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Nouri H, Abtahi SH, Mazloumi M, Samadikhadem S, Arevalo JF, Ahmadieh H. Optical coherence tomography angiography in diabetic retinopathy: A major review. Surv Ophthalmol 2024; 69:558-574. [PMID: 38521424 DOI: 10.1016/j.survophthal.2024.03.004] [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: 09/23/2023] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
Diabetic retinopathy (DR) is characterized by retinal vasculopathy and is a leading cause of visual impairment. Optical coherence tomography angiography (OCTA) is an innovative imaging technology that can detect various pathologies and quantifiable changes in retinal microvasculature. We briefly describe its functional principles and advantages over fluorescein angiography and perform a comprehensive review on its clinical applications in the screening or management of people with prediabetes, diabetes without clinical retinopathy (NDR), nonproliferative DR (NPDR), proliferative DR (PDR), and diabetic macular edema (DME). OCTA reveals early microvascular alterations in prediabetic and NDR eyes, which may coexist with sub-clinical neuroretinal dysfunction. Its applications in NPDR include measuring ischemia, detecting retinal neovascularization, and timing of early treatment through predicting the risk of retinopathy worsening or development of DME. In PDR, OCTA helps characterize the flow within neovascular complexes and evaluate their progression or regression in response to treatment. In eyes with DME, OCTA perfusion parameters may be of predictive value regarding the visual and anatomical gains associated with treatment. We further discussed the limitations of OCTA and the benefits of its incorporation into an updated DR severity scale.
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Affiliation(s)
- Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehdi Mazloumi
- Eye Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sanam Samadikhadem
- Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sborgia L, Albano V, Sborgia A, Viggiano P, Boscia G, Zerbinati M, Pozharitskiy N, Binetti R, Dimiccoli R, Fracchiolla A, Boscia F, Alessio G. FUNCTIONAL AND ANATOMICAL OUTCOMES AFTER SHORT-TERM HEAVY SILICONE OIL ENDOTAMPONADE FOR INFERIOR RHEGMATOGENOUS RETINAL REDETACHMENT: A Pilot Study. Retina 2024; 44:1142-1149. [PMID: 38452264 DOI: 10.1097/iae.0000000000004092] [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: 03/09/2024]
Abstract
PURPOSE To assess the success of the short-term location of the heavy silicone oil (Densiron 68, HSO) as endotamponade after pars plana vitrectomy for rhegmatogenous complex retinal redetachment. METHODS Consecutive, retrospective, nonrandomized, pilot study was conducted. Twenty-two eyes of 22 patients with complex inferior retinal redetachment previously tamponade with gas (SF6 or C3F8) or 1000 cSt standard silicone oil (SSO) were selected. All were treated with HSO endotamponade, and its removal was performed after 1 month. The main outcomes were best-corrected visual acuity and postoperative complications after the HSO removal. RESULTS Of the 22 eyes, 10 were treated with SSO endotamponade, 3 with fluorinated gas 14% C3F8, and 9 with 20% SF6 at first surgery. In all eyes, a complex inferior retinal redetachment was observed after the first surgery, in 1 month to 3 months after silicone oil removal or gas endotamponade introduction. In 10 eyes, the proliferative vitreoretinopathy (Grade B or C 1-3) was found. The main best-corrected visual acuity before HSO removal was 0.55 ± 0.20 the logarithm of the minimum angle of resolution (range 0.4-0.7) and after the HSO removal, it was 0.32 ± 0.29 the logarithm of the minimum angle of resolution (0.1-0.4). Among the postoperative complications, only in four eyes the macular edema was found (medically resolved), in four eyes an increase of intraocular pressure, and none of these developed the epiretinal membrane. CONCLUSION The main purpose of this study is to establish a short-term HSO endotamponade in eyes with complex retinal detachment recurrences, reducing the possible postoperative complications and having a better prognosis for visual acuity outcomes.
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Affiliation(s)
- Luigi Sborgia
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Valeria Albano
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University Hospital Polyclinic of Bari, Bari, Italy; and
| | - Alessandra Sborgia
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Pasquale Viggiano
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Giacomo Boscia
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Marta Zerbinati
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Nikolai Pozharitskiy
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Roberta Binetti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Roberta Dimiccoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Antonio Fracchiolla
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Francesco Boscia
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Giovanni Alessio
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
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Qu S, Zhou Q, Shao YT, Lin MY, Shen JQ, Niu GZ, Han WT, Zhang L, Bi YL. Posterior capsular radial sign: a novel method to confirm anterior vitreous cortex resection in phacovitrectomy. BMC Ophthalmol 2024; 24:231. [PMID: 38822280 PMCID: PMC11143691 DOI: 10.1186/s12886-024-03474-x] [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: 09/09/2023] [Accepted: 05/02/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The main purpose of this paper is to introduce a method that can accurately locate the posterior capsule of the lens to facilitate a relatively complete resection of the anterior vitreous body. METHODS A total of 51 patients in the experimental group and control group were enrolled in this study. Phacoemulsification combined with vitrectomy was performed in all cases. After the cataract procedure was completed in the control group, the surgeon performed a conventional anterior vitrectomy with the operative eye. In the experimental group, anterior vitrectomy was performed according to the threadiness corrugation of the posterior capsule of the lens. During the operation, with the help of triamcinolone, two surgeons confirmed the resection of the anterior vitreous cortex; the best corrected visual acuity and intraocular pressure of all patients were recorded at 1 week, 1 month and 3 months after surgery. RESULTS Fifty patients underwent phacoemulsification combined with vitrectomy, except one patient in the experimental group who was lost to follow-up. After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. There was no significant difference in preoperative visual acuity between the two groups (t = 0.83, P = 0.25). Both groups had varying degrees of improvement in best corrected visual acuity at 1 week, 1 month and 3 months after surgery. Moreover, there was no significant difference in BCVA between the two groups at the three follow-up time points (t=-1.15, -1.65, -1.09, P = 0.53, 0.21, 0.23). After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. Incomplete resection of the anterior vitreous cortex was observed in 2 patients in each group, but there was no significant difference (χ2 = 7.81, P > 0.05). CONCLUSION In the process of cataract surgery combined with vitrectomy, thready corrugation appears in the posterior capsule of the lens and is an important sign of its localization. Anterior vitrectomy can be accomplished safely and effectively with the help of thread-like corrugation, and the surgical effect is almost the same as that of traditional surgery. Especially suitable for beginners in vitreous surgery.
