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Holzwarth J, Krohne TU, Lommatzsch A, Priglinger SG, Hattenbach LO. [Epiretinal membrane: diagnostics, indications and surgical treatment]. DIE OPHTHALMOLOGIE 2024; 121:443-451. [PMID: 38831204 DOI: 10.1007/s00347-024-02055-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/05/2024]
Abstract
An epiretinal membrane (ERM) is a frequently occurring disease affecting the macula, which can be associated with visual impairment and metamorphopsia, depending on the severity and location. A distinction is made between an idiopathic form caused by age-related changes of the vitreous body and a secondary form associated with diseases of the posterior segment. The development of fibrocellular epiretinal membranes formed by dedifferentiation of intraretinal and extraretinal cells at the level of the vitreomacular interface plays a major role in the pathogenesis. The diagnostics and indications for surgical treatment of ERM are based on the visual acuity, evidence of metamorphopsia, ophthalmoscopic findings and optical coherence tomography (OCT) of the macula. In addition to the possibility of observation of the course where benign spontaneous courses are not uncommon, pars plana vitrectomy (PPV) with peeling of the ERM and internal limiting membrane (ILM) to prevent recurrences is the treatment of choice in symptomatic patients. The prognosis after surgical treatment is very good. In approximately two thirds of the cases, an improvement in visual acuity and/or a reduction of metamorphopsia can be achieved, with a number of predictive, primarily OCT-based factors enabling a prediction of the functional prognosis. Comprehensive patient education regarding the generally long duration of postoperative rehabilitation and the possibility of persistent symptoms or visual deterioration despite successful membrane removal is essential.
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Affiliation(s)
- Jakob Holzwarth
- Augenklinik, Klinikum Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen am Rhein, Deutschland
| | - Tim U Krohne
- Augenzentrum, St. Franziskus Hospital, Münster, Deutschland
| | - Albrecht Lommatzsch
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland
| | | | - Lars-Olof Hattenbach
- Augenklinik, Klinikum Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen am Rhein, Deutschland.
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Hattenbach LO, Krohne TU. [Vitreomacular Interface Diseases : Epiretinal membrane, Macular Hole and Co.]. DIE OPHTHALMOLOGIE 2024; 121:441-442. [PMID: 38886224 DOI: 10.1007/s00347-024-02057-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/20/2024]
Affiliation(s)
- Lars-Olof Hattenbach
- Augenklinik des Klinikums Ludwigshafen, Bremserstraße 79, 67063, Ludwigshafen am Rhein, Deutschland.
| | - Tim U Krohne
- Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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Mishra AV, Vermeirsch S, Lin S, Martin-Gutierrez MP, Simcoe M, Pontikos N, Schiff E, de Guimarães TAC, Hysi PG, Michaelides M, Arno G, Webster AR, Mahroo OA. Sex Distributions in Non-ABCA4 Autosomal Macular Dystrophies. Invest Ophthalmol Vis Sci 2024; 65:9. [PMID: 38700873 PMCID: PMC11077905 DOI: 10.1167/iovs.65.5.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/22/2024] [Indexed: 05/08/2024] Open
Abstract
Purpose We sought to explore whether sex imbalances are discernible in several autosomally inherited macular dystrophies. Methods We searched the electronic patient records of our large inherited retinal disease cohort, quantifying numbers of males and females with the more common (non-ABCA4) inherited macular dystrophies (associated with BEST1, EFEMP1, PROM1, PRPH2, RP1L1, and TIMP3). BEST1 cases were subdivided into typical autosomal dominant and recessive disease. For PRPH2, only patients with variants at codons 172 or 142 were included. Recessive PROM1 and recessive RP1L1 cases were excluded because these variants give a more widespread or peripheral degeneration. The proportion of females was calculated for each condition; two-tailed binomial testing was performed. Where a significant imbalance was found, previously published cohorts were also explored. Results Of 325 patients included, numbers for BEST1, EFEMP1, PROM1, PRPH2, RP1L1, and TIMP3 were 152, 35, 30, 50, 14, and 44, respectively. For autosomal dominant Best disease (n = 115), there were fewer females (38%; 95% confidence interval [CI], 29-48%; P = 0.015). For EFEMP1-associated disease (n = 35), there were significantly more females (77%; 95% CI, 60%-90%; P = 0.0019). No significant imbalances were seen for the other genes. When pooling our cohort with previous large dominant Best disease cohorts, the proportion of females was 37% (95% CI, 31%-43%; P = 1.2 × 10-5). Pooling previously published EFEMP1-cases with ours yielded an overall female proportion of 62% (95% CI, 54%-69%; P = 0.0023). Conclusions This exploratory study found significant sex imbalances in two autosomal macular dystrophies, suggesting that sex could be a modifier. Our findings invite replication in further cohorts and the investigation of potential mechanisms.
