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Hübnerová P, Karhanová M, Krhovská P, Minařík J, Mlčák P, Pašková B, Schreiberová Z, Šínová I, Zapletalová J, Šín M. Retinal oxygen saturation in monoclonal gammopathies patients: A pilot study. Acta Ophthalmol 2023; 101:e143-e153. [PMID: 36004612 DOI: 10.1111/aos.15239] [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: 12/18/2021] [Revised: 07/06/2022] [Accepted: 08/14/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this pilot study was to assess oxygen saturation in retinal blood vessels in patients with monoclonal gammopathies (MGs). METHODS Thirty-one patients with MGs (11 women and 20 men, mean age 65.9 ± 8.9 years) were enrolled during 2016-2020. The patients were diagnosed at the Haemato-Oncology Department and subsequently examined at the Ophthalmology Department before initiating systemic therapy. All patients were subjected to automatic retinal oximetry (Oxymap ehf.) and had their fundus photographed (Topcon TRC-50DX retinal camera). We assessed the association between retinal oxygen saturation (SatO2 ) - arterial SatO2 , venous SatO2 and arterio-venous (AV) difference-and MGs parameters: serum monoclonal immunoglobulin (M-protein) level and serum immunoglobulin-free light chains (FLC kappa and lambda), total protein, serum viscosity, haemoglobin, albumin, lactate dehydrogenase, C-reactive protein, creatinine and serum calcium level. Hyperviscosity-related retinopathy was also evaluated. RESULTS Statistical analysis showed a significant positive correlation (r = 0.462; p = 0.009) between the AV difference and the haemoglobin level. A significant, medium strong negative correlation was found between the AV difference and the serum levels of the monoclonal light lambda chains (r = -0.450; p = 0.011). Contrary to expectations, no statistically significant correlation was found between retinal oxygen saturation and the total protein or viscosity. CONCLUSION This study found correlation between retinal oxygen saturation and certain parameters in the blood of patients with MGs. Increasing levels of monoclonal immunoglobulin seem to reduce oxygen absorption in retinal arterioles, resulting in a lower AV difference, particularly in patients with a high free light chain level.
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Affiliation(s)
- Petra Hübnerová
- Department of Ophthalmology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic.,Department of Physiology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Marta Karhanová
- Department of Ophthalmology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Petra Krhovská
- Department of Haemato-oncology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jiří Minařík
- Department of Haemato-oncology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Petr Mlčák
- Department of Ophthalmology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic.,Department of Physiology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Barbora Pašková
- Department of Ophthalmology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic.,Department of Physiology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Zuzana Schreiberová
- Department of Ophthalmology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Irena Šínová
- Department of Ophthalmology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jana Zapletalová
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Martin Šín
- Department of Ophthalmology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic.,Department of Ophthalmology, 1st Faculty of Medicine, Military University Hospital Prague, Charles University, Prague, Czech Republic
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Weigert G, Georgopoulos M, Buehl W, Maccora K, Aliyeva L, Steiner I, Schmidt‐Erfurth U, Sacu S. The influence of retinal oxygen saturation and choroidal volume on postoperative outcomes in patients with epiretinal membrane. Acta Ophthalmol 2022; 100:e743-e752. [PMID: 34396704 PMCID: PMC9291286 DOI: 10.1111/aos.14966] [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: 01/31/2021] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
Purpose To investigate the effects of vitrectomy (Vy) with or without same time cataract surgery and membrane plus internal limiting membrane peeling (MP+ILMP) on retinal oxygenation and choroidal volume and their role on postoperative outcome. Methods Thirty‐two eyes were included in this prospective clinical study. All patients received 23 gauge Vy+MP+ILMP without endotamponade. Additional cataract surgery was performed in 14 patients. Follow‐up visits were scheduled at day 1, week 1, month 1 and month 3. At each visit, best corrected visual acuity (BCVA) using ETDRS charts (except at day 1), oxygenation of retinal vessels using the Oxymap T1, and optical coherence tomography (OCT, Heidelberg Spectralis) was performed. Results Mean BCVA increased significantly from 73 ± 11 letters to 77 ± 7 letters at month 3 (p = 0.02). Mean