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Affiliation(s)
- Shen Qu
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Qi Zhou
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Yu-Ting Shao
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Ming-Yue Lin
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Jia-Qi Shen
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Guo-Zhen Niu
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Wen-Ting Han
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Li Zhang
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Yan-Long Bi
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
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Huang RS, Mihalache A, Lau THA, Popovic MM, Kertes PJ, Muni RH. Pars Plana Vitrectomy With Silicone Oil or Gas Tamponade for Uncomplicated Retinal Detachment: A Systematic Review and Meta-Analysis. Am J Ophthalmol 2024; 266:144-155. [PMID: 38815844 DOI: 10.1016/j.ajo.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE To compare the efficacy and safety of pars plana vitrectomy (PPV) with silicone oil compared to gas tamponade for uncomplicated rhegmatogenous retinal detachment (RRD). DESIGN Systematic review and meta-analysis. METHODS A systematic literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Library from January 2000 to September 2023 for comparative studies evaluating the efficacy and safety of PPV with either silicone oil or gas tamponade in the setting of uncomplicated RRD. Our primary outcome was best-corrected visual acuity at the last study observation. Secondary outcomes included the rates of retinal reattachment, retinal thickness, and the incidence of adverse events. We performed a meta-analysis using a random-effects model. RESULTS Nine observational studies reporting on 491 RRD eyes were included. The mean best-corrected visual acuity at the last study observation was significantly better in the gas tamponade group than in the silicone oil group (weighted mean difference [WMD] = 0.17 logMAR, 95% confidence interval [CI] = [0.06, 0.27], P = .002). Rates of primary retinal reattachment were similar between the silicone oil and gas tamponade groups (P = .89). The ganglion cell layer was significantly thinner in the silicone oil group compared to the gas tamponade group (WMD =-3.70 µm, 95% CI = [-5.87, -1.53, P = .0008), as was the inner plexiform layer (WMD = -2.45, 95% CI = [-4.50, -0.40], P = .02) and outer nuclear layer (WMD = -11.74 µm, 95% CI = [-18.39, -5.10], P = .0005). CONCLUSIONS PPV with gas tamponade was associated with better functional outcomes compared to PPV with silicone oil, although both tamponades yielded comparable primary reattachment rates. The absence of randomized trials and the potential for selection bias underscore the importance of further investigation in diverse patient populations.
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Affiliation(s)
- Ryan S Huang
- Temerty Faculty of Medicine, University of Toronto (RSH, AM), Toronto, Ontario, Canada
| | - Andrew Mihalache
- Temerty Faculty of Medicine, University of Toronto (RSH, AM), Toronto, Ontario, Canada
| | - Tsz Hin Alexander Lau
- Department of Ophthalmology and Visual Sciences, McGill University (THAL), Montreal, Quebec, Canada
| | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto (MMP, PJK, RHM), Toronto, Ontario, Canada
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto (MMP, PJK, RHM), Toronto, Ontario, Canada; John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre (PJK), Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto (MMP, PJK, RHM), Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto (RHM), Toronto, Ontario, Canada.
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Al-Shehri AM, Aljohani S, Aldihan KA, Alrashedi MJ, Alrasheed S, Schatz P. Effect of silicone oil versus gas tamponade on macular layer microstructure after pars plana vitrectomy for macula on rhegmatogenous retinal detachment. BMC Ophthalmol 2024; 24:119. [PMID: 38486220 PMCID: PMC10938769 DOI: 10.1186/s12886-024-03377-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
PURPOSE To analyze structural changes in the macular retinal layers and sub-foveal choroidal thickness (SFCT) in eyes after macula-on rhegmatogenous retinal detachment (RRD) repair by pars plana vitrectomy with either silicone oil (SO) or gas tamponade, and the effect of these changes on visual acuity. PATIENTS AND METHODS Retrospective study which included 26 eyes in the SO Group and 32 in the Gas Group. Optical coherence tomography (OCT) scans of the affected eyes were obtained before surgery, and 3 months after PPV in the Gas Group, and during silicone oil in situ and 3 months after SO removal, in the SO Group. Qualitative assessment of photoreceptor layer and foveal contour, along with quantitative assessment of macular retinal thickness and SFCT was performed. Postoperative OCT macular microstructural changes were recorded and correlated to corrected distance visual acuity (CDVA). Intraocular pressure (IOP) was measured preoperative and at 3 months post operative. RESULTS There was a 2-line loss (from 20/28 preoperatively to 20/40 at final follow-up) of CDVA in the SO Group (p=0.051), while there was no statistically significant change in CDVA in the Gas Group (p=0.786). There was no significant correlation between CDVA loss and duration of silicon tamponade (r=-0.031, p=0.893). There was a statistically significant increase in IOP from its baseline to final follow-up of 0.7 mmHg in the SO Group (p=0.023) while there was no statistically significant change in IOP in the Gas Group. During silicone oil tamponade, there was approximately 11% and 5% of retinal and sub-foveal choroidal thinning respectively, which was moderately resolved following silicone oil removal. 20% (5/24) of eyes in the SO Group had qualitative flattening of foveal contour during SO tamponade that resolved after SO removal. CONCLUSION Thinning of the macula was noticed after macula-on RRD repair with SO tamponade. Such thinning was only partially reversible after the removal of SO.
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Affiliation(s)
- Abdulaziz Mohammed Al-Shehri
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
- Surgery Department, Taif university, Taif, Saudi Arabia.
| | - Saud Aljohani
- Ophthalmology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalid Abdulaziz Aldihan
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Musa Johaiman Alrashedi
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Saad Alrasheed
- Diagnosic imaging department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Patrik Schatz
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Ophthalmology, Clinical Sciences, Skane University Hospital, Lund University, Lund, Sweden
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Bellucci C, Riboni N, Ricciotti G, Spadini F, Pasquali A, Rossi M, Gandolfi S, Ribezzi E, Marraffa E, Bianchi F, Careri M, Mora P. Contamination Profile of Different Formulations of Silicone Oil Tamponade Before and After Intraocular Permanence for Rhegmatogenous Retinal Detachment. Transl Vis Sci Technol 2024; 13:4. [PMID: 38466299 DOI: 10.1167/tvst.13.3.4] [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: 03/12/2024] Open
Abstract
Purpose The purpose of this study was to search for contaminants in silicone oil tamponades removed from eyes treated for retinal detachment, and to correlate chemical results with some clinical/functional parameters of the considered eyes. Methods We examined a sequential cohort of eyes grouped according to the tamponade received: (1) Siluron2000 (S2), (2) RS-OIL ECS5000 (S5), and (3) Densiron Xtra (DX). Samples were collected at the beginning of the scheduled removal and analyzed by untargeted headspace gas-chromatography mass spectrometry (HS-GC-MS). Visual acuity and optic coherence tomography assessments were obtained before and after the tamponade removal. Results Forty-one samples were analyzed: 22 belonging to the DX group, 13 to the S2 group, and 6 to the S5 group. For each group, a mixture of uninjected commercial preparation was analyzed as the reference. Different siloxanes and fluorinated compounds including perfluorodecalin (PFCL) were the most prevalent chemicals, found in 55% to 100% of the intraocular samples of the 3 groups. Some siloxanes were present also in the control matrices, whereas PFCL was only in the extracted tamponades. In the DX group, the concentration of hexamethylcyclotrisiloxane showed an inverse correlation trend with the duration of its permanence inside the eye (P = 0.054). Different alkanes, propanol, and acetaldehyde were identified only in the control matrices. Conclusions Several contaminants including siloxanes were identified in the intraocular samples and in the control matrices. A time-related ocular uptake of some of these is conceivable. PFCL was also highly present but only in intraocular samples. Translational Relevance After intraocular permanence silicone oils (SOs) have various unlabeled contaminants with some relevant differences with the commercial formulation chemical profile.
