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Kalogeropoulos D, Lotery AJ, Gupta B, Lash S, Antonakis S. Epiretinal membranes in patients with uveitis: an update on the current state of management. Int Ophthalmol 2024; 44:291. [PMID: 38940960 PMCID: PMC11213727 DOI: 10.1007/s10792-024-03199-2] [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: 12/21/2023] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up, and therapeutic approach of uveitic epiretinal membranes (ERM). METHODS A thorough investigation of the literature was conducted using the PubMed database. Additionally, a complementary search was carried out on Google Scholar to ensure the inclusion of all relevant items in the collection. RESULTS ERM is an abnormal layer at the vitreoretinal interface, resulting from myofibroblastic cell proliferation along the inner surface of the central retina, causing visual impairment. Known by various names, ERM has diverse causes, including idiopathic or secondary factors, with ophthalmic imaging techniques like OCT improving detection. In uveitis, ERM occurrence is common, and surgical intervention involves pars plana vitrectomy with ERM peeling, although debates persist on optimal approaches. CONCLUSIONS Histopathological studies and OCT advancements improved ERM understanding, revealing a diverse group of diseases without a unified model. Consensus supports surgery for uveitic ERM in progressive cases, but variability requires careful consideration and effective inflammation management. OCT biomarkers, deep learning, and surgical advances may enhance outcomes, and medical interventions and robotics show promise for early ERM intervention.
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Affiliation(s)
- Dimitrios Kalogeropoulos
- Southampton Eye Unit, University Hospital Southampton, Tremona Road, Hampshire, Southampton, SO16 6YD, UK
| | - Andrew John Lotery
- Southampton Eye Unit, University Hospital Southampton, Tremona Road, Hampshire, Southampton, SO16 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Bhaskar Gupta
- Southampton Eye Unit, University Hospital Southampton, Tremona Road, Hampshire, Southampton, SO16 6YD, UK
| | - Stephen Lash
- Southampton Eye Unit, University Hospital Southampton, Tremona Road, Hampshire, Southampton, SO16 6YD, UK
| | - Serafeim Antonakis
- Southampton Eye Unit, University Hospital Southampton, Tremona Road, Hampshire, Southampton, SO16 6YD, UK.
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Serino F, Franco FGS, Bacherini D, Lupidi M, Gallio S, Esposito C, Virgili G, Mariotti C, Giansanti F. Role of Vitreous Detachment in Epiretinal Membrane Peeling: A Multimodal Imaging and Microperimetry Study. J Clin Med 2024; 13:3565. [PMID: 38930094 PMCID: PMC11204599 DOI: 10.3390/jcm13123565] [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: 05/05/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Background: To investigate anatomical and functional changes of the macula caused by epiretinal membrane (ERM) peeling procedures in patients with or without posterior vitreous detachment (PVD). Methods: This is a multicentric prospective observational study on thirty-seven (37) patients affected by symptomatic ERM who underwent 25-gauge pars plana vitrectomy (PPV), induction of a PVD (as needed) and peeling of both the internal limiting membrane (ILM) and ERM. Optical coherence tomography-angiography (OCT-A) (RS 3000, Nidek, Japan) and microperimetry (MP-3, Nidek, Japan) were performed; central retinal thickness (CRT), foveal avascular zone (FAZ) area and perimeter, vessel density and perfusion density, retinal sensitivity and fixation stability (as a total mean retinal sensitivity (MRS), and MRS in the ellipse area and bivariate contour ellipse area (BCEA)) were recorded at baseline and up to postoperative month 3. Results: Eyes were classified as having complete PVD (51.4%) or incomplete PVD (48.6%). At baseline, patients with incomplete PVD had worse best-corrected distance visual acuity (BCDVA), total MRS, MRS in the ellipse area and BCEA, and higher CRT than patients with complete PVD. At month 3, the differences in BCDVA between the two groups remained statistically significant, with patients with incomplete PVD having worse results (difference: 0.199 logMAR, p < 0.001). The difference in the MRS in the ellipse area was statistically significant at month 3 (-3.378 Db, p = 0.035), with greater improvement in patients with complete PVD. Conclusions: Our study shows that patients with incomplete PVD have worse conditions at baseline than patients with complete PVD, and the differences in visual acuity and retinal sensitivity were maintained postoperatively.
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Affiliation(s)
- Federica Serino
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy; (F.G.S.F.); (D.B.); (G.V.); (F.G.)
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (S.G.); (C.E.)
| | - Fabrizio Gaetano Saverio Franco
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy; (F.G.S.F.); (D.B.); (G.V.); (F.G.)
| | - Daniela Bacherini
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy; (F.G.S.F.); (D.B.); (G.V.); (F.G.)
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (S.G.); (C.E.)
| | - Marco Lupidi
- Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (M.L.); (C.M.)
| | - Stefano Gallio
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (S.G.); (C.E.)
| | - Claudio Esposito
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (S.G.); (C.E.)
| | - Gianni Virgili
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy; (F.G.S.F.); (D.B.); (G.V.); (F.G.)
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (S.G.); (C.E.)
| | - Cesare Mariotti
- Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (M.L.); (C.M.)
| | - Fabrizio Giansanti
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, 50134 Florence, Italy; (F.G.S.F.); (D.B.); (G.V.); (F.G.)
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50121 Florence, Italy; (S.G.); (C.E.)
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Gelernter J, Levey DF, Galimberti M, Harrington K, Zhou H, Adhikari K, Gupta P, Gaziano JM, Eliott D, Stein MB. Genome-wide association study of the common retinal disorder epiretinal membrane: Significant risk loci in each of three American populations. CELL GENOMICS 2024; 4:100582. [PMID: 38870908 DOI: 10.1016/j.xgen.2024.100582] [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: 09/05/2023] [Revised: 02/20/2024] [Accepted: 05/10/2024] [Indexed: 06/15/2024]
Abstract
Epiretinal membrane (ERM) is a common retinal condition characterized by the presence of fibrocellular tissue on the retinal surface, often with visual distortion and loss of visual acuity. We studied European American (EUR), African American (AFR), and Latino (admixed American, AMR) ERM participants in the Million Veteran Program (MVP) for genome-wide association analysis-a total of 38,232 case individuals and 557,988 control individuals. We completed a genome-wide association study (GWAS) in each population separately, and then results were meta-analyzed. Genome-wide significant (GWS) associations were observed in all three populations studied: 31 risk loci in EUR subjects, 3 in AFR, and 2 in AMR, with 48 in trans-ancestry meta-analysis. Many results replicated in the FinnGen sample. Several GWS variants associate to alterations in gene expression in the macula. ERM showed significant genetic correlation to multiple traits. Pathway enrichment analyses implicated collagen and collagen-adjacent mechanisms, among others. This well-powered ERM GWAS identified novel genetic associations that point to biological mechanisms for ERM.
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Affiliation(s)
- Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, VA Connecticut Healthcare Center, West Haven, CT, USA; Departments of Genetics and Neuroscience, Yale School of Medicine, New Haven, CT, USA.
| | - Daniel F Levey
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, VA Connecticut Healthcare Center, West Haven, CT, USA
| | - Marco Galimberti
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, VA Connecticut Healthcare Center, West Haven, CT, USA
| | - Kelly Harrington
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Hang Zhou
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, VA Connecticut Healthcare Center, West Haven, CT, USA
| | - Keyrun Adhikari
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, VA Connecticut Healthcare Center, West Haven, CT, USA
| | - Priya Gupta
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, VA Connecticut Healthcare Center, West Haven, CT, USA
| | - J Michael Gaziano
- Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Medicine, Divisions of Aging and Preventative Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Dean Eliott
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Murray B Stein
- University of California, San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA
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Fouad YA, Soliman MK, Elhusseiny AM, Yang YC, Sallam AB. Visual outcomes and complications of combined versus sequential pars plana vitrectomy and phacoemulsification for epiretinal membrane. Eye (Lond) 2024; 38:1707-1713. [PMID: 38486117 PMCID: PMC11156636 DOI: 10.1038/s41433-024-03004-5] [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: 07/31/2023] [Revised: 02/02/2024] [Accepted: 02/28/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Symptomatic epiretinal membrane (ERM) often requires surgical intervention via pars plana vitrectomy (PPV), for which cataract development is a common complication. There is insufficient data on the visual outcomes and complications of combined phacovitrectomy (COMB) in comparison to sequential PPV with deferred cataract surgery (SEQ) for ERM. METHODS A retrospective dataset analysis of 8 National Health Service ophthalmology departments. The main outcome measures were postoperative visual acuity (VA), operative complications, postoperative cystoid macular oedema (CMO) and recurrent ERM. RESULTS We included 898 and 299 eyes in the COMB and SEQ groups, respectively. Both procedures resulted in significantly better VA across all follow-up intervals (24 weeks). The proportion of eyes with Snellen VA of at least 20/40 at 12-24 weeks was comparable in both groups (47.8% [COMB] vs. 54.7% [SEQ], p = 0.4456). More eyes in the COMB group experienced posterior capsular rupture (2.9% vs. 0%, p = 0.0009) and iatrogenic retinal trauma (2.4% vs. 0%, p = 0.0023). However, regression analysis revealed that combined surgery did not predict either complication. There were no significant differences in the rates of CMO (6.5% [COMB] vs. 9% [SEQ], p = 0.1522) and recurrent ERM (2.1% [COMB] vs. 3.3% [SEQ], p = 0.2758) between both groups. CONCLUSION Both combined and sequential procedures are comparably effective and safe means for managing eyes with ERM.
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Affiliation(s)
- Yousef A Fouad
- Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt
| | - Mohamed K Soliman
- Department of Ophthalmology, Assiut University Hospitals, Assiut, Egypt
- University Hospitals Eye Institute, Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Yit C Yang
- Wolverhampton Eye Infirmary, Royal Wolverhampton Hospitals NHS Trust, New Cross, Wolverhampton, UK
| | - Ahmed B Sallam
- Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt.
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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Hazelwood JE, Ah-See K, Young SL, Bennett HGB, Khan A, Goudie CR. Title - Long term outcomes of vitrectomy and ERM peel: Can pre-operative metamorphopsia measured using the D-Chart help improve surgical candidate selection? Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06514-w. [PMID: 38758377 DOI: 10.1007/s00417-024-06514-w] [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: 02/11/2024] [Revised: 04/18/2024] [Accepted: 05/09/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To assess the predictive value of pre-operative metamorphopsia, measured using the D-Chart, in patients undergoing epiretinal membrane (ERM) surgery and how this relates to improvement in quality of life after surgery. METHODS 17 patients from vitreo-retinal surgery clinics at a tertiary ophthalmology centre were recruited when listed for pars plana vitrectomy (PPV) with ERM peel between September 2019 - February 2020. Pre-operatively patients underwent visual acuity (VA), Visual-Function Index 14 (VF-14) and metamorphopsia (D-Chart-Thomson Software Solutions) assessment and answered a questionnaire regarding cardinal ERM symptoms. Post-operatively patients were re-assessed in the same domains. RESULTS 13 patients completed the protocol (inclusion rate 76%) with a mean follow-up of 32.1 (± 3.1) months. Mean pre-operative VA of the affected eye was 0.42 logMAR (± 0.25). Mean pre-operative VF-14 score was 81.51 (± 12.8) and mean M-Score of the affected eye was 14.6 (± 12.7). Post-operatively, mean VA of the operated eye was 0.11 logMAR (± 0.11), mean VF-14 score was 97.4 (± 3.8) and mean M-Score was 1.31 (± 2.8). Mean improvement in VA was 0.31 logMAR (p < 0.001), in VF-14 15.9 (p = 0.002), and M-Score -13.3 (p = 0.003). There was a significant association between pre-operative D-Chart score and improvement in VA (r = -0.570, p = 0.042), visual functioning (r = 0.606 p = 0.028) and metamorphopsia (r = 0.916 p < 0.001), with those demonstrating poorer D-Chart scores showing greater improvements. CONCLUSION Pre- and post-operative visual distortion measured using the D-Chart, correlates with vision related quality of life in patients undergoing epiretinal membrane surgery. Patients with worse pre-operative distortion scores noticed the greatest improvements in distortion and vision related quality of life following surgery. With a mean follow-up time of 32.1 months, this long-term follow-up data further reinforces the efficacy of vitrectomy and ERM peel by demonstrating significant and sustained improvement in visual acuity, metamorphopsia and visual functioning. The authors suggest there is a role for D-Chart assessment pre-operatively to improve selection of patients in ERM surgery.