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Affiliation(s)
- Amit V. Mishra
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Sandra Vermeirsch
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Siying Lin
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | | | - Mark Simcoe
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Section of Ophthalmology, King's College London, St. Thomas’ Hospital Campus, London, United Kingdom
| | - Nikolas Pontikos
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Elena Schiff
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Thales A. C. de Guimarães
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Pirro G. Hysi
- Section of Ophthalmology, King's College London, St. Thomas’ Hospital Campus, London, United Kingdom
| | - Michel Michaelides
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Gavin Arno
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- North East Thames Regional Genetics Service, Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Andrew R. Webster
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Omar A. Mahroo
- Genetics Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Section of Ophthalmology, King's College London, St. Thomas’ Hospital Campus, London, United Kingdom
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
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Venkatesh R, Mangla R, Handa A, Chitturi SP, Parmar Y, Sangoram R, Yadav NK, Chhablani J. Vitreomacular interface abnormalities in type 2 macular telangiectasia (MacTel). Graefes Arch Clin Exp Ophthalmol 2024; 262:1455-1463. [PMID: 38108907 DOI: 10.1007/s00417-023-06330-8] [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: 02/20/2023] [Revised: 11/20/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To describe the different types of vitreomacular interface abnormalities (VMIA) seen on optical coherence tomography (OCT) in type 2 macular telangiectasia (MacTel) and explain the possible reasons for its development. METHODS In this retrospective cross-sectional study, type 2 MacTel eyes with macular volumetric OCT imaging protocol were included to identify different types of VMIA such as abnormal PVD, vitreomacular traction (VMT), ERM, and lamellar and full-thickness macular hole. The VMIA findings were then correlated with different MacTel disease stages and visual acuity. RESULTS One thousand forty-three OCTs of 332 type 2 MacTel eyes from 169 patients at different visits were examined. VMIA was detected in 709 (68%) of those OCT scans in 216 (65%) eyes. There were 273 (39%), 31 (4%), 89 (13%), 7 (1%), and 381 (54%) OCT scans with vitreomacular adhesion, VMT, ERM, and inner and outer lamellar macular holes discovered respectively. VMIA eyes had a high frequency of abnormal PVD (p = 0.001) and retinal pigment clumps (RPCs) [p = 0.032]. Eyes with abnormal PVD (p = 0.034) and RPC (p = 0.000) had a higher rate of ERM development. RPC was linked to an increased risk of developing ERM (odd ratio 2.472; 95% CI 1.488-4.052). RPC and ERM contributed significantly to poor visual acuity (0.661 ± 0.416, 20/92). CONCLUSION OCT reveals a high frequency of VMIA in advanced type 2 MacTel eyes. RPC could be responsible for the development of anomalous PVD, as well as subsequent VMIAs and ERM. Additional work is required to examine the long-term changes and surgical outcomes of these eyes.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India.
| | - Rubble Mangla
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Ashit Handa
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Sai Prashanti Chitturi
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Yash Parmar
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Rohini Sangoram
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Jay Chhablani
- University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, 203 Lothrop Street, Suite 800, Pittsburgh, PA, 15213, USA
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Amoaku WM, Cushley L, Silvestri V, Akafo S, Amissah-Arthur KN, Lartey S, Hageman CN, Pappas CM, Hubbard WC, Bernstein PS, Vitale A, Roberts M, Virgili G, Hageman GS, Silvestri G. Vitreomacular interface abnormalities in the Ghanaian African. Eye (Lond) 2024; 38:578-584. [PMID: 37773435 PMCID: PMC10858261 DOI: 10.1038/s41433-023-02737-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND/OBJECTIVE Describe vitreomacular interface abnormalities (VMIA) using spectral-domain optical coherence tomography (SD-OCT), and correlations with age-related macular degeneration (AMD) grade in Ghanaian Africans. SUBJECTS/METHODS Prospective, cross-sectional study of adults aged ≥50 years recruited in Ghana AMD Study. Participant demographics, medical histories, ophthalmic examination, digital colour fundus photography (CFP) were obtained. High-resolution five-line raster OCT, Macular Cube 512 × 128 scans, and additional line scans in areas of clinical abnormality, were acquired. SD-OCT VMI features classified by International Vitreomacular Traction Study Group system and relationships to AMD grade were evaluated. OUTCOMES VMIA prevalence, posterior vitreous detachment (PVD), vitreomacular adhesions (VMA), vitreomacular traction (VMT), epiretinal membranes (ERM), correlations with AMD grade. RESULTS The full Ghana AMD cohort included 718 participants; 624 participants (1248 eyes) aged ≥50 years (range = 50-101, mean = 68.8), 68.9% female were included in this analysis. CFP with OCT scans were available for 776 eyes (397 participants); 707 (91.1%) had gradable CFP and OCT scans for both AMD and VMI grading forming the dataset for this report. PVD was absent in 504 (71.3%); partial and complete PVD occurred in 16.7% and 12.0% respectively. PVD did not increase with age (p = 0.720). VMIA without traction and macular holes were observed in 12.2% of eyes; 87.8% had no abnormalities. VMIA was not significantly correlated with AMD grade (p = 0.819). CONCLUSIONS This provides the first assessment of VMIA in Ghanaian Africans. VMIA are common in Africans; PVD may be less common than in Caucasians. There was no significant association of AMD grade with VMIA.
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Affiliation(s)
- Winfried M Amoaku
- Academic Ophthalmology, Mental Health & Clinical Neurosciences, University of Nottingham and University Hospitals, Nottingham, UK.
| | - Laura Cushley
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | | | - Stephen Akafo
- Unit of Ophthalmology, Department of Surgery, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Kwesi N Amissah-Arthur
- Unit of Ophthalmology, Department of Surgery, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Seth Lartey
- Eye Unit, Eye Ear Nose and Throat Department, Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Courtney N Hageman
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Christian M Pappas
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - William C Hubbard
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Paul S Bernstein
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Albert Vitale
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Megan Roberts
- Ophthalmology Services, Eye and ENT Clinic, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK
| | | | - Gregory S Hageman
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Giuliana Silvestri
- Ophthalmology Services, Eye and ENT Clinic, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK
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Wilde C, Panos GD, Pooschti A, MacNab HK, Hillman JG, Vernon SA, Amoaku WM. Prevalence and Associations of Epiretinal Membranes in an Elderly English Population: The Bridlington Eye Assessment Project. J Clin Med 2024; 13:739. [PMID: 38337433 PMCID: PMC10856010 DOI: 10.3390/jcm13030739] [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: 12/25/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Purpose: To determine the prevalence and risk factors of epiretinal membranes (ERMs) in an adult English population. Methods: The Bridlington Eye Assessment Project is a population-based study of eye disease among residents aged 65 years or older. Comprehensive interviews and ophthalmic examinations were conducted to assess potential risk factors. Digital mydriatic nonstereoscopic 30° colour fundus photography (CFP) was performed. ERMs were classified as primary/idiopathic or secondary on the basis of findings from the ocular examination and the structured questionnaire. Logistic regression models were used to determine the independence of potential risk factors for idiopathic ERMs. Results: In a comprehensive screening of 3588 patients aged over 65, we identified an eye-based prevalence of ERMs of 4.26% and a subject-based prevalence of ERMs of 6.88%. The majority of these cases were idiopathic in nature (90.7%), while 9.3% were secondary ERMs; predominantly, there was a history of cataract surgery (43.5%). No significant correlation between idiopathic ERMs and factors such as age, gender, diabetes, hypertension, a history of stroke, or the presence of AMD was found. Conclusions: The prevalence of ERMs in an elderly English population and the proportion of idiopathic and secondary ERMs are similar to previous reports. However, in elderly patients aged over 65 years, age is not a risk factor for the presence of idiopathic ERMs. The presence of diabetes, hypertension, a history of stroke, and AMD of any grade was not associated with ERMs.
