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Takabatake R, Takahashi M. Impact of posterior vitreous detachment on visual acuity after the implantation of a diffractive multifocal intraocular lens. J Cataract Refract Surg 2024; 50:339-344. [PMID: 37937973 DOI: 10.1097/j.jcrs.0000000000001360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/30/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To investigate the effect of posterior vitreous detachment (PVD) on visual acuity (VA) after implantation of a diffractive multifocal intraocular lens (mIOL). SETTING Eye Clinic, Okayama, Japan. DESIGN Retrospective case series. METHODS This study evaluated 475 eyes of 475 patients who underwent cataract surgery with a TECNIS Multifocal ZLB00 lens implant between November 2017 and October 2019. Patient eyes were classified into the complete PVD group (PVD group) or the control group with no PVD/partial PVD (non-PVD group) and divided into 3 age categories: 65 to 69, 70 to 74, and 75 to 79 years. The postoperative VA of the PVD and non-PVD groups was compared between and within groups by age. RESULTS Distance-corrected near VA (DCNVA) was significantly worse in the PVD group than in the non-PVD group in all age categories ( P ≤ .029). In the PVD group, both corrected distance VA (CDVA) and DCNVA were significantly worse in the 75 to 79 years age group than in the 65 to 69 and 70 to 74 years age groups ( P ≤ .034). CDVA and DCNVA in the non-PVD group did not differ significantly between age categories. CONCLUSIONS The results of this study suggest that complete PVD worsens near VA in eyes with a diffractive mIOL. Furthermore, eyes with complete PVD may show an age-related decline in both CDVA and DCNVA. In particular, eyes ≥75 years of age with complete PVD have a poor visual prognosis and should be given careful consideration when deciding whether to implant a diffractive mIOL.
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Affiliation(s)
- Ryu Takabatake
- From the Takabatake West Eye Clinic, Okayama City, Okayama, Japan
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Zvorničanin J, Zvorničanin E, Popović M. Accuracy of biomicroscopy, ultrasonography and spectral-domain OCT in detection of complete posterior vitreous detachment. BMC Ophthalmol 2023; 23:488. [PMID: 38017434 PMCID: PMC10685579 DOI: 10.1186/s12886-023-03233-4] [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: 06/16/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND To evaluate the accuracy of preoperative biomicroscopy (BM), ultrasonography (US), and spectral domain optical coherence tomography (SD-OCT) to determine complete posterior vitreous detachment (PVD) confirmed by intraoperative findings of triamcinolone acetonide-assisted pars plana vitrectomy (PPV). METHODS This prospective study included all consecutive patients admitted for surgical treatment of the epiretinal membrane (ERM) and macular hole (MH). The presence of complete PVD was determined one day before PPV using BM, US, SD-OCT. The preoperative findings were compared to the PVD status determined during PPV. RESULTS A total of 123 eyes from 123 patients were included in the study. Indications for PPV included ERM in 57 (46.3%), full thickness macular hole in 57 (46.3%) and lamellar macular hole in 9 (7.3%) patients. Complete PVD during PPV was observed in 18 (31.6%; 95%CI:18.7-49.9) patients with ERM and 13 (19.7%; 95%CI:10.4-33.7) patients with MH. The sensitivity of preoperative BM, US, SD-OCT was 48.4% (95%CI:30.2-66.9), 61.3% (95%CI:42.2-78.2) and 54.8% (95%CI:36.0-72.7) respectively. The specificity of preoperative BM, US, SD-OCT was 81.5% (95%CI:72.1-88.9), 90.2% (95%CI:82.2-95.4) and 85.9% (95%CI:77.0-92.3) respectively. With a prevalence of 25.2% of PVD in our sample the positive predictive value of preoperative BM, US, SD-OCT was 46.9% (95%CI:29.1-65.3), 67.9% (95%CI:47.6-84.1) and 56.7% (95%CI:37.4-74.5) respectively. CONCLUSION Preoperative BM, US, and SD-OCT showed relatively low sensitivity but also good specificity in assessing complete PVD. A combination of all three diagnostic methods can provide a good assessment of the vitreoretinal interface state.
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Affiliation(s)
- Jasmin Zvorničanin
- Department of Ophthalmology, University Clinical Centre Tuzla, 75000, Tuzla, Bosnia and Herzegovina.
- Faculty of Health Studies, University of Bihać, 77000, Bihać, Bosnia and Herzegovina.
| | - Edita Zvorničanin
- Private Healthcare Institution "Vase Zdravlje", 75000, Tuzla, Bosnia and Herzegovina
| | - Maja Popović
- Department of Medical Sciences, Cancer Epidemiology Unit, University of Turin and CPO-Piemonte, 10125, Turin, Italy
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Maggio E, Maraone G, Mete M, Vingolo EM, Grenga PL, Guerriero M, Pertile G. The prevalence of vitreomacular adhesion in eyes with macular oedema secondary to retinal vein occlusion selected for intravitreal injections. Acta Ophthalmol 2021; 99:e1154-e1161. [PMID: 33421346 DOI: 10.1111/aos.14746] [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: 05/22/2020] [Revised: 11/21/2020] [Accepted: 11/29/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the prevalence of vitreomacular adhesion (VMA) in consecutive naïve eyes diagnosed with macular oedema (ME) secondary to retinal vein occlusion (RVO) and to longitudinally evaluate the incidence of vitreomacular interface changes over time and the influence on response to treatment. DESIGN Retrospective cross-sectional analysis and longitudinal cohort study conducted at two Italian tertiary referral centres. METHODS A total of 295 eyes, treated with intravitreal ranibizumab and/or dexamethasone for ME secondary to RVO between June 2008 and May 2018, were enrolled in the study. 280 fellow eyes met the inclusion criteria and were included as control group. The vitreomacular interface status was evaluated by spectral domain optical coherence tomography (OCT) and graded according to the OCT-based International Classification System developed by the International Vitreomacular Traction Study (IVTS) group. RESULTS At baseline, VMA was present in 130 (44.07%) RVO eyes and 142 (50.7%) control eyes (no statistically significant difference was found; p = 0.455). Mean follow-up (FU) was 35.98 months (min 6 - max 112). Throughout the FU, the incidence of spontaneous release of VMA (RVMA) in RVO eyes was significantly higher in comparison with that of the control group [59 (41.84%) RVO eyes versus 18 (12.33%) control eyes; p < 0.0001]. The number of injections in VMA+ eyes was significantly higher when compared with VMA- eyes. No significant difference was found between VMA+ and VMA- eyes regarding their mean best-corrected visual acuity (BCVA) at baseline and at each annual time point (p = 0.2). Differences in central macular thickness (CMT) were significant only at the baseline evaluation (p = 0.0303). CONCLUSIONS Vitreomacular adhesion (VMA) was not found to be more prevalent in eyes with RVO compared to healthy fellow eyes, and RVO, in turn, did not result in a higher persistence of VMA over time. This suggests that VMA and RVO might be two independent retinal phenomena, with no mutual pathogenetic influence. Vitreomacular adhesion (VMA) might have an impact on the response to treatment, since it was found to result in a more intensive treatment regimen; however, it did not affect visual and anatomic outcomes. These results do not support vitrectomy or PVD induction in the prevention, nor the treatment, of RVO.