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Affiliation(s)
| | - Kim Ah-See
- Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh, UK
| | - Su Ling Young
- Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh, UK
- Moorfields Eye Hospital, City Road, London, UK
| | | | - Ashraf Khan
- Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh, UK
| | - Colin R Goudie
- Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh, UK
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Englmaier VA, Storp JJ, Dierse S, Eter N, Al-Nawaiseh S. Idiopathic Epiretinal Membranes - Pathophysiology, Classifications and OCT-Biomarkers. Klin Monbl Augenheilkd 2024; 241:666-674. [PMID: 36849107 DOI: 10.1055/a-2043-4662] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Epiretinal membranes (ERMs) are a common finding in patients with increasing age. Diagnosis and treatment of ERMs have changed dramatically in recent years due to technological advances in ophthalmological care. In recent years, tomographic imaging has allowed for accurate visualization of ERMs and contributed to the growing understanding of the pathophysiology of this condition. The literature review conducted here summarizes recent innovations in diagnosis, classification, and treatment of idiopathic ERMs and specifically addresses novel optical coherence tomography (OCT) biomarkers that allow for the generation of prognoses regarding the clinical postoperative outcome.
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Affiliation(s)
| | - Jens Julian Storp
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
| | - Sebastian Dierse
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
| | - Nicole Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
| | - Sami Al-Nawaiseh
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Deutschland
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7
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Ayhan MS, Neubauer J, Uzel MM, Gelisken F, Berens P. Interpretable detection of epiretinal membrane from optical coherence tomography with deep neural networks. Sci Rep 2024; 14:8484. [PMID: 38605115 PMCID: PMC11009346 DOI: 10.1038/s41598-024-57798-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
This study aimed to automatically detect epiretinal membranes (ERM) in various OCT-scans of the central and paracentral macula region and classify them by size using deep-neural-networks (DNNs). To this end, 11,061 OCT-images were included and graded according to the presence of an ERM and its size (small 100-1000 µm, large > 1000 µm). The data set was divided into training, validation and test sets (75%, 10%, 15% of the data, respectively). An ensemble of DNNs was trained and saliency maps were generated using Guided-Backprob. OCT-scans were also transformed into a one-dimensional-value using t-SNE analysis. The DNNs' receiver-operating-characteristics on the test set showed a high performance for no-ERM, small-ERM and large-ERM cases (AUC: 0.99, 0.92, 0.99, respectively; 3-way accuracy: 89%), with small-ERMs being the most difficult ones to detect. t-SNE analysis sorted cases by size and, in particular, revealed increased classification uncertainty at the transitions between groups. Saliency maps reliably highlighted ERM, regardless of the presence of other OCT features (i.e. retinal-thickening, intraretinal pseudo-cysts, epiretinal-proliferation) and entities such as ERM-retinoschisis, macular-pseudohole and lamellar-macular-hole. This study showed therefore that DNNs can reliably detect and grade ERMs according to their size not only in the fovea but also in the paracentral region. This is also achieved in cases of hard-to-detect, small-ERMs. In addition, the generated saliency maps can be used to highlight small-ERMs that might otherwise be missed. The proposed model could be used for screening-programs or decision-support-systems in the future.
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Affiliation(s)
- Murat Seçkin Ayhan
- Institute for Ophthalmic Research, University of Tübingen, Elfriede Aulhorn Str. 7, 72076, Tübingen, Germany
| | - Jonas Neubauer
- University Eye Clinic, University of Tübingen, Tübingen, Germany
| | - Mehmet Murat Uzel
- University Eye Clinic, University of Tübingen, Tübingen, Germany
- Department of Ophthalmology, Balıkesir University School of Medicine, Balıkesir, Turkey
| | - Faik Gelisken
- University Eye Clinic, University of Tübingen, Tübingen, Germany.
| | - Philipp Berens
- Institute for Ophthalmic Research, University of Tübingen, Elfriede Aulhorn Str. 7, 72076, Tübingen, Germany.
- Tübingen AI Center, Tübingen, Germany.
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Sartini F, Menchini M, Palma A, Casini G, Figus M. Epiretinal membrane development after Ex-Press glaucoma filtration device implant: 2-year results of a case control study. Int Ophthalmol 2024; 44:93. [PMID: 38367121 PMCID: PMC10874323 DOI: 10.1007/s10792-024-02958-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/04/2023] [Indexed: 02/19/2024]
Abstract
BACKGROUND The most common retinal complications after glaucoma surgery are choroidal detachment, hypotony maculopathy, malignant glaucoma, vitreous hemorrhage, endophthalmitis and retinal detachment. However, if glaucoma surgery is a risk factor for the ERM development needs to be clarified. This study aims to assess the incidence of epiretinal membrane (ERM) in 2 years of follow-up in patients with primary open-angle glaucoma (POAG) treated with Ex-Press shunt implant. METHODS A prospective, consecutive, single-center, case-control study. We enrolled patients affected by POAG and scheduled for Ex-Press device implant with or without concomitant cataract surgery. The control group was the contralateral eyes which continues anti-glaucomatous eyedrops. Complete ophthalmologic evaluation and spectral-domain optical coherence tomography were performed before surgery, at 6 months and 24 months of follow-up. RESULTS Eighty-two eyes of 41 consecutive patients, 18 males and 23 females with a mean age of 70, 29 ± 8,45, were analyzed at 24 months. 39.1% of eyes developed ERM: 29.3% were cellophane macular reflex (CMR) and 9.8% were pre-macular fibrosis (PMF). In the control group, 19.5% of eyes developed ERM: 17.1% were CMR and 2.4% were PMF. No statistically significant difference was reported (p = 0.121) between treated and control group. ERM development did not affect significantly the central foveal thickness (260.13 ± 35.01 μm at baseline, 265.03 ± 34.90 μm at 6 months and 275.18 ± 33.31 μm at 24 months) and macular volume (7.75 ± 0.43 mm3 at baseline, 7.77 ± 0.48 mm3 at 6 months and 7.77 ± 0.46 mm3 at 24 months), remained comparable to reported average measures in healthy individuals during the follow-up. Concomitant cataract surgery did not increase the ERM incidence. CONCLUSION Ex-Press implant may increase the ERM incidence regardless concomitant cataract surgery, accelerating or inducing a posterior vitreous detachment, such as other ocular surgical procedure. Nevertheless, the vast majority of ERM are CMR, not affecting the macular profile.
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Affiliation(s)
- Francesco Sartini
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | - Martina Menchini
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | - Alessandro Palma
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | - Giamberto Casini
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126, Pisa, Italy
| | - Michele Figus
- Ophthalmology, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi, 10, 56126, Pisa, Italy.
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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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Quiroz-Reyes MA, Quiroz-Gonzalez EA, Quiroz-Gonzalez MA, Lima-Gomez V. Surgical management, use and efficacy of adjuvant dyes in idiopathic epiretinal membranes: a systemic review with network meta-analysis. Int J Retina Vitreous 2023; 9:77. [PMID: 38057831 DOI: 10.1186/s40942-023-00515-3] [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: 10/19/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The epiretinal membrane (ERM) is a nonvascular fibrocellular tissue formed by cellular metaplasia and proliferation at the vitreoretinal surface and is generally treated by pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) peeling. This network meta-analysis aimed to compare the efficacy of all available ERM removal interventions and assessed the use and efficacy of surgical dyes in managing idiopathic ERMs. METHODS MEDLINE, EMBASE, Cochrane CENTRAL, and the US National Library of Medicine were searched (June 28, 2023). Clinical studies that included patients with ERMs were included. Randomized controlled trials (RCTs) were also appraised using Cochrane risk of bias (ROB). RESULTS Ten RCTs and ten non-RCTs were included in this study. A pairwise meta-analysis between ERM removal and combined ERM and ILM removal showed no significant difference in visual outcome (change in BCVA) 1 year postintervention (MD = - 0.0034, SE = 0.16, p = 0.832). Similarly, there was no significant difference in the central macular thickness postoperatively between the two groups (MD = - 4.95, SE = 11.11, p = 0.656) (Q = 4.85, df = 3, p = 0.182, I2 = 41.21%). The difference in ERM recurrence between the groups was also not statistically significant (OR = 4.64, p = 0.062, I2 = 0). In a network meta-analysis, there was no significant difference in visual outcomes between ERM removal only and other treatment modalities: combined ILM and ERM removal (MD = 0.039, p = 0.837) or watchful waiting (MD = 0.020, p = 0.550). In a network meta-analysis, there was no significant difference in the visual outcomes between ERM removal alone and dye-stained combined ERM and ILM peeling (MD = 0.122, p = 0.742 for brilliant blue G; BBG and MD = 0.00, p = 1.00 for membrane blue-dual; MBD). The probability of being a better surgical dye for better visual outcomes was 0.539 for the MBD group and 0.396 for the BBG group. The recurrence of ERM was not significantly different when the ILM was stained with any of the dyes. No study was judged on ROB assessment as having low ROB in all seven domains. CONCLUSION The two types of surgical modalities provided comparable efficacy, with no significant differences between the outcomes. Among the dye-assisted ILM peeling methods, the membrane blue-dual dye was the most effective in providing better structural and functional outcomes.
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Affiliation(s)
- Miguel A Quiroz-Reyes
- Retina Department of Oftalmologia Integral ABC (Medical and Surgical Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, Lomas de Chapultepec, 11000, Mexico City, Mexico.
| | - Erick A Quiroz-Gonzalez
- Institute of Ophthalmology, Fundacion Conde de Valenciana (Nonprofit Organization) affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Av. Chimalpopoca 14. Col. Obrera, 06800, Mexico City, Mexico
| | - Miguel A Quiroz-Gonzalez
- Retina Department of Oftalmologia Integral ABC (Medical and Surgical Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, Lomas de Chapultepec, 11000, Mexico City, Mexico
| | - Virgilio Lima-Gomez
- Juarez Hospital, Public Assistance Institution (Nonprofit Organization), Av. Politecnico Nacional 5160, Colonia Magdalena de las Salinas, 07760, Mexico City, Mexico
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12
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Aoki R, Dote S, Oogi S, Nagata Y, Ueda K, Terao E, Nakakura S. Evaluation of New and Preexisting Epiretinal Membranes Following Glaucoma Filtration Surgery. Cureus 2023; 15:e46441. [PMID: 37927709 PMCID: PMC10622603 DOI: 10.7759/cureus.46441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Secondary epiretinal membranes (ERMs) can develop from various causes, including those associated with glaucoma treatments such as trabeculectomy (TLE) and EX-PRESS (EXP) insertion surgery. This study aimed to investigate the occurrence of new ERMs and changes in preexisting ERMs following TLE or EXP insertion. Between April 2018 and March 2019, 102 and 74 eyes that underwent primary and standalone TLE and EXP insertion, respectively, were evaluated. Of these, 48 eyes were included in the TLE group and 32 eyes were included in the EXP group. Optical coherence tomography (OCT) was used to assess preoperative and postoperative ERMs. In the TLE group, postoperative ERMs were observed in one (case 1) (3%) out of 34 eyes without preexisting ERMs and in one (case 2) (7%) out of 14 eyes with preexisting ERMs, showing an increase in ERM stage. In the EXP group, postoperative ERMs were observed in one (case 3) (5%) out of 22 eyes without preexisting ERMs and in one (case 4) (10%) out of 10 eyes with preexisting ERMs, showing a decrease in the ERM stage. Case 1 was a 58-year-old man with primary open-angle glaucoma (POAG) in the left eye who underwent TLE. Although no preoperative ERMs were observed, postoperative ERM was noted at the three-month follow-up. Case 2 was a 49-year-old man with POAG in the right eye who underwent TLE. Although ERM was observed preoperatively, ERM progressed at six months postoperatively. Case 3 was a 59-year-old woman with POAG in the right eye who underwent EXP insertion. No preoperative ERMs were observed, but an ERM was noted at the 15-month follow-up. Case 4 was a 72-year-old woman with steroid-induced glaucoma in the right eye who underwent EXP insertion surgery. A preoperative ERM was present, and the foveal pit was absent; however, the foveal pit was observed at the 12-month follow-up. Despite the low incidence of ERMs, filtration surgery may be associated with ERM development and the progression or regression of preexisting ERMs.
