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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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Pfister N, Dormegny L, Ballonzoli L, Sauer A, Speeg-Schatz C, Bourcier T, Gaucher D. LONG-TERM MICROVASCULAR REMODELING AND CYSTIC CHANGES AFTER RETINAL DETACHMENT TREATED WITH SILICON OIL TAMPONADE. Retina 2023; 43:923-931. [PMID: 38235973 DOI: 10.1097/iae.0000000000003755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE To determine the long-term microvascular alterations associated with macular cystic changes after retinal detachment surgery with silicone oil tamponade. METHODS The results of two optical coherence tomography angiographies performed at 11 months and 38 months after silicone removal were retrospectively analyzed for 30 eyes. The data were compared between both measurements and between eyes with macular cysts (MC+) and without macular cysts (MC-). Two patterns of cysts were identified and compared: cysts exclusively involving the inner nuclear layer (INLc) and cysts present in all retinal layers. RESULTS At both end points, 20 eyes (67%) presented with macular cysts, 12 of them (40%) had INLc. At the first end point, vascular density of superficial capillary plexus was higher and superficial foveal avascular zone was smaller in MC+ eyes than in MC- eyes (P = 0.04 and P = 0.017, respectively). At the second end point, vascular density of superficial capillary plexus significantly decreased in MC+ eyes as compared with the first end point (P < 0.001) and superficial foveal avascular zone enlarged (P < 0.001). Macular central thickness decreased between follow-ups only in eyes with INLc (P < 0.01). The final best-corrected visual acuity was better in eyes with INLc than in eyes with cysts present in all retinal layers (P < 0.01). There was no difference between the final best-corrected visual acuity in eyes with INLc and MC- eyes. CONCLUSION Macular cysts are a common finding long after silicon removal. Vascular remodeling seems characterized by an initial increase of the vascular density of superficial capillary plexus in eyes with cysts, which is followed by its progressive decrease. The INLc is the most common pattern of cysts. They are associated with a progressive decrease of the central macular thickness without visual impairment.
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Affiliation(s)
- Nathalie Pfister
- Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, Strasbourg, France
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Christou EE, Papaconstantinou D, Droutsas K, Stefaniotou M, Stavrakas P, Kandarakis S, Petrou P, Georgalas I. Effect of silicone oil on retinal microcirculation after vitrectomy for rhegmatogenous retinal detachment evaluated by OCT angiography: a literature review. Ther Adv Ophthalmol 2023; 15:25158414231174145. [PMID: 37255621 PMCID: PMC10226327 DOI: 10.1177/25158414231174145] [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: 01/04/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023] Open
Abstract
Silicone oil (SO) has been widely used as intravitreal tamponade agent for rhegmatogenous retinal detachment (RRD) and has been occasionally associated with incomplete retinal structural and functional recovery. The use of Optical Coherence Tomography Angiography (OCT-A) has recently attracted significant attention for detailed analysis of retinal capillary plexus and blood flow changes as predicting factors for postoperative outcomes. A detailed literature search was performed in PubMed database until October 2022. The following keywords were used: rhegmatogenous retinal detachment, silicone oil, optical coherence tomography angiography, macular microvasculature, peripapillary capillary plexus, vessel density, and foveal avascular zone. We identified and reviewed 19 studies referring to microcirculation alterations of the retinal capillary plexus as seen on OCT-A in eyes treated by vitrectomy with intravitreal SO for RRD. A comprehensive update revealed variability of microcirculation characteristics of the retinal capillary plexus including the macular and the peripapillary capillaries. Further studies are warranted to clarify the OCT-A values in an attempt to identify the potential effect of SO on retinal tissue in clinical practice. A review of the existing literature sheds light on the effect of SO on retinal capillary plexus and the potential impact on functional outcomes after vitrectomy for RRD. This article discusses important aspects of key publications on the topic, highlights the importance to identify distinct alterations of the microvasculature status, and proposes the need for further future research in this field.