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Affiliation(s)
- Emilia Maggio
- IRCCS Sacro Cuore Don Calabria Hospital Verona Italy
| | | | - Maurizio Mete
- IRCCS Sacro Cuore Don Calabria Hospital Verona Italy
| | - Enzo Maria Vingolo
- Polo Pontino UOC Ophthalmology Sapienza University of Rome Terracina Italy
| | - Pier Luigi Grenga
- Polo Pontino UOC Ophthalmology Sapienza University of Rome Terracina Italy
| | - Massimo Guerriero
- IRCCS Sacro Cuore Don Calabria Hospital Verona Italy
- Department Computer Science University of Verona Verona Italy
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Albabtain B, Mura M, Schatz P, Alsulaiman SM, Alsakran WA, Semidey VA. Comparison of Posterior Hyaloid Assessment Using Preoperative Optical Coherence Tomography and Intraoperative Triamcinolone Acetonide Staining During Vitrectomy. Clin Ophthalmol 2021; 15:3939-3945. [PMID: 34616138 PMCID: PMC8488048 DOI: 10.2147/opth.s331700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/16/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the specificity of diagnosing posterior vitreous detachment (PVD) using preoperative optical coherence tomography (OCT) versus intraoperative triamcinolone acetonide (TA) staining in patients undergoing vitrectomy. Patients and Methods This retrospective cohort study included patients undergoing pars plana vitrectomy for diverse retinal pathologies. Intraoperatively, surgeons evaluated the posterior hyaloid status with TA staining and compared it with preoperative OCT findings. Results One hundred six patients underwent intraoperative assessments of posterior hyaloid status, with 72% (76/106) of the eyes showing positive staining. Sixty-two patients had also undergone preoperative OCT. Of the patients diagnosed with PVD on preoperative OCT, 50% (15/30) showed positive TA staining intraoperatively. The sensitivity of preoperative OCT assessment was 83.3%, and its specificity was 65.9%. Conclusion Preoperative OCT imaging is associated with lower sensitivity and specificity for diagnosing PVD when compared to intraoperative TA staining.
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Affiliation(s)
- Budoor Albabtain
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology, Prince Sultan Medical Military City, Riyadh, Saudi Arabia
| | - Marco Mura
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Patrik Schatz
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology, Clinical Sciences, Skane County University Hospital, Lund University, Lund, Sweden
| | | | - Wael A Alsakran
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Valmore A Semidey
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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5
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Stavrakas P, Christou EE, Ananikas K, Tsiogka A, Tranos P, Theodossiadis P, Stefaniotou M, Chatziralli I. Sensitivity of spectral domain optical coherence tomography in the diagnosis of posterior vitreous detachment in vitreomacular interface disorders: A prospective cohort study. Eur J Ophthalmol 2021; 32:11206721211020644. [PMID: 34058907 DOI: 10.1177/11206721211020644] [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: 11/15/2022]
Abstract
PURPOSE To evaluate the sensitivity of Spectral Domain Optical Coherence Tomography (SD-OCT) regarding the diagnosis of posterior vitreous detachment (PVD) in vitreomacular interface disorders (VID). METHODS A total of 48 eyes of 48 patients were included in this prospective cohort study. PVD in eyes with VID was investigated. We determined the status of posterior vitreous cortex using slit lamp (SL) biomicroscopy and SD-OCT preoperatively, during vitrectomy and on the intraoperative video recording. Sensitivity and specificity of the examining methods were analysed. Four masked independent examiners participated in this study. RESULTS PVD was diagnosed in 16 eyes (33.3%) on SD-OCT, 20 eyes (41.7%) on SL examination and 28 eyes (58.3%) during vitrectomy. Sensitivity and specificity for diagnosis of PVD was 37.5% and 31.3% using SD-OCT, 90% and 64.3% on the SL examination, 92.9% and 90% on the video recording respectively, compared to the intraoperative PVD diagnosis. CONCLUSION SD-OCT shows a relatively low detection sensitivity of PVD in VID. Thorough OCT investigation is necessary to establish an appropriate diagnosis of PVD and treatment in VID.
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Affiliation(s)
| | | | - Konstantinos Ananikas
- Second Department of Ophthalmology, University of Athens Medical School, Athens, Greece
| | | | | | | | | | - Irini Chatziralli
- Second Department of Ophthalmology, University of Athens Medical School, Athens, Greece
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The Effect of the Idiopathic Epiretinal Membrane and Surgically Induced Posterior Vitreous Detachment on the Retinal Nerve Fiber Layer. J Ophthalmol 2021; 2020:5217645. [PMID: 33824761 PMCID: PMC8006755 DOI: 10.1155/2020/5217645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 12/01/2022] Open
Abstract
Aim To investigate the changes in the retinal nerve fiber layer (RNFL) following pars plana vitrectomy (PPV) with surgically induced posterior vitreous detachment (PVD) and idiopathic epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling. Methods Patients with unilateral ERM with vitreomacular traction were included in this prospective, randomized, and controlled clinical trial. The control group (Group 1) was formed with the nonoperated fellow eyes of the patients, and the study group (Group 2) was formed with the eyes that underwent PPV including idiopathic ERM and ILM peeling. In the preoperative and postoperative periods (1st, 2nd, 3rd, 6th, and 12th months), complete ophthalmological examination of the eyes was performed and RNFL measurements were examined in 4 different quadrants (superior, temporal, inferior, and nasal) with the help of spectral domain optical coherence tomography (OCT). Results There was no statistically significant change in Group 1 during the follow-up period in all quadrants (p > 0.05). The mean RNFL thickness in Group 2 was statistically significantly higher than in Group 1 in superior, inferior, and temporal quadrants (p < 0.01), preoperatively. The mean RNFL in Group 2 was higher in the 1st, 2nd, 3rd, and 6th months and lower in the 12th month in superior, inferior, and temporal quadrants (p < 0.01) when compared to the preoperative period. The mean RNFL thickness in the nasal quadrant in Group 2 was higher in the 1st, 2nd, and 3rd (p < 0.01) months, same in the 6th month (p > 0.05), and lower in the 12th (p < 0.01) month when compared to the preoperative period. Conclusion Idiopathic ERM may cause an increase in RNFL thickness in superior, inferior, and temporal quadrants with possible tractional effect. PPV with PVD induction and ERM and ILM peeling may cause these RNFL changes.
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Wang MD, Truong C, Mammo Z, Hussnain SA, Chen RWS. Swept Source Optical Coherence Tomography Compared to Ultrasound and Biomicroscopy for Diagnosis of Posterior Vitreous Detachment. Clin Ophthalmol 2021; 15:507-512. [PMID: 33603328 PMCID: PMC7886381 DOI: 10.2147/opth.s297307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/19/2021] [Indexed: 11/29/2022] Open
Abstract
Background Biomicroscopy, B-scan ultrasound imaging, and SD-OCT are all modalities used to characterize a posterior vitreous detachment (PVD). Our objective is to assess the precision of the diagnosis of PVD by SS-OCT. Methods This prospective observational study examines ninety-five eyes of forty-nine patients with biomicroscopy, B-scan ultrasound, and SS-OCT for the presence or absence of a complete PVD. All SS-OCT images were reviewed by two retina specialists (RWSC, ZM). All three diagnostic methods were evaluated for agreement by Cohen’s kappa statistic. Results The inter-rater reliability between retina specialists reading the SS-OCT images was 97.9% (κ = 0.957). Agreement on PVD status between SS-OCT and biomicroscopy was 85.3% (κ = 0.711). Agreement between SS-OCT and B-scan ultrasound was 83.2% (κ = 0.667). Agreement between B-scan ultrasound and biomicroscopy was 87.4% (κ = 0.743). Conclusion For the diagnosis of complete PVD, SS-OCT allows for high accuracy and agreement between graders.