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Affiliation(s)
- Carlo Bellucci
- Ophthalmology Unit, University Hospital of Parma, Parma, Italy
| | - Nicolò Riboni
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Guido Ricciotti
- Ophthalmology Unit, University Hospital of Parma, Parma, Italy
| | | | - Andrea Pasquali
- Ophthalmology Unit, University Hospital of Parma, Parma, Italy
| | - Maurizio Rossi
- Department of Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | | | - Erika Ribezzi
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Enrico Marraffa
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Federica Bianchi
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Maria Careri
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Paolo Mora
- Ophthalmology Unit, University Hospital of Parma, Parma, Italy
- https://orcid.org/0000-0001-7133-8250
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Hassan A, Abdel-Radi M, Aly MOM, Alattar S. Correlation between multifocal electroretinogram and optical coherence tomography findings with visual acuity after vitrectomy surgery for retinal detachment: an observational study. Int J Retina Vitreous 2024; 10:10. [PMID: 38263142 PMCID: PMC10804544 DOI: 10.1186/s40942-024-00527-7] [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: 12/08/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Despite the marked increase in the anatomical success rates of macula-off rhegmatogenous retinal detachment (RRD) surgery, patients may still complain about unsatisfactory visual outcome. This study aims to correlate the postoperative corrected distance visual acuity (CDVA) with the mf-ERG (multifocal electroretinogram) and OCT (optical coherence tomography) findings following vitrectomy surgery for RRD. PATIENTS AND METHODS This retrospective observational study included 40 eyes of 40 patients who underwent successful vitrectomy surgery for macula-off RRD. CDVA, mf-ERG amplitudes, mf-ERG latencies, the central macular thickness (CMT) and the integrity of the inner segment/outer segment (IS/OS) junction assessed by OCT, were evaluated 6 months postoperatively. The correlations between CDVA with mf-ERG amplitudes, mf-ERG latencies, central macular thickness, and IS/OS junction integrity were analyzed. RESULTS There was a statistically significant moderate positive correlation between CDVA of the studied eyes with mf-ERG amplitudes of N1, P1 and N2 in ring 1 (P = 0.008; P < 0.001 and P = 0.004, respectively), CMT (P < 0.001), and the integrity of IS/OS junction (P < 0.001). There was no significant correlation between CDVA and mf-ERG latencies in ring 1 (P > 0.05). Linear regression analysis revealed that CDVA was significantly associated with mf-ERG amplitudes and the IS/OS junction integrity. In addition, there was a strong positive correlation between mf-ERG amplitudes in ring 1 and the IS/OS junction integrity. CONCLUSIONS The integrated interpretation of postoperative CDVA, multifocal ERG parameters, and OCT findings provides useful information about functional visual recovery and retinal microstructural changes following vitrectomy for macula-off RRD surgery. The positive correlation between the IS/OS junction integrity and the mf-ERG amplitudes was stronger than the correlation between the IS/OS junction integrity and CDVA suggesting that mf-ERG may be superior to CDVA in reflecting the extent of microstructural damage in the photoreceptor layer. TRIAL REGISTRATION Clinicaltrials.gov, NCT05993208. Registered 15 August 2023 - Retrospectively registered, https://classic. CLINICALTRIALS gov/ct2/show/NCT05993208 .
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Affiliation(s)
- Asmaa Hassan
- Department of Ophthalmology, New Valley University, New Valley, Egypt
| | | | | | - Sara Alattar
- Department of Ophthalmology, Assiut University, Assiut, Egypt
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Riboni N, Ribezzi E, Marraffa E, Mora P, Bellucci C, Bianchi F, Careri M. An ex vivo headspace gas chromatography-mass spectrometry method for the determination of short-chain siloxanes in silicon oil tamponades used in ophthalmic surgery. J Pharm Biomed Anal 2024; 238:115871. [PMID: 38006704 DOI: 10.1016/j.jpba.2023.115871] [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: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
Being able to facilitate retinal reattachment by preventing water migration into the subretinal space, silicone oils are widely used as long-term intraocular tamponade to treat cases of retinal detachment. Various commercial tamponades constituted by linear polydimethylsiloxane polymers with different molecular weights and cyclic impurities are available. In this study, for the first time, an untargeted headspace-gas-chromatography-mass spectrometry (HS-GC-MS) method was developed to identify low-molecular weight contaminants in three different types of silicone oil tamponades, namely Siluron 2000, RS-OIL ECS5000 and Densiron Xtra. Both commercial and post-operative tamponades were analysed to screen for the different classes of compounds present in the samples. The most abundant classes were short-chain siloxanes, fluorinated compounds, and hydrocarbons. To quantify the siloxanes present in the samples, a targeted HS-GS-MS was optimized using a central composite design and validated according to guidelines for bioanalytical methods. Lower limits of quantification in the low μg/L range, good precision with RSD% < 12% and accuracy with recovery rates in the 81 ( ± 7) - 96 ( ± 4) % range were achieved. Short-chain siloxanes were quantified in both commercial and post-operative tamponades, being the RS-OIL ECS5000 characterized by the highest concentration levels of the investigated analytes. By contrast, Densiron Xtra tamponades showed the lowest amount of short-chain siloxanes, observing a general decrease in their concentration levels according to the residence time in the eyes.
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Affiliation(s)
- Nicolò Riboni
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy.
| | - Erika Ribezzi
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
| | - Enrico Marraffa
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
| | - Paolo Mora
- Ophthalmology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Carlo Bellucci
- Ophthalmology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Federica Bianchi
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy.
| | - Maria Careri
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
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Sun X, Wang X, Guo X, Wang M, Liu H. Combined Use of Anti-VEGF Drugs Before and During Pars Plana Vitrectomy for Severe Proliferative Diabetic Retinopathy. Ophthalmol Ther 2023; 12:3133-3142. [PMID: 37713065 PMCID: PMC10640465 DOI: 10.1007/s40123-023-00803-z] [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: 06/05/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate the combined administration of anti-vascular endothelial growth factor (anti-VEGF) drugs before and during pars plana vitrectomy (PPV) and to explore its efficacy and safety in the treatment of patients with severe proliferative diabetic retinopathy (PDR). METHODS This retrospective case series included consecutive patients who underwent PPV. Patients were categorized into two groups: the preoperative group was injected with anti-VEGF drugs before PPV, and the combination group was injected with anti-VEGF drugs before and during PPV. Preoperative, intraoperative, and postoperative clinical data were collected for analysis. The main outcome measures were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) and occurrence of postoperative vitreous cavity haemorrhage (POVCH). RESULTS In total, 63 eyes of 60 patients with severe PDR were analysed. The operative duration and occurrence of intraoperative haemorrhage, iatrogenic retinal breaks, and silicone oil tamponade were similar between the two groups. The benefits on BCVA, and CRT after 1 week postoperatively, were more obvious in the combination group (P < 0.01). Combination therapy had the potential to reduce the incidence of POVCH. No ocular or systemic adverse events occurred in either group. CONCLUSIONS The combined use of anti-VEGF drugs before and during PPV in patients with severe PDR not only includes the advantages of preoperative injection, but also has more significant prognostic benefits and favourable safety profiles.
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Affiliation(s)
- Xincheng Sun
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
- Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Xianhuai Wang
- Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Xinyu Guo
- Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Mengjiao Wang
- Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.