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Affiliation(s)
| | - Dimitrios Papaconstantinou
- First Department of Ophthalmology, University
of Athens, ‘G. Gennimatas’ General Hospital of Athens, Athens, Greece
| | - Konstantinos Droutsas
- First Department of Ophthalmology, University
of Athens, ‘G. Gennimatas’ General Hospital of Athens, Athens, Greece
| | - Maria Stefaniotou
- Department of Ophthalmology, Faculty of
Medicine, University Hospital of Ioannina, Ioannina, Greece
| | - Panagiotis Stavrakas
- Department of Ophthalmology, Faculty of
Medicine, University Hospital of Patras, Patras, Greece
| | - Stylianos Kandarakis
- First Department of Ophthalmology, University
of Athens, ‘G. Gennimatas’ General Hospital of Athens, Athens, Greece
| | - Petros Petrou
- First Department of Ophthalmology, University
of Athens, ‘G. Gennimatas’ General Hospital of Athens, Athens, Greece
| | - Ilias Georgalas
- First Department of Ophthalmology, University
of Athens, ‘G. Gennimatas’ General Hospital of Athens, Athens, Greece
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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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Merad M, Vérité F, Baudin F, Ghezala IB, Meillon C, Bron AM, Arnould L, Eid P, Creuzot-Garcher C, Gabrielle PH. Cystoid Macular Edema after Rhegmatogenous Retinal Detachment Repair with Pars Plana Vitrectomy: Rate, Risk Factors, and Outcomes. J Clin Med 2022; 11:jcm11164914. [PMID: 36013153 PMCID: PMC9410086 DOI: 10.3390/jcm11164914] [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: 07/01/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/26/2022] Open
Abstract
(1) Background: The aim was to describe the rate and outcomes of cystoid macular edema (CME) after pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) and to identify risk factors and imaging characteristics. (2) Methods: A retrospective consecutive case study was conducted over a 5-year period among adult patients who underwent PPV for primary RRD repair. The main outcome measure was the rate of CME at 12 months following PPV. (3) Results: Overall, 493 eyes were included. The CME rate was 28% (93 patients) at 12 months. In multivariate analysis, eyes with worse presenting visual acuity (VA) (odds ratio [OR], 1.55; 95% CI, 1.07–2.25; p = 0.02) and grade C proliferative vitreoretinopathy (PVR) (OR, 2.88; 95% CI, 1.04–8.16; p = 0.04) were more at risk of developing CME 1 year after PPV. Endolaser retinopexy was associated with a greater risk of CME than cryotherapy retinopexy (OR, 3.06; 95% CI, 1.33–7.84; p = 0.01). Eyes undergoing cataract surgery within 6 months of the initial RRD repair were more likely to develop CME at 12 months (OR, 1.96; 95% CI, 1.06–3.63; p = 0.03). (4) Conclusions: CME is a common complication after PPV for primary RRD repair. Eyes with worse presenting VA, severe PVR at initial presentation, endolaser retinopexy, and cataract surgery within 6 months of initial RRD repair were risk factors for postoperative CME at 12 months.