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Affiliation(s)
- Marlene D Wang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Cecile Truong
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Zaid Mammo
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Syed Amal Hussnain
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Royce W S Chen
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, 10032, USA
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Chaudhury M, Parida B, Panigrahi SK. Diagnostic accuracy of B scan ultrasonography for posterior segment eye disorders in a tertiary care setting in Eastern India.. [DOI: 10.1101/2020.08.13.20173898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
Abstract
AbstractIntroductionOphthalmic ultrasound (USG) produces real time high resolution images of the eye and orbit. It can categorize and predict the location of pathology in the posterior chamber of eye very well. It is useful even in pre-operative evaluation and diagnosing posterior segment eye disorders. However, the diagnostic accuracy has usually not being studied thoroughly, with special emphasis to its probability of predicting posterior-segment eye disorders using B-scan USG.ObjectivesTo find out the prevalence and pattern of posterior segment disorders using B-scan ultrasonography, and to find its diagnostic accuracy.Materials and MethodsThe study was prospective in nature and conducted in the department of radiodiagnosis and ophthalmology of a tertiary care center of Eastern India. Patients referred to the radiology department for ruling out intra-ocular pathology using B-scan ophthalmic ultrasound were included in the study, irrespective of any age and gender. Data were captured on an excel sheet and analyzed using Stata 12.1 SE.ResultsThe mean age of 84 study participants was 37.4 ± 19.5 years, with maximum in between 40-50 years. Males were more (72.6%). 50% presented with low vision, and most commonly associated with cataract (45%). Prevalence of posterior segment eye disorders was 13.1%. Sensitivity and negative predictive values were 100%. Post-test probability was 95.5%. Accuracy was however very less (39.3%).ConclusionUsing B-scan ultrasonography for pre-operative assessment and confirmation of diagnosis increases the probability of detecting presence or absence of posterior segment pathology. Absence of posterior segment disorder using this is also very helpful in ruling out disease entirely. It also a very high sensitivity and hence can be used even in rural health centers.
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Kim JH, Kim JW, Kim CG, Lee DW. Long-term natural history of the idiopathic epiretinal membrane in children and young adults. Graefes Arch Clin Exp Ophthalmol 2020; 258:2141-2150. [PMID: 32524241 DOI: 10.1007/s00417-020-04787-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the natural history of the idiopathic epiretinal membrane (ERM) in children and young adults. METHODS This retrospective study included 52 patients younger than 40 years who had been diagnosed with idiopathic ERM. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) measured at diagnosis were compared with those at the final visit. Incidence and factors predictive of the spontaneous release of ERM were additionally investigated. Moreover, the proportion of eyes that eventually underwent surgery was identified. RESULTS The mean age of the patients was 32.5 ± 6.7 years, and the mean follow-up duration was 34.5 ± 23.4 months. The mean logarithm of the minimal angle of resolution BCVA (0.05 ± 0.10, Snellen equivalents = 20/22) and CRT (340.6 ± 61.6 μm) at diagnosis were not different from BCVA (0.06 ± 0.10, 20/23) (P = 0.928) and CRT (326.6 ± 70.8 μm) (P = 0.079) at the final follow-up. Two lines or greater deterioration in the BCVA was noted in 2 eyes (3.8%). Spontaneous release of ERM was noted in 14 eyes (26.9%). The release of ERM was more frequently noted in eyes without cystoid intraretinal edema or retinoschisis (P = 0.020) or eyes with loss of foveal concavity at diagnosis (P = 0.008). During the follow-up period, 5 eyes (9.6%) underwent surgery. CONCLUSIONS The natural history of the idiopathic ERM in children and young adults was generally favorable with definite deterioration in visual acuity noted only in a limited proportion of patients. Baseline retinal morphology may be predictive of the spontaneous release of ERM.
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Affiliation(s)
- Jae Hui Kim
- Department of Ophthalmology, Kim's Eye Hospital, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea.
| | - Jong Woo Kim
- Department of Ophthalmology, Kim's Eye Hospital, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea
| | - Chul Gu Kim
- Department of Ophthalmology, Kim's Eye Hospital, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea
| | - Dong Won Lee
- Department of Ophthalmology, Kim's Eye Hospital, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea
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Xu J, Zhao M, Li JP, Liu NP. Ghost cell glaucoma after intravitreous injection of ranibizumab in proliferative diabetic retinopathy. BMC Ophthalmol 2020; 20:149. [PMID: 32295566 PMCID: PMC7161240 DOI: 10.1186/s12886-020-01422-z] [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: 07/13/2019] [Accepted: 04/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background The development of ghost cell glaucoma in patients with proliferative diabetic retinopathy (PDR) after intravitreous injection (IV) was rare. Here we reported a series of patients with PDR who received Intravitreous Ranibizumab (IVR) and developed ghost cell glaucoma and analyzed the potential factors that might be related to the development of ghost cell glaucoma. Methods Retrospective case series study. The medical records of 71 consecutive eyes of 68 PDR patients who received vitrectomy after IVR from January 2015 to January 2017 were reviewed. The development of ghost cell glaucoma after IVR was recorded. Characteristics of enrolled patients were retrieved from their medical charts. Factors associated with ghost cell glaucoma were compared between eyes with the development of ghost cell glaucoma and eyes without the development of ghost cell glaucoma. Variables were further enrolled in a binary backward stepwise logistic regression model, and the model that had the lowest AIC was chosen. Results There were 8 out of 71 eyes of the PDR patients developed ghost cell glaucoma after they received IVR. The interval between detection of elevation of intraocular pressure (IOP) and IV ranged from 0 to 2 days. Among them, after IVR, there were two eyes had IOP greater than 30 mmHg within 30 min, four eyes showed normal IOP at 30 min, and then developed ghost cell glaucoma within 1 day, two eyes developed ghost cell glaucoma between 24 and 48 h. The mean IOP was 46.5 ± 8.0 mmHg. All patients gained normal IOP after vitrectomy without medicine for lowering IOP. The presence of ghost cell glaucoma was associated with tractional retinal detachment (RR = 4.60 [2.02 ~ 8.48], p = 0.004) and fibrovascular membrane involving disk (RR = -3.57 [− 7.59 ~ − 0.92], p = 0.03) (AIC = 39.23, AUC = 0.88) in a logistic regression model. Conclusion Attention to postoperative IOP should be paid to patients with PDR undergoing vitrectomy who receive a preoperative IV of anti-VEGF agents. PDR patients with tractional retinal detachment or fibrovasucular membrane involving optic disc are more likely to develop ghost cell glaucoma after IV.
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Affiliation(s)
- Jun Xu
- Address: Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, No1. Dongjiaominxiang street, Dongcheng District, Beijing, 100730, China
| | - Meng Zhao
- Address: Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, No1. Dongjiaominxiang street, Dongcheng District, Beijing, 100730, China.
| | - Ji Peng Li
- Address: Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, No1. Dongjiaominxiang street, Dongcheng District, Beijing, 100730, China
| | - Ning Pu Liu
- Address: Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, No1. Dongjiaominxiang street, Dongcheng District, Beijing, 100730, China
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Moon SY, Park SP, Kim Y. Evaluation of posterior vitreous detachment using ultrasonography and optical coherence tomography. Acta Ophthalmol 2020; 98:e29-e35. [PMID: 31301107 DOI: 10.1111/aos.14189] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/23/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To compare the diagnostic ability of ultrasonography (US) and optical coherence tomography (OCT) in evaluating posterior vitreous detachment (PVD) status. METHODS In total, 124 eyes in 63 patients were prospectively enrolled. Posterior vitreous detachment (PVD) status was evaluated by two examiners independently using US and OCT (transverse scan with/without peripapillary scan). By combining all examination results from both examiners, a final agreement on the PVD status was made. Inter-observer agreement and inter-examination agreement on PVD detection were evaluated. RESULTS The inter-observer agreement on PVD grading based on US was substantial (kappa = 0.628). The inter-observer agreement on PVD grading based on OCT was almost perfect (transverse and peripapillary scan, kappa = 0.893; transverse scan only, kappa = 0.923). The PVD grading based on transverse and peripapillary OCT perfectly matched the final PVD grading (kappa = 1.00). The PVD grading made based on US and transverse scan only showed almost perfect agreement with the final PVD grading (US, kappa = 0.834; transverse scan only, kappa = 0.906). CONCLUSION Both US and OCT could accurately evaluate PVD. The interpretation of the US images was more subjective, leading to lower inter-examiner agreement than that of the OCT. By adding peripapillary OCT scan images, the diagnostic ability of OCT was improved.