central retinal thickness (CRT) decreased from 456 ± 84 µm at baseline to 418±58µm (p = 0.01 baseline versus month 3). In the cataract surgery group, CRT was higher at month 3 than in the group without (400 ± 58 µm versus 441 ± 51 µm; p = 0.007). There was no statistically significant difference in choroidal volume or oxygenation of retinal vessels between groups (additional cataract surgery versus vitrectomy alone). Oxygenation of retinal arteries tended to decrease at day 1 followed by an increase, but the changes did not reach the level of significance (p = 0.29 baseline versus month 3). Oxygenation of retinal veins increased significantly (p = 0.02 baseline versus month 1; p = 0.04 baseline versus month 3, accordingly). There was a significant negative correlation (Spearman correlation coefficient rs = −0.35, p = 0.047) between visual acuity and oxygenation of retinal veins at month 3. No statistically significant correlation was found between CRT and oxygenation of neither retinal arteries nor veins. Choroidal volume (CV) of the central mm did not change significantly during the study period (baseline: 0.203 ± 0.04 mm3, median: 0.206, month 3: 0.205 ± 0.04 mm3, p = 0.54). There was no statistically significant effect of choroidal volume at baseline on postoperative clinical outcomes (change in BCVA estimate [95% CI]: 7 [−76; 90], p = 0.86; change in CRT: 147 [−577; 871], p = 0.68). Conclusion Oxygen saturation may affect the visual acuity outcome but not the CRT in patients after vitrectomy for epiretinal membrane. Choroidal thickness had no statistically significant influence on the study outcomes. Further studies are needed to evaluate if the measurement of retinal oxygenation may be helpful in the decision for surgery.
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Affiliation(s)
- Günther Weigert
- Department of Ophthalmology Medical University of Vienna Vienna Austria
| | | | - Wolf Buehl
- Department of Ophthalmology Medical University of Vienna Vienna Austria
- Vienna Clinical Trial Center Medical University of Vienna Vienna Austria
| | - Katia Maccora
- Department of Ophthalmology Medical University of Vienna Vienna Austria
- Vienna Clinical Trial Center Medical University of Vienna Vienna Austria
| | - Leyla Aliyeva
- Department of Ophthalmology Medical University of Vienna Vienna Austria
- Vienna Clinical Trial Center Medical University of Vienna Vienna Austria
| | - Irene Steiner
- CeMSIIS Center for Medical Statistics, Informatics and Intelligent Systems Section for Medical Statistics Medical University of Vienna Vienna Austria
| | | | - Stefan Sacu
- Department of Ophthalmology Medical University of Vienna Vienna Austria
- Vienna Clinical Trial Center Medical University of Vienna Vienna Austria
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Heitmar R, Cubbidge RP. Retinal Vessel Oxygen Saturation Measurement Protocols and Their Agreement. Transl Vis Sci Technol 2020; 9:17. [PMID: 32821514 PMCID: PMC7409221 DOI: 10.1167/tvst.9.6.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/04/2020] [Indexed: 12/01/2022] Open
Abstract
Purpose To assess agreement between different image sizes and analysis protocols for determination of retinal vessel oxygen saturation in the peripapillary retina of healthy individuals. Methods Retinal oximetry measurements were acquired from 87 healthy volunteers using the IMEDOS Systems oxygen module. The peripapillary retinal vessels were assessed in a concentric annulus around the optic nerve head. Single and average vessel comparisons were made at different image field sizes of 30° and 50°. Comparisons between images obtained at 30° and 50° were made in a subset of 47 of the 87 individuals. Results All subjects were normotensive and had normal intraocular pressures (9–16 mm Hg). Analyses of agreement between single vessel, averaged vessel, and between different size images were sought by Bland-Altman analyses, of which all yielded a low bias (<1% oxygen saturation). However, agreement between single vessels of consecutive images showed increased limits of agreement compared with saturation values calculated by averaging all or just the four major arcades of one image. Agreement between 30° and 50° images showed a similar bias as when comparing data obtained with the same camera angle setting but exhibited larger confidence intervals (arteries: bias = 0.21% [9.04/–8.62]%; veins: bias = 0.71% [14.82/–13.40]%). Conclusions Averaging methods yielded the best agreement; there was little difference in average arterial and venous oxygen saturation between protocols, which analyze all vessels versus the four largest vessels. The least agreement was found for single vessel measurements and comparisons between different camera angles. Translational Relevance Standardization of image capture protocols (same image size and undertaking a vessel averaging approach for oxygenation analysis) will enhance the detection of smaller physiological changes in eye disease.