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Affiliation(s)
- Craig Wilde
- Division of Ophthalmology and Visual Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK; (C.W.); (A.P.); (S.A.V.); (W.M.A.)
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
| | - Georgios D. Panos
- Division of Ophthalmology and Visual Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK; (C.W.); (A.P.); (S.A.V.); (W.M.A.)
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
| | - Ali Pooschti
- Division of Ophthalmology and Visual Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK; (C.W.); (A.P.); (S.A.V.); (W.M.A.)
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
| | | | | | - Stephen A. Vernon
- Division of Ophthalmology and Visual Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK; (C.W.); (A.P.); (S.A.V.); (W.M.A.)
| | - Winfried M. Amoaku
- Division of Ophthalmology and Visual Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK; (C.W.); (A.P.); (S.A.V.); (W.M.A.)
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
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Serino F, Bernardi E, Franco F. Efficacy and safety of combined Xen Gel Stent-45 implantation and 25-gauge Pars Plana Vitrectomy: a case series. Rom J Ophthalmol 2023; 67:362-367. [PMID: 38239415 PMCID: PMC10793369 DOI: 10.22336/rjo.2023.57] [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] [Accepted: 12/03/2023] [Indexed: 01/22/2024] Open
Abstract
Purpose: To report outcomes in terms of efficacy and safety of patients affected with Primary Open Angle Glaucoma (POAG) and Vitreoretinal Disease, who have undergone Pars Plana Vitrectomy (PPV) and ab-interno XEN gel 45 (Abbvie) implantations. Methods: This is a retrospective, observational, case series on five patients who underwent combined Pars Plana Vitrectomy and XEN gel Stent 45 implantation at "Careggi Hospital" Eye Clinic of Florence. Best-corrected visual acuity (BCVA) evaluation, intraocular pressure (IOP) measurements with Goldmann applanation tonometer (GAT), and several glaucoma medications were evaluated at the baseline and at one, three, six, and twelve months after surgery. Complications were recorded up to 1 year after surgery. Results: 5 eyes in five patients were enrolled. IOP dropped from an average of 21,2 ± 3,3 mmHg preoperatively to 14,6 ± 1,1 mmHg at the end of the follow-up period (month 12), with a mean percentage reduction of 58%. One patient needed a needling procedure (20%). None needed reintervention. We did not register any case of hypotony (IOP < 6,5 mmHg), hypotony maculopathy and choroidal detachment. The postoperative number of anti-glaucomatous molecules was on average 0,2 ± 0,4. Conclusion: Our results suggested that combined Pars Plana Vitrectomy and XEN gel stent 45 implantation is safe and effective for patients affected by visually significant vitreoretinal diseases and POAG. Abbreviations: AC = anterior chamber, BCVA = Best-corrected visual acuity, ERM = epiretinal membrane, FTMH = full-thickness macular holes, FU = fluorouracil, GAT = Goldmann applanation tonometer, IOP = intraocular pressure, MIGS = minimally invasive glaucoma surgery, MMC = mitomycin C, NVG = neovascular glaucoma, OCT = optical coherence tomography, POAG = Primary Open Angle Glaucoma, PPV = Pars Plana Vitrectomy, SD = standard deviation, TB = Trabeculectomy, VF = visual field, VMI = Vitreomacular Interface, VMA = vitreomacular adhesion, VMT = vitreomacular traction.
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Affiliation(s)
| | - Enrico Bernardi
- Department of Ophthalmology, Inselspital, University Hospital Bern, Switzerland
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Ach T, Agostini H, Claessens D, Gehrig C, Hattenbach LO, Lommatzsch A, Ostrowski A, Schumann RG. [Macular hole and vitreomacular traction : S1 guideline of the German Society of Ophthalmology (DOG), the German Retina Society (RG) and the German Professional Association of Ophthalmologists (BVA). Version: 22 September 2022]. DIE OPHTHALMOLOGIE 2023; 120:1-14. [PMID: 36512120 DOI: 10.1007/s00347-022-01774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 12/14/2022]
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9
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Wu L, Bradshaw R. Primary Lamellar Macular Holes: To Vit or Not to Vit. J Clin Med 2022; 11:5046. [PMID: 36078977 PMCID: PMC9457236 DOI: 10.3390/jcm11175046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/21/2022] [Accepted: 08/26/2022] [Indexed: 11/19/2022] Open
Abstract
There is a wide spectrum of macular conditions that are characterized by an irregular foveal contour caused by a break in the inner fovea. These include full-thickness macular hole (FTMH), foveal pseudocyst, lamellar macular hole (LMH) and macular pseudohole (MPH). Clinical examination of vitreomacular interface disorders is notoriously poor in differentiating these conditions. These conditions were initially described with slit-lamp biomicroscopy, and the main goal was to distinguish an FTMH from the others. The introduction of optical coherence tomography (OCT) has revolutionized our understanding of the foveal microstructural anatomy and has facilitated differentiating these conditions from an FTMH. However, the definitions of the other conditions, particularly LMH, has evolved over the past two decades. Initially the term LMH encompassed a wide spectrum of clinical conditions. As OCT became more widely used and observations became more refined, two different phenotypes of LMH became apparent, raising the question of different pathogenic mechanisms for each phenotype. Tractional and degenerative pathological mechanisms were proposed. Epiretinal membranes (ERMs) associated with each phenotype were identified. Typical ERMs were associated with a tractional mechanism, whereas an epiretinal proliferation was associated with a degenerative mechanism. Epiretinal proliferation represents Müller cell proliferation as a reactive process to retinal injury. These two types of ERM were differentiated by their characteristics on SD-OCT. The latest consensus definitions take into account this phenotypic differentiation and classifies these entities into LMH, MPH and ERM foveoschisis. The initial event in both ERM foveoschisis and LMH is a tractional event that disrupts the Müller cell cone in the foveola or the foveal walls. Depending on the extent of Müller cell disruption, either a LMH or an ERM foveoschisis may develop. Although surgical intervention for LMH remains controversial and no clear guidelines exist for pars plana vitrectomy (PPV), eyes with symptomatic, progressive ERM foveoschisis and LMH may benefit from surgical intervention.