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Affiliation(s)
- Su Young Moon
- Department of Ophthalmology Hallym University College of Medicine Kangdong Sacred Heart Hospital Seoul South Korea
| | - Sung Pyo Park
- Department of Ophthalmology Hallym University College of Medicine Kangdong Sacred Heart Hospital Seoul South Korea
| | - Yong‐Kyu Kim
- Department of Ophthalmology Hallym University College of Medicine Kangdong Sacred Heart Hospital Seoul South Korea
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12
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Abraham JR, Ehlers JP. Posterior Vitreous Detachment: Methods for Detection. ACTA ACUST UNITED AC 2020; 4:119-121. [DOI: 10.1016/j.oret.2019.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/15/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022]
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Accuracy of Spectral-Domain OCT of the Macula for Detection of Complete Posterior Vitreous Detachment. Ophthalmol Retina 2019; 4:148-153. [PMID: 31864940 DOI: 10.1016/j.oret.2019.10.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/19/2019] [Accepted: 10/24/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE To assess the accuracy of macular spectral-domain OCT in detecting complete posterior vitreous detachment (PVD). DESIGN Evaluation of diagnostic test or technology using a retrospective comparative study. PARTICIPANTS One hundred seventy-five eyes in 175 patients (111 women and 64 men; mean age, 65 years) with preoperative OCT within 90 days of vitrectomy. METHODS Posterior vitreous detachment status on preoperative macular OCT was compared with PVD determination during vitrectomy. Attached vitreous was identified on OCT by visualizing the posterior vitreous cortex or premacular bursa. Complete PVD was identified by the absence of these findings and considered a positive outcome for the purpose of analysis. MAIN OUTCOME MEASURES Sensitivity, specificity, positive predictive value, and negative predictive value of macular OCT for detection of complete PVD compared with findings at surgery. RESULTS Of the 38 eyes graded as showing complete PVD on OCT, 20 eyes were found to have pre-existing PVD at the time of surgery (true-positive results), and 18 eyes were found to have attached vitreous at the time of surgery (false-positive results). Of the 137 eyes graded as showing attached vitreous on OCT, 129 eyes had attached vitreous at the time of surgery (true-negative results), and 8 eyes had pre-existing PVD at the time of surgery (false-negative results). The sensitivity of OCT for detecting complete PVD was 71% and the specificity was 88%. In the study population, the positive predictive value of an OCT scan showing complete PVD was 53%, whereas the negative predictive value of an OCT scan showing attached vitreous was 94%. CONCLUSIONS If the premacular bursa or posterior vitreous cortex are visualized on macular OCT, an accurate determination of attached vitreous can be made. The diagnosis of complete PVD by macular OCT is less accurate and requires ultrasound.
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Anderson W, Piggott K, Bao YK, Pham H, Kavali S, Rajagopal R. Complete Posterior Vitreous Detachment Reduces the Need for Treatment of Diabetic Macular Edema. Ophthalmic Surg Lasers Imaging Retina 2019; 50:e266-e273. [PMID: 31755977 PMCID: PMC7941753 DOI: 10.3928/23258160-20191031-13] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 03/22/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the vitreomacular interface and its relation to treatment burden for diabetic macular edema (DME) in patients without overt vitreomacular traction (VMT). PATIENTS AND METHODS A retrospective cohort study of 494 eyes from 274 patients who had macular spectral-domain optical coherence tomography (SD-OCT) and did not have proliferative diabetic retinopathy, DME, or VMT at the initial visit. Posterior vitreous detachment (PVD) was categorized at the initial visit into five stages (0-4) using SD-OCT parameters alone. RESULTS Two of 34 eyes (6.9%) presenting with a complete PVD required DME treatment during follow-up, whereas 144 of 460 eyes (31.3%) without a complete PVD at baseline required treatment (P = .001, Chi-squared). After adjusting for age, ethnicity, gender, and HbA1c, complete PVD at baseline was associated with a significant reduction in risk of DME therapy (hazard ratio: 0.18; 95% confidence interval, 0.05-0.73; P = .02). CONCLUSION Complete PVD is independently associated with a reduced need for DME treatment. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e266-e273.].
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Affiliation(s)
- William Anderson
- Department of Ophthalmology, Saint Louis University School of Medicine, Saint Louis, MO 63104 (WA, HP, SK)
| | - Kisha Piggott
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Saint Louis, MO 63110 (KP, RR)
| | - Yicheng K. Bao
- Department of Medicine, University of Missouri – Kansas City School of Medicine, Kansas City, MO 64112 (YKB)
| | - Hang Pham
- Department of Ophthalmology, Saint Louis University School of Medicine, Saint Louis, MO 63104 (WA, HP, SK)
| | - Sweta Kavali
- Department of Ophthalmology, Saint Louis University School of Medicine, Saint Louis, MO 63104 (WA, HP, SK)
| | - Rithwick Rajagopal
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Saint Louis, MO 63110 (KP, RR)
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Zhao M, Yu Y, Liu W. Vitreous Biopsy Under Air: Technique, Complications, and Volume Outcomes. Ophthalmic Surg Lasers Imaging Retina 2019; 50:365-370. [PMID: 31233153 DOI: 10.3928/23258160-20190605-04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 01/17/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Classic vitreous biopsy, which targets the vitreous with an undiluted sample of 1 mL to 2 mL, has been used as a diagnostic analysis. Vitrectomy under air infusions have been reported to be able to extract more vitreous sample. In this study, the authors introduce a way of obtaining vitreous sample under air irrigation using 23-gauge vitrectomy and discuss the benefits and potential risks of this procedure. PATIENTS AND METHODS In this retrospective case series study, a total of 65 eyes of 65 patients with macular epiretinal membrane (ERM) or macular hole (MH) were enrolled. A vitreous biopsy was carried out with air infusion. Vitrectomy with fluid infusion was then carried out to remove the residual vitreous. Medical records of patients with macular ERM or MH were reviewed and analyzed. Clinical data, including age, sex, best-corrected visual acuity (BCVA), optical coherence tomography (OCT), axial length, presence of posterior vitreous detachment (PVD), presence of liquefication of vitreous, and refraction, were recorded and investigated. The volume of vitreous sample, visual outcome, and complications related to vitreous biopsy at 1-month follow-up were recorded and analyzed. RESULTS The mean of undiluted vitreous sample volume was 2.1 mL ± 0.2 mL. There were seven patients whose vitreous samples were less than 2 mL during the vitreous biopsy. The mean age of patients was 62.9 years ± 8.4 years (range: 35 years to 85 years) at diagnosis. There were 18 male and 47 female patients. At 1-month follow-up, no patient had decreased visual acuity. There was one patient who had a peripheral retinal break and was treated with photocoagulation during the operation (1.5%). The insufficient vitreous sample that may occur during the vitreous biopsy under air infusion was related to liquefication of vitreous (28.8%). CONCLUSION In summary, vitreous biopsy with air infusion is a safe and effective maneuver to harvest undiluted vitreous in patients without significant vitreous inflammation. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:365-370.].
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Neudorfer M, Fuhrer AE, Zur D, Barak A. The role of posterior vitreous detachment on the efficacy of anti-vascular endothelial growth factor intravitreal injection for treatment of neovascular age-related macular degeneration. Indian J Ophthalmol 2018; 66:1802-1807. [PMID: 30451182 PMCID: PMC6256908 DOI: 10.4103/ijo.ijo_373_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose: A prospective cohort study investigating the effect of posterior vitreous detachment (PVD) on the efficacy of intravitreal bevacizumab for exudative age-related macular degeneration (AMD), in view of evidence that the vitreoretinal interface impacts the severity of the disease. Methods: Treatment-naïve AMD eyes with (+) complete PVD and without (−) PVD on ultrasonography received three monthly and then pro re nata bevacizumab injections. Best-corrected visual acuity (BCVA) on Snellen charts and optical coherence tomography (OCT) findings were recorded for 12 months. Secondary analysis included PVD definition and group allocation according to OCT baseline scan. Results: Forty-one eyes of 34 patients met the inclusion criteria. At 12 months, median BCVA improved by 0.12 logMAR in the PVD+ group [interquartile range (IQR) −0.52, 0.03, P = 0.140] and remained the same in the PVD− group (IQR −0.12, 0.15, P = 0.643). Median central retinal thickness improved by 43.5 μm and 43 μm in the PVD+ (IQR −143, 3, P = 0.016) and PVD− group (IQR −90, −14, P = 0.008), respectively. All parameters were similar in the two groups at final follow up (P > 0.05). The secondary analysis included 32 eyes of 26 patients and showed no significant differences between the groups at the 12 months endpoint (P > 0.05). Conclusion: Our findings show no significant impact of PVD as assessed by ultrasound or by OCT on visual and anatomical outcomes in exudative AMD treated with bevacizumab.