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Affiliation(s)
- Ryota Aoki
- Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, JPN
| | - Saki Dote
- Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, JPN
| | - Satomi Oogi
- Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, JPN
| | - Yuki Nagata
- Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, JPN
| | - Kanae Ueda
- Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, JPN
| | - Etsuko Terao
- Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, JPN
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13
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Güvenç U, Üney G, Ünlü N, Acar MA, Hazırolan D, Candan Ö. Epiretinal membrane related vascular changes in diabetic eyes evaluated with optical coherence tomography angiography. Int J Ophthalmol 2023; 16:1503-1511. [PMID: 37724284 PMCID: PMC10475617 DOI: 10.18240/ijo.2023.09.18] [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: 10/29/2022] [Accepted: 07/03/2023] [Indexed: 09/20/2023] Open
Abstract
AIM To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and non-diabetic patients with epiretinal membrane (ERM) with the help of optical coherence tomography angiography (OCT-A) and compare them with healthy control subjects. METHODS In this prospective, cross-sectional study, a total of 165 eyes were evaluated, including 50 eyes of patients with diabetic ERM, 54 eyes of idiopathic ERM (iERM) patients, and 61 eyes of healthy controls. Macula and disc angiography was performed by OCT-A. Macular vessel density (VD) ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal region. Statistical calculations were evaluated at the 95% confidence interval. RESULTS Macula superficial VD values of ERM cases were lower than that in the control group, while foveal VD was higher in ERM cases. Macula deep VD values of ERM cases were lower in all quadrants, except the fovea. The width of the foveal avascular zone (FAZ) area was significantly lower in the ERM groups, and the FAZ width was lowest in iERM group. Macula superficial VD ratio was significantly higher in the ERM groups, but there was no significant difference between ERM groups. Macula deep VD ratio was significantly higher in the iERM group than in the control group. CONCLUSION Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation, as well as their effect on retinal vascular structures. If the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A, then, OCT-A can be used as a guide for ERM prognosis.
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Affiliation(s)
- Umay Güvenç
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Güner Üney
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Nurten Ünlü
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Mehmet Akif Acar
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Dicle Hazırolan
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
| | - Özlem Candan
- Ankara Training and Research Hospital Ophthalmology Department, Ankara 06800, Türkiye
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Englmaier VA, Storp JJ, Eter N, Al-Nawaiseh S. Short-term-outcomes of idiopathic epiretinal membranes treated with pars-plana-vitrectomy - examination of visual function and OCT-morphology. Int J Retina Vitreous 2023; 9:55. [PMID: 37710332 PMCID: PMC10500920 DOI: 10.1186/s40942-023-00496-3] [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: 07/24/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Epiretinal membranes (ERM) represent one of the most common findings in retinal examination. Structural changes of the retinal layers in patients with ERM can be visualized and classified using OCT. The purpose of this study is to evaluate structural and functional changes related to surgical treatment of ERM. METHODS Monocentric retrospective analysis of 92 patients who underwent 23-gauge-pars plana vitrectomy (ppV) combined with cataract surgery for idiopathic ERM from 2015 to 2020. Visual acuity was determined directly preoperatively, at four weeks and three months postoperatively. Disease stage and tomographic biomarkers related to ERM were assessed in OCT imaging. RESULTS 92 eyes of 92 patients were included. At the time of surgery, the mean patient age was 71 years. Visual acuity improved significantly by 2 lines postoperatively, on average from LogMar 0.4 to 0.2 (p < 0.001). Disease stage regressed from stage 3 to stage 2 postoperatively (p < 0.001). No patient had stage 4 postoperatively (n = 0). In the presence of preoperative intraretinal fluid, mean retinal thickness was 488 μm and decreased to 392 μm postoperatively (n = 32; p < 0.001). Preoperative presence of a Cotton Ball Sign (n = 30) was associated with better visual acuity (p = 0.009). This was also visible in patients with preoperative vitreomacular traction syndrome (p < 0.001). The presence of preoperative intraretinal fluid showed a tendency towards better disease staging after surgery (p = 0.080). CONCLUSION Surgery was able to achieve visual improvement and morphological regression of the preoperative OCT findings related to ERM. ppV led to a reduction in retinal thickness and disease stage. The presence of the Cotton Ball Sign and vitreomacular traction was associated with better visual acuity in the follow-up period. In our cohort the preoperative presence of intraretinal fluid showed a tendency for better postoperative disease staging.
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Affiliation(s)
- Verena Anna Englmaier
- Department of Ophthalmology, University Medical Center Muenster, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany.
| | - Jens Julian Storp
- Department of Ophthalmology, University Medical Center Muenster, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - Nicole Eter
- Department of Ophthalmology, University Medical Center Muenster, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - Sami Al-Nawaiseh
- Department of Ophthalmology, University Medical Center Muenster, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
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15
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Ożóg MK, Nowak-Wąs M, Rokicki W. Pathophysiology and clinical aspects of epiretinal membrane - review. Front Med (Lausanne) 2023; 10:1121270. [PMID: 37636571 PMCID: PMC10447902 DOI: 10.3389/fmed.2023.1121270] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
The epiretinal membrane (ERM) is a pathological tissue formed at the vitreoretinal interface. The formation of this tissue is associated with numerous symptoms related to disturbances of vision. These types of lesions may arise idiopathically or be secondary to eye diseases, injuries and retinal surgeries. ERM tissue contains numerous cell types and numerous cytokines, which participate in its formation. The aim of this paper is to summarize information about the etiology, epidemiology, pathophysiology and treatment of ERM, with a brief description of the main cells that build the ERM - as well as the cytokines and molecules related to ERM pathogenesis - being provided in addition.
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Affiliation(s)
- Mateusz Kamil Ożóg
- Department of Histology and Cell Pathology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine, Academy of Silesia, Zabrze, Poland
| | - Marta Nowak-Wąs
- Department of Histology and Cell Pathology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
- Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland
| | - Wojciech Rokicki
- Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland
- Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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16
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Confalonieri F, Lumi X, Petrovski G. Spontaneous Epiretinal Membrane Resolution and Angiotensin Receptor Blockers: Case Observation, Literature Review and Perspectives. Biomedicines 2023; 11:1976. [PMID: 37509613 PMCID: PMC10377102 DOI: 10.3390/biomedicines11071976] [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: 05/13/2023] [Revised: 06/05/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION Epiretinal membrane (ERM) is a relatively common condition affecting the macula. When symptoms become apparent and compromise a patient's quality of vision, the only therapeutic approach available today is surgery with a vitrectomy and peeling of the ERM. Angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACE-Is) reduce the effect of angiotensin II, limit the amount of fibrosis, and demonstrate consequences on fibrinogenesis in the human body. Case Description and Materials and Methods: A rare case of spontaneous ERM resolution with concomitant administration of ARB is reported. The patient was set on ARB treatment for migraines and arterial hypertension, and a posterior vitreous detachment was already present at the first diagnosis of ERM. The scientific literature addressing the systemic relationship between ARB, ACE-Is, and fibrosis in the past 25 years was searched in the PubMed, Medline, and EMBASE databases. RESULTS In total, 38 and 16 original articles have been selected for ARBs and ACE-Is, respectively, in regard to fibrosis modulation. CONCLUSION ARBs and ACE-Is might have antifibrotic activity on ERM formation and resolution. Further clinical studies are necessary to explore this phenomenon.
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Affiliation(s)
- Filippo Confalonieri
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
| | - Xhevat Lumi
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Eye Hospital, University Medical Centre Ljubljana, Zaloška Cesta 2, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Goran Petrovski
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, 21000 Split, Croatia
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Hung CL, Lin KH, Lee YK, Mrozek D, Tsai YT, Lin CH. The Classification of Stages of Epiretinal Membrane using Convolutional Neural Network on Optical Coherence Tomography Image. Methods 2023; 214:28-34. [PMID: 37116670 DOI: 10.1016/j.ymeth.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 03/18/2023] [Accepted: 04/22/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The gold standard for diagnosing epiretinal membranes is to observe the surface of the internal limiting membrane on optical coherence tomography images. The stages of the epiretinal membrane are used to decide the condition of the health of the membrane. The stages are not detected because some of them are similar. To accurately classify the stages, a deep-learning technology can be used to improve the classification accuracy. METHODS A combinatorial fusion with multiple convolutional neural networks (CNN) algorithms are proposed to enhance the accuracy of a single image classification model. The proposed method was trained using a dataset of 1947 optical coherence tomography images diagnosed with the epiretinal membrane at the Taichung Veterans General Hospital in Taiwan. The images consisted of 4 stages; stages 1, 2, 3, and 4. RESULTS The overall accuracy of the classification was 84%. The combination of five and six CNN models achieves the highest testing accuracy (85%) among other combinations, respectively. Any combination with a different number of CNN models outperforms any single CNN algorithm working alone. Meanwhile, the accuracy of the proposed method is better than ophthalmologists with years of clinical experience. CONCLUSIONS We have developed an efficient epiretinal membrane classification method by using combinatorial fusion with CNN models on optical coherence tomography images. The proposed method can be used for screening purposes to facilitate ophthalmologists making the correct diagnoses in general medical practice.
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Affiliation(s)
- Che-Lun Hung
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taiwan R.O. C; Computer Science and Communication Engineering, Providence University, Taiwan R.O. C.
| | - Keng-Hung Lin
- Department of Ophthalmology, Taichung Veterans General Hospital, Taiwan R.O.C
| | - Yu-Kai Lee
- Department of Computer Science and Information Engineering, Providence University, Taiwan R.O.C.
| | - Dariusz Mrozek
- Department of Applied Informatics, Silesian University of Technology.
| | - Yin-Te Tsai
- Computer Science and Communication Engineering, Providence University, Taiwan R.O. C.
| | - Chun-Hsien Lin
- Department of Ophthalmology, Taichung Veterans General Hospital, Taiwan R.O.C.
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18
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Ma IH, Wang SW, Huang WL, Hsia Y, Hung KC, Huang CJ, Chen MS, Ho TC. Comparison of Refractive Outcomes in Patients with Highly Myopic Versus Non-highly Myopic Eyes Undergoing Phacovitrectomy. Ophthalmol Ther 2023; 12:1025-1032. [PMID: 36680657 PMCID: PMC10011233 DOI: 10.1007/s40123-023-00655-7] [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: 10/30/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Combined phacovitrectomy is gaining popularity due to efficiency and immediate visual improvement. However, concerns regarding erroneous intraocular lens (IOL) calculation in combination surgery are increasing, such as myopic shift owing to a thick macula and consequent underestimation of the axial length. Therefore, this study aimed to compare the refractive outcomes of combined phacovitrectomy in patients with highly myopic and non-highly myopic eyes. METHODS A retrospective chart review was performed on patients who received combined phacoemulsification, intraocular lens implantation, and small gauge pars plana vitrectomy for cataract and macular pathologies in highly myopic and non-highly myopic eyes. Pre- and postoperative evaluation and ocular parameters were recorded, and analyses were performed using the Student's t test and regression analysis. RESULTS A total of 133 patients with macular pathologies, including myopic tractional maculopathy, macular hole, and epiretinal membrane, were enrolled. SRK II or SRK/T models were used for calculating IOL. The mean absolute error of refraction change was 0.65 D; 83.5% of patients were within 1-D error, 57.9% within 0.5-D error, and 35.3% within 0.25-D error, with SRK/T showing better precision and yielding more myopic shift. Furthermore, the predictive accuracy of SRK II or SRK/T was better in patients with non-highly myopic eyes. Moreover, Barrett's universal II formula was not superior to SRK II or SRK/T in the prediction of postoperative refractive error (p = 0.48). CONCLUSION Refractive outcomes were satisfactory in the cohort of patients with highly myopic eyes. The combined implementation of SRK II and SRK/T was not inferior to Barrett's universal II formula in predicting satisfactory refractive outcomes. Combination surgery can be an option for patients with both cataract and macular pathologies.