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Affiliation(s)
- Lihteh Wu
- Asociados de Macula, Vitreo y Retina de Costa Rica, Primer Piso Torre Mercedes, Paseo Colón, San José 10102, Costa Rica
- Illinois Eye and Ear Infirmary, Department of Ophthalmology, School of Medicine, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Ryan Bradshaw
- Centro de Oftalmologia y Microcirugia Boyd, Departamento de Retina, Panama City 0816-02593, Panama
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Lin A, Xia H, Zhang A, Liu X, Chen H. Vitreomacular Interface Disorders in Proliferative Diabetic Retinopathy: An Optical Coherence Tomography Study. J Clin Med 2022; 11:3266. [PMID: 35743337 PMCID: PMC9224563 DOI: 10.3390/jcm11123266] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/24/2022] [Accepted: 06/06/2022] [Indexed: 02/05/2023] Open
Abstract
Vitreomacular interface plays an important role in the pathogenesis and progression of proliferative diabetic retinopathy (PDR). This study investigated the prevalence and risk factors of vitreomacular interface disorders (VMID) in PDR. The macular optical coherence tomography (OCT) scans of 493 eyes from 378 PDR patients were retrospectively reviewed to detect VMID, including vitreomacular adhesion (VMA), vitreomacular traction (VMT), epiretinal membrane (ERM), lamellar hole-associated epiretinal proliferation (LHEP), and macular hole (MH). The associations between VMID and baseline factors, intraretinal structure, and visual acuity were analyzed. The prevalence was 78.9% for ERM, 13.4% for VMT, 4.8% for MH, 2.2% for LHEP, and 2.0% for VMA, respectively. On multivariable analyses (odds ratio, 95% confidence interval), fibrovascular proliferation (FVP) was positively associated with MH (8.029, 1.873-34.420), VMT (3.774, 1.827-7.798), and ERM (2.305, 1.460-3.640). High-risk PDR was another risk factor of ERM (1.846, 1.101-3.090). Female gender was positively associated with MH (3.836, 1.132-13.006), while vitreous hemorrhage was negatively associated with MH (0.344, 0.133-0.890). Eyes with all VMID subtypes showed more frequent macular cysts and tractional retinal detachment with poorer visual acuity (p ≤ 0.001). Therefore, the prevalence of VMID was considerably high, indicating that this distinct entity should be considered in interventions for PDR.
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Affiliation(s)
- Aidi Lin
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou 515041, China
| | | | | | | | - Haoyu Chen
- Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou 515041, China
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Catania F, Allegrini D, Nembri A, Confalonieri F, Zollet P, Crincoli E, Romano MR. Macular Microvascular Modifications in Progressive Lamellar Macular Holes. Diagnostics (Basel) 2021; 11:diagnostics11091717. [PMID: 34574058 PMCID: PMC8466957 DOI: 10.3390/diagnostics11091717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/27/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
Lamellar macular holes (LMHs) may show morphological and functional deterioration over time, yet no definite prognostic factor for progression has been identified. Since neurovascular retinal unit impairment may take part in neurodegeneration, we compare progressive LMHs to stable ones in optical coherence tomography (OCT) angiography parameters. METHODS OCT B scans of eyes with LMH were analyzed to detect the presence of tissue loss (TL) over time, allowing us to identify a TL group and a stable (ST) group (14 patients each). The best corrected visual acuity (BCVA) at each considered imaging time point was collected. Lastly, patients underwent macular OCT angiography. RESULTS BCVA at last follow up was significantly reduced in the TL group compared to both the ST group and TL group baseline assessment. SCP foveal vessel density (VD), SCP and deep capillary plexus (DCP) perfusion density (PD) and parafoveal PD were lower in the TL group. Linear correlations between quantitative TL over time and parafoveal PD in SCP and between the speed of TL and BCVA variation during follow up were also detected. CONCLUSIONS TL in LMHs is associated with both OCT angiography modifications and BCVA deterioration over time. We suggest these findings to be a manifestation of foveal Muller cell impairment in progressive LMHs.
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Affiliation(s)
- Fiammetta Catania
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy; (F.C.); (P.Z.); (M.R.R.)
- Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128 Bergamo, Italy; (D.A.); (A.N.)
- Correspondence:
| | - Davide Allegrini
- Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128 Bergamo, Italy; (D.A.); (A.N.)
| | - Alessandra Nembri
- Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128 Bergamo, Italy; (D.A.); (A.N.)
| | - Filippo Confalonieri
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy; (F.C.); (P.Z.); (M.R.R.)
- Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128 Bergamo, Italy; (D.A.); (A.N.)
| | - Piero Zollet
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy; (F.C.); (P.Z.); (M.R.R.)
- Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128 Bergamo, Italy; (D.A.); (A.N.)
| | - Emanuele Crincoli
- Ophthalmology Unit, “Fondazione Policlinico Universitario A. Gemelli IRCCS”, 00168 Rome, Italy;
- Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
| | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy; (F.C.); (P.Z.); (M.R.R.)
- Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128 Bergamo, Italy; (D.A.); (A.N.)
