (VMT; n = 1; 0.8%) and macular pucker (MP; n = 1; 0.8%). Eyes with initial VMA had a significantly greater possibility of complications than eyes with initial vitreomacular separation (p = 0.03). Among these eyes with MH (n = 8), the pre-operative BCVA (LogMAR) was 1.1 ± 0.5, which was insignificantly (p = 0.35) improved to 0.8 ± 0.7 post-operatively. The VMAng of VMA eyes with MHs was 24.2 ± 24.9° (n = 8). The critical VMAng was 13.3°. Conclusions A minority of eyes with VMA or vitreomacular separation had floaters. Moreover, the use of SD-OCT could identify vision-threatening sequelae, namely MH, RD, MP and VMT, and this was significantly more frequent in eyes with VMA than in eyes with complete vitreomacular separation. Therefore, SD-OCT might be a useful way of identifying either identity, and evaluating VMA-associated complications. Whether VMA eyes with MH (n = 8) that have a VMAng greater than critical VMAng have a greater likelihood of tangential traction and subsequent MH needs further investigation.
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Affiliation(s)
- Ding-Ying Liao
- Department of Ophthalmology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jorn-Hon Liu
- Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Yu-Ping Zheng
- Department of Ophthalmology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huei-Wen Shiu
- Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Jian-Ming Wang
- Department of Ophthalmology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| | - Hsiao-Ming Chao
- Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan. .,Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Chinese Medicine, School of Chinese Medicine, China Medical University, Taichung, Taiwan. .,Department of Ophthalmology, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, Taipei, Taiwan. .,Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
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Flaxel CJ, Adelman RA, Bailey ST, Fawzi A, Lim JI, Vemulakonda GA, Ying GS. Idiopathic Epiretinal Membrane and Vitreomacular Traction Preferred Practice Pattern®. Ophthalmology 2019; 127:P145-P183. [PMID: 31757497 DOI: 10.1016/j.ophtha.2019.09.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
| | | | - Steven T Bailey
- Casey Eye Institute, Oregon Health & Science University, Portland, OR
| | - Amani Fawzi
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - G Atma Vemulakonda
- Department of Ophthalmology, Palo Alto Medical Foundation, Palo Alto, CA
| | - Gui-Shuang Ying
- Center for Preventative Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Nakamura K, Otake M. [Current progress of research and use of microminipigs in drug development]. Nihon Yakurigaku Zasshi 2019; 152:202-207. [PMID: 30298842 DOI: 10.1254/fpj.152.202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The use of minipigs has been increasing in the areas of pharmacology researches and drug development. The microminipig developed by Fuji Micra Inc. (Shizuoka, Japan) inherits characteristics of other pig strains showing several similarities to humans in anatomy, physiology, omnivorousness and diurnal, but at the same time has several advantages over other pig strains because of its small size which allows easy keeping, handling and dosing, and saving of test substances. The microminipig weighs about 10 kg at the age of 6 months. Canine cages can be used to keep the animal. Swine leukocyte antigens (SLA) are defined in each individual animal which is useful for testing immunological reactions. As there are many similarities in metabolic enzymes and transporters to those in humans, the microminipig is a powerful animal model for toxicokinetic studies. Unfortunately as in other minipigs the microminipig is not appropriate for embryo-fetal development studies of antibody drugs due to its poor placental transfer, but can be used for other reproductive and developmental studies. Repeat dose toxicity, safety pharmacology, immunotoxicity and local tolerance studies should be also other arenas of this animal model.