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Affiliation(s)
- I-Hsin Ma
- Department of Ophthalmology, College of Medicine, National Taiwan University Hospital, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei City, 10002, Taiwan R.O.C.,Department of Ophthalmology, Hsinchu Branch, National Taiwan University Hospital, Hsinchu, Taiwan R.O.C
| | - Shih-Wen Wang
- Department of Ophthalmology, College of Medicine, National Taiwan University Hospital, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei City, 10002, Taiwan R.O.C.,Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan R.O.C
| | - Wei-Lun Huang
- Department of Ophthalmology, College of Medicine, National Taiwan University Hospital, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei City, 10002, Taiwan R.O.C.,Department of Ophthalmology, Hsinchu Branch, National Taiwan University Hospital, Hsinchu, Taiwan R.O.C
| | - Yun Hsia
- Department of Ophthalmology, College of Medicine, National Taiwan University Hospital, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei City, 10002, Taiwan R.O.C.,Department of Ophthalmology, Hsinchu Branch, National Taiwan University Hospital, Hsinchu, Taiwan R.O.C
| | - Kuo-Chi Hung
- Department of Ophthalmology, College of Medicine, National Taiwan University Hospital, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei City, 10002, Taiwan R.O.C.,Universal Eye Clinic, Taipei, Taiwan R.O.C
| | - Chien-Jung Huang
- Department of Ophthalmology, Fu Jen University Hospital, New Taipei City, Taiwan R.O.C
| | - Muh-Shy Chen
- Department of Ophthalmology, College of Medicine, National Taiwan University Hospital, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei City, 10002, Taiwan R.O.C.,Department of Ophthalmology, Cardinal Tien Hospital, Fu Jen Catholic University, New Taipei City, Taiwan R.O.C
| | - Tzyy-Chang Ho
- Department of Ophthalmology, College of Medicine, National Taiwan University Hospital, National Taiwan University, No. 7, Chung-Shan S. Rd., Taipei City, 10002, Taiwan R.O.C..
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Zhang Z, Mao J, Lao J, Chen N, Deng X, Chen Y, Tao J, Chen Y, Shen L. Total and horizontal distances of the foveal stereotaxic displacement can be prognostic indicators for patients with idiopathic epiretinal membrane. Front Med (Lausanne) 2023; 10:1109471. [PMID: 37051219 PMCID: PMC10084726 DOI: 10.3389/fmed.2023.1109471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
IntroductionThis study aimed to examine the foveal stereo deviations in the different ectopic inner foveal layer (EIFL) stages of idiopathic epiretinal membrane (iERM) and assess its predictive utility for the baseline and postoperative best-corrected visual acuity (BCVA).MethodsBased on the calculational combination of foveal displacements in the horizontal and vertical axial optical coherence tomography (OCT) images, the foveal stereotaxic displacement was estimated through the total distance (TD, the distance from the foveal bottom to the inner edge of displaced central foveal) and horizontal distance (HD, projection of the TD in the retinal plane). The preoperative TD, HD, and other OCT- and OCT angiography (OCTA)-related indicators were obtained. The correlations between structural parameters and baseline and postoperative BCVA were evaluated through correlation and multiple linear regression analyses.ResultsIn patients with advanced EIFL stage, there was a significant increase in the HD, TD, baseline log of the minimum angle of resolution unit for BCVA, central macular thickness (CMT), acircularity index, and incidence of microcystic macular edema (MME; p < 0.05). Further, they showed a decreased foveal avascular zone (FAZ) area and perimeter (p < 0.001). HD, TD, CMT, MME, FAZ area, and FAZ perimeter were significantly correlated with the baseline and postoperative BCVA (p < 0.05). TD had the highest correlation indexic and was an individual predictor of the baseline and postoperative BCVA. Moreover, FD-300 and MME were individual predictors of postoperative BCVA.DiscussionStereoscopic foveal deviations significantly correlated with the baseline and postoperative visual acuity. TD may be used as an independent prognostic factor for BCVA.
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Affiliation(s)
- Zhengxi Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jianbo Mao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Department of Retina Center, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Jimeng Lao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Nuo Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Xinyi Deng
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Yijing Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jiwei Tao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Yiqi Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Department of Retina Center, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Lijun Shen
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
- *Correspondence: Lijun Shen,
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20
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da Silva RA, Roda VMDP, Akamine PS, da Silva DS, Siqueira PV, Matsuda M, Hamassaki DE. Blockade of the TGF-β pathway by galunisertib inhibits the glial-mesenchymal transition in Müller glial cells. Exp Eye Res 2023; 226:109336. [PMID: 36455675 DOI: 10.1016/j.exer.2022.109336] [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: 08/31/2022] [Revised: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 11/30/2022]
Abstract
Aging increases the risks for developing fibrocontractile membranes on the retina, which causes significant macular distortion, as in the idiopathic epiretinal membrane (iERM). Retinal Müller glial cells are components of these membranes and may play a key role in the iERM pathogenesis. The transforming growth factor-β (TGF-β) induces Müller cell transdifferentiation into myofibroblast, reducing glial cell markers (glutamine synthetase, GS, and glial fibrillary acidic protein, GFAP) and increasing α-smooth muscle actin (α-SMA). Our aim was to investigate the effect of the TGF-β inhibitor galunisertib (LY2157299) on the glial-mesenchymal transition and contraction of Müller cells. MIO-M1 human Müller cells were treated with TGF-β1 (10 ng/mL), galunisertib (5, 10 and 20 μM) and TGF-β1+galunisertib for 24h and 48h. Galunisertib cytotoxicity was analyzed by MTT and trypan blue, and TGF-β1 blockade by phospho-SMAD3 immunofluorescence. Caspase-3 (cell death indicator), GS, GFAP and α-SMA expression was examined by immunofluorescence, Western blotting, and qPCR analysis. Cell contractility was determined by collagen gel contraction assay with Müller cells incorporated. Galunisertib did not show cytotoxicity at the concentrations evaluated and maintained the Müller cells phenotype, ensuring the GS expression. Galunisertib inhibited the TGF-β1 pathway by decreasing phospho-SMAD3 immunoreactivity, attenuated the α-SMA expression, and prevented the contraction of Müller cells in collagen gel. Although more studies are needed, in vitro assays suggest that galunisertib may be a potential candidate to attenuate the formation of fibrocontractile membranes and prevent retinal detachment and consequent loss of vision.
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Affiliation(s)
- Rafael André da Silva
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Vinicius Moraes de Paiva Roda
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Priscilla Sayami Akamine
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Daniela Simões da Silva
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Paula Veloso Siqueira
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Monique Matsuda
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil; Laboratory of Investigation in Ophthalmology (LIM-33), Division of Ophthalmology, University of São Paulo Faculty of Medicine, São Paulo, SP, Brazil
| | - Dânia Emi Hamassaki
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil.
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21
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Peck T, Salabati M, Mahmoudzadeh R, Soares R, Xu D, Myers JS, Hsu J, Garg SJ, Khan MA. Epiretinal Membrane Surgery in Eyes with Glaucoma: Visual Outcomes and Clinical Significance of Inner Microcystoid Changes. Ophthalmol Retina 2022; 6:693-701. [PMID: 35314387 DOI: 10.1016/j.oret.2022.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate visual acuity (VA) outcomes and OCT-based biomarkers of vision outcomes in eyes with glaucoma undergoing pars plana vitrectomy (PPV) for idiopathic epiretinal membrane (ERM). DESIGN Retrospective, consecutive case-control series. A previously described ERM grading scale was utilized for OCT analysis. SUBJECTS Eyes with glaucoma undergoing PPV for idiopathic ERM. INTERVENTION PPV with membrane peel (MP) surgery. MAIN OUTCOME MEASURES The primary outcome was VA at postoperative month 6. Outcomes were compared to a contemporary, matched control group of eyes without concurrent glaucoma undergoing PPV for idiopathic ERM. RESULTS A total of 103 eyes from 103 patients with ERM and glaucoma were followed for a mean (± standard deviation) of 656 (± 421) days after PPV with MP surgery. Glaucoma was classified as open angle in 98 (95.1%) eyes and closed angle in 5 (4.9%) eyes. Visual acuity improved from 0.72 ± 0.48 (20/105) to 0.55 ± 0.51 (20/71) at 6 months and to 0.50 ± 0.56 (20/63) at final follow-up (P < 0.001 for both the time points). Eyes with preoperative inner microcystoid changes (n = 59; 57.3%) had significantly worse preoperative VA, postoperative VA at month 6, and final VA compared to eyes without inner microcystoid changes (P = 0.028, 0.004, and 0.007, respectively). Eyes were then compared to a matched control group of 139 eyes without glaucoma. Eyes with ERM and glaucoma had a higher rate of microcystic changes both before surgery (P < 0.001) and at postoperative month 6 (P < 0.001), and had a worse VA at 6 months (P = 0.03) and final follow-up (P = 0.04) compared to control eyes without glaucoma. Advanced disc cupping was the only factor independently correlated with worse 6-month (P = 0.01) and final (P = 0.007) VA in multivariate analysis. CONCLUSIONS Preoperative inner microcystoid changes on OCT were present in over half of eyes with ERM and concurrent glaucoma, and may be a poor prognostic OCT biomarker. Eyes with ERM and concurrent glaucoma experienced worse vision outcomes compared to eyes with ERM alone, particularly those with advanced disc cupping.
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Affiliation(s)
- Travis Peck
- Wills Eye Hospital, Retina Service, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mirataollah Salabati
- Wills Eye Hospital, Retina Service, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Raziyeh Mahmoudzadeh
- Wills Eye Hospital, Retina Service, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rebecca Soares
- Wills Eye Hospital, Retina Service, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - David Xu
- Wills Eye Hospital, Retina Service, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jonathan S Myers
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; Wills Eye Hospital, Glaucoma Service, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jason Hsu
- Wills Eye Hospital, Retina Service, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sunir J Garg
- Wills Eye Hospital, Retina Service, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - M Ali Khan
- Wills Eye Hospital, Retina Service, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Jiang H, Yan B, Meng Z, Zhang L, Lei H, Luo J. The MDM2 Single-Nucleotide Polymorphism T309G Is Associated With the Development of Epimacular Membranes. Front Cell Dev Biol 2022; 10:841660. [PMID: 35359434 PMCID: PMC8963840 DOI: 10.3389/fcell.2022.841660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate the role of the mouse double minute 2 (MDM2) gene single-nucleotide polymorphism (SNP) T309G in the development of epimacular membranes (EMMs) by analyzing the genotype distribution and consistency of the polymorphism in paired membrane-blood samples. Methods: This was a cross–sectional genetic association study of patients with proliferative vitreoretinopathy (PVR) or EMMs. PVR membranes (PVRMs), internal limiting membranes (ILMs) (PVR-ILMs) and blood samples (PVR-blood) from patients with PVR, and EMMs, EMM-ILMs and EMM-blood from patients with EMMs were collected. The genotype of all samples was determined by Sanger sequencing. Sex composition, mean age, the genotype distribution of MDM2 T309G, the allelic frequency of the MDM2 SNP309 G allele (% G) and the somatic mutation rate at the MDM2 T309G locus (% M) were analyzed and compared. The PVR and healthy Chinese donor groups were used as controls for different comparisons. Results: The EMM group of 62 patients was older than the PVR group of 61 patients by an average of 8.87 years (p < 0.0001), but the two groups were statistically similar in the sex composition (p = 0.1754). Importantly, G allele carriers were at a higher risk of developing EMMs than non-G allele carriers (p = 0.0479; OR = 2.047). Moreover, EMM-blood exhibited a significantly higher % G than blood samples from healthy Chinese donors (EMM-blood: 56.78%, donors: 45.61%; p = 0.0256; OR = 1.567). Regarding membrane-blood consistency, % M was significantly different between PVRMs and EMMs (PVRMs: 2.63%, EMMs: 21.57%; p = 0.0097; OR = 10.18) but not between different types of ILMs (PVR-ILMs: 18.18%, EMM-ILMs: 29.17%; p = 0.6855). Furthermore, EMMs (p = 0.0053; OR = 8.250) and EMM-ILMs (p = 0.0233; OR = 14.40) from patients with preoperative macular holes were more predisposed toward somatic mutations at the MDM2 T309G locus than those from patients without preoperative macular holes. Conclusions:MDM2 T309G is associated with the development of EMMs. Herein, the MDM2 SNP309 G allele is first reported as an associated factor of EMMs in a Chinese population. In addition, EMMs and ILMs are genetically unstable at the MDM2 T309G locus, especially when complicated with preoperative macular holes.