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Affiliation(s)
- Rebekka Heitmar
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Robert P Cubbidge
- School of Life and Health Sciences, Aston University, Birmingham, UK
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Li Z, Zhang J, Lin T, Peng W, Lu L, Hu J. Macular vascular circulation and retinal oxygen saturation changes for idiopathic macular epiretinal membrane after vitrectomy. Acta Ophthalmol 2019; 97:296-302. [PMID: 30843354 DOI: 10.1111/aos.14066] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 02/02/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To investigate the postoperative changes in retinal-choroidal blood flow area and retinal vascular oxygen saturation among patients with idiopathic macular epiretinal membranes (iERMs). METHODS This study prospectively included 24 eyes of 24 consecutive patients who underwent vitrectomy for iERMs. The flow area of choriocapillary layer, retinal superficial capillary plexuses (SCPs) and retinal deep capillary plexuses (DCPs) were performed using optical coherence tomography angiography with angiovue prototype software, and retinal vascular oxygen saturation was measured using retinal oximeter with the built-in software. The flow area of choriocapillary layers and mean retinal vessel oxygen saturation before and after surgery were compared. RESULTS Three months after vitrectomy, the foveal flow area of choriocapillary layer increased clinically significantly from 1.5 ± 0.2 to 1.6 ± 0.2 mm2 (p = 0.02). The retinal vascular changes of SCPs and DCPs were not statistically significant. The mean retinal arterial oxygen saturation was 89.9 ± 11.3% preoperatively and increased to 94.5 ± 9.7% postoperatively (p = 0.04). Foveal retinal thickness revealed a clinically significant decrease from 547.8 ± 88.2 μm to 403.0 ± 47.5 μm after surgery (p < 0.05). Postoperative best corrected visual acuity had no statistically significant correlation with foveal flow area of the choriocapillary layer and retinal vascular oxygen saturation. CONCLUSIONS There was a decrease of retinal thickness, an improved flow area of choriocapillary layer in macular region, and an increase of retinal arterial vascular oxygen among iERMs patients after vitrectomy.
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Affiliation(s)
- Zhixi Li
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Jie Zhang
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Tao Lin
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Wenyan Peng
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Lin Lu
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Jie Hu
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
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Retinal oximetry: Metabolic imaging for diseases of the retina and brain. Prog Retin Eye Res 2019; 70:1-22. [DOI: 10.1016/j.preteyeres.2019.04.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/27/2019] [Accepted: 04/10/2019] [Indexed: 12/20/2022]
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Willekens K, Abegão Pinto L, Lemmens S, Bataillie S, Somers A, Vandewalle E, Stalmans P, Stalmans I. The vitreopapillary interface in healthy and glaucoma: posterior vitreous detachment in the vitreopapillary interface study. Acta Ophthalmol 2018; 96:573-581. [PMID: 30280516 DOI: 10.1111/aos.13818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 04/13/2018] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate the vitreopapillary interface (VPI) in health and glaucoma according to the different stages of posterior vitreous detachment (PVD) formation. METHODS Prospective single centre study including healthy subjects and glaucoma patients. PVD staging was performed with spectral domain optical coherence tomography. Gender, age, lens status and refractive error were assessed in both groups. Glaucoma patients additionally had a comprehensive ophthalmological investigation including intraocular pressure measurement, visual field testing and confocal imaging of the optic nerve head. RESULTS Data on 523 subjects (993 eyes) were included from the VPI study (clinicaltrials.gov NCT02290795) database (493 eyes of 258 healthy subjects and 500 eyes of 265 glaucoma patients). Healthy subjects were significantly younger than primary open angle glaucoma patients (59.7 ± 14.81 versus 70.0 ± 10.78 years, p < 0.001), but were otherwise matched for refractive error and gender. Significantly more glaucomatous eyes were pseudophakic (26.6% versus 5.1%). Including only phakic nonoperated eyes from subjects between 50 and 80 years old decreased the age difference between healthy and open angle glaucoma (64.1 ± 8.0 versus 65.9 ± 6.7 years, p = 0.051). Comparing these subgroups rendered similar average ages for PVD stages 0 and 4, in contrast to the significant older age for the glaucoma subgroup in stage 1 (64.1 ± 6.01 versus 61.4 ± 8.38 years, p < 0.001) and a trend towards significance in stage 3 (70.8 ± 69.8 versus 67.5 ± 5.92 years, p = 0.051). CONCLUSION The VPI study is a large clinical trial investigating the VPI in health and glaucoma. A subset of glaucoma patients seems to experience stages 1-3 of PVD formation at older age compared to healthy subjects.