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EPIDEMIOLOGY OF VITREOMACULAR INTERFACE ABNORMALITIES USING MACULAR SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN AN ELDERLY POPULATION (THE MONTRACHET STUDY). Retina 2021; 41:60-67. [PMID: 32282647 DOI: 10.1097/iae.0000000000002802] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to investigate the prevalence of vitreomacular interface abnormalities (VMIAs) and to identify associated factors in an elderly population in Europe. METHODS The MONTRACHET (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases) Study is a population-based study, conducted in subjects older than 75 years. Vitreomacular adhesions, vitreomacular tractions, macular holes, epiretinal membranes, and macular cysts were assessed on spectral-domain optical coherence tomography examinations. The prevalence of VMIAs was estimated. We studied the association of demographic and clinical factors with VMIAs. RESULTS The mean age of the participants was 82.3 (SD, 3.8) years, and 37.3% were men. The prevalence rates of VMIAs were vitreomacular adhesions (17.7%), vitreomacular tractions (1.4%), lamellar macular holes (1.0%), full-thickness macular holes (0.2%), macular pseudoholes (0.4%), epiretinal membranes (38.9%), and macular cysts (5.8%). In multivariate analysis, vitreomacular adhesions were positively associated with male sex (P < 0.001) and negatively associated with older age (P < 0.001) and cataract extraction (P < 0.001). Epiretinal membranes were positively associated with older age (P < 0.001) and cataract extraction (P < 0.001). CONCLUSION The prevalence of VMIAs based on spectral-domain optical coherence tomography analysis was high in subjects older than 75 years.
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De Clerck EEB, Schouten JSAG, Berendschot TTJM, Goezinne F, Liesenborghs I, Dagnelie PC, Schaper NC, Kroon AA, Henry RMA, Reesink KD, Schram MT, Stehouwer CDA, Webers CAB. Vascular risk factors for optical coherence tomography-detected macular cysts: The Maastricht Study. Acta Ophthalmol 2021; 99:e860-e868. [PMID: 33258290 DOI: 10.1111/aos.14677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate whether higher blood pressure and greater arterial stiffness are associated with the presence of macular cysts and whether this association is already present in the absence of micro-aneurysms in individuals with and without type 2 diabetes. METHODS Using spectral domain optical coherence tomography (OCT), we performed a macular volume scan in 2647 individuals (mean age 60 ± 8 years, 50% men, 27% type 2 diabetes). The association between macular cysts and 24-hour systolic and diastolic blood pressure, pulse pressure, mean arterial blood pressure, carotid-femoral pulse wave velocity and carotid distensibility was assessed by use of logistic regression. RESULTS Twenty-four hours systolic blood pressure was associated with the presence of macular cysts [OR = 1.03 (95% CI 1.00-1.05) per 1 mmHg, p = 0.03]. 24 hr pulse pressure [OR = 1.61 (95% CI 1.11-2.34) per 10 mmHg, p = 0.01] and carotid-femoral pulse wave velocity [OR = 1.16 (95% CI 1.02-1.32) per 1 m/s, p = 0.02] were associated with macular cysts, while carotid distensibility was not [OR = 1.03 (95% CI 0.96-1.11) per 1.0*10-3 /kPa, p = 0.45]. Associations were similar in individuals with and without type 2 diabetes and were already present in the absence of micro-aneurysms. CONCLUSION Twenty-four hours systolic blood pressure, 24 hr pulse pressure and carotid-femoral pulse wave velocity are associated with the presence of OCT-detected macular cysts in individuals with and without type 2 diabetes, even in the absence of micro-aneurysms. Therefore, blood pressure and aortic stiffness are potential factors contributing to macular cysts.
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Affiliation(s)
- Eline E. B. De Clerck
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Jan S. A. G. Schouten
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Tos T. J. M. Berendschot
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Fleur Goezinne
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Ilona Liesenborghs
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Pieter C. Dagnelie
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Epidemiology Maastricht University Maastricht The Netherlands
- School for Public Health and Primary Care (CAPHRI) Maastricht University Maastricht The Netherlands
| | - Nicolaas C. Schaper
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Epidemiology Maastricht University Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Abraham A. Kroon
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Ronald M. A. Henry
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Koen D. Reesink
- Department of Biomedical Engineering Maastricht University Medical Center+ Maastricht The Netherlands
| | - Miranda T. Schram
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
- Heart and Vascular Center Maastricht University Medical Center+ Maastricht The Netherlands
| | - Coen D. A. Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Carroll A. B. Webers
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
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Wang Y, Zhao X, Zhang W, Yang J, Chen Y. FOVEA-SPARING VERSUS COMPLETE INTERNAL LIMITING MEMBRANE PEELING IN VITRECTOMY FOR VITREOMACULAR INTERFACE DISEASES: A Systematic Review and Meta-Analysis. Retina 2021; 41:1143-1152. [PMID: 34001832 PMCID: PMC8140668 DOI: 10.1097/iae.0000000000003140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate fovea-sparing internal limiting membrane (ILM) peeling in vitrectomy compared with traditional complete ILM peeling in vitreomacular interface diseases, including macular hole (MH), epiretinal membrane, macular foveoschisis, myopic traction maculopathy, and the like. METHODS PubMed, EMBASE, Cochrane, CNKI Databases, and the ClinicalTrials.gov website (PROSPERO number CRD42020187401) were searched. Controlled trials comparing fovea-sparing with complete ILM peeling were included. Postoperative changes in best-corrected visual acuity, central retinal thickness in vitreomacular interface diseases, the incidence of MH closure in MH cases, full-thickness macular hole development in non-MH cases, and retinal reattachment in retinoschisis cases were extracted. RESULTS Fourteen studies (487 eyes) were eligible. Compared with complete ILM peeling, the fovea-sparing technique revealed significant improvement in best-corrected visual acuity ( logarithm of the minimum angle of resolution; weighted mean difference = -0.70; 95% confidence interval, -1.11 to -0.30), and a reduced incidence of full-thickness macular hole was noted in non-MH cases (risk ratios = 0.25; 95% confidence interval, 0.08-0.76). However, no significant differences in mean change in central retinal thickness, incidence of MH closure in MH cases, and retinal reattachment in retinoschisis cases were noted. CONCLUSION Based on current evidence, fovea-sparing ILM peeling significantly improve visual outcomes and decrease complications of full-thickness macular hole development in vitreomacular interface diseases.