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Affiliation(s)
- Heng Jiang
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Bin Yan
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhishang Meng
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lusi Zhang
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hetian Lei
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
- *Correspondence: Hetian Lei, , Jing Luo,
| | - Jing Luo
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Hetian Lei, , Jing Luo,
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23
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Finite Element Analysis of the Epiretinal Membrane Contraction. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
The epiretinal membrane is a thin sheet of fibrous tissue that can form over the macular area of the retina, and may result in the loss of visual acuity or metamorphopsia, due to superficial retinal folds. A vitrectomy surgery, the current treatment procedure for this pathology, is only performed after symptoms are present. However, sometimes the patients do not present any vision improvements after the surgery. The use of computational methods for a patient-specific biomechanical analysis can contribute to better understanding the mechanisms behind the success or failure of a vitrectomy. Using medical data from two patients who underwent a vitrectomy, one with substantial improvements and another with no improvements, an analysis of the retinal displacement due to the contraction of the epiretinal membrane was performed. Our results suggest a causal effect between the magnitude of the retinal displacements caused by the epiretinal membrane contraction and the outcome of the vitrectomy procedure.
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24
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Liu X, Zhao C, Wang L, Wang G, Lv B, Lv C, Xie G, Wang F. Evaluation of an OCT-AI-Based Telemedicine Platform for Retinal Disease Screening and Referral in a Primary Care Setting. Transl Vis Sci Technol 2022; 11:4. [PMID: 35254422 PMCID: PMC8914565 DOI: 10.1167/tvst.11.3.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose To evaluate the performance of a telemedicine platform integrated with optical coherence tomography (OCT) and artificial intelligence (AI) techniques for retinal disease screening and referral. Methods We constructed an OCT-AI–based telemedicine platform and deployed it at four primary care stations located in Jing'an district, Shanghai, to detect retinal disease cases among aged groups and refer them to Shanghai Tenth People's Hospital (TENTH Hospital). Two ophthalmologists jointly graded the data set collected from this pilot application, and then the performance of this platform was analyzed from multiple aspects. Results This study included 1257 participants between July 2020 and September 2020, of whom 394 had retinal pathologies and 146 were even considered urgent cases by the ophthalmologists. The OCT-AI models achieved a sensitivity of 96.6% (95% confidence interval [CI], 91.8%–98.7%) and specificity of 98.8% (95% CI, 98.0%–99.3%) for detecting urgent cases and a sensitivity of 98.5% (95% CI, 96.5%–99.4%) and specificity of 96.2% (95% CI, 94.6%–97.3%) for detecting both urgent and routine cases. Coupled with AI, our platform reduced the workload of human consultation by 96.2% for massive normal cases. The detected disease cases received online medical suggestions at an average time of 21.4 hours via this platform. Conclusions This platform can automatically identify patients with retinal disease with high sensitivity and specificity, support timely human consultation, and bring necessary referrals. Translational Relevance The OCT-AI–based telemedicine platform shows great practical value for retinal disease screening and referral in a real-world primary care setting.
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Affiliation(s)
- Xiaoqiang Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chun Zhao
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lilong Wang
- Ping An Healthcare Technology, Beijing, China
| | | | - Bin Lv
- Ping An Healthcare Technology, Beijing, China
| | | | - Guotong Xie
- Ping An Healthcare Technology, Beijing, China.,Ping An Healthcare and Technology Company Limited, Shanghai, China.,Ping An International Smart City Technology Company Limited, Shenzhen, China
| | - Fang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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25
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Chua PY, Sandinha MT, Steel DH. Idiopathic epiretinal membrane: progression and timing of surgery. Eye (Lond) 2022; 36:495-503. [PMID: 34290446 PMCID: PMC9074182 DOI: 10.1038/s41433-021-01681-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 02/01/2023] Open
Abstract
Primary idiopathic epiretinal membrane (iERM) is a common finding, particularly so in the era of high street spectral-domain optical coherence tomography. Clinicians often face the dilemma of early versus delayed surgical intervention in the management of iERM with macular pucker, especially in those patients with good vision. The aim of this review is to assist clinicians in their understanding of the natural history of iERM to enable decision-making and optimally advising patients. We systematically searched the Medline and EMBASE databases for relevant publications from 2001 onwards using defined search terms with pre-planned inclusion and exclusion criteria. In this article, we review the epidemiology of iERM, classifications, their effect on visual function, the natural history and factors predicting progression and finally, factors which might predict the visual outcome with surgery.
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Affiliation(s)
- Paul Y. Chua
- grid.415970.e0000 0004 0417 2395St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
| | - Maria T. Sandinha
- grid.415970.e0000 0004 0417 2395St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK ,grid.10025.360000 0004 1936 8470Department of Eye and Vision Science, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
| | - David H. Steel
- grid.10025.360000 0004 1936 8470Department of Eye and Vision Science, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK ,grid.419700.b0000 0004 0399 9171Sunderland Eye Infirmary, Sunderland, Sunderland, UK ,grid.1006.70000 0001 0462 7212Bioscience Institute, Newcastle University, Newcastle upon Tyne, UK
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26
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Chueh KM, Hsieh YT, Chen HH, Ma IH, Huang SL. Identification of Sex and Age from Macular Optical Coherence Tomography and Feature Analysis Using Deep Learning. Am J Ophthalmol 2022; 235:221-228. [PMID: 34582766 DOI: 10.1016/j.ajo.2021.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/09/2021] [Accepted: 09/15/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To develop deep learning models for identification of sex and age from macular optical coherence tomography (OCT) and to analyze the features for differentiation of sex and age. DESIGN Algorithm development using database of macular OCT. METHODS We reviewed 6147 sets of macular OCT images from the healthy eyes of 3134 individuals from a single eye center in Taiwan. Deep learning-based algorithms were used to develop models for the identification of sex and age, and 10-fold cross-validation was applied. Gradient-weighted class activation mapping was used for feature analysis. RESULTS The accuracy for sex prediction using deep learning from macular OCT was 85.6% ± 2.1% compared with accuracy of 61.9% using macular thickness and 61.4% ± 4.0% using deep learning from infrared fundus photography (P < .001 for both). The mean absolute error for age prediction using deep learning from macular OCT was 5.78 ± 0.29 years. A thorough analysis of the prediction accuracy and the gradient-weighted class activation mapping showed that the cross-sectional foveal contour lead to a better sex distinction than macular thickness or fundus photography, and the age-related characteristics of macula were on the whole layers of retina rather than the choroid. CONCLUSIONS Sex and age could be identified from macular OCT using deep learning with good accuracy. The main sexual difference of macula lies in the foveal contour, and the whole layers of retina differ with aging. These novel findings provide useful information for further investigation in the pathogenesis of sex- and age-related macular structural diseases.
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27
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Pan Q, Gao Z, Hu X, Wu Q, Zheng JW, Zhang ZD. Risk factors for epiretinal membrane in eyes with primary rhegmatogenous retinal detachment that received silicone oil tamponade. Br J Ophthalmol 2022; 107:856-861. [DOI: 10.1136/bjophthalmol-2021-320121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/12/2022] [Indexed: 11/03/2022]
Abstract
Background/aimsThis study investigated the risk factors for epiretinal membrane (ERM) in eyes with primary rhegmatogenous retinal detachment (RRD) that received silicone oil (SO) tamponade.MethodsThis retrospective analysis included 1140 patients (1140 eyes) with RRD who underwent primary vitrectomy and SO tamponade. The prevalence of ERM was estimated and possible risk factors (eg, type 2 diabetes, proliferative vitreoretinopathy (PVR), SO tamponade time (SOTT), photocoagulation, vitreous haemorrhage, choroidal detachment, cryotherapy and retinal tear size) were analysed via multiple logistic regression.ResultsThe prevalence of ERM was 12.3% (140/1140), and the accuracy of preoperative ERM diagnosis was 40.5%. Multivariate logistic regression analysis showed that risk factors for ERM in eyes with SO tamponade included preoperative PVR (OR=4.336, 95% CI 2.533 to 7.424, p<0.001), type 2 diabetes (OR=3.996, 95% CI 2.013 to 7.932, p<0.001), photocoagulation energy (OR=1.785, 95% CI 1.306 to 2.439, p<0.001) and SOTT (OR=1.523, 95% CI 1.261 to 1.840, p<0.001). No statistically significant associations were observed between the incidence of ERM and other risk factors. Preoperative PVR showed the strongest association with risk of ERM. The risk of ERM was positively associated with SOTT, photocoagulation energy and preoperative PVR grade.ConclusionIn eyes with RRD that received SO tamponade, the prevalence of ERM was 12.3%, while the accuracy of preoperative ERM diagnosis was low. Preoperative PVR, type 2 diabetes, photocoagulation energy and SOTT were the main risk factors for ERM.
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28
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Padidam S, Skopis G, Lai MM. Prevalence of Cystoid Macular Edema After Cataract Surgery in Eyes with Previous Macular Surgery. Clin Ophthalmol 2022; 16:423-427. [PMID: 35210747 PMCID: PMC8859272 DOI: 10.2147/opth.s333754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/26/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To determine the prevalence and risk factors for cystoid macular edema (CME) after cataract surgery in eyes that have previously undergone macular surgery. Study Design and Methods Retrospective consecutive interventional case series. Patient medical records and Spectral Domain Optical Coherence Tomography (SD-OCT) were reviewed for eyes that underwent vitrectomy for full thickness macular hole (FTMH), lamellar macular hole (LMH) or epiretinal membrane (ERM) and subsequent cataract surgery at a large private retina practice between 2016 and 2018. Results Around 9.1% of eyes (22/243) developed CME post cataract surgery. The mean time from macular surgery to cataract surgery was 273 days (range: 87–797) in eyes with CME and 289 days (range: 22–897) in eyes without CME (p = 0.67). There was no difference in final visual acuity between eyes with CME (20/40, logMAR 0.312) and without CME (20/30, logMAR 0.206) (p = 0.101). Compared with patients with FTMH or LMH, patients with epiretinal membrane were more likely to develop post cataract CME (OR = 2.97, p = 0.031, Chi square test). Conclusion In eyes with history of macular surgery, the prevalence of post cataract surgery CME was around 9.1%. The development of CME is not dependent on timing of cataract surgery but is more common in eyes with history of epiretinal membrane.
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Affiliation(s)
- Sneha Padidam
- The Retina Group of Washington, Chevy Chase, MD, USA
- Department of Ophthalmology, Medstar Washington Hospital Center, Washington, DC, USA
| | - George Skopis
- Department of Ophthalmology, Medstar Washington Hospital Center, Washington, DC, USA
| | - Michael M Lai
- The Retina Group of Washington, Chevy Chase, MD, USA
- Department of Ophthalmology, Medstar Washington Hospital Center, Washington, DC, USA
- Correspondence: Michael M Lai, Tel +301-656-8100, Email
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29
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Xue CC, Cui J, Zhu XB, Xu J, Zhang C, Chen DN, Wang YX, Jonas JB. Serum Sodium Concentration and Increased Risk for Primary Epiretinal Membrane. Front Med (Lausanne) 2022; 8:770362. [PMID: 35004738 PMCID: PMC8739264 DOI: 10.3389/fmed.2021.770362] [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: 09/03/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: To examine the prevalence of primary epiretinal membranes (ERMs) and associated systemic factors. Methods: The cross-sectional, community-based Tongren Health Care Study enrolled participants who received regular health examinations in the Beijing Tongren Hospital from 2017 to 2019. Using fundus photographs, retinal specialists assessed the presence of ERMs and their systemic associations. Results: Primary ERMs were detected in 841/22820 individuals, with a prevalence of 3.7% [95% confidence intervals (CI): 3.4–3.9%] in the total study population (mean age: 44.5 ± 13.8 years) and 6.5% (95% CI: 6.1–7.0%) in individuals aged 40+ years. In multivariable analysis, a higher ERMs prevalence was associated with older age [odds ratio (OR): 1.10; P < 0.001], higher serum cholesterol concentration (OR: 1.14; P = 0.003) and higher serum sodium concentration (SSC) (OR: 1.12; P < 0.001). In women, a higher SSC, even within the normal range, was associated with an increased risk of ERMs (OR: 1.19; P < 0.001). Female participants with an SSC of 144–145mmol/L as compared with those with an SSC of 135–137 mmol/L had a 5-fold increased odds of having ERMs (All women: OR: 5.33; P < 0.001; Women aged 40+years: OR: 4.63; P < 0.001). Conclusion: Besides older age and higher serum cholesterol concentration, a higher SSC, even if within the normal range, was independently associated with a higher ERM prevalence in women.