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Chen J, Guan L, Liu Y, Song Y, Tang Y, Cao Y, Li M, Sheng A, Zhang Z, Liu H. Choroidal vascular changes in silicone oil-filled eyes after vitrectomy for rhegmatogenous retinal detachments. BMC Ophthalmol 2023; 23:442. [PMID: 37919665 PMCID: PMC10621110 DOI: 10.1186/s12886-023-03167-x] [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: 07/07/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION The tamponade of silicone oil (SO) can affect both the structure and blood flow of the retina. However, there are few studies on the effect of SO tamponade on choroidal blood flow. Our study aimed to compare the effects of SO tamponade on the choroidal vascular index (CVI) and choroidal thickness (CT) in patients with unilateral rhegmatogenous retinal detachment (RRD) with operated eyes and fellow healthy eyes. METHODS We retrospectively collected demographic and clinical data from 36 patients who underwent 23G pars plana vitrectomy and SO tamponade for unilateral complicated RRD. Enhanced depth imaging-optical coherence tomography (EDI-OCT) scans were performed both within 1 week before SO removal and at the last follow-up visit after SO removal. Using ImageJ software, images were binarized to segment the total choroidal area, luminal area, and stromal area, respectively. The CVI was calculated as CVI=(luminal area)/(total choroidal area), and CT was also evaluated. RESULTS During SO tamponade, the CVI and luminal area in operated eyes were significantly lower compared to fellow eyes (57.616 ± 0.030 vs. 60.042 ± 0.019, P < 0.0001; 0.909 [0.694; 1.185] vs. 1.091 [0.785; 1.296], P = 0.007). Even after SO removal, the CVI remained lower in operated eyes than in fellow eyes (59.530 ± 0.018 vs. 60.319 ± 0.020, P = 0.031). Both CVI and luminal area were lower in operated eyes before SO removal than after SO removal (57.616 ± 0.030 vs. 59.530 ± 0.018, P = 0.0003; 0.909 [0.694; 1.185] vs. 0.994 [0.712; 1.348], P = 0.028). The duration of SO tamponade was positively correlated with the difference in CVI between fellow eyes and operated eyes during SO tamponade (P = 0.035). Total choroidal area, stromal area, and CT did not differ significantly between fellow eyes and operated eyes or between pre- and post-SO removal. CONCLUSIONS SO tamponade reduces CVI and decreases choroidal blood circulation in patients with retinal detachments required vitrectomy combined with SO tamponade. The longer the SO tamponade time, the more CVI reduction. In future work, we will aim to reduce these side effects by shortening the duration of silicone oil filling.
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Affiliation(s)
- Jiayu Chen
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Lina Guan
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Yalu Liu
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Yingying Song
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Yu Tang
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Yumei Cao
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Meishuang Li
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Aiqin Sheng
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Zhengpei Zhang
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China.
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China.
| | - Haiyang Liu
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China.
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China.
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Mete M, Parolini B, Maggio E, Airaghi G, De Santis N, Guerriero M, Pertile G. Use of Heavy Silicon Oil as Intraocular Tamponade for Inferior Retinal Detachment Complicated by Proliferative Vitreoretinopathy: A Multicentric Experience. Ophthalmologica 2023; 246:209-218. [PMID: 37245503 DOI: 10.1159/000531141] [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: 01/23/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION This is a multicentric study on the use of heavy silicon oil (HSO) as an intraocular tamponade for inferior retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR). METHODS 139 eyes treated for RD with PVR were included in the study. 10 (7.2%) were affected by primary RD with inferior PVR, while 129 (92.8%) were affected by recurrent RD with inferior PVR. 102 eyes (73.9%) had received a silicon oil (SO) tamponade in a previous intervention prior to receiving HSO. Mean follow-up was 36.5 (standard deviation = 32.3) months. RESULTS The median interval between HSO injection and removal was 4 months (interquartile range: 3). At the time of HSO removal, the retina was attached in 120 eyes (87.6%), whereas in 17 eyes (12.4%), it had re-detached while the HSO was in situ. 32 eyes (23.2%) showed recurrent RD. A subsequent RD relapse was observed in 14.2% of cases with no RD at the time of HSO removal, and in 88.2% if an RD was present at the time of HSO removal. Advancing age showed a positive association with retinal attachment at the end of follow-up, while the risk of RD relapse at the end of the follow-up showed a significant negative association with HSO tamponade duration and with the use of SO rather than air or gas as post-HSO tamponade materials. Mean best corrected visual acuity was 1.1 logarithm of minimum angle of resolution at all follow-up time points. 56 cases (40.3%) needed treatment for elevated intraocular pressure (IOP), with which no clinically relevant variables were associated during follow-up. CONCLUSION HSO represents a safe and effective tamponade in cases of inferior RD with PVR. The presence of RD at the time of HSO removal is a negative prognostic factor for the development of a subsequent RD relapse. According to our findings, in cases of RD at the time of HSO removal, a short-term tamponade should definitely be avoided, in favor of SO. Special attention must be paid to the risk of IOP elevation, and patients should be closely monitored.
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Affiliation(s)
- Maurizio Mete
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | | | - Emilia Maggio
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Giulia Airaghi
- Department of Ophthalmology, ASST Valle Olona, Varese, Italy
| | - Nicoletta De Santis
- Clinic Research Unit, URC, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Massimo Guerriero
- Clinic Research Unit, URC, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Grazia Pertile
- Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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12
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Felfeli T, Murtaza F, Herman J, Pereira AM, Mandelcorn MS, Mandelcorn ED. Anatomical and functional outcomes of short-term DensironXTRA heavy silicone oil for rhegmatogenous retinal detachments: a comparative case series. Sci Rep 2023; 13:3729. [PMID: 36878935 PMCID: PMC9988839 DOI: 10.1038/s41598-023-30210-0] [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: 10/08/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
To assess the safety and efficacy of short-term DensironXTRA tamponade for repair of complicated rhegmatogenous retinal detachments (RRD). This is a retrospective consecutive case series of patients undergoing pars plana vitrectomy (PPV) with intravitreal DensironXTRA and a comparator group with gas (sulfur hexafluoride (SF6) or perfluoropropane (C3F8)) tamponades by a single surgeon between January 2017 and November 2020 at a tertiary care centre. A total of 121 eyes with DensironXTRA and 81 comparator eyes with a gas tamponade were included. The DensironXTRA group had a significantly higher number of cases with inferior breaks (82% vs. 48%; p < 0.0001) and a history of previous PPV for RRD (64% vs. 12%; p < 0.0001). DensironXTRA was removed after a median period of 70 (IQR: 48.5-105.5) days. There was similar anatomical success in both the comparator gas tamponade and DensironXTRA groups (98.8% vs. 97.5%, p = 0.6506). Although both groups experienced a significant improvement in visual acuity, this change was significantly higher in the comparator gas tamponade group versus DensironXTRA group (p = 0.0017). There was no significant change in IOP in the DensironXTRA group (mean difference - 0.7; 95% CI - 1.753 to 0.331, p = 0.1785). The rates of complications were low and not significantly different between the two groups. There was no evidence for central macular thinning with DensironXTRA compared to the contralateral eye without RRD as well as with DensironXTRA in situ versus after its removal. DensironXTRA is a promising short-term tamponade agent with good anatomical and functional outcomes and low rates of complications for the repair of complicated RRDs.