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Affiliation(s)
- Malik Merad
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Fabien Vérité
- Agathe Group INSERM U 1150, UMR 7222 CNRS, ISIR (Institute of Intelligent Systems and Robotics), Sorbonne Université, 75005 Paris, France
| | - Florian Baudin
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Inès Ben Ghezala
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Cyril Meillon
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Alain Marie Bron
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
| | - Louis Arnould
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Pétra Eid
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Catherine Creuzot-Garcher
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
| | - Pierre-Henry Gabrielle
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
- Correspondence: ; Tel.: +33-380-293-031
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Pan Q, Gao Z, Hu X, Wu Q, Zheng JW, Zhang ZD. Risk factors for epiretinal membrane in eyes with primary rhegmatogenous retinal detachment that received silicone oil tamponade. Br J Ophthalmol 2022; 107:856-861. [DOI: 10.1136/bjophthalmol-2021-320121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/12/2022] [Indexed: 11/03/2022]
Abstract
Background/aimsThis study investigated the risk factors for epiretinal membrane (ERM) in eyes with primary rhegmatogenous retinal detachment (RRD) that received silicone oil (SO) tamponade.MethodsThis retrospective analysis included 1140 patients (1140 eyes) with RRD who underwent primary vitrectomy and SO tamponade. The prevalence of ERM was estimated and possible risk factors (eg, type 2 diabetes, proliferative vitreoretinopathy (PVR), SO tamponade time (SOTT), photocoagulation, vitreous haemorrhage, choroidal detachment, cryotherapy and retinal tear size) were analysed via multiple logistic regression.ResultsThe prevalence of ERM was 12.3% (140/1140), and the accuracy of preoperative ERM diagnosis was 40.5%. Multivariate logistic regression analysis showed that risk factors for ERM in eyes with SO tamponade included preoperative PVR (OR=4.336, 95% CI 2.533 to 7.424, p<0.001), type 2 diabetes (OR=3.996, 95% CI 2.013 to 7.932, p<0.001), photocoagulation energy (OR=1.785, 95% CI 1.306 to 2.439, p<0.001) and SOTT (OR=1.523, 95% CI 1.261 to 1.840, p<0.001). No statistically significant associations were observed between the incidence of ERM and other risk factors. Preoperative PVR showed the strongest association with risk of ERM. The risk of ERM was positively associated with SOTT, photocoagulation energy and preoperative PVR grade.ConclusionIn eyes with RRD that received SO tamponade, the prevalence of ERM was 12.3%, while the accuracy of preoperative ERM diagnosis was low. Preoperative PVR, type 2 diabetes, photocoagulation energy and SOTT were the main risk factors for ERM.
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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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Funatsu R, Terasaki H, Koriyama C, Yamashita T, Shiihara H, Sakamoto T. Silicone oil versus gas tamponade for primary rhegmatogenous retinal detachment treated successfully with a propensity score analysis: Japan Retinal Detachment Registry. Br J Ophthalmol 2021; 106:1044-1050. [PMID: 34373251 PMCID: PMC9340049 DOI: 10.1136/bjophthalmol-2021-319876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 07/25/2021] [Indexed: 12/29/2022]
Abstract
Background/aims To compare the effects of silicone oil tamponade (SOT) to that of gas tamponade (GT) on the best-corrected visual acuity (BCVA) after successful vitrectomy for retinal detachment (RD). Methods A retrospective, multicentre, nationwide study with RD who were registered in the Japan-RD Registry. All cases with RD treated with successful vitrectomy between February 2016 and March 2017 were studied. A propensity score matching was performed using the preoperative findings as covariates to adjust the relevant confounders. The primary outcome was the estimated mean difference of the postoperative BCVA in 6 months between eyes treated with SOT to those treated with GT. Results Of the 3446 cases registered, 2097 cases met the entry criteria. There were 2042 eyes that had GT and 55 eyes that had SOT. Primary success was defined as a reattached retina with no tamponade at 6 months. After propensity score matching, each group contained 40 cases. The preoperative BCVA was 0.966±0.738 logMAR units in the GT group and 1.270±0.945 logMAR units in the SOT group (p=0.177). Six months postoperatively, the BCVA in the GT group was significantly better at 0.309 logMAR units in the GT group than the 0.671 logMAR units in the SOT group (p=0.002). Conclusions Even after successful surgery for RD, eyes that experienced SOT had poorer BCVA than eyes treated with GOT. SOT should be considered cautiously. Precis Propensity score analysis of eyes with rhegmatogenous RD showed that postoperative vision was worse in eyes treated once with silicone oil than with gas even after completely successful surgery.
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Affiliation(s)
- Ryoh Funatsu
- Ophhtalmology, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
| | - Hiroto Terasaki
- Ophhtalmology, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
| | - Chihaya Koriyama
- Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
| | - Toshifumi Yamashita
- Ophhtalmology, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
| | - Hideki Shiihara
- Ophhtalmology, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Ophhtalmology, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
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