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Affiliation(s)
- Can Can Xue
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing Cui
- Department of Physical Examination, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiao Bo Zhu
- Department of Ophthalmology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jie Xu
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Chun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Dong Ning Chen
- Department of Physical Examination, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ya Xing Wang
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jost B Jonas
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Medical Faculty Mannheim, Department of Ophthalmology, Heidelberg University, Mannheim, Germany.,Institute of Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda, Heidelberg, Germany.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
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Redick DW, Hwang JC, Kloosterboer A, Yannuzzi NA, Patel NA, Kuriyan AE, Sridhar J. Content, Readability, and Accountability of Freely Available Online Information for Patients Regarding Epiretinal Membranes. Semin Ophthalmol 2022; 37:67-70. [PMID: 33998392 PMCID: PMC8594279 DOI: 10.1080/08820538.2021.1913192] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To assess content, readability, and accountability of online information for patients regarding epiretinal membranes (ERMs). METHODS Cross-sectional study evaluating nine major medical websites on ERMs. Fifteen questions assessed patient-relevant content. Four indices estimated U.S. grade literacy level of the text. JAMA benchmarks (authorship, attribution, disclosure, currency) evaluated website accountability. RESULTS Average content score was 36.78 (SD 13.91, 95% CI ±0.64) from a possible maximum of 60, with significant variability between websites (H = 22.68, p=0.004). Mean reading grade level was 12.29 (SD 2.30, 95% CI ±1.50). No website achieved all JAMA benchmarks; only one website fulfilled three of the four. Content score did not correlate with Google rank (order of listed websites, r = -0.23, p=0.55) or JAMA benchmarks (r = 0.19, p=0.62) but significantly correlated with mean reading grade (r = 0.67, p=0.05). CONCLUSION Online information regarding ERMs varies significantly, may not adequately answer common patient questions, and is written at too complex a literacy level for the average patient.
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Affiliation(s)
- David W. Redick
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
| | - Jodi C. Hwang
- University of Miami Miller School of Medicine, 1600 NW 10th Avenue #1140, Miami, FL, 33136
| | - Amy Kloosterboer
- University Hospitals Cleveland Medical Center, Department of Ophthalmology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106
| | - Nicolas A. Yannuzzi
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
| | - Nimesh A. Patel
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
| | - Ajay E. Kuriyan
- Mid-Atlantic Retina, The Retina Service, Wills Eye Institute, Thomas Jefferson University, 840 Walnut St. 10th Floor, Philadelphia, Pennsylvania, 19107,David and Ilene Flaum Eye Institute, Department of Ophthalmology, University of Rochester Medical Center, 210 Crittenden Boulevard, Rochester, NY, 14642
| | - Jayanth Sridhar
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, Florida 33136
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da Silva RA, Roda VMDP, Matsuda M, Siqueira PV, Lustoza-Costa GJ, Wu DC, Hamassaki DE. Cellular components of the idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2021; 260:1435-1444. [PMID: 34842983 DOI: 10.1007/s00417-021-05492-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/24/2021] [Accepted: 11/04/2021] [Indexed: 01/19/2023] Open
Abstract
Idiopathic epiretinal membrane (iERM) is a fibrocellular proliferation on the inner surface of the retina, which leads to decreased visual acuity and even central visual loss. As iERM is associated to advanced age and posterior vitreous detachment, a higher prevalence is expected with increasing life expectancy and aging of the global population. Although various cell types of retinal and extra-retinal origin have been described in iERMs (Müller glial cells, astrocytes, hyalocytes, retinal pigment epithelium cells, myofibroblasts, and fibroblasts), myofibroblasts have a central role in collagen production and contractile activity. Thus, myofibroblast differentiation is considered a key event for the iERM formation and progression, and fibroblasts, Müller glial cells, hyalocytes, and retinal pigment epithelium have been identified as myofibroblast precursors. On the other side, the different cell types synthesize growth factors, cytokines, and extracellular matrix, which have a crucial role in ERM pathogenesis. In the present review, the major cellular components and their functions are summarized, and their possible roles in the iERM formation are discussed. By exploring in detail the cellular and molecular aspects of iERM, we seek to contribute for better understanding of this fibrotic disease and the origin of myofibroblasts, which may eventually drive to more targeted therapeutic approaches.
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Affiliation(s)
- Rafael André da Silva
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Vinicius Moraes de Paiva Roda
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Monique Matsuda
- Laboratory of Investigation in Ophthalmology (LIM-33), Division of Ophthalmology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Paula Veloso Siqueira
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Gabriela Jesus Lustoza-Costa
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil
| | - Davi Chen Wu
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil.,Department of Ophthalmology, Irmandade de Misericórdia da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Dânia Emi Hamassaki
- Department of Cell & Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-000, Brazil.
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Wang YH, Huang C, Tseng YL, Zhong J, Li XM. Refractive Error and Eye Health: An Umbrella Review of Meta-Analyses. Front Med (Lausanne) 2021; 8:759767. [PMID: 34805225 PMCID: PMC8599990 DOI: 10.3389/fmed.2021.759767] [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: 08/17/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022] Open
Abstract
Purpose: To explore the associations between refractive errors and multiple eye health outcomes. Methods: This is an umbrella review based on systematic reviews with meta-analyses. In our study, refractive errors included myopia, hyperopia, astigmatism, and anisometropia. We reconducted the meta-analyses whose primary data were available in sufficient detail by random effect model. Heterogeneity was assessed by I 2. The main outcomes included myopic macular degeneration (MMD), retinal detachment (RD), cataract, open-angle glaucoma (OAG), strabismus, age-related macular degeneration (AMD), and diabetic retinopathy (DR). Results: Myopia was associated with increased risk of MMD (relative risk = 102.11, 95% CI 52.6-198.22), RD (3.45, 1.08-11.00), nuclear cataract (2.15, 1.53-3.03), posterior subcapsular (PSC) cataract (1.74, 1.41-2.15), OAG (1.95, 1.74-2.19), exotropia (5.23, 2.26-12.09), but decreased risk of DR (0.83, 0.66-1.04), and early AMD (0.80, 0.67-0.94). From mild-to-high myopia, the association strengthened for MMD, RD, nuclear cataract, PSC cataract, OAG, and DR. Hyperopia was associated with an increased risk of early AMD (1.09, 1.01-1.18) and esotropia (22.94, 10.20-51.62). Astigmatism and anisometropia were associated with increased risk of both exotropia and esotropia. Conclusions: Myopia, especially high myopia, demonstrated the highest risk for eye health outcomes, such as MMD, RD, OAG, nuclear and PSC cataracts, and exotropia. However, myopia was associated with a lower risk of early AMD and DR. Individuals with hyperopia are more likely to suffer early AMD and esotropia. Astigmatism and anisometropia predispose to strabismus. A lot of research studies on the mechanism of the associations are needed. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=239744; identifier: 239744.
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Affiliation(s)
- Yin-Hao Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Chen Huang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Center of Basic Medical Research, Peking University Third Hospital, Beijing, China
| | - Yu-Lin Tseng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Jing Zhong
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xue-Min Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Colombo L, Maltese PE, Romano D, Fogagnolo P, Castori M, Marceddu G, Cristofoli F, Percio M, Piteková B, Modarelli AM, Bertelli M, Rossetti L. SD-OCT analysis in syndromic and non-syndromic forms of retinitis pigmentosa due to USH2A gene mutations. Ophthalmic Res 2021; 65:180-195. [PMID: 34781295 DOI: 10.1159/000520329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/09/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aims to analyze macular structure by using SD-OCT in a cohort of patients affected by autosomal recessive retinitis pigmentosa and Usher syndrome, due to genetic variants in USH2A gene, and to correlate OCT parameters with functional and genetic data. METHODS The subjects of this study were 92 patients, 46 syndromic (Ush2) and 46 non-syndromic (arRP), with clinical and genetic diagnosis of USH2A-related retinal dystrophy, who underwent a complete ophthalmic examination and spectral domain OCT analysis. The study focused on evaluating the differences between the two groups in the following parameters: best corrected visual acuity (BCVA), ellipsoid zone width (EZ), presence of epiretinal membrane (ERM) and cystic macular lesions (CML). Variants in USH2A gene were divided in 3 categories, according to the expected impact (low/high) at protein level of the different variants on each allele. RESULTS BCVA and EZ width were significantly lower in Ush2 than in arRP patients (p < 0.0001 and p = 0.001). ERM was detected in 34.8% (16/46) of arRP patients and in 65.2% (30/46) of Ush2 patients (p = 0.003). CML was detected in 17.4% (8/46) of arRP patients and 30.4% (14/46) of Ush2 patients (p = 0.14). The allelic distribution was statistically different (p = 0.0003) by dividing the two diseases: for Ush2 patients it was 45.7% (high/high), 39.1% (low/high) and 15.2% (low/low); for arRP patients it was 8.7% (high/high), 56.5% (low/high) and 34.8% (low/low). The severity class of the variants significantly affected VA and EZ width parameters (p = 0.004 and p = 0.002, respectively). CONCLUSION Retinal disease, as evaluated by means of SD-OCT, shows more advanced degeneration signs in the syndromic than the non-syndromic form of retinal dystrophy related to USH2A gene. Variant types and allelic profiles are determining factors for the onset of syndromic features. However, since the three allelic profiles can be found in both Usher and RP patients, other factors must necessarily play a determining role.
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Affiliation(s)
- Leonardo Colombo
- Department of Ophthalmology, ASST Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | | | - Dario Romano
- Department of Ophthalmology, ASST Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | - Paolo Fogagnolo
- Department of Ophthalmology, ASST Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | - Marco Castori
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | | | | | - Barbora Piteková
- Department of Pediatrics, Comenius University Faculty of Medicine, National Institute of Children's Diseases, Bratislava, Slovakia
| | - Antonio Mattia Modarelli
- Department of Ophthalmology, ASST Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
| | - Matteo Bertelli
- MAGI'S Lab s.r.l., Rovereto, Italy
- MAGI Euregio s.c.s., Bolzano, Italy
| | - Luca Rossetti
- Department of Ophthalmology, ASST Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy
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Norton JC, Soliman MK, Yang YC, Kurup S, Sallam AB. Visual outcomes of primary versus secondary epiretinal membrane following vitrectomy and cataract surgery. Graefes Arch Clin Exp Ophthalmol 2021; 260:817-825. [PMID: 34625846 DOI: 10.1007/s00417-021-05425-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/30/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To compare visual outcomes, incidence of cystoid macular edema (CME), and rate of repeat epiretinal membrane (ERM) surgery following phacovitrectomy for primary and secondary ERM. METHODS Retrospective review of 178,856 cataract surgeries from 2003 to 2015. Eyes that underwent cataract surgery combined with ERM peel were included (n = 708). Eyes were divided into primary (n = 538) and secondary (n = 170) ERM groups. Patient demographics, visual acuity (VA), and postoperative CME were recorded. RESULTS Patients with secondary ERM had worse preoperative VA, 0.9 ± 0.6 logMAR (20/160 Snellen equivalent) as compared to patients with primary ERM, 0.6 ± 0.3 (20/80), respectively (p < 0.0001). There was no difference between the secondary and primary ERM groups in postoperative vision (0.5 ± 0.4 logMAR vs. 0.5 ± 0.3; p = 0.9962) or proportion with VA ≥ 20/40 (46.4% vs. 43.1%; p = 0.6744) at 12-24 weeks. Postoperative CME was twice as likely in the secondary ERM group (16.5%) compared to the primary ERM group (7.8%) (p = 0.0018). There was no difference in the rate of repeat ERM surgery between the secondary ERM group (1.8%) and the primary ERM group (1.5%) (p = 0.7308). CONCLUSION Eyes with secondary ERM had significant postoperative improvement in VA. They had worse preoperative VA and had a twofold increase in postoperative CME than primary ERM.
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Affiliation(s)
- J Corbin Norton
- Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72205, USA
| | - Mohamed K Soliman
- Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Yit C Yang
- Wolverhampton Eye Infirmary, Royal Wolverhampton Hospitals NHS Trust, New Cross, Wolverhampton, UK
| | - Shree Kurup
- Department of Ophthalmology and Visual Sciences, University Hospitals Eye Institute, Case Western Reserve University, Cleveland, OH, USA
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72205, USA.