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Affiliation(s)
- Kazuichi Nakamura
- Laboratory of Toxicology, School of Veterinary Medicine, Kitasato University
| | - Masayoshi Otake
- Swine and Poultry Department, Shizuoka Prefectural Research Institute of Animal Industry, Swine and Poultry Research Center
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ILHAN C, CITIRIK M, UZEL MM, TEKIN K. The Relationship of Neutrophil to Lymphocyte Ratio with Vitreomacular Traction Syndrome. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2019; 8:22-27. [PMID: 30923719 PMCID: PMC6433203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study was conducted to reveal the role of systemic low-grade inflammation by calculating the Neutrophil/Lymphocyte Ratio (NLR) in Vitreomacular Traction Syndrome (VMTS) of different etiologies. A retrospective examination was made of the medical records at a tertiary referral hospital. The study included 31 patients with diabetic VMTS, 27 patients with idiopathic VMTS, and 35 healthy subjects as the control group. The White Blood Cell (WBC) counts and Neutrophil-to-Lymphocyte Ratio (NLR) was compared. There were insignificant differences between the groups in terms of mean age and female/male ratio (P>0.05). The mean ± Standard Deviation (SD) of NLR was calculated as 2.43 ± 0.83 in the diabetic VMTS group, 2.38 0.96 in the idiopathic VMTS group, and 1.83 WBC: White blood cell; VMTS: Vitreomacular traction syndrome; SD: standard deviation; µL: microliter; fL: femtolitre; n: number. 0.52 in the control group (P=0.007). The values of the diabetic and idiopathic VMTS groups were significantly higher than those of the control group (P=0.002 and P=0.032, respectively). However, differences between the diabetic and idiopathic VMTS groups were insignificant (P=0.651). This study found significantly higher NLR in patients with diabetic and idiopathic VMTS than the control group. Elevated NLR could therefore be a potential indicator of VMTS, irrespective of the etiology.
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Affiliation(s)
- Cagri ILHAN
- Department of Ophthalmology, Hatay State Hospital, Hatay, Turkey
| | - Mehmet CITIRIK
- Department of Ophthalmology, University of Health Sciences, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Mehmet Murat UZEL
- Department of Ophthalmology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Kemal TEKIN
- Department of Ophthalmology, Kars Harakani State Hospital, Kars, Turkey
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Chen T, Su B, Chen Z, Tong J, Bedell H, Song Z, Zhang B. The Associations among Metamorphopsia, Orientation Discrimination Threshold, and Retinal Layer Thickness in Patients with Idiopathic Epiretinal Membrane. Curr Eye Res 2018; 43:1151-1159. [PMID: 29804466 DOI: 10.1080/02713683.2018.1481515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Tianyu Chen
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Binbin Su
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zheyi Chen
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | | | - Harold Bedell
- College of optometry, University of Houston, Houston, TX, USA
| | - Zongming Song
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bin Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- College of Optometry, Nova Southeastern University, Davie, FL, USA
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8
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Kozak I, Barteselli G, Sepah YJ, Sadiq MA, High R, Do DV, Nguyen QD. Correlation of Vitreomacular Traction with Foveal Thickness, Subfoveal Choroidal Thickness, and Vitreomacular/Foveal Angle. Curr Eye Res 2016; 42:297-301. [PMID: 27362467 DOI: 10.1080/02713683.2016.1175020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the structure of vitreomacular traction (VMT), specifically, if a correlation exists between 1) the VMT type/grade and the central foveal thickness (CFT) and subfoveal and adjacent choroidal thickness, 2) the vitreomacular/foveal angle (VMFA) and the CFT and subfoveal and adjacent choroidal thickness, and 3) the diameter of vitreomacular adhesion (VMA) and CFT and subfoveal and adjacent choroidal thickness. MATERIALS AND METHODS Retrospective, multicenter image analysis study. We analyzed raster scans of the macula taken with spectral-domain optical coherence tomography (SD-OCT) of 61 eyes of 55 patients with VMT. Conventional scans of the vitreoretinal interface were analyzed to measure CFT and the degree of VMFA. Enhanced depth imaging (EDI) scans were analyzed to measure the choroidal thickness in the macula. The multivariate test of means and the t-test were used for statistical comparisons. RESULTS There was no statistically significant difference in CFT between focal vs broad and concurrent vs isolated type VMT. Central (p = 0.009), nasal (p = 0.004), and temporal (p = 0.007) subfoveal choroidal thickness was significantly higher in broad VMT compared to focal VMT. There was difference in both CFT (p = 0.035) and central (p = 0.005), nasal (p = 0.01), and temporal (p = 0.001) choroidal thickness between moderate and severe VMT. There was a correlation between VMFA and CFT, where a wider angle was associated with increased CFT (p = 0.026). The broader VMA was associated with increased central subfoveal (p = 0.032), nasal (p = 0.05), and temporal (p = 0.01) choroidal thickness. CONCLUSIONS Eyes with broad VMT have thicker choroid than eyes with focal VMT, which have a more open vitreomacular angle. The angle of VMT is related to distinct CFTs.