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Affiliation(s)
- Meira Neudorfer
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Audelia Eshel Fuhrer
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Dinah Zur
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Adiel Barak
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel
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Seyhan Karatepe A, Menteş J, Erakgün ET, Afrashi F, Nalçacı S, Akkın C, Ateş Y. Vitreoretinal Interface Characteristics in Eyes with Idiopathic Macular Holes: Qualitative and Quantitative Analysis. Turk J Ophthalmol 2018; 48:70-74. [PMID: 29755819 PMCID: PMC5938479 DOI: 10.4274/tjo.23327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/29/2017] [Indexed: 12/01/2022] Open
Abstract
Objectives To determine the qualitative and quantitative vitreoretinal interface characteristics with spectral domain optical coherence tomography (SD-OCT) in eyes with macular hole (MH) and investigate their relation with best corrected visual acuity (BCVA) and MH duration. Materials and Methods Sixty-one eyes of 46 consecutive patients diagnosed with idiopathic MH were included in the study. The mean age of the patients was 66.7±7.5 (51-79) years. Complete ophthalmologic examination and SD-OCT examination were performed in all eyes and MH stages were determined according to SD-OCT findings. Qualitative characteristics of the vitreoretinal interface were investigated, including vitreomacular traction, vitreopapillary traction, maculopapillary traction, vitreoschisis, intraretinal cyst, presence of epiretinal membrane, and the integrity of the photoreceptor inner segment-outer segment junction (IS/OS) and external limiting membrane (ELM). In addition, MH diameter, MH base diameter (MHBD), ELM defect diameter, IS/OS defect diameter, and MH height were quantitatively measured and the MH index was calculated. Results Out of 61 eyes, 9.8% were classified as stage 1a, 19.7% as stage 1b, 18% as stage 2, 23% as stage 3, and 29.5% as stage 4. Mean BCVA was 0.28±0.24 (1 mps-1.0) Snellen and MH duration was 10.08±18.6 (1-108) months. The most common interface characteristics associated with MH were determined as intraretinal cyst (91.8%), IS/OS defect (78.7%) and ELM defect (63.9%). Duration and stage of MH were inversely proportional to BCVA but directly proportional to the presence and diameter of IS/OS and ELM defects. BCVA was significantly lower in eyes with IS/OS and ELM defects (p<0.0001; p<0.0001 Mann-Whitney U test). Conclusion We determined that the most important factors affecting BCVA in cases with idiopathic MH were MH stage, MH duration, MHBD, and the presence and diameter of IS/OS and ELM defects, which suggests that these parameters should be considered while making decisions about prognosis and treatment.
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Affiliation(s)
- Arzu Seyhan Karatepe
- Okan University Faculty of Medicine Hospital, Department of Ophthalmology, İstanbul, Turkey
| | - Jale Menteş
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - E Tansu Erakgün
- Kaşkaloğlu Eye Hospital, Ophthalmology Clinic, İzmir, Turkey
| | - Filiz Afrashi
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Serhad Nalçacı
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Cezmi Akkın
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Yeşim Ateş
- Kaşkaloğlu Eye Hospital, Ophthalmology Clinic, İzmir, Turkey
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Fincham GS, James S, Spickett C, Hollingshead M, Thrasivoulou C, Poulson AV, McNinch A, Richards A, Snead D, Limb GA, Snead MP. Posterior Vitreous Detachment and the Posterior Hyaloid Membrane. Ophthalmology 2018; 125:227-236. [PMID: 28867131 DOI: 10.1016/j.ophtha.2017.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/11/2017] [Accepted: 08/01/2017] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Despite posterior vitreous detachment being a common ocular event affecting most individuals in an aging population, there is little consensus regarding its precise anatomic definition. We investigated the morphologic appearance and molecular composition of the posterior hyaloid membrane to determine whether the structure clinically observed enveloping the posterior vitreous surface after posterior vitreous detachment is a true basement membrane and to postulate its origin. Understanding the relationship between the vitreous (in both its attached and detached state) and the internal limiting membrane of the retina is essential to understanding the cause of rhegmatogenous retinal detachment and vitreoretinal interface disorders, as well as potential future prophylactic and treatment strategies. DESIGN Clinicohistologic correlation study. PARTICIPANTS Thirty-six human donor globes. METHODS Vitreous bodies identified to have posterior vitreous detachment were examined with phase-contrast microscopy and confocal microscopy after immunohistochemically staining for collagen IV basement membrane markers, in addition to extracellular proteins that characterize the vitreoretinal junction (fibronectin, laminin) and vitreous gel (opticin) markers. The posterior retina similarly was stained to evaluate the internal limiting membrane. Findings were correlated to the clinical appearance of the posterior hyaloid membrane observed during slit-lamp biomicroscopy after posterior vitreous detachment and compared with previously published studies. MAIN OUTCOME MEASURES Morphologic appearance and molecular composition of the posterior hyaloid membrane. RESULTS Phase-contrast microscopy consistently identified a creased and distinct glassy membranous sheet enveloping the posterior vitreous surface, correlating closely with the posterior hyaloid membrane observed during slit-lamp biomicroscopy in patients with posterior vitreous detachment. Immunofluorescent confocal micrographs demonstrated the enveloping membranous structure identified on phase-contrast microscopy to show positive stain results for type IV collagen. Immunofluorescence of the residual intact internal limiting membrane on the retinal surface also showed positive stain results for type IV collagen. CONCLUSIONS The results of this study provide immunohistochemical evidence that the posterior hyaloid membrane is a true basement membrane enveloping the posterior hyaloid surface. Because this membranous structure is observed only after posterior vitreous detachment, the results of this study indicate that it forms part of the internal limiting membrane when the vitreous is in its attached state.
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Affiliation(s)
- Gregory S Fincham
- Vitreoretinal Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Sean James
- Department of Histopathology, Coventry Hospital, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Carl Spickett
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | | | - Christopher Thrasivoulou
- Research Department of Cell and Developmental Biology, University College London, London, United Kingdom
| | - Arabella V Poulson
- Vitreoretinal Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Annie McNinch
- Vitreoretinal Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Allan Richards
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom; Regional Molecular Genetic Laboratory, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - David Snead
- Department of Histopathology, Coventry Hospital, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Gloria A Limb
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Martin P Snead
- Vitreoretinal Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
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Bertelmann T, Strodthoff S, Sekundo W, Mennel S. Intravitreal Actilyse® injection to induce posterior vitreous detachment in eyes with recent onset of retinal vein occlusion. SPEKTRUM DER AUGENHEILKUNDE 2018. [DOI: 10.1007/s00717-017-0351-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zvorničanin J, Zvorničanin E. Re: Evaluation of posterior vitreous detachment after uneventful phacoemulsification surgery by optical coherence tomography and ultrasonography. Clin Exp Optom 2017; 100:736-737. [PMID: 28975671 DOI: 10.1111/cxo.12608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jasmin Zvorničanin
- Department of Ophthalmology, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Edita Zvorničanin
- Department of Ophthalmology, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
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Lee YS, Wang NK, Chen YP, Chen KJ, Hwang YS, Lai CC, Wu WC. Plasmin Enzyme-Assisted Vitrectomy in Pediatric Patients with Vitreoretinal Diseases. Ophthalmic Res 2016; 56:193-201. [PMID: 27497808 DOI: 10.1159/000447406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/04/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of using plasmin-assisted vitrectomy in pediatric patients with vitreoretinal diseases. METHODS We prospectively recruited children aged 16 years or younger who presented with vitreoretinopathies and underwent plasmin-assisted vitrectomy between 2012 and 2013. The main outcome measure was the induction of posterior vitreous detachment (PVD) using a suction power of 200 mm Hg or less during surgery. RESULTS Eleven eyes of 11 patients (mean age: 3.7 years; average follow-up duration: 14.1 months) were included. Of these 11 patients, there were 3 (27%) cases of stage 5 retinopathy of prematurity, 2 (18%) cases of persistent fetal vasculature, 2 (18%) cases of rhegmatogenous retinal detachment, 2 (18%) cases of idiopathic epiretinal membrane, 1 (9%) case of traumatic macular pucker, and 1 (9%) case of traumatic vitreous hemorrhage (9%). PVD was achieved in all cases (100%) during surgery using low suction after plasmin treatment (mean: 150 ± 39 mm Hg; range: 100-200). Overall, anatomical success was achieved in 8 eyes (73%). Visual acuity improved in all 5 (100%) patients for whom vision could be measured at 6 months after the operation. Cataracts were found in 4 eyes (36%), and a rise in transient intraocular pressure was observed in 1 eye (9%). CONCLUSIONS Plasmin-assisted vitrectomy offers an effective and less traumatic intervention for a variety of pediatric vitreoretinal diseases.