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Affiliation(s)
- Tina Felfeli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada. .,Management and Evaluation (IHPME), Dalla Lana School of Public Health, The Institute of Health Policy, University of Toronto, Toronto, ON, Canada. .,Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital, Eaton Building, 10th Floor, Toronto, ON, M5G 2C4, Canada.
| | - Fahmeeda Murtaza
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Joshua Herman
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Austin M Pereira
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Mark S Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.,Department of Ophthalmology, Toronto Western Hospital, University Health Network, 6E-432, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada
| | - Efrem D Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada. .,Department of Ophthalmology, Toronto Western Hospital, University Health Network, 6E-432, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
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13
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Barth T, Helbig H, Maerker D, Gamulescu MA, Radeck V, Barth T. Unexplained visual loss after primary pars-plana-vitrectomy with silicone oil tamponade in fovea-sparing retinal detachment. BMC Ophthalmol 2023; 23:75. [PMID: 36829157 PMCID: PMC9951486 DOI: 10.1186/s12886-023-02823-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/17/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND To investigate the incidence and clinical characteristics of unexplained visual loss in patients with fovea-sparing rhegmatogenous retinal detachment (RRD) during or after silicone oil (SO) tamponade. METHODS The medical charts of all patients with macula-on RRDs, who underwent pars-plana-vitrectomy (ppV) with SO tamponade were retrospectively assessed regarding unexplained visual loss (UVL) of ≥ 3 Snellen lines and alterations on optical coherence tomography (OCT) during or after SO tamponade. The clinical data analysed included visual acuity, surgical parameters, OCT images, duration of SO tamponade and the time point of visual decline. Cases with re-detachment or secondary causes of visual loss such as SO emulsification, epiretinal membranes or macular edema were excluded. RESULTS Over a 15-year-period, 22 cases with macula-on RRD, which had primarily been treated with ppV and SO tamponade, met the inclusion criteria. In most eyes (n = 20; 91%), the RRD was caused by a giant retinal tear (GRT). In 11 of these 22 cases (50%), best-corrected visual acuity (BCVA) had dropped by at least 3 lines for no apparent reason. In these 11 cases, mean preoperative logMAR BCVA was 0.2 (SD 0.13; range 0-0.5), equal to Snellen's VA of 0.63, and mean postoperative logMAR BCVA 1.0 (SD 0.24; range 0.5-1.3), equal to Snellen's VA of 0.10. Visual decline occurred about 12 weeks postoperatively (SD 6.2; range 3-20 ) and comprised 8 lines (SD 2.3; range -11 to -4). SO was removed on average 139 (SD 50.0; range 88-271) days after the first ppV. In 9 cases visual decline occurred while the SO was in-situ. In 2 patients, BCVA decline was noted 2 weeks after SO removal. In all eyes, preoperative central foveal thickness (CFT) was 254 μm (SD 24.2), which decreased to 224 μm (SD 29.6) during SO tamponade and increased to 247 μm (SD 29.2) after SO removal, irrespective of the presence of UVL. The mean follow-up time was 20 months (SD 30.6) after SO removal. CONCLUSION UVL after SO tamponade for macula-on RRD is more frequent than expected. The incidence in our case series was 50%. The mechanism of this phenomenon is still unknown. In general, vitreoretinal surgeons should thoroughly question the need for SO tamponade, inform their patients of possible UVL and remove SO as early as possible. TRIAL REGISTRATION The study was approved by the local ethics committee on 6th of May 2022 (Ethikkommission der Universität Regensburg, Votum 22-2925-104) and was conducted in accordance with the ethical standards of the Declaration of Helsinki.
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Affiliation(s)
- T Barth
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - H Helbig
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - D Maerker
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - M-A Gamulescu
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - V Radeck
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Teresa Barth
- Department of Ophthalmology, University Medical Centre Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
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Chikmah FA, Ichsan AM, Islam IC, Hendarto J, Muhiddin HS, Budu. Retinal Nerve Fiber Layer Changes after Intraocular Silicone Oil Tamponade in Rhegmatogenous Retinal Detachment. Vision (Basel) 2023; 7:13. [PMID: 36977293 PMCID: PMC10051192 DOI: 10.3390/vision7010013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/08/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Rhegmatogenous retinal detachment (RRD) is a serious and emergency condition that may cause visual disturbance. Treatment includes pars plana vitrectomy with a tamponade such as intraocular gas or silicone oil (SO). In many countries, silicone oil is still favorable compared to intraocular gases as tamponade for reattachment of retinal detachment surgery. The application provides a higher anatomical success rate, especially in cases of proliferative vitreoretinopathy (PVR) that were previously considered untreatable. Objective assessment of the retinal nerve fiber layer (RNFL) using optical coherence tomography (OCT) in the eye with silicone oil tamponade is a challenge because of the limitations and difficulties in taking images. This study aims to assess the RNFL thickness changes in rhegmatogenous retinal detachment patients using SO tamponade and its subsequent removal conducted on a total of 35 post-operative RRD patients. Central macular and RNFL thickness, as well as best-corrected visual acuity (BCVA), were recorded at the time of tamponade and after the removal of the SO at 1, 4, and 8 weeks, respectively. The results showed that the changes in RNFL thickness significantly decreased in the group of ≤6 months, especially in the superior and temporal quadrants, and BCVA increased after SO removal (p < 0.05). Central macular thickness was significant (p < 0.001) at the end of the visit. Improved visual acuity is associated with decreased RNFL and central macular thickness after SO removal.
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Affiliation(s)
- Fitri Annur Chikmah
- Ophthalmology Department, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
- Hasanuddin University Hospital, Makassar 90245, Indonesia
| | - Andi Muhammad Ichsan
- Ophthalmology Department, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
- Hasanuddin University Hospital, Makassar 90245, Indonesia
- JEC Orbita, Makassar 90222, Indonesia
| | - Itzar Chaidir Islam
- Ophthalmology Department, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
| | - Joko Hendarto
- Hasanuddin University Hospital, Makassar 90245, Indonesia
- Public Health Medicine Department, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
| | - Habibah Setyawati Muhiddin
- Ophthalmology Department, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
- Hasanuddin University Hospital, Makassar 90245, Indonesia
- JEC Orbita, Makassar 90222, Indonesia
| | - Budu
- Ophthalmology Department, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
- Hasanuddin University Hospital, Makassar 90245, Indonesia
- JEC Orbita, Makassar 90222, Indonesia
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15
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Davidović S, Živković M, Risimić D, Rapajić M, Teodorović S, Barišić S. Macular Parameters Change during Silicon Oil Tamponade for Retinal Detachment Surgery. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020334. [PMID: 36837535 PMCID: PMC9960314 DOI: 10.3390/medicina59020334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
Background and Objectives: To evaluate possible changes in macular thickness parameters during and after silicon oil tamponade and in pars plana rhegmatogenous retinal detachment surgery. Materials and Methods: Our retrospective study included 34 consecutive patients who underwent 23-gauge retinal detachment surgery with silicon oil tamponade. Central macular thickness (CMT), central macular volume cube (CMV) and average macular thickness cube (AVG) were measured by optical coherence tomography (OCT) before rhegmatogenous retinal detachment surgery with silicon oil tamponade during tamponade (seven days, one month and three months after surgery), and one month after silicon oil removal. Results: In our sample, macular parameters CMT, CMV and AVG in patients who underwent retinal detachment surgery were statistically reduced during silicon oil tamponade (p < 0.05). After silicon oil removal, all parameters recovered, reaching numeric values which were not statistically significant compared to preoperative values. The average span of silicon oil tamponade was 162 +/- 23 days. Conclusions: Silicon oil tamponade during 23-gauge rhegmatogenous retinal detachment surgery leads to a transitory reduction of central macular thickness, central macular volume cube and average macular thickness cube in eyes that underwent retinal surgery. After silicon oil removal, macular parameters returned to preoperative values in most of the patients.