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Affiliation(s)
- Igor Kozak
- a King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Giulio Barteselli
- b Ophthalmological Unit, Department of Clinical Sciences and Community Health , Ca' Granda Foundation-Ospedale Maggiore Policlinico, University of Milan , Milan , Italy.,c Genentech Inc ., South San Francisco , CA , USA
| | - Yasir J Sepah
- d Truhlsen Eye Institute, University of Nebraska Medical Center , Omaha , NE , USA
| | - Mohammad Ali Sadiq
- d Truhlsen Eye Institute, University of Nebraska Medical Center , Omaha , NE , USA
| | - Robin High
- e Maurer College of Public Health at the University of Nebraska Medical Center Omaha , NE , USA
| | - Diana V Do
- d Truhlsen Eye Institute, University of Nebraska Medical Center , Omaha , NE , USA
| | - Quan Dong Nguyen
- d Truhlsen Eye Institute, University of Nebraska Medical Center , Omaha , NE , USA
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Steel DHW, Downey L, Greiner K, Heimann H, Jackson TL, Koshy Z, Laidlaw DAH, Wickham L, Yang Y. The design and validation of an optical coherence tomography-based classification system for focal vitreomacular traction. Eye (Lond) 2016; 30:314-24; quiz 325. [PMID: 26768921 DOI: 10.1038/eye.2015.262] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 10/13/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To develop and validate a classification system for focal vitreomacular traction (VMT) with and without macular hole based on spectral domain optical coherence tomography (SD-OCT), intended to aid in decision-making and prognostication. METHODS A panel of retinal specialists convened to develop this system. A literature review followed by discussion on a wide range of cases formed the basis for the proposed classification. Key features on OCT were identified and analysed for their utility in clinical practice. A final classification was devised based on two sequential, independent validation exercises to improve interobserver variability. RESULTS This classification tool pertains to idiopathic focal VMT assessed by a horizontal line scan using SD-OCT. The system uses width (W), interface features (I), foveal shape (S), retinal pigment epithelial changes (P), elevation of vitreous attachment (E), and inner and outer retinal changes (R) to give the acronym WISPERR. Each category is scored hierarchically. Results from the second independent validation exercise indicated a high level of agreement between graders: intraclass correlation ranged from 0.84 to 0.99 for continuous variables and Fleiss' kappa values ranged from 0.76 to 0.95 for categorical variables. CONCLUSIONS We present an OCT-based classification system for focal VMT that allows anatomical detail to be scrutinised and scored qualitatively and quantitatively using a simple, pragmatic algorithm, which may be of value in clinical practice as well as in future research studies.
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Affiliation(s)
- D H W Steel
- Sunderland Eye Infirmary, Sunderland, UK.,Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - L Downey
- Ophthalmology Department, Hull and East Yorkshire Eye Hospital, Hull and East Yorkshire NHS Trust, Hull, UK
| | - K Greiner
- Ophthalmology Department, Aberdeen Royal Infirmary, Aberdeen, UK
| | - H Heimann
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - T L Jackson
- Department of Ophthalmology, School of Medicine, King's College London, London, UK
| | - Z Koshy
- Department of Ophthalmology, University Hospital Ayr, Ayr, UK
| | - D A H Laidlaw
- Ophthalmology Department, St Thomas' Hospital, London, UK
| | - L Wickham
- Ophthalmology Department, Moorfields Eye Hospital, London, UK
| | - Y Yang
- School of Life and Health Sciences, Aston University, Birmingham, UK
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Variability in Presentation of Bilateral Vitreomacular Traction. Optom Vis Sci 2016; 93:310-7. [PMID: 26760576 DOI: 10.1097/opx.0000000000000786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Vitreomacular traction (VMT) is a condition characterized by an incomplete posterior vitreous detachment resulting in traction on the macula and possible subsequent decrease in visual acuity and/or other symptomatology. Vitreomacular traction often presents as a unilateral condition, with some cases developing bilaterality with disease progression. The natural course and presentation of VMT vary widely among individuals. There is no extensive literature regarding the prevalence of VMT in the general population; therefore, little is known on the laterality. CASE REPORTS We present eight cases of bilateral VMT encountered in a primary care setting. These cases highlight the variability in presentation, symptomatology, and clinical outcome between and within eyes of patients with bilateral VMT. CONCLUSIONS Spectral-domain optical coherence tomography has provided new insight into VMT by allowing better visualization of the vitreoretinal interface. Using spectral-domain optical coherence tomography, eight unique cases of bilateral VMT were confirmed and classified. However, despite the bilaterality noted in each case, the clinical presentation and course of disease varied among patients. Because of the paucity of epidemiological data regarding VMT, the laterality of the condition, risk factors for involvement, and overall prognosis remain unclear.