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Affiliation(s)
- Yuelin Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; and
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinyu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; and
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenfei Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; and
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingyuan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; and
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; and
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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15
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[Statement of the Professional Association of German Ophthalmologists (BVA), the German Ophthalmological Society (DOG) and the Retinological Society (RG) on the development, diagnostics and treatment of epiretinal gliosis : Status October 2020]. Ophthalmologe 2021; 118:121-138. [PMID: 33346894 DOI: 10.1007/s00347-020-01291-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Shpak AA, Shkvorchenko DO, Vedernikova OY, Shahabutdinova PM. [Natural course of lamellar macular holes]. Vestn Oftalmol 2020; 136:5-10. [PMID: 32779451 DOI: 10.17116/oftalma20201360415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The issue of indications for surgical treatment of lamellar macular holes (LMH) remains debatable, especially considering the different opinions about the possibility of their progression. PURPOSE To study natural course of LMH and to develop criteria of their progression. MATERIAL AND METHODS The study analyses retrospective data of patients with LMH observed in S. Fyodorov Eye Microsurgery Federal State Institution from 2013 to 2018 who were examined by optical coherence tomography (OCT) at least 2 times with an interval between the initial and last examinations of at least 6 months. The examinations were carried out to evaluate the types of LMH and epiretinal membrane, the ellipsoid zone of photoreceptors and vitreoretinal interface, as well as calculate the changes in the quantitative parameters of the LMH. RESULTS One hundred and three patients with LMH were identified; data of 65 patients (65 eyes) was studied in detail. The follow-up lasted 20.5±12.9 months on average. Statistically substantiated criteria for the progression of tractional and degenerative LMH were developed, taking into account the OCT changes most significant for each type of LMH. According to the proposed criteria, signs of marked progression were found in 2 (5.3%) of 38 patients with tractional and 4 (14.8%) of 27 patients with degenerative LMH. Moderate progression was detected in 2 (5.3%) patients with tractional and 2 (7.4%) patients with degenerative LMH. In two patients who were not included in the groups for calculating the criteria for progression, the formation of a full-thickness macular hole has occurred. CONCLUSION One of the variants of the natural course of LMH can be its progression up to transition into a full-thickness macular hole. The proposed statistically substantiated criteria allows identifying dangerous progression of LMH, which should be taken into account when determining the treatment tactics.
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Affiliation(s)
- A A Shpak
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - D O Shkvorchenko
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - O Yu Vedernikova
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
| | - P M Shahabutdinova
- S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Moscow, Russia
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TWENTY-FIVE GAUGE ULTRASONIC VITRECTOMY: Experimental and Clinical Performance Analysis. Retina 2020; 40:1443-1450. [PMID: 32472825 DOI: 10.1097/iae.0000000000002863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Schuster AK, Kluck A, Korb CA, Stoffelns B, Nickels S, Schulz A, Münzel T, Wild PS, Beutel ME, Schmidtmann I, Lackner KJ, Peto T, Pfeiffer N. Characteristics and pathologies of the vitreo-macular interface-results from the Gutenberg Health Study. Acta Ophthalmol 2020; 98:e273-e281. [PMID: 31680456 DOI: 10.1111/aos.14285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 10/01/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE We aimed to determine the prevalence of characteristics and pathologies of the vitreo-macular interface within the general population. METHODS The Gutenberg Health Study is a population-based study in Germany, including an ophthalmological examination with refraction, biometry and optical coherence tomography (OCT) imaging. Characteristics of the vitreo-macular interface were graded on volume scans including visibility of an epiretinal membrane, full-thickness macular hole, lamellar hole and pseudohole. Overall and age-specific prevalences including 95% confidence intervals [95%-CI] were calculated. Association analyses were conducted to determine systemic and ocular factors that are associated with epiretinal membranes (the most common pathology) using multivariable logistic regression. RESULTS A total of 1890 people aged 40-80 years were included in the study. Of these, 4.7% (95%-CI: 3.8%-5.8%) had an epiretinal membrane in at least one eye, 0.1% a full-thickness macular hole, 0.6% a lamellar hole and 0.6% a pseudohole. The presence of an epiretinal membrane was associated with higher age, myopic refractive error and prior retinal laser therapy, but not with gender, body height, body weight, smoking, prior cataract surgery or intraocular pressure. CONCLUSIONS Epiretinal membranes are more frequent in older and myopic subjects and in those with prior retinal laser therapy.
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Affiliation(s)
| | - Anne‐Kristin Kluck
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Christina A. Korb
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Stefan Nickels
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine Center for Cardiology University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Thomas Münzel
- Center for Cardiology I University Medical Center Mainz Mainz Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine Center for Cardiology University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
- Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
- DZHK (German Center for Cardiovascular Research), partner site Rhine‐Main Mainz Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy University Medical Center Mainz Mainz Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine University Medical Center Mainz Mainz Germany
| | - Tunde Peto
- Centre for Public Health Queen's University Belfast Northern Ireland UK
| | - Norbert Pfeiffer
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
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Ben Ghezala I, Mariet A, Benzenine E, Bron AM, Baudin F, Daien V, Korobelnik J, Quantin C, Creuzot‐Garcher C. Incidence of acute postoperative endophthalmitis following macular surgery in France between 2006 and 2016. Acta Ophthalmol 2020; 98:e333-e338. [PMID: 31680475 DOI: 10.1111/aos.14279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/26/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To report the incidence of acute postoperative endophthalmitis (POE) after macular surgery in France between 2006 and 2016 and to identify associated factors. METHODS This retrospective database study included all hospital discharge records involving a surgical procedure for an epiretinal membrane or a macular hole in France from January 2006 to October 2016. Acute POE was identified by two codes in the tenth edition of the International Classification of Diseases within 42 days of a macular surgical procedure in the French national administrative database. RESULTS In France, 152 034 macular surgical procedures for epiretinal membranes or macular holes were recorded from 1 January 2006 to 31 October 2016. Suspected acute POE was reported in 381 cases. The incidence of POE was 0.25% overall, 0.30% for epiretinal membrane surgery and 0.14% for macular hole surgery. In multivariable Poisson regression analysis, epiretinal membrane surgery was associated with POE [incidence rate ratio (IRR), 2.24; 95% CI, 1.62-3.11; p < 0.001]. For epiretinal membrane surgery, the 2010-2011 period was significantly associated with a higher risk of POE (IRR, 1.66; 95% CI, 1.13-2.42; p = 0.03). CONCLUSION The incidence of POE after macular surgery was 0.25% overall in France between 2006 and 2016 and twice higher for epiretinal membrane surgery than for macular hole surgery. For epiretinal surgery only, the incidence of POE was higher in 2010-2011 (period of the switch to transconjunctival vitrectomy) than in the rest of the study period.