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Affiliation(s)
- Sofija Davidović
- Medical Faculty, University of Novi Sad, 21000 Novi Sad, Serbia
- Eye Clinic, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
- Correspondence: ; Tel.: +381-63-546-999
| | - Maja Živković
- Medical Faculty, University of Niš, 18000 Niš, Serbia
- Eye Clinic, Clinical Centre Niš, 18000 Niš, Serbia
| | - Dijana Risimić
- Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia
- Eye Clinic, Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Maša Rapajić
- Eye Clinic, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Srđan Teodorović
- Eye Clinic, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Sava Barišić
- Eye Clinic, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
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Retinal and Corneal Changes Associated with Intraocular Silicone Oil Tamponade. J Clin Med 2022; 11:jcm11175234. [PMID: 36079165 PMCID: PMC9457190 DOI: 10.3390/jcm11175234] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/13/2022] [Accepted: 09/01/2022] [Indexed: 12/22/2022] Open
Abstract
Silicone oils (SO) are used as long-term intraocular tamponades and have an irreplaceable role in vitreoretinal surgery. They can, however, be associated with multiple and potentially severe complications, involving different ocular tissues, in particular retina and cornea. Recent advances in ophthalmic imaging have allowed the precise characterization of retinal and corneal microstructural changes, at a subclinical level. This detailed analysis of SO-related retinal and corneal changes has improved our understanding of their pathogenesis and offer the potential for optimized monitoring and management of patients with SO-filled eyes. This review aims to provide clinicians and ophthalmic scientists with an updated and comprehensive overview of the corneal and retinal changes associated with SO tamponade.
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Li S, Tang J, Han X, Wang Z, Zhang L, Zhao M, Qu J. Prospective Comparison of Surgery Outcome Between Preoperative and Intraoperative Intravitreal Injection of Ranibizumab for Vitrectomy in Proliferative Diabetic Retinopathy Patients. Ophthalmol Ther 2022; 11:1833-1845. [PMID: 35904708 PMCID: PMC9437166 DOI: 10.1007/s40123-022-00550-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION To compare the efficacy and safety of intravitreal injections of ranibizumab (IVR) before and at the end of vitrectomy in proliferative diabetic retinopathy (PDR) patients. METHODS A prospective comparative study was performed on 60 eyes of 52 PDR patients who received ranibizumab injection (0.5 mg/0.05 ml) 3-5 days before vitrectomy (preoperative group) and 55 eyes of 50 PDR patients who received ranibizumab injection (0.5 mg/0.05 ml) at the end of vitrectomy (intraoperative group). Intra- and postoperative indices were collected for further comparison. RESULTS Postoperative best-corrected visual acuity (BCVA) in preoperative group was better than in intraoperative group at 1 week after surgery (P < 0.05) but comparable at 1- and 3-month follow-up (P = 0.20 and P = 0.37, respectively). Central retinal thickness (CRT) in preoperative group was lower than in intraoperative group at 1 week postoperatively (P < 0.05), but comparable at 1- and 3-month follow-up (P = 0.39 and P = 0.77, respectively). The average surgery time was significantly shorter in preoperative group than in intraoperative group (61.50 ± 11.44 min vs. 74.49 ± 12.01 min, P < 0.01). The incidence of intraoperative bleeding was significant lower in preoperative group than in intraoperative group (21.7% vs. 40.0%, P < 0.05). Moreover, the incidence of intraocular electrocoagulation use, iatrogenic retinal breaks, relaxing retinotomy and silicone oil tamponade were all significantly lower in preoperative group than that in intraoperative group (P < 0.05, respectively). The incidences of postoperative vitreous hemorrhage (VH), neovascular glaucoma (NVG), recurrent retinal detachment, postoperative fibrovascular proliferation progression and reoperation showed no statistical differences between the two groups (P > 0.05, respectively). Both groups had no ocular or system adverse events during observation period. CONCLUSION In vitrectomy for PDR, preoperative IVR can significantly reduce surgery time and lower the incidence of intraoperative bleeding, intraocular electrocoagulation use, iatrogenic retinal breaks, relaxing retinotomy and silicone oil tamponade during surgery and gain short-term better postoperative BCVA and thinner CRT. TRIAL REGISTRATION ClinicalTrials.gov (identifier, NCT05408416).
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Affiliation(s)
- Siying Li
- Department of Ophthalmology, Peking University People's Hospital, No. 11 South Avenue of XiZhiMen, Xi Cheng District, Beijing, 100044, People's Republic of China
- Eye Diseases and Optometry Institute, Beijing, 100044, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, 100044, China
| | - Jiyang Tang
- Department of Ophthalmology, Peking University People's Hospital, No. 11 South Avenue of XiZhiMen, Xi Cheng District, Beijing, 100044, People's Republic of China
- Eye Diseases and Optometry Institute, Beijing, 100044, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, 100044, China
| | - Xinyao Han
- Department of Ophthalmology, Peking University People's Hospital, No. 11 South Avenue of XiZhiMen, Xi Cheng District, Beijing, 100044, People's Republic of China
- Eye Diseases and Optometry Institute, Beijing, 100044, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, 100044, China
| | - Zongyi Wang
- Department of Ophthalmology, Peking University People's Hospital, No. 11 South Avenue of XiZhiMen, Xi Cheng District, Beijing, 100044, People's Republic of China
- Eye Diseases and Optometry Institute, Beijing, 100044, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, 100044, China
| | - Linqi Zhang
- Department of Ophthalmology, Peking University People's Hospital, No. 11 South Avenue of XiZhiMen, Xi Cheng District, Beijing, 100044, People's Republic of China
- Eye Diseases and Optometry Institute, Beijing, 100044, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, 100044, China
| | - Mingwei Zhao
- Department of Ophthalmology, Peking University People's Hospital, No. 11 South Avenue of XiZhiMen, Xi Cheng District, Beijing, 100044, People's Republic of China
- Eye Diseases and Optometry Institute, Beijing, 100044, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, 100044, China
| | - Jinfeng Qu
- Department of Ophthalmology, Peking University People's Hospital, No. 11 South Avenue of XiZhiMen, Xi Cheng District, Beijing, 100044, People's Republic of China.
- Eye Diseases and Optometry Institute, Beijing, 100044, China.
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, 100044, China.