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Romano MR, Comune C, Ferrara M, Cennamo G, De Cillà S, Toto L, Cennamo G. Retinal Changes Induced by Epiretinal Tangential Forces. J Ophthalmol 2015; 2015:372564. [PMID: 26421183 PMCID: PMC4573429 DOI: 10.1155/2015/372564] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/11/2015] [Accepted: 06/22/2015] [Indexed: 12/05/2022] Open
Abstract
Two kinds of forces are active in vitreoretinal traction diseases: tangential and anterior-posterior forces. However, tangential forces are less characterized and classified in literature compared to the anterior-posterior ones. Tangential epiretinal forces are mainly due to anomalous posterior vitreous detachment (PVD), vitreoschisis, vitreopapillary adhesion (VPA), and epiretinal membranes (ERMs). Anomalous PVD plays a key role in the formation of the tangential vectorial forces on the retinal surface as consequence of gel liquefaction (synchysis) without sufficient and fast vitreous dehiscence at the vitreoretinal interface. The anomalous and persistent adherence of the posterior hyaloid to the retina can lead to vitreomacular/vitreopapillary adhesion or to a formation of avascular fibrocellular tissue (ERM) resulting from the proliferation and transdifferentiation of hyalocytes resident in the cortical vitreous remnants after vitreoschisis. The right interpretation of the forces involved in the epiretinal tangential tractions helps in a better definition of diagnosis, progression, prognosis, and surgical outcomes of vitreomacular interfaces.
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Affiliation(s)
- Mario R. Romano
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
| | - Chiara Comune
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
| | - Mariantonia Ferrara
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
| | - Gilda Cennamo
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
| | - Stefano De Cillà
- Azienda Ospedaliero-Universitaria “Maggiore della Carità” di Novara, 28100 Novara, Italy
| | - Lisa Toto
- Ophthalmology Clinic, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Giovanni Cennamo
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University Federico II, Napoli, Italy
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Schaal S, Reddy SV, Kaplan HJ. Current medical and surgical therapeutic approaches to cystoid macular edema in uveitis. EXPERT REVIEW OF OPHTHALMOLOGY 2015. [DOI: 10.1586/17469899.2015.1003042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Mayer WJ, Schumann RG, Kampik A, Haritoglou C. [Importance of morphological and functional diagnostics of the vitreoretinal interface]. Ophthalmologe 2014; 112:29-34. [PMID: 25501929 DOI: 10.1007/s00347-014-3050-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Optical coherence tomography (OCT) is the standard examination for assessment of the vitreoretinal interface (VRI); therefore, it is essential to select the appropriate scan modalities to detect the total amount of morphological changes, not only at the VRI but also in all layers of the retina and in both the foveal and parafoveal areas. For the success of a surgical intervention in the treatment of vitreomacular interface disorders, morphological changes, especially in the outer retinal layers, have been determined to be of prognostic interest in high-resolution OCT. This article gives an overview of current OCT examination procedures as well as correlative aspects of morphological and functional findings.
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Affiliation(s)
- W J Mayer
- Augenklinik, Ludwig-Maximilians-Universität München, Mathildenstr. 8, 80336, München, Deutschland,
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