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Affiliation(s)
- Koen Willekens
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
| | - Luìs Abegão Pinto
- Department of Ophthalmology; Centro Hospitalar Lisboa Norte; Lisbon Portugal
| | - Sophie Lemmens
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
| | - Sophie Bataillie
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
| | - Alix Somers
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
| | - Evelien Vandewalle
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
| | - Peter Stalmans
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
| | - Ingeborg Stalmans
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
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Chen P, Cai X, Xu L, Zhang J, Yang Y, Gao Q, Ge J, Yu K, Zhuang J. Assessing oxygen saturation in retinal vessels in high myopia patients pre- and post-implantable collamer lens implantation surgery. Acta Ophthalmol 2017; 95:576-582. [PMID: 28205338 DOI: 10.1111/aos.13368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 11/21/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE To determine whether posterior chamber phakic implantable collamer lens (ICL) surgery in high myopia patients impedes oxygen saturation of retinal vessels. METHODS Mean oxygen saturation and diameter in retinal blood vessels were measured before and after ICL implantation surgery to correct high myopia refractive errors (i.e. -6.00 to -20.25 dioptres [D]), using an Oxymap T1 retinal oximeter. RESULTS In 17 eyes of 17 patients, the Oxymap T1 retinal oximeter detected a small but significant decrease in oxygen saturation of retinal venules, 1-week postoperatively (compared to preoperative measurements). Moreover, at 1 week after ICL implantation, the diameter of patient retinal vessels had consistently contracted, compared to preoperative measurements. By 1 month after ICL surgery, however, both the oxygen saturation and retinal vessel diameter had returned to preoperative levels. Otherwise, no statistically significant difference in oxygen saturation and diameter of retinal arterioles was found when comparing their measurements before and 1 week after implantation. CONCLUSION Stable levels of oxygen saturation in retinal vessels, as detected by the Oxymap T1 oximeter, show ICL implantation would not leave lasting impact or adverse effects to retina oxygen saturation in high myopia patients.