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Prasuhn M, Rommel F, Mohi A, Grisanti S, Ranjbar M. Impact of Silicone Oil Removal on Macular Perfusion. Tomography 2022; 8:1735-1741. [PMID: 35894011 PMCID: PMC9326514 DOI: 10.3390/tomography8040146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/23/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022] Open
Abstract
(1) Background: Silicone oil (SO) can be used as an endotamponade during vitreoretinal surgery for retinal detachment. There is emerging evidence that SO filling of the vitreous cavity and its removal may impact macular perfusion. So far, studies have not focused on choroidal sublayer perfusion, yet. (2) Methods: Optical coherence tomography angiography was applied in 19 patients with SO endotamponade before and four weeks after removal of SO. (3) Results: Perfusion of choriocapillaris increased significantly after SO removal, while perfusion of Haller’s and Sattler’s layer decreased significantly. (4) Conclusions: Removal of SO impacts choroidal perfusion and leads to a perfusion shift within choroidal sublayers. This study underlines that it is worth to conduct larger prospective studies that evaluate the choroidal perfusion and its functional implications in more detail.
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19
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Tang Y, Lin B, Chen J, Chen D, Wu R. Outcomes of 25-gauge pars plana vitrectomy alone with air tamponade for the management of rhegmatogenous retinal detachment with inferior breaks. BMC Ophthalmol 2022; 22:213. [PMID: 35549685 PMCID: PMC9097233 DOI: 10.1186/s12886-022-02445-4] [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: 06/21/2021] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background This study was investigated the surgical outcomes of primary rhegmatogenous retinal detachment (RRD) with inferior retinal breaks (IRBs) that were repaired by 25-gauge pars plana vitrectomy (PPV) with air tamponade. Methods This retrospective review included 81 consecutive patients who had RRD with IRBs and underwent PPV with air tamponade in our hospital from January 2017 to January 2020. The main outcomes were single surgery anatomical success (SSAS) rate, postoperative best-corrected visual acuity (BCVA), and complications. Results The patient population consisted of 29 women and 52 men (mean age, 52.12 years); the mean follow-up interval was 8.88 months. The mean number of affected quadrants was 1.65 (range, 1–4 quadrants) and the mean number of breaks was 3.25. A single break was present in 20 cases (24.7%); two to 10 breaks were present in 61 (75.3%) cases. The SSAS rate was 91.36% (74/81) and the final anatomical success rate was 96.30% (78/81). More than half of the patients had BCVA < 0.3 logarithm of the minimum angle of resolution at the last follow-up. Axial length and patient age were candidate risk factors for redetachment (axial length, p = 0.03; age, p = 0.002). Postoperative complications included macular epiretinal membrane formation in one patient, lens opacity in three patients, and clinically significant macular edema in one patient. Conclusions PPV with air tamponade may be effective for the treatment of primary RRD with IRBs. Extensive preoperative discussion may be necessary for young patients and patients with particularly long axial length.
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Affiliation(s)
- Yongping Tang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Bo Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Jing Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Daosen Chen
- Yuying Children's Hospital, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ronghan Wu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China. .,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.
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20
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Bayraktar Z, Pehlivanoglu S, Hagverdiyeva S, Albayrak S, Karakaya M, Bayraktar Ş. Longitudinal evaluation of retinal thickness and OCTA parameters before and following silicone oil removal in eyes with macula-on and macula-off retinal detachments. Int Ophthalmol 2022; 42:1963-1973. [PMID: 34997372 DOI: 10.1007/s10792-021-02196-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 12/18/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND To investigate the longitudinal retinal vascular and structural alterations by using OCTA following successful repair of retinal detachment (RD) by using silicone oil (SO) endotamponade. METHODS A prospective cohort study was performed on 24 eyes of 24 subjects; 17 of them with macula-off and seven with macula-on RD. At least four OCTA scans were generated for each study eye; two before and two after SO removal (SOR). At each session, retinal thickness (RT), vascular density (VD) in the superficial (SCP) and deep capillary plexuses (DCP) and foveal avascular zone(FAZ) size were measured within the fovea, parafovea and whole macular image. The changes in repeated measures of the same parameters especially before and after SOR were performed and compared within macula-on and macula-off groups and between fellow eyes. RESULTS "In the macula-off eyes, RT measurements within the whole macula, fovea and parafovea reduced as compared with their fellow eyes(p < 0.0001, p = 0.001 and p < 0.0001, respectively) and did not improve after SOR. Additionally, all of the whole macular, foveal, and parafoveal VD measurements at SCP and foveal VD at DCP were less than their fellow eyes after SOR (p = 0.026, p = 0.023 p = 0.026, and p = 0.002, respectively). In macula-on eyes, RT measurements decreased within the parafovea and whole macular area before SOR (p = 0.018 and p = 0.011, respectively) but improved after SOR. Also, VD measurements did not change during follow-up and were not statistically different than their fellow eyes (p > 0.05). FAZ enlargement was found in eyes with macular-off RD after SOR, whereas it was not observed with macular-on RD (p = 0.038and p = 0.237, respectively). CONCLUSIONS Treatment of macula-off RD with SO tamponade has been associated with vascular retinal abnormalities which did not improve following SOR. On the contrary, successful treatment of RD with SO tamponade in macula-on eyes VD measurements of SCP and DCP were not statistically different than their fellow eyes.
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Affiliation(s)
- Zerrin Bayraktar
- Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26 Cevizlibağ, 34010, Zeytinburnu, Istanbul, Turkey
| | - Seren Pehlivanoglu
- Beyoğlu Eye Trainning and Research Hospital, Bereketzade, Bereketzade Cami Sk. No:2, 34421, Beyoğlu, Istanbul, Turkey.
| | - Samira Hagverdiyeva
- Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26 Cevizlibağ, 34010, Zeytinburnu, Istanbul, Turkey
| | - Sinan Albayrak
- Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26 Cevizlibağ, 34010, Zeytinburnu, Istanbul, Turkey
| | - Muharrem Karakaya
- Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26 Cevizlibağ, 34010, Zeytinburnu, Istanbul, Turkey
| | - Şükrü Bayraktar
- Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26 Cevizlibağ, 34010, Zeytinburnu, Istanbul, Turkey
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21
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Dubroux C, Salleron J, Angioi-Duprez K, Berrod JP, Conart JB. Effect of Duration of Silicone Oil Tamponade on Retinal Structure after Rhegmatogenous Retinal Detachment Surgery. Ophthalmologica 2021; 245:144-151. [PMID: 34929691 DOI: 10.1159/000519520] [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: 06/01/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of the study was to investigate the effect of tamponade duration on retinal changes induced by silicone oil (SO) in patients who underwent successful rhegmatogenous retinal detachment (RRD) surgery. METHODS Retrospective comparative case series of 68 patients who underwent SO tamponade for RRD. Patients were divided into 2 groups based on timing of SO removal: <6 months (group 1, n = 34) versus ≥6 months (group 2, n = 34). The main outcome measure was the change in central macular, inner, and outer retinal layer thickness (CMT, IRLT, and ORLT) before and after SO removal (SOR). RESULTS The median tamponade duration was 4 [Clin Ophthalmol. 2016;10:471-6, Zhonghua Yan Ke Za Zhi. 1997 Jan;33(1):39-41] months in group 1 and 8 [Arch Ophthalmol. 1994 Jun;112(6):778-85, Retina. 2004 Dec;24(6):871-7] months in group 2 (p < 0.001). The mean CMT significantly increased from 245.3 ± 22.2 μm and 238.8 ± 41.6 μm under SO to 281.3 ± 60.2 μm and 259.0 ± 43.5 μm after SOR in group 1 (p = 0.009) and in group 2 (p = 0.007), respectively. Automated segmentation measurement revealed a significant increase in mean IRLT (p = 0.014 and p = 0.013) but no change in mean ORLT (p = 0.080 and p = 0.257) in both groups. After adjustment, there was no difference between the 2 groups in terms of mean final CMT, IRLT, and ORLT and mean retinal thickness changes after SOR. There was also no correlation between the tamponade duration and macular microstructural changes or visual recovery. CONCLUSION SO tamponade causes a thinning of all retinal layers, mainly affecting the inner retinal layer. However, these changes resolved following SO extraction and were not affected by longer tamponade duration.