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Affiliation(s)
- Yung-Sung Lee
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC
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Syed Z, Stewart MW. Age-dependent vitreous separation from the macula in a clinic population. Clin Ophthalmol 2016; 10:1237-43. [PMID: 27462138 PMCID: PMC4940013 DOI: 10.2147/opth.s99635] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Vitreous degeneration begins soon after birth and accelerates throughout life. Vitreous liquefaction with a slowly progressive separation of the posterior hyaloid from the peripheral macula usually leads to complete posterior vitreous detachment. The purpose of this study is to measure the age-related prevalence of partial vitreous separation and the length of residual vitreous adhesion in an ophthalmology clinic population. Methods Patients examined by the senior author (MWS) during a 6-month period were included in a retrospective chart review. Demographic data and spectral domain optical coherence tomography scan results were gathered. Data analysis with descriptive statistics focused on the prevalence and extent of partial vitreous separation. Results The mean age of the study patients was 69.9 years, and 62% were phakic. The highest prevalence of partial posterior hyaloid separation from the internal limiting membrane (71.2%) was seen in the 50- to 54-year age group. This prevalence rate steadily decreased to 5.6% in the 95- to 99-year age group. The prevalence of complete vitreous detachment as determined by slit-lamp biomicroscopy increased from 1.7% in the <50-year age group to a maximum of 29.2% in the 75- to 79-year group. The length of vitreomacular adhesion averaged 4.6 mm in the 50- to 54-year age group and steadily decreased to 2.1 mm in the 90- to 95-year group. Conclusion Vitreomacular separation affects the majority of eyes in the sixth decade of life. The prevalence of partial vitreous separation decreases with advancing age, probably because an increasing number of these patients progress to complete posterior vitreous detachment.
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Affiliation(s)
| | - Michael W Stewart
- Department of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USA
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Is Optical Coherence Tomography a Useful Tool to Objectively Detect Actual Posterior Vitreous Adhesion Status? Case Rep Ophthalmol Med 2016; 2016:3953147. [PMID: 26989538 PMCID: PMC4771875 DOI: 10.1155/2016/3953147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 01/21/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To objectively detect true posterior vitreous cortex (PVC) adhesion status using a commercially available swept-source OCT device (DRI OCT-1, Atlantis(©)). Material and Methods. Case report, review of the literature, and methodical discussion of concepts to improve OCT-guided PVC imaging. Results. Standard OCT imaging misdiagnosed PVC adhesion status as totally detached in this case report when using a horizontal 6 mm scan only. Contrariwise imaging the same eye with a 12 mm horizontal scan, partial posterior vitreous detachment (PVD) and the presence of a bursa premacularis were clearly discernible. Besides a broader scan, specific scan patterns, highest resolution, and contrast sensitivity, an anterior-to-posterior adjusted scan through the entire vitreous as well as the detection of characteristic undulating aftermovements might enhance the capability of OCT imaging to detect true PVC adhesion status. Conclusions. Further developments are needed to address these issues and to establish OCT recordings as the standard and objective method of choice in PVC adhesion status imaging.
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Bertelmann T, Kicova N, Mennel S, Schmidt J, Irle S, Sekundo W, Schulze S. The impact of posterior vitreous adhesion on ischaemia in eyes with retinal vein occlusion. Acta Ophthalmol 2016; 94:e43-8. [PMID: 26290142 DOI: 10.1111/aos.12815] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/27/2015] [Indexed: 01/04/2023]
Abstract
PURPOSE To evaluate whether posterior vitreous adhesion (PVA) contributes to retinal ischaemia in eyes suffering from central (CRVO) or branch retinal vein occlusion (BRVO). METHODS Retrospective patient chart analysis of eyes with CRVO/BRVO receiving pars-plana vitrectomy (ppV). Prior to surgery fluorescence angiography was conducted to classify RVO as ischaemic or not. RESULTS Sixty eyes were included, thereof 36 (60%)/24 (40%) with CRVO/BRVO. In the CRVO group, 17 (47%)/19 (53%) eyes were classified as ischaemic/non-ischaemic. Respective results for BRVO-affected eyes were 16 (67%)/8 (33%). PVA/posterior vitreous detachment (PVD) was found in 33 (92%)/3 (8%) eyes with CRVO and in 23 (96%)/1 (4%) patients suffering from BRVO. Value differences of PVA/PVD between ischaemic- and non-ischaemic-typed RVO failed statistical significance for both, CRVO (p = 0.095) and BRVO (p = 1.0). CONCLUSIONS Posterior vitreous adhesion had no impact on retinal ischaemia in this investigation. As an attached posterior vitreous cortex acts as a scaffold and thus significantly increases neovascularization (NV) development in ischaemic-typed RVO, a prospective study evaluating the effect of enzymatic vitreolysis is indicated.
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Affiliation(s)
- Thomas Bertelmann
- Department of Ophthalmology; Philipps-University Marburg; Marburg Germany
| | | | - Stefan Mennel
- Department of Ophthalmology; Feldkirch Regional Hospital; Feldkirch Austria
| | - Jörg Schmidt
- Eye Clinic Tausendfensterhaus Duisburg; Duisburg Germany
| | | | - Walter Sekundo
- Department of Ophthalmology; Philipps-University Marburg; Marburg Germany
| | - Stephan Schulze
- Department of Ophthalmology; Philipps-University Marburg; Marburg Germany
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Castilla-Marti M, van den Berg TJTP, de Smet MD. Effect of vitreous opacities on straylight measurements. Retina 2015; 35:1240-6. [PMID: 25650709 DOI: 10.1097/iae.0000000000000456] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effect of vitreous floaters on intraocular straylight. METHODS Records of bilaterally phakic patients with unilateral complaint of floaters as the main symptom were identified from an electronic database. Patients who underwent straylight measurements on both affected and unaffected eyes using a C-Quant straylight meter were selected. Data were collected on age, sex, visual acuity, straylight measurements, and optical coherence tomography. The unaffected eye served as a control. RESULTS Fifteen cases were included (7 women and 8 men; mean age, 54.3 years; age range, 24-71 years). Visual acuity was not correlated with the complaint of floaters. Average straylight value in eyes with floaters was 1.426 log(s) (±0.23 SD) with a median value of 1.52 log(s). The mean value for fellow eyes was 1.275 (±0.23 SD) with a median of 1.25 log(s). The differences between both groups using a Wilcoxon matched-pair signed-rank test was statistically significant at P = 0.0009. On optical coherence tomography, most patients had a confirmed or probable posterior vitreous detachment. However, in four patients, a posterior vitreous detachment was absent in the affected eyes. Vitreous floaters were inconsistently imaged by optical coherence tomography, with only a few patients presenting appreciable condensations close to the retinal surface. These were present in both affected and unaffected eyes. CONCLUSION Intraocular straylight is significantly increased in eyes affected by floaters. No correlation was seen with vision or optical coherence tomography appearance. Straylight is an independent objective measure of visual perception that seems to be closely correlated to complaints expressed by patients experiencing floaters.