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Affiliation(s)
- Pei Chen
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Xiaoxiao Cai
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Lijun Xu
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Jing Zhang
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Ying Yang
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Qianying Gao
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Jian Ge
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Keming Yu
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
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Lee SU, Nam KY, Lee SJ. Surgically induced changes in retinal vessel diameter, retinal nerve fibre layer thickness, and the optic disc after 23-gauge pars plana vitrectomy. Int Ophthalmol 2016; 37:575-581. [PMID: 27492729 DOI: 10.1007/s10792-016-0302-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 07/16/2016] [Indexed: 11/29/2022]
Abstract
The aim of the study is to investigate the retinal vascular calibre, retinal nerve fibre layer's thickness, and optic disc changes in patients after pars plana vitrectomy. We examined 40 eyes in 40 patients who had undergone unilateral pars plana vitrectomy at three time points: prior to surgery, and at 3 and 6 months after the operation. The diameters of central retinal arteries and veins were measured using retinal photographs. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated using the revised Parr-Hubbard formula. Retinal nerve fibre layer thickness was obtained using Stratus optical coherence tomography. The cup-to-disc vertical ratio of the optic disc was evaluated using stereo optic disc photography. There were no significant differences between the eyes of individual patients before the operation. Cup-to-disc vertical ratios of the optic disc were significantly increased 3 and 6 months postoperatively (p < 0.01, p < 0.01), and there was a significant difference between the operative eye and fellow eye at the same time points (p < 0.01, p < 0.01). Changes in CRAE and CRVE in the operative eyes were significantly larger than the fellow eyes 6 months postoperatively (p < 0.01, p < 0.01). The retinal nerve fibre layer thickness showed no significant changes. While there were no changes in retinal nerve fibre layer thickness, vitrectomy induced changes in the cup-to-disc vertical ratio of the optic disc and retinal vessel diameter for at least 6 months after surgery.
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Affiliation(s)
- Seung Uk Lee
- Department of Ophthalmology, College of Medicine, Kosin University, Seo-gu GamCheon-ro 262, Busan, 49267, South Korea
| | - Ki Yup Nam
- Department of Ophthalmology, College of Medicine, Kosin University, Seo-gu GamCheon-ro 262, Busan, 49267, South Korea
| | - Sang Joon Lee
- Department of Ophthalmology, College of Medicine, Kosin University, Seo-gu GamCheon-ro 262, Busan, 49267, South Korea.
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Microincision 25G Pars Plana Vitrectomy with Peeling of the Inner Limiting Membrane and Air Tamponade in Idiopathic Macular Hole. Eur J Ophthalmol 2016; 27:93-97. [DOI: 10.5301/ejo.5000815] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2016] [Indexed: 11/20/2022]
Abstract
Purpose To evaluate the success of a mini-invasive technique for operation of idiopathic macular hole (IMH). Methods We retrospectively examined 29 patients (30 eyes) in whom 25-G pars plana vitrectomy (PPV), peeling of the inner limiting membrane (ILM), and application of air tamponade were performed. The group of the patients included 7 males and 22 females (76%), age range 57-79 years (median 70). The follow-up period was 3-47 months (median 17). Results Pars plana vitrectomy was indicated only in the stages of full-thickness macular hole. Prior to operation, 13 eyes (43%) were in stage 2, 15 eyes (50%) in stage 3, and 2 eyes (7%) in stage 4. The IMH healed in 28 eyes after operation. Persistence of IMH occurred in 2 eyes (7%). After subsequent reoperation with extension of the peeling zone of the ILM and gas tamponade (with 10% C3F8), these macular holes also healed (100%). Prior to carrying out PPV, best-corrected visual acuity (BCVA) ranged between 20/40 and 20/500 (median 20/125). At the end of the follow-up period, BCVA was improved to 20/40 (median). The change in the final BCVA compared to the initial visual acuity was statistically significant (p = 0.008; Wilcoxon). Conclusions The 25-G PPV with peeling of the ILM and air tamponade is an effective technique and presents no increased risks in comparison with routine procedures. The main benefit of the intervention is its good tolerance by the patient, particularly with respect to painfulness and postoperative irritation.