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Affiliation(s)
- Chloé Dubroux
- Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Julia Salleron
- Institut de Cancérologie de Lorraine, Department of Biostatistics and Data Management, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Karine Angioi-Duprez
- Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Jean-Paul Berrod
- Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Jean-Baptiste Conart
- Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
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22
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Ghanbari H, Kianersi F, Jamshidi Madad A, Dehghani A, Rahimi A, Feizi A, Naderi Beni A. The effect of silicone oil tamponade on retinal layers and choroidal thickness in patients with rhegmatogenous retinal detachment: a systematic review and meta-analysis. Int J Retina Vitreous 2021; 7:76. [PMID: 34930505 PMCID: PMC8691011 DOI: 10.1186/s40942-021-00348-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/25/2021] [Indexed: 01/10/2023] Open
Abstract
Background To evaluate the effects of intravitreal silicone oil (SO) on the retinal and choroidal thickness in eyes with rhegmatogenous retinal detachment (RRD). Methods A literature search was performed in Web of Science, Scopus, ProQuest, Embase, Clinical Key, Science Direct, Cochrane Library, and Springer, as well as Persian databases, including IranDoc, MagIran, SID, MOH thesis, and MOH articles until June 2020. Two reviewers independently searched and extracted the data. Results Sixteen studies (n = 391) met the inclusion criteria. The meta-analysis showed that the SO tamponade could significantly reduce the central macular thickness (CMT) in patients with RRD as compared to gas tamponade WMD = − 14.91; 95% CI: − 22.23, − 7.60; P < 0.001, I2 = 71%). No significant change was found in CMT between the eye with SO tamponade (after SO removal) and the fellow healthy eye in patients with RRD (WMD = − 3.52; 95% CI: − 17.63, 10.59; I2 = 68.6%). Compared to the preoperative stage, the SO tamponade could significantly reduce the subfoveal choroidal thickness in patients with RRD (WMD = − 18.67, 95% CI: − 30.07, − 1.28; I2 = 80.1%). However, there was no significant difference in the subfoveal choroidal thickness before and after SO removal (WMD = − 1.13, 95% CI: − 5.97, 3.71; I2 = 87.6%). Conclusion The SO tamponade had a significant effect on the reduction of retinal layers and the subfoveal choroidal thickness.
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Affiliation(s)
| | - Farzan Kianersi
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Alireza Dehghani
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Rahimi
- Clinical Informationist Resarch Group, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afsaneh Naderi Beni
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Lee J, Cho H, Kang M, Hong R, Seong M, Shin Y. Retinal Changes before and after Silicone Oil Removal in Eyes with Rhegmatogenous Retinal Detachment Using Swept-Source Optical Coherence Tomography. J Clin Med 2021; 10:jcm10225436. [PMID: 34830717 PMCID: PMC8619201 DOI: 10.3390/jcm10225436] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/04/2021] [Accepted: 11/18/2021] [Indexed: 12/03/2022] Open
Abstract
This study aimed to evaluate and compare the retinal and choroidal thickness and vessel density (VD) changes between silicone oil (SO) tamponade and after SO removal using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Thirty patients who underwent pars plana vitrectomy for retinal detachment (RD) with SO tamponade were included. SS-OCT and OCTA were conducted before RD surgery, during SO tamponade, and after SO removal. A 3-dimensional volumetric wide scan protocol was used for the analysis. The segmented retina, choroidal thickness map, and peripapillary thickness were then measured. For the OCTA analysis, 4.5 × 4.5 mm scans were used. Superficial and deep capillary plexus VDs in unaffected fellow eyes and eyes after SO removal were compared. During the SO tamponade period, the thickness of the parafoveal total retina, ganglion cell-inner plexiform layer, and peripapillary retinal nerve fiber layer (ppRNFL) were significantly thinner than those of unaffected fellow eyes (p < 0.05). The parafoveal layer thickness thinning recovered up to three to six months after SO removal. Moreover, six months after SO removal, the parafoveal thickness was not significantly different compared to that of unaffected fellow eyes (p > 0.05). However, the ppRNFL thickness was significantly decreased during SO tamponade and remained unrecovered six months after SO removal. There was no significant difference in the VD on the OCTA. Thus, SO tamponade and removal for RD resulted in a change in the retinal and peripapillary thickness. This may be due to the mechanical pressure effect of SO.
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Wang E, Chen Y, Li N, Min H. Effect of silicone oil on peripapillary capillary density in patients with rhegmatogenous retinal detachment. BMC Ophthalmol 2020; 20:268. [PMID: 32635899 PMCID: PMC7339486 DOI: 10.1186/s12886-020-01533-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/26/2020] [Indexed: 01/01/2023] Open
Abstract
Purpose To evaluate the effect of silicone oil (SO) on peripapillary blood flow using OCT angiography. Methods This prospective case series recruited patients with unilateral rhegmatogenous retinal detachment (RRD) who underwent vitrectomy and SO tamponade. Patients were examined before SO removal and at 10 days, 1 month, and 3 months after SO removal on a spectral domain OCT angiography device (RTVue XR Avanti, Optovue Inc., CA, USA) for the measurement of radial peripapillary capillaries (RPC) vessel density (VD) in global field, superior hemifield, and inferior hemifield. Changes in RPC VD following SO removal were compared between affected eyes and contralateral eyes. Results Twenty-two patients were analyzed. The average duration of SO tamponade was 101.3 days (range, 90 to 119 days). After SO removal, global RPC VD increased by 1.3% (95%CI, 0.3 to 2.3%), compared with a − 0.4% (95%CI, − 1.4 to 0.7%) change in contralateral eyes (P = 0.007). The increase in RPC VD after SO removal mainly occurred in the superior hemifield, which was 1.6% (95%CI, 0.6 to 2.7%). The increase in RPC VD in the inferior hemifield was 1.0% (95%CI, − 0.2 to 2.1%) after SO removal. Conclusions We detected a mild increase in peripapillary capillary density after SO removal, mainly in the superior hemifield. Our results suggested that SO tamponade could have negative effect on peripapillary blood flow, possibly by capillary compression.
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Affiliation(s)
- Erqian Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Ningning Li
- Department of Ophthalmology, Peking Union Medical College Hospital, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, China.,Department of Operating Room, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Hanyi Min
- Department of Ophthalmology, Peking Union Medical College Hospital, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, China. .,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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