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Affiliation(s)
- Inès Ben Ghezala
- Department of Ophthalmology Dijon University Hospital Dijon France
| | - Anne‐Sophie Mariet
- CIC 1432 Inserm Dijon France
- Clinical Epidemiology/Clinical Trials Unit Clinical Investigation Center Dijon University Hospital Dijon France
- Biostatistics and Bioinformatics (DIM) University Hospital Dijon France
- Bourgogne Franche‐Comté University Dijon France
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI) Inserm UVSQ Institut Pasteur Université Paris‐Saclay Paris France
| | - Eric Benzenine
- Biostatistics and Bioinformatics (DIM) University Hospital Dijon France
- Bourgogne Franche‐Comté University Dijon France
| | - Alain M. Bron
- Department of Ophthalmology Dijon University Hospital Dijon France
- Bourgogne Franche‐Comté University Dijon France
- Eye and Nutrition Research Group Bourgogne Franche‐Comté University Dijon France
| | - Florian Baudin
- Department of Ophthalmology Dijon University Hospital Dijon France
| | - Vincent Daien
- Department of Ophthalmology University Hospital of Montpellier Montpellier France
- Inserm, U1061 University of Montpellier Montpellier France
| | - Jean‐François Korobelnik
- Department of Ophthalmology University Hospital of Bordeaux Bordeaux France
- UMR 1219 Inserm Bordeaux Population Health Research Center Team LEHA University of Bordeaux Bordeaux France
| | - Catherine Quantin
- CIC 1432 Inserm Dijon France
- Clinical Epidemiology/Clinical Trials Unit Clinical Investigation Center Dijon University Hospital Dijon France
- Biostatistics and Bioinformatics (DIM) University Hospital Dijon France
- Bourgogne Franche‐Comté University Dijon France
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI) Inserm UVSQ Institut Pasteur Université Paris‐Saclay Paris France
| | - Catherine Creuzot‐Garcher
- Department of Ophthalmology Dijon University Hospital Dijon France
- Bourgogne Franche‐Comté University Dijon France
- Eye and Nutrition Research Group Bourgogne Franche‐Comté University Dijon France
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20
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Quinn NB, Steel DH, Chakravarthy U, Peto T, Hamill B, Muldrew A, Graham K, Elliott D, Hennessy R, Cruise S, McGuinness B, Young IS, Kee F, Hogg RE. Assessment of the Vitreomacular Interface Using High-Resolution OCT in a Population-Based Cohort Study of Older Adults. Ophthalmol Retina 2020; 4:801-813. [PMID: 32335034 DOI: 10.1016/j.oret.2020.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe the prevalence of vitreomacular interface (VMI) features and their associated risk factors in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) Study. DESIGN Cross-sectional population-based study. PARTICIPANTS Noninstitutionalized Northern Irish adults 40 years of age or older. METHODS Using geographic stratification, a representative sample of people in Northern Ireland was invited to participate in the NICOLA Study. SD OCT images of participants were graded for vitreomacular traction (VMT), macular hole (MH), and epiretinal membrane (ERM) according to the International Vitreomacular Traction Study Group. A subsample was graded in more detail to estimate the prevalence of VMA and VMA area detailing size and location of VMA. Descriptive analysis and risk factors for each VMI feature were determined using generalized estimating equations. Results were standardized to the Northern Ireland population census (2011). MAIN OUTCOME MEASURES Cohort profile, standardized prevalence, and risk factor associations of each VMI feature. RESULTS Three thousand three hundred fifty-one NICOLA participants had gradable SD OCT images available for at least 1 eye. The prevalence of VMT was 0.5% (CI, 0.31%-0.70%), that for MH was 0.3% (CI, 0.23%-0.52%), and that for ERM was 7.6% (CI, 7.0%-8.3%). A detailed VMA analysis was performed on a subsample consisting of the first 1481 participants. The prevalence of VMA was 22.6% (CI, 21.1-24.2), and VMA area ranged from 0.25 to 42.7 mm2 (mean, 12.53 mm2; standard deviation, 6.90 mm2). In multivariate analyses, increased age was associated with an increased odds ratio (OR) of VMT, MH, and ERM. VMA area was positively associated with younger age and normal blood pressure. ERM and MH were present more often in more myopic eyes, associated with an increase in levels of high-density lipoprotein (HDL) cholesterol and triglycerides. CONCLUSIONS The epidemiologic characteristics of VMI features indicated that VMI interactions throughout life are age dependent. Vitreous separation reduced to a greater extent in the horizontal meridians compared with the vertical, differing from previous studies. Future longitudinal studies of the evolution of these VMI changes over time would be of great interest.