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Šín M, Chrapek O, Karhanová M, Šínová I, Špačková K, Langová K, Řehák J. The effect of pars plana vitrectomy and nuclear cataract on oxygen saturation in retinal vessels, diabetic and non-diabetic patients compared. Acta Ophthalmol 2016; 94:41-7. [PMID: 26310901 DOI: 10.1111/aos.12828] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 07/12/2015] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine the effect of pars plana vitrectomy (PPV) on oxygen saturation in retinal vessels in patients with diabetes and non-diabetes after a 1-year follow-up. METHODS This was a prospective consecutive interventional case series in 82 eyes in 82 patients. The sample consisted of 25 patients with non-proliferative diabetic retinopathy with macular oedema based on vitreoretinal traction or epiretinal membrane (ERM) and 57 non-diabetic patients with macular hole and ERM. Automatic retinal oximetry (Oxymap Inc.) was used on all patients 24 hr prior to PPV, and it was also used 7 and 52 weeks after PPV (classic 20G or sutureless 23G). We analysed the data according to subgroup diagnosis and lens status. RESULTS Arterial saturation increased significantly from 96.4 ± 2.9% at baseline to 96.6 ± 3.4% at week 7 and 97.3 ± 3.4% at week 52 (p < 0.0001; Friedman test). Vein saturation also increased significantly from 63.5 ± 7.9% at baseline to 66.1 ± 7.7% and 67.0 ± 7.2% at weeks 7 and 52 (p < 0.0001; Friedman test). The value of the arteriovenous (A-V) difference decreased significantly after vitrectomy from 32.8 ± 7.5% at baseline to 30.5 ± 7.5% and 30.3 ± 7.0% at weeks 7 and 52 (p < 0.0001; Friedman test). The subgroup analysis revealed that in patients with diabetes, there were no statistically significant changes in oxygen saturation in blood vessels or in the A-V difference after PPV. After vitrectomy, retinal vessel diameter reduced by about 3.5% in both groups of patients. Further, the analysis revealed that opacification of the lens leads to a decrease in oxygen saturation in contrast to a clear lens and pseudophakic IOLs. CONCLUSION Oxygen saturation is higher in the retinal veins and arteries after PPV in patients with non-diabetes, and this lasts for at least 52 weeks. In contrast, in patients with diabetes, there is no increase in oxygen saturation in the retinal vessels after vitrectomy. After vitrectomy, retinal vessel diameter reduced in both groups of patients. Further, the nuclear cataract progression has substantial effect on oximetry results. Patients with nuclear cataract exhibited an increase in saturation in both arteries and veins, but the A-V difference remained the same.
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Affiliation(s)
- Martin Šín
- Department of Ophthalmology; University Hospital and Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
| | - Oldřich Chrapek
- Department of Ophthalmology; University Hospital and Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
| | - Marta Karhanová
- Department of Ophthalmology; University Hospital and Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
| | - Irena Šínová
- Department of Ophthalmology; University Hospital and Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
| | | | - Kateřina Langová
- Department of Medical Biophysics; Faculty of Medicine and Dentistry; Institute of Molecular and Translational Medicine; Palacky University; Olomouc Czech Republic
| | - Jiří Řehák
- Department of Ophthalmology; University Hospital and Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
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The Changes of Retinal Saturation after Long-Term Tamponade with Silicone Oil. BIOMED RESEARCH INTERNATIONAL 2015; 2015:713828. [PMID: 26557694 PMCID: PMC4628732 DOI: 10.1155/2015/713828] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 06/17/2015] [Accepted: 06/18/2015] [Indexed: 11/30/2022]
Abstract
Purpose. To evaluate the effects of long-term tamponade with silicone oil on retinal saturation. Methods. A total of 49 eyes that received tamponade with silicone oil were included. The patients were divided into 3 groups (3–6 months, 6–9 months, and >9 months) according to the duration of silicone oil tamponade. Retinal oximetry was performed using the Oxymap system before and 2 months after silicone oil removal. Results. The mean retinal oxygen saturation before silicone oil removal was 107% ± 12% in the arterioles and 60% ± 10% in the venules, with an overall arteriovenous difference (AVD) of 47% ± 14%. The AVD in the >9-month group was significantly higher than that in the 3–6-month group (54% ± 16% versus 44% ± 11%, P = 0.042). After silicone oil removal, the AVD in the >9-month group was significantly decreased (45% ± 9% versus 54% ± 16%, P = 0.009); additionally, the arterioles were significantly wider than before surgery (10.8 ± 0.7 pixels versus 10.4 ± 0.9 pixels, P = 0.015). Conclusions. The tamponade with silicone oil for more than 9 months will cause the alterations of retinal saturation and the narrowing of retinal arterioles, which may further interfere with the oxygen metabolism in the retina.