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35
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Shao E, Liu C, Wang L, Song D, Guo L, Yao X, Xiong J, Wang B, Hu Y. Artificial intelligence-based detection of epimacular membrane from color fundus photographs. Sci Rep 2021; 11:19291. [PMID: 34588493 PMCID: PMC8481557 DOI: 10.1038/s41598-021-98510-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 09/01/2021] [Indexed: 12/25/2022] Open
Abstract
Epiretinal membrane (ERM) is a common ophthalmological disorder of high prevalence. Its symptoms include metamorphopsia, blurred vision, and decreased visual acuity. Early diagnosis and timely treatment of ERM is crucial to preventing vision loss. Although optical coherence tomography (OCT) is regarded as a de facto standard for ERM diagnosis due to its intuitiveness and high sensitivity, ophthalmoscopic examination or fundus photographs still have the advantages of price and accessibility. Artificial intelligence (AI) has been widely applied in the health care industry for its robust and significant performance in detecting various diseases. In this study, we validated the use of a previously trained deep neural network based-AI model in ERM detection based on color fundus photographs. An independent test set of fundus photographs was labeled by a group of ophthalmologists according to their corresponding OCT images as the gold standard. Then the test set was interpreted by other ophthalmologists and AI model without knowing their OCT results. Compared with manual diagnosis based on fundus photographs alone, the AI model had comparable accuracy (AI model 77.08% vs. integrated manual diagnosis 75.69%, χ2 = 0.038, P = 0.845, McNemar’s test), higher sensitivity (75.90% vs. 63.86%, χ2 = 4.500, P = 0.034, McNemar’s test), under the cost of lower but reasonable specificity (78.69% vs. 91.80%, χ2 = 6.125, P = 0.013, McNemar’s test). Thus our AI model can serve as a possible alternative for manual diagnosis in ERM screening.
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Affiliation(s)
- Enhua Shao
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Congxin Liu
- Beijing Eaglevision Technology Co., Ltd, Beijing, China
| | - Lei Wang
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Dan Song
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Libin Guo
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xuan Yao
- Beijing Eaglevision Technology Co., Ltd, Beijing, China
| | - Jianhao Xiong
- Beijing Eaglevision Technology Co., Ltd, Beijing, China
| | - Bin Wang
- Beijing Eaglevision Technology Co., Ltd, Beijing, China
| | - Yuntao Hu
- Department of Ophthalmology, Beijing Tisnghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
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36
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Lee DH, Park SE, Lee CS. MICROCYSTIC MACULAR EDEMA AND CYSTOID MACULAR EDEMA BEFORE AND AFTER EPIRETINAL MEMBRANE SURGERY. Retina 2021; 41:1652-1659. [PMID: 33394969 DOI: 10.1097/iae.0000000000003087] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the types of intraretinal cysts that are associated with epiretinal membranes and to evaluate the effects of each type of intraretinal cyst on postoperative outcomes. METHODS Retrospective, cross-sectional study design. Patients who underwent preoperative fluorescent angiography and epiretinal membrane surgery from February 2014 to May 2019 were included. Intraretinal cysts were subdivided into cystoid macular edema with angiographic leakage and microcystic macular edema (MME) without angiographic leakage. RESULTS A total of 100 eyes from 100 patients were enrolled. Intraretinal cysts were present in 54 (54.0%) eyes before surgery, of which 27 (27.0%) eyes showed MME, 18 (18.0%) eyes showed cystoid macular edema, and 9 (9.0%) eyes showed cystoid macular edema and MME. After surgery, the number of eyes with cystoid macular edema decreased significantly (P < 0.001), whereas the number of eyes with MME did not (P = 0.302). Absence of preoperative MME, poorer initial visual acuity, increased central foveal thickness, and intact ellipsoidal zone were associated with favorable visual recovery (P = 0.035, 0.033, 0.018, and 0.035, respectively). CONCLUSION Microcystic macular edema associated with epiretinal membranes was a poor prognostic factor for epiretinal membrane surgery. The persistent existence of MME after surgery affirms related chronic structural changes. Further studies should investigate whether earlier surgical intervention (possibly before the development of MME) benefits visual outcomes.
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Affiliation(s)
- Dong Hyun Lee
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Inha University Hospital, Inha University School of Medicine, Incheon , Republic of Korea; and
| | - Sung Eun Park
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Chen YC, Chen SJ, Li AF, Huang YM. Visual outcomes and incidence of pseudophakic cystoid macular oedema in eyes with cataract and idiopathic epiretinal membrane after two-step sequential surgery. Eye (Lond) 2021; 36:1597-1603. [PMID: 34290439 PMCID: PMC9307847 DOI: 10.1038/s41433-021-01673-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To determine whether pars plana vitrectomy (PPV) or cataract surgery should be performed first in concurrent epiretinal membrane (ERM) and cataract treatment with respect to visual outcome and pseudophakic cystoid macular oedema (PCMO) incidence. METHODS Patients who underwent PPV and cataract surgery sequentially at a tertiary medical centre were retrospectively recruited. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) measured from optical coherence tomography (OCT) images collected before and after each surgery were documented. OCT-defined PCMO incidence and its influence on visual outcomes were analysed. RESULTS In total, 259 and 159 eyes received PPV (ERM-CATA) before and after cataract surgery (CATA-ERM), respectively. The ERM-CATA group had better final BCVA (logMAR: 0.274 vs. 0.558, p < 0.001) and greater BCVA gain (logMAR VA change: -0.379 vs. -0.220, p = 0.001) than did the CATA-ERM group. Baseline BCVA was positively correlated with final BCVA (p < 0.001), whereas baseline CMT, final CMT, and postoperative CMT changes were not. PCMO incidence did not differ significantly between the two groups (15.4% vs. 19.5%, p = 0.287), and final BCVA changes did not significantly differ between eyes with and without PCMO. PCMO incidence was much higher (29.40% vs. 16.30%, p = 0.008) in eyes with baseline CMT ≥ 500 μm. CONCLUSIONS When managing ERM and cataract, PPV should be performed before cataract surgery to yield better visual outcomes. Both surgical sequences yield similar PCMO rates. Greater baseline CMT is a risk factor for PCMO after cataract surgery.
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Affiliation(s)
- Yen-Cheng Chen
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Jen Chen
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.,National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - An-Fei Li
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Yi-Ming Huang
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan. .,National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.
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Liew G, Nguyen H, Ho IV, White AJ, Burlutsky G, Gopinath B, Mitchell P. Prevalence of Vitreoretinal Interface Disorders in an Australian Population. OPHTHALMOLOGY SCIENCE 2021; 1:100019. [PMID: 36249297 PMCID: PMC9560650 DOI: 10.1016/j.xops.2021.100019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/05/2021] [Accepted: 04/05/2021] [Indexed: 11/27/2022]
Abstract
Purpose To describe the prevalence, risk factors, and associations of vitreoretinal interface (VRI) abnormalities in a population-based study of older adults. Design Cross-sectional analysis of cohort study participants. Participants Of the 1149 participants (mean age, 76.1 ± 6.9 years) in the 15-year Blue Mountains Eye Study follow-up examination from 2007 through 2009, 905 (1791 eyes) had gradable time-domain or spectral-domain OCT scans of the macula from at least 1 eye. Methods OCT scans were graded according to the International Vitreomacular Traction Study Group classification system of VRI abnormalities. Best-corrected visual acuity (BCVA) was recorded. Main Outcome Measures Prevalence of VRIs. Results Overall, 451 participants showed any VRI abnormality (49.8%). Prevalence of VRI abnormality by person was: vitreomacular adhesion (VMA), 33.6%; vitreomacular traction (VMT), 1.6%; epiretinal membrane (ERM), 21.4%; full-thickness macular hole (FTMH), 0.7%; and lamellar macular hole (LMH), 0.7%. Twenty-two percent of VMAs were focal, and 78% were broad based; 76% of VMTs were focal, and 24% were broad based. All FTMHs observed were large (>400 μm), with mean aperture size of 573 μm (range, 459–771 μm). Increased age was associated with higher ERM and lower VMA prevalence (P < 0.001 for both). Pseudophakia and myopia were associated with ERM (age- and sex-adjusted odds ratios [ORs], 1.48 [95% confidence interval (CI), 1.01–2.17] and 1.72 [95% CI, 1.05–2.81], respectively). Moderate or severe ERM and FTMH were associated with worse BCVA of 9.2 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (95% CI, 3.4–15.0 ETDRS letters; P = 0.008) and 26.0 ETDRS letters (95% CI, 10.9–41.1 ETDRS letters; P = 0.001), respectively. Conclusions The prevalence of VRI abnormalities is high in older individuals. Epiretinal membrane was associated with increasing age, pseudophakia, and myopia. Epiretinal membrane and FTMH may account for significant visual loss in the affected eye. This study provided useful population-based data on the prevalence of VRI abnormalities in older individuals.
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Affiliation(s)
- Gerald Liew
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
- South West Retina, Retina Associates, Sydney, Australia
- Corresponding author: Gerald Liew, MD, PhD, Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, Westmead Hospital, 176 Hawkesbury Road, Westmead, NSW Australia, 2145.
| | - Helen Nguyen
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - I-Van Ho
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
- South West Retina, Retina Associates, Sydney, Australia
- Macquarie University, Department of Ophthalmology, Macquarie Park, Sydney, Australia
| | - Andrew J. White
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - George Burlutsky
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Bamini Gopinath
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
- Macquarie University, Department of Ophthalmology, Macquarie Park, Sydney, Australia
| | - Paul Mitchell
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
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Ikegami Y, Numaga J, Ue S, Sano T. Morphological alternation and influence of aqueous flare in idiopathic epiretinal membrane. Int J Retina Vitreous 2021; 7:40. [PMID: 34001276 PMCID: PMC8127242 DOI: 10.1186/s40942-021-00294-9] [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: 09/26/2020] [Accepted: 03/09/2021] [Indexed: 11/12/2022] Open
Abstract
Background Idiopathic epiretinal membrane (iERM) is a common retinal disease in the elderly population. The exact pathogenesis of iERM is unknown. The present study aimed to evaluate the relationship between aqueous flare and morphology of iERM using swept-source optical coherence tomography (OCT). Methods A consecutive series of 36 eyes of 33 patients with iERM and 109 control eyes of 109 patients were retrospectively examined. Aqueous flare measurements and OCT images were obtained on the same day. The average total retinal, inner retinal, outer retinal, and choroidal thicknesses were calculated using the thickness map mode with an Early Treatment Diabetic Retinopathy Study nine-zone grid that was divided into three zones. The maximum depth of the retinal folds in iERMs was manually measured. The correlation among flare value, maximum depth of folds, and retinal and choroidal thicknesses was evaluated. The morphological changes between the control eyes and the eyes with iERM in different stages were examined. Results The result demonstrated a significant positive correlation between the aqueous flare value and total and inner retinal thicknesses in the early stage of iERM. There was a significant positive correlation between the maximum depth of folds and total and inner retinal thicknesses in the early stage of iERM, and the maximum depth of folds significantly increased in the advanced stage. The total and inner retinal thicknesses and proportion of inner retinal thickness significantly increased as the stage of iERM progressed. Conclusions The aqueous flare value was associated with retinal thickness in the early stage of iERM, which supports the idea that inflammation or breakdown of blood–ocular barrier is involved in the process of iERM formation. The maximum retinal folds increased as the stage of iERM progressed and retinal thickness increased, which indicates that the tangential force increases as the iERM stage progresses.
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Affiliation(s)
- Yasuko Ikegami
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan. .,Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
| | - Jiro Numaga
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
| | - Saori Ue
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
| | - Tomohiro Sano
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
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Fung AT, Galvin J, Tran T. Epiretinal membrane: A review. Clin Exp Ophthalmol 2021; 49:289-308. [PMID: 33656784 DOI: 10.1111/ceo.13914] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 02/07/2023]
Abstract
The prevalence of epiretinal membrane (ERM) is 7% to 11.8%, with increasing age being the most important risk factor. Although most ERM is idiopathic, common secondary causes include cataract surgery, retinal vascular disease, uveitis and retinal tears. The myofibroblastic pre-retinal cells are thought to transdifferentiate from glial and retinal pigment epithelial cells that reach the retinal surface via defects in the internal limiting membrane (ILM) or from the vitreous cavity. Grading schemes have evolved from clinical signs to ocular coherence tomography (OCT) based classification with associated features such as the cotton ball sign. Features predictive of better prognosis include absence of ectopic inner foveal layers, cystoid macular oedema, acquired vitelliform lesions and ellipsoid and cone outer segment termination defects. OCT-angiography shows reduced size of the foveal avascular zone. Vitrectomy with membrane peeling remains the mainstay of treatment for symptomatic ERMs. Additional ILM peeling reduces recurrence but is associated with anatomical changes including inner retinal dimpling.