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Affiliation(s)
- Nicola B Quinn
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - David H Steel
- Sunderland Eye Infirmary, Sunderland, United Kingdom, and Institute of Genetic Medicine, Newcastle University, Newcastle-Upon-Tyne, United Kingdom
| | - Usha Chakravarthy
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Barbra Hamill
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Alyson Muldrew
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Katie Graham
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - David Elliott
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Riona Hennessy
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Sharon Cruise
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | | | - Ian S Young
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ruth E Hogg
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
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21
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Abstract
PURPOSE To investigate whether age-related macular degeneration (AMD) has an influence on the prevalence and anatomical characteristics of lamellar macular holes (LMHs). METHODS Clinical records and spectral-domain optical coherence tomography images of 756 eyes of 423 consecutive patients diagnosed with AMD were reviewed and analyzed. Spectral-domain optical coherence tomography was used to identify degenerative or tractional LMH subtypes and assess their morphology. The clinical and optical coherence tomography findings of AMD eyes with LMH were compared with those of a control group of eyes with LMH without AMD from a previously published report. RESULTS Lamellar macular holes were identified in 25 eyes of 23 patients (3.3%; 25 of 756). Seventeen of 25 eyes (68%) presented with degenerative LMH and underlying late neovascular AMD. Mean best-corrected visual acuity was worse in eyes with AMD and LMH eyes than in those with AMD and no LMH (20/230 vs. 20/98; P = 0.02). The mean outer diameter was greater in the group with degenerative LMH with concomitant AMD than in the control group of degenerative LMH without AMD (1,323.9 ± 999.1 µm vs. 905.9 ± 356.8 µm, respectively; P = 0.01). CONCLUSION The incidence of degenerative LMH increased in advanced forms of AMD, whereas the presence of tractional LMH subtype may be unrelated to AMD evolution.
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Guixeres Esteve MC, Postelmans L. Central perpendicular line in macular spectral-domain optical coherence tomography in five eyes. Eur J Ophthalmol 2019; 30:NP16-NP22. [PMID: 30866678 DOI: 10.1177/1120672119834476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of this study is to report a rare spectral-domain optical coherence tomography finding in the macula. METHODS This is a descriptive consecutive case series. Patients diagnosed with hyperreflective central perpendicular line in the macular spectral-domain optical coherence tomography were included. Best-corrected visual acuity assessment, standard Amsler grid test, biomicroscopic examination and macular spectral-domain optical coherence tomography were performed. RESULTS We examined three men and one woman, aged 56 to 91 years (average age: 75.25 years). Spectral-domain optical coherence tomography showed a hyperreflective central perpendicular line in five eyes accompanied by vitreofoveal adhesion in all of them. In two eyes, we observed a lifting of the ellipsoid zone, and in one eye the external limiting membrane was also pulled. In one eye, a subtle lifting of the interdigitation zone was revealed. In another eye, we also found a triangular foveolar detachment of the interdigitation zone. Snellen's best-corrected visual acuity ranged from 0.2 to -0.1 logMAR (average of 0.006 logMAR). Amsler grid test was unremarkable in four eyes and metamorphopsia was detected in one eye. One eye developed a full-thickness macular hole several weeks after the phacoemulsification cataract surgery. CONCLUSION The presence of a central perpendicular line can be revealed by the macular spectral-domain optical coherence tomography. We hypothesize that this finding could be considered as a sign of vitreomacular traction. In our patients, best-corrected visual acuity was only mildly reduced, and Amsler grid test was affected in only one eye.
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Affiliation(s)
| | - Laurence Postelmans
- Department of Ophthalmology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Menzler J, Neubauer AS, Haritoglou C, Jackson TL. Incidence and prevalence of vitreomacular traction with and without macular hole in Germany. Clin Ophthalmol 2019; 13:177-188. [PMID: 30697035 PMCID: PMC6339449 DOI: 10.2147/opth.s188704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Symptomatic vitreomacular adhesion (sVMA) comprises vitreomacular traction (VMT) and stage 1 and 2 full-thickness macular holes (MHs) associated with vitreomacular adhesion (VMA). We aimed to estimate the incidence and prevalence of sVMA in Germany. MATERIALS AND METHODS A systematic literature review was conducted to identify the incidence and prevalence of sVMA based on international epidemiologic studies, weighted for study size and then averaged across eligible studies. A second systematic review aimed to estimate the proportion of vitrectomy undertaken for sVMA in Germany. This was combined with the reported number of vitrectomies in Germany in 2016 to estimate the number of patients undergoing vitrectomy for sVMA. RESULTS The prevalence of sVMA is 1,365 per 100,000 population, with an incidence of 6.96 per 100,000 per year. For Germany, this translates to 1,119,300 cases, with 5,700 new cases reported annually. Analyzing the national hospital statistics, ~2,300 patients undergo vitrectomy due to sVMA in Germany each year, of which about 1,700 patients have VMT. CONCLUSION Incidence figures, driven by patients presenting to clinic, are much lower than expected based on population-based studies, suggesting that many patients with sVMA exist outside of the clinic system.
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Affiliation(s)
- Jacob Menzler
- Institute for Health- and Pharmacoeconomics/Neubauer Consult, Munich, Germany,
| | - Aljoscha Steffen Neubauer
- Institute for Health- and Pharmacoeconomics/Neubauer Consult, Munich, Germany,
- Private practice, Munich, Germany
| | | | - Timothy L Jackson
- Department of Ophthalmology, Faculty of Life Course Sciences and Medicine, King's College London, London, UK
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24
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Frisina R, Pilotto E, Midena E. Lamellar Macular Hole: State of the Art. Ophthalmic Res 2019; 61:73-82. [PMID: 30625477 DOI: 10.1159/000494687] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/19/2018] [Indexed: 11/19/2022]
Abstract
Lamellar macular hole (LMH) is a vitreoretinal disorder characterized by an irregular foveal contour, a break in the inner fovea, dehiscence of the inner foveal retina from the outer retina, and the absence of a full-thickness foveal defect with intact foveal photoreceptors. The pathogenesis is only partially known. The advent of high-resolution optical coherence tomography has allowed distinguishing between two types of epiretinal membrane (ERM) associated with LMH: a conventional ERM (commonly found in macular pucker) and an atypical ERM (known by varied names: dense, epiretinal proliferation, or degenerative). These two types of ERM not only influence LMH morphology but also differ in cell and collagen composition. It remains unclear if these two types are indeed two distinct clinical entities or rather two stages of the same macular disorder. Studies of the natural evolution of LMH have not fully resolved this issue and also offered variable results. Surgical treatment leads to excellent anatomical and functional outcomes, but not without risks. This review provides a critical summary of the available data on LMH including some new insights.
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Affiliation(s)
- Rino Frisina
- Department of Ophthalmology, University of Padua, Padua, Italy,
| | | | - Edoardo Midena
- Department of Ophthalmology, University of Padua, Padua, Italy
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