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Effects of Vitreomacular Adhesion on Age-Related Macular Degeneration. J Ophthalmol 2015; 2015:865083. [PMID: 26425354 PMCID: PMC4573628 DOI: 10.1155/2015/865083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/07/2015] [Indexed: 01/10/2023] Open
Abstract
Herein, we review the association between vitreomacular adhesion (VMA) and neovascular age-related macular degeneration (AMD). Meta-analyses have shown that eyes with neovascular AMD are twice as likely to have VMA as normal eyes. VMA in neovascular AMD may induce inflammation, macular traction, decrease in oxygenation, sequestering of vascular endothelial growth factor (VEGF), and other cytokines or may directly stimulate VEGF production. VMA may also interfere with the treatment effects of anti-VEGF therapy, which is the standard treatment for neovascular AMD, and releasing VMA can improve the treatment response to anti-VEGF treatment in neovascular AMD. We also reviewed currently available methods of relieving VMA.
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Türksever C, Orgül S, Todorova MG. Reproducibility of retinal oximetry measurements in healthy and diseased retinas. Acta Ophthalmol 2015; 93:e439-45. [PMID: 25430037 DOI: 10.1111/aos.12598] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/12/2014] [Indexed: 01/03/2023]
Abstract
PURPOSE Retinal oximetry (RO) has been established as a non-invasive method to analyse oxygen saturation in retinal vessels. The aim of our study was to determine the reproducibility of RO images in healthy and in diseased retinas. METHODS A total of 61 right eyes (244 RO images) in 61 subjects (35♀, 26♂) were examined: 22 controls, 18 patients with glaucoma and 21 patients with inherited retinal diseases (IRDs). Four test-retest RO images were obtained in each subject. Oxygen saturation was measured with the oxygen saturation measurement tool of the Retinal Vessel Analyser (RVA; IMEDOS Systems UG, Jena, Germany). The test-retest standard deviation within the subject's (±SDw ) measurements (the mean vessel oxygen saturation in retinal venules and arterioles), its coefficient of variation (CoV) and the intraclass correlation coefficients (ICC) were analysed. RESULTS The average test-retest SDw in venules was ±2.52% (CoV = 4.35%) and in arterioles was ±1.67% (CoV = 1.76%). Among controls, glaucoma eyes and eyes with IRDs, the test-retest SDw in venules were ±2.33% (CoV = 4.48%), ±2.85% (CoV = 4.71%) and ±2.43% (CoV = 3.90%) (SDw p = 0.366 (CoV p = 0.452); one-way anova). The test-retest SDw in arterioles were ±1.65% (CoV = 1.80%), ±1.83% (CoV = 1.92%) and ±1.54% (CoV = 1.56%), respectively [SDw p = 0.762 (CoV p = 0.686)]. The ICCs in venules were 0.76 in controls, 0.69 in patients with glaucoma and 0.82 in patients with IRD. The ICCs in arterioles were, respectively, 0.92, 0.70 and 0.93. CONCLUSION The reproducibility of RO in healthy, as well as in diseased retinas, is excellent. In the glaucoma group, the lower standard deviation between subjects (SDb ) for arterioles contributes to the lower ICCs. Nevertheless, the measurements of oxygen saturation in arterioles seem more reliable when compared to venules.
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Affiliation(s)
- Cengiz Türksever
- Department of Ophthalmology; University of Basel; Basel Switzerland
| | - Selim Orgül
- Department of Ophthalmology; University of Basel; Basel Switzerland
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Beach J. Pathway to Retinal Oximetry. Transl Vis Sci Technol 2014; 3:2. [PMID: 25237591 PMCID: PMC4164112 DOI: 10.1167/tvst.3.5.2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/16/2014] [Indexed: 12/21/2022] Open
Abstract
Events and discoveries in oxygen monitoring over the past two centuries are presented as the background from which oximetry of the human retina evolved. Achievements and the people behind them are discussed, showing parallels between the work in tissue measurements and later in the eye. Developments in the two-wavelength technique for oxygen saturation measurements in retinal vessels are shown to exploit the forms of imaging technology available over time. The last section provides a short summary of the recent research in retinal diseases using vessel oximetry.
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