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Affiliation(s)
- Miguel Castilla-Marti
- *MIOS SA, Retina and Ocular Inflammation Clinic, Lausanne, Switzerland; and †Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
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Abstract
PURPOSE The aim of this study was to evaluate whether the adhesion status of the posterior vitreous cortex (PVC) towards the internal limiting membrane (ILM) has an impact on the development of retinal vein occlusion (RVO). MATERIAL AND METHODS In a retrospective analysis the operation protocols of 238 eyes receiving pars plana vitrectomy (ppV) and radial optic neurotomy (RON) for central retinal vein occlusion (CRVO) or ppV in combination with arteriovenous sheathotomy (AVS) for branch retinal vein occlusion (BRVO) were evaluated with respect to the intraoperative status of posterior vitreous body adhesion. The results were compared with age-matched healthy controls. RESULTS In this study 145 eyes (60.9 %) suffering from CRVO and 93 eyes (39.1 %) diagnosed with BRVO were included. In eyes with CRVO and BRVO the posterior vitreous cortex (PVC) was significantly more often attached (126 eyes, 86.9 % and 89 eyes, 95.7 %, respectively) than completely detached (19 eyes, 13.1 % and 4 eyes, 4.3 %, respectively, in each case p < 0.001). In the age groups between 70 and 79 years as well as between 80 and 89 years the PVC was significantly more often attached in both RVO entities in comparison to age-matched healthy controls (CRVO 70-79 years, p = 0.001 and 80-89 years, p = 0.002 and BRVO 70-79 years, p < 0.001, 80-89 years, p = 0.011). In eyes from the age group between 65 and 69 years (of age) the PVC was not significantly more often attached in comparison to healthy controls (CRVO p = 0.334 and BRVO p = 0.114). CONCLUSION According to these findings posterior vitreous adhesion is an independent risk factor for the development of retinal vein occlusion among patients aged 70 years or older.
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Ascaso FJ, Padgett E, Núñez E, Villén L, Grzybowski A, Cristóbal JA. Branch retinal vein occlusion and vitreovascular traction: a preliminary spectral domain OCT case-control study. Graefes Arch Clin Exp Ophthalmol 2014; 252:375-81. [PMID: 25147879 DOI: 10.1007/s00417-013-2463-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Branch retinal vein occlusion (BRVO) typically occurs at an arteriovenous (AV) crossing site. Although the pathogenesis is unclear, vitreovascular traction might have a significant role in some BRVO cases. The purpose of present study was to determine the incidence of vitreoretinal traction at the obstruction site in patients diagnosed with BRVO. METHODS In this prospective observational case–control study, 32 consecutive BRVO patients were studied with spectral-domain optical coherence tomography (SD-OCT) to detect the presence of vitreovascular traction or vitreous adherence at the occlusion site. RESULTS SD-OCT directed to the occlusion site revealed a vitreovascular traction at this point in eight eyes (25 %). Fourteen eyes (43.75 %) were associated with an adherence of posterior hyaloids without signs of retinal traction, whereas ten eyes (31.25 %) had neither vitreoretinal adherence nor vitreous traction. Regarding either the same vessel segment of the fellow eye, none of the cases revealed vitreovascular traction in the correspondent AV crossing site; 12 cases (37.5 %) presented vitreoretinal adherence; and the remaining 20 cases (62.5 %) showed neither traction nor adhesion. Thus, vitreovascular traction in the occlusion site was significantly associated with BRVO (p = 0.024, chi-squared test). B-scan ultrasonography showed that the posterior vitreous cortex remains more frequently attached in eyes with BRVO compared to unaffected fellow eyes (p = 0.041, chi-squared test). CONCLUSIONS A common firm vitreous adhesion at the obstruction site is reported herein, pointing out the possible role of vitreovascular traction in the etiology of some cases of BRVO. Likewise, although not all BRVO cases can be explained by this pathogenic mechanism, an attached posterior vitreous cortex might be a cofactor in the origin of this entity.
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Lee EJ, Kim TW, Kim M, Choi YJ. Peripapillary retinoschisis in glaucomatous eyes. PLoS One 2014; 9:e90129. [PMID: 24587238 PMCID: PMC3938601 DOI: 10.1371/journal.pone.0090129] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 01/27/2014] [Indexed: 02/03/2023] Open
Abstract
Purpose To investigate the structural and clinical characteristics of peripapillary retinoschisis observed in glaucomatous eyes using spectral-domain optical coherence tomography (SD-OCT). Methods Circumpapillary retinal nerve fiber layer (cpRNFL) and macular cross-hair SD-OCT scans and infrared fundus images of the glaucoma patients from the Investigating Glaucoma Progression Study (IGPS) and healthy volunteers were reviewed. Optic disc images obtained using enhanced depth imaging (EDI) SD-OCT were also evaluated. The structural characteristics and clinical course of the retinoschisis associated with glaucoma were investigated. Results Twenty-five retinoschisis areas were found in 22 of the 372 patients (5.9%) included in the IGPS, and in 1 area in 1 of 187 healthy control subjects (0.5%). In the 22 glaucomatous eyes with retinoschisis, the schisis was attached to the optic disc and overlapped with the retinal nerve fiber layer (RNFL) defect. The RNFL was the layer most commonly affected by the retinoschisis, either alone or together with other deeper layers. Acquired optic disc pit was identified in 8 eyes on disc photography and/or B-scan images obtained by EDI SD-OCT. Spontaneous resolution of this condition was observed in nine eyes. No retinal detachment or macular involvement of the retinoschisis was observed in any of the eyes. Multivariate analysis showed a significant influence of a higher intraocular pressure at SD-OCT scanning on the presence of retinoschisis (Odds ratio = 1.418, P = 0.001). Conclusions The present study investigated 22 cases of peripapillary retinoschisis in glaucomatous eyes. The retinoschisis was attached to the optic nerve and topographically correlated with RNFL defect. It often resolved spontaneously without causing severe visual disturbance. Care should be taken not to overestimate the RNFL thickness in eyes with retinoschisis, and also not to misinterpret the resolution of retinoschisis as a rapid glaucomatous RNFL deterioration.
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Affiliation(s)
- Eun Ji Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae-Woo Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail:
| | - Mijin Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yun Jeong Choi
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Schwartz SG, Flynn HW, Fisher YL. "Floater scotoma" demonstrated on spectral-domain optical coherence tomography and caused by vitreous opacification. Ophthalmic Surg Lasers Imaging Retina 2014; 44:415-8. [PMID: 23883538 DOI: 10.3928/23258160-20130715-14] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 05/07/2013] [Indexed: 11/20/2022]
Abstract
Patients with prominent vitreous opacities may demonstrate a characteristic shadowing on the volume-scanning protocols using spectral-domain optical coherence tomography. The authors present five cases of this characteristic shadowing artifact. This finding may be useful in objectively documenting the status of vitreous opacification and verifying the patient's complaint of symptomatic floaters, a so-called "floater scotoma".
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Affiliation(s)
- Stephen G Schwartz
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 34102, USA.
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Abstract
Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography (OCT). By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD) or a partial posterior vitreous detachment (P-PVD). A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage) and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage). A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]). By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole.
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Affiliation(s)
- Akihiro Kakehashi
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Mikiko Takezawa
- Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Jun Akiba
- Kanjodori Eye Clinic, Asahikawa, Japan
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Henrich PB, Valmaggia C, Lang C, Cattin PC. The price for reduced light toxicity: Do endoilluminator spectral filters decrease color contrast during Brilliant Blue G-assisted chromovitrectomy? Graefes Arch Clin Exp Ophthalmol 2013; 252:367-74. [PMID: 24013579 PMCID: PMC3939013 DOI: 10.1007/s00417-013-2461-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 08/07/2013] [Accepted: 08/26/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Vitreoretinal surgeons have been slow to adopt the use of spectral filters for endoillumination to reduce retinal light toxicity. This study shows that spectral filters can be used without a loss in color contrast during brilliant blue G chromovitrectomy. METHODS To evaluate the influence of intra operative spectral light filters on perceivable contrast during Brilliant Blue G chromovitrectomy, a prospective, observational clinical study was carried out on 59 consecutive Brilliant Blue G chromovitrectomy interventions in 59 patients admitted for macular holes, macular pucker or vitreomacular traction syndromes. Subsequent to peeling of the internal limiting membrane, six different illumination modes were enabled consecutively: mercury vapor, mercury vapor/xenon, and xenon followed by xenon combined with an amber, green or yellow spectral filter. Main outcome measure was the chromaticity spread between stained internal limiting membrane and unstained retina as a measure for the color contrast perceived by the human eye. RESULTS Mean chromaticity scores were similar for all light sources: mercury vapor 7.97, mercury vapor/xenon 7.96 (p = 0.96), and xenon 7.41 (p = 0.55). Compared to xenon, the additional use of endoillumination spectral filters did not change contrast recognizability: Chromaticity scores were 9.38 for the amber filter (p = 0.13), 6.63 for the green and 7.02 for the yellow filter (p = 0.37 and 0.64, respectively). When comparing the different filters head-to-head, the amber filter was superior to the green filter (p = 0.03), while the yellow was intermediate and not significantly different from either the amber (p = 0.08) or the green filter (p = 0.51). CONCLUSIONS Color contrast perceptibility during Brilliant Blue G assisted chromovitrectomy is similar with mercury vapor, mercury vapor/xenon or xenon light sources. Spectral filters do not decrease color contrast recognizability. Head-to-head comparison shows a significant advantage for the amber over the green filter with respect to contrast generation, the yellow filter is intermediate. As spectral filters are known to greatly reduce retinal light toxicity, we suggest donor eye studies to validate whether the amber filter should be generally recommended for Brilliant Blue G chromovitrectomy.
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Affiliation(s)
- Paul B Henrich
- Department of Ophthalmology, University of Basel, Basel, Switzerland,
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Shen Z, Duan X, Wang F, Wang N, Peng Y, Liu DTL, Peng X, Li S, Liang Y. Prevalence and risk factors of posterior vitreous detachment in a Chinese adult population: the Handan eye study. BMC Ophthalmol 2013; 13:33. [PMID: 23855829 PMCID: PMC3726418 DOI: 10.1186/1471-2415-13-33] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 07/13/2013] [Indexed: 12/17/2022] Open
Abstract
Background To describe the prevalence and associations of posterior vitreous detachment (PVD) in a rural adult Chinese population. Methods All eligible subjects were requested to carry out a comprehensive eye examination; PVD was a pre-specified outcome variable and was determined via biomicroscopical examination (slit-lamp biomicroscopy) with a +90-D preset lens after mydriasis. Prevalence was standardized to China population census (2000). Results 5890 (86.2%) subjects completed the examination of slit-lamp biomicroscopy with a +90-D lens. PVD was present in 160 participants (2.7%); the standardized prevalence was 2.0% (95% confidence interval [CI], 1.6-2.3%). PVD developed increasingly with age (P for trend < 0.001) for both men and women. Using a multivariate regression model, older people were found to run a higher risk of developing PVD than younger people, and women were found to have a higher risk than men (OR, 2.9; 95% CI, 1.5-5.9). Diabetes, hypertension, smoking, drinking, and intraocular pressure (IOP) were not significantly associated with PVD. Conclusions About one in fifty people is found to have PVD in this population-based study. Age and female are independently associated with PVD occurrence.
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Affiliation(s)
- Zhijun Shen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Henrich PB, Valmaggia C, Lang C, Priglinger SG, Haritoglou C, Strauss RW, Cattin PC. Contrast recognizability during brilliant blue G - and heavier-than-water brilliant blue G-assisted chromovitrectomy: a quantitative analysis. Acta Ophthalmol 2013; 91:e120-4. [PMID: 23164096 DOI: 10.1111/aos.12005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE To evaluate the potential of heavier-than-water brilliant blue G (BBG-D(2) 0) to stain the internal limiting membrane (ILM) during chromovitrectomy. METHODS In a nonrandomized, prospective, clinical multicentre study, 71 consecutive chromovitrectomy interventions in 71 patients were analysed. During routine 23-gauge vitrectomy, conventional 0.25 mg/ml BBG was employed in 21 and 0.25 mg/ml BBG-D(2) 0 in 50 patients. All interventions were videotaped. Post-operatively, video frames were viewed and dye performance assessed subjectively and objectively. Main outcome measure was the chromaticity difference between the stained ILM and the unstained underlying retina, measured by means of an objective and quantitative analysis method to describe colour contrast strengths as they are perceived by the human eye. RESULTS Removal of the ILM was possible in all interventions without additional vital dyes. BBG-D(2) 0 readily sank to the retinal surface, while conventional BBG tended to swirl up throughout the vitreous cavity. Conventional BBG was removed either with active suction or with a flute needle. Brilliant blue G-D(2) 0 needed to be whirled up from the retinal surface with a flute needle before aspiration. Objective chromaticity measurements yielded a mean chromaticity score of 7.98 for BBG-D(2) 0 and 6.51 for BBG (p = 0.09). CONCLUSIONS Brilliant blue G-D(2) 0 readily sinks to the retinal surface after injection and can be conveniently removed with a flute needle or active suction during chromovitrectomy. Based on the premises of the chromaticity measurements in this study, BBG's ILM staining capacity was not significantly improved through the recent revision its preparation, although a tendency towards slightly improved contrasts between the ILM and the underlying retina was observed.
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Affiliation(s)
- Paul B Henrich
- Department of Ophthalmology, University of Basel, Basel, Switzerland.
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de Smet MD, Gad Elkareem AM, Zwinderman AH. The Vitreous, the Retinal Interface in Ocular Health and Disease. Ophthalmologica 2013; 230:165-78. [DOI: 10.1159/000353447] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 04/02/2013] [Indexed: 11/19/2022]
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Ascaso FJ, Huerva V. Vitreoretinal traction in impending branch retinal vein occlusion: a pathogenetic role? Thromb Haemost 2012; 108:208-9. [PMID: 22688432 DOI: 10.1160/th12-03-0190] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 05/04/2012] [Indexed: 11/05/2022]
Affiliation(s)
- Francisco J Ascaso
- Department of Ophthalmology, "Lozano Blesa" University Clinic Hospital, San Juan Bosco 15, 50009 Zaragoza, Spain.
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Spectral domain optical coherence tomography in the diagnosis and management of vitreoretinal interface pathologies. J Ophthalmol 2012; 2012:876472. [PMID: 22701779 PMCID: PMC3373197 DOI: 10.1155/2012/876472] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 03/19/2012] [Accepted: 04/05/2012] [Indexed: 02/02/2023] Open
Abstract
The introduction of spectral domain optical coherence tomography (SD-OCT) has enhanced Vitreoretinal Interface (VRI) imaging considerably and facilitated the diagnosis, followup, prognosis determination, and management of VRI-associated pathologies. HR-OCT became a common practical tool seen in almost every ophthalmology practice. Knowledge of SD-OCT image interpretation and recognition of pathologies are required for all ophthalmologists. This paper methodically reviews the normal aging process of the VRI and discusses several commonly encountered VRI pathologies. The role of SD-OCT imaging in VRI-associated disorders such as posterior vitreous detachment, vitreomacular traction syndrome, idiopathic epiretinal membranes, lamellar holes, pseudoholes, and full thickness macular holes is portrayed. Future perspectives of new OCT technologies based on SD-OCT are discussed.
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