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Affiliation(s)
- Adrian T Fung
- Westmead Clinical School, Discipline of Ophthalmology and Eye Health, The University of Sydney, Sydney, New South Wales, Australia.,Save Sight Institute, Central Clinical School, Discipline of Ophthalmology and Eye Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University Hospital, Sydney, New South Wales, Australia
| | - Justin Galvin
- St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Tuan Tran
- Save Sight Institute, Central Clinical School, Discipline of Ophthalmology and Eye Health, The University of Sydney, Sydney, New South Wales, Australia
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Li M, Zhang XF, Yusufu M, Liu LJ, Wang S, Wang JD, Zhang JS, Wang KJ, Mao YY, Cao K, Chen SY, Yao QN, Li JJ, Wan XH. Prevalence and Clinical Characteristics of Myelinated Retinal Nerve Fibres in a Chinese Teleophthalmology System. Curr Eye Res 2021; 46:1406-1413. [PMID: 33645355 DOI: 10.1080/02713683.2021.1887273] [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: 10/22/2022]
Abstract
Purpose: To investigate the prevalence and clinical characteristics of myelinated retinal nerve fibre (MRNF) in a large teleophthalmology system.Methods: All records between January 2015 and December 2015 from Daheng Prust teleophthalmology system were reviewed by 2 ophthalmologists independently. MRNF was classified into continuous group and discontinuous group according to the relationship between MRNF patches and optic disc. The number, total area and location of MRNF patches were analysed. Concomitant ocular diseases were documented.Results: Out of 51469 subjects, MRNF was detected in 304 eyes of 263 subjects with a prevalence rate of 0.51 ± 7.1% per subject and 0.30 ± 5.4% per eye. Among 304 eyes with MRNF, 239 (78.6%) eyes were in continuous group and 65 (21.4%) eyes were in discontinuous group. Single MRNF patch was found in 249 (81.9%) eyes and multiple MRNF patches were found in 55 (18.1%) eyes. MRNF of small size was found in 150 (49.3%) eyes. The ratios of multiple MRNF patches and small-sized MRNF in the continuous group were significantly higher than those in the discontinuous group (P = .014 and P < .001). In continuous group, the MRNF patches were located most frequently in the superior region (68.6%) of the optic disc; In discontinuous group, the MRNF patches were located most frequently in the inferotemporal region (38.5%) of the retina. Epiretinal membrane (12 eyes, 3.9%) was the most common concomitant ocular disease.Conclusion: MRNF is uncommon in China. MRNF usually presents unilaterally and as a single small whitish patch that is connected with optic disc.
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Affiliation(s)
- Meng Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Xi-Fang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Li-Juan Liu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shuang Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jin-Da Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jing-Shang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Kai-Jie Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Ying-Yan Mao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shu-Ying Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Qin-Nan Yao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jian-Jun Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Xiu-Hua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
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Tuifua TS, Sood AB, Abraham JR, Srivastava SK, Kaiser PK, Sharma S, Rachitskaya A, Singh RP, Reese J, Ehlers JP. Epiretinal Membrane Surgery Using Intraoperative OCT-Guided Membrane Removal in the DISCOVER Study versus Conventional Membrane Removal. Ophthalmol Retina 2021; 5:1254-1262. [PMID: 33647472 DOI: 10.1016/j.oret.2021.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/09/2021] [Accepted: 02/22/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE To provide a comparative assessment of clinical outcomes between patients undergoing intraoperative OCT (iOCT) and conventional surgery for pars plana vitrectomy (PPV) with epiretinal membrane (ERM) peel. DESIGN Case-control retrospective, comparative assessment. PARTICIPANTS Patients undergoing PPV with membrane peel for ERM with eyes pooled from the prospective Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/Integrated OCT Visualization During En Face Retinal and Ophthalmic Surgery (DISCOVER) iOCT study and eyes undergoing conventional ERM surgery without iOCT. METHODS Visual acuity and OCT assessment before ERM surgery and at 1-, 3-, 6-, and 12-month follow-up after standard small-gauge PPV with iOCT feedback (iOCT DISCOVER group) or PPV with compulsory internal limiting membrane (ILM) peeling (conventional group). Visual acuity, central subfield thickness (CST), reoperation rate, and ERM recurrence were determined by record review and post hoc assessment of clinical OCTs after ERM peel. MAIN OUTCOME MEASURES Visual acuity and ERM recurrence. RESULTS A total of 262 eyes were included. Visual acuity (VA) improved 11.9 letters in the iOCT group (P < 0.0001) and 12.1 letters in the conventional group (P < 0.0001) at 12 months after ERM surgery. Visual acuity improvement did not differ between the iOCT and conventional groups at 1, 3, 6, or 12 months after surgery (P > 0.05 for each time point). Preoperative mean CST decreased in the iOCT group (P < 0.0001) and conventional group (P < 0.0001) with no difference between groups in CST reduction at 12 months (P = 0.36). No reoperations or visually significant recurrent ERMs occurred in either cohort. CONCLUSIONS Intraoperative OCT-guided ERM removal without mandated ILM peeling provided similar VA and anatomic results to conventional ILM peeling for ERM. Future randomized prospective studies are needed to assess fully the possible role of iOCT in ERM surgery and to evaluate the potential impact of nonfoveal ERM persistence or recurrence in comparison with conventional surgery.
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Affiliation(s)
- Tisileli S Tuifua
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Arjun B Sood
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Joseph R Abraham
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sunil K Srivastava
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Peter K Kaiser
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sumit Sharma
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Aleksandra Rachitskaya
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rishi P Singh
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jamie Reese
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Justis P Ehlers
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
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Wide-based foveal pit: a predisposition to idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2021; 259:2095-2102. [PMID: 33528644 DOI: 10.1007/s00417-021-05092-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/07/2021] [Accepted: 01/20/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To report the anatomical characteristics of wide-based foveal pit and its possible associations with macular diseases. METHODS Wide-based foveal pit was defined as a foveal base width (FBW) larger than the mean value plus one standard deviation of the normal population. Eyes with a wide-based foveal pit were retrospectively collected as the study group, and age- and sex-matched subjects with a normal FBW were recruited as the control group. FBW, area of foveal avascular zone (FAZ), and retinal artery trajectory (RAT) were compared between the two groups. The characteristics of the fellow eyes in the study group were also described. RESULTS Fifty-two eyes from 52 patients were identified as having a wide-based foveal pit; 43 (82.7%) were female. Both their FBW (474.7 ± 84.6 μm) and area of FAZ (0.50 ± 0.11 mm2) were significantly larger than in the control group (297.6 ± 42.3 μm and 0.29 ± 0.10 mm2, respectively; p < 0.001 for both), and they also had a wider RAT than the control group (p < 0.001). During follow-up, three eyes had developed idiopathic epiretinal membrane. As for their fellow eyes, they either also had a wide-based foveal pit (11 eyes) or had various macular diseases including idiopathic epiretinal membrane (27 eyes), macular hole (5 eyes), and others (16 eyes). CONCLUSIONS Eyes with a wide-based foveal pit had a large FAZ and a wide RAT, and they might have a predisposition to idiopathic epiretinal membrane formation. Their fellow eyes also had a predisposition to epiretinal membrane and macular hole.
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Shimizu H, Asaoka R, Omoto T, Fujino Y, Mitaki S, Onoda K, Nagai A, Yamaguchi S, Tanito M. Prevalence of Epiretinal Membrane among Subjects in a Health Examination Program in Japan. Life (Basel) 2021; 11:life11020093. [PMID: 33513873 PMCID: PMC7912057 DOI: 10.3390/life11020093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
The prevalence of an epiretinal membrane (ERM) was elucidated using a dataset from a health examination program database in Japan. From the cohort database, 5042 eyes of 2552 subjects were included. The presence of an ERM, cellophane macular reflex (CMR), or preretinal macular fibrosis (PMF) was detected using color fundus photographs, and crude and age-standardized prevalence were obtained. To further assess the possible risk factors of ERM, background parameters were compared between ERM+ and − groups, and multiple logistic regression analysis was performed. ERM was detected in fundus photographs of 275 eyes (eye-based prevalence of 5.5%) from 217 subjects (subject-based prevalence of 8.5%). CMR was detected in 169 eyes (3.4%) of 138 subjects (5.4%), and PMF was detected in 106 eyes (2.1%) of 97 subjects (3.8%). By univariate analyses, compared with ERM− eyes or subjects, higher Scheie’s H grade (p < 0.0001), S grade (p < 0.0001), and glaucoma prevalence (p = 0.0440) were found in ERM+ eyes, and older age (p < 0.0001), more frequent histories of hypertension (p = 0.0033) and hyperlipidemia (p = 0.0441), and more frequent uses of medication for hypertension (p = 0.0034) and hyperlipidemia (p = 0.0074), shorter body height (p = 0.0122), and higher systolic blood pressure (p = 0.0078), and thicker intimal medial thickness (p = 0.0318) were found in ERM+ subjects. By multivariate analyses, older age (p < 0.0001, estimate = 0.05/year) was the only significant factor of ERM prevalence. Age-standardized prevalence of ERM was calculated to be 2.4%, 6.7%, and 13.3% for all ages, subjects older than 40 years, and subjects older than 65 years, respectively. We reported the prevalence of ERM and its subclasses in Japanese subjects. Since its prevalence is remarkably high in older subjects, an ERM can be seen as an important cause of visual impairment in Japan and in areas of the world where individuals live to an advanced age.
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Affiliation(s)
- Hiroshi Shimizu
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan; (R.A.); (Y.F.)
| | - Takashi Omoto
- Department of Ophthalmology, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Yuri Fujino
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu 430-8558, Japan; (R.A.); (Y.F.)
| | - Shingo Mitaki
- Department of Neurology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (S.M.); (A.N.); (S.Y.)
| | - Keiichi Onoda
- Faculty of Psychology, Otemon Gakuin University, Ibaraki 567-8502, Japan;
| | - Atsushi Nagai
- Department of Neurology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (S.M.); (A.N.); (S.Y.)
| | - Shuhei Yamaguchi
- Department of Neurology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan; (S.M.); (A.N.); (S.Y.)
| | - Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
- Correspondence: ; Tel.: +81-853-20-2284
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Tan L, Long Y, Li Z, Ying X, Ren J, Sun C, Meng X, Li S. Ocular abnormalities in a large patient cohort with retinitis pigmentosa in Western China. BMC Ophthalmol 2021; 21:43. [PMID: 33461530 PMCID: PMC7812647 DOI: 10.1186/s12886-020-01797-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background To report the prevalence of ocular abnormalities and investigate visual acuity in a large cohort of retinitis pigmentosa (RP) patients in Western China. Methods The medical records and ophthalmic examination reports of 2127 eyes of 1065 RP patients at one eye hospital were retrospectively reviewed to determined the prevalence of ocular abnormalities and the relationship between best corrected visual acuity (BCVA) and macular abnormalities. Results Nyctalopia (58.2%) and blurred vision (27.1%) were the leading reasons for RP patients to request an ophthalmic examination. BCVA measurements in the better eyes at first clinical presentation showed that 304 patients (28.5%) were categorised as blind and 220 patients (20.7%) as low vision. The most common ocular abnormalities were macular abnormalities (59.7%) and cataracts (43.1%). The macular abnormalities included epiretinal membranes (51.1%), cystoid macular edema (18.4%), vitreomacular traction syndrome (2.4%), macular holes (2.3%) and choroidal neovascular membranes (0.05%). Glaucoma was found in 35 eyes (1.6%). The proportions of epiretinal membranes (p = 0.001) and macular holes (p = 0.008) increased significantly with age. Cystoid macular edema was significantly associated with poorer visual acuity in RP patients with clear lens (p = 0.002). Conclusion Cataracts and macular abnormalities are common in RP patients. Of the macular abnormalities, cystoid macular edema may have a negative effect on BCVA in RP patients with clear lens. Therefore, optical coherence tomography screening in RP patients is highly recommended for early detection and treatment of maculopathy. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-020-01797-z.
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Affiliation(s)
- Lian Tan
- Southwest Eye Hospital/Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China
| | - Yanling Long
- Southwest Eye Hospital/Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China
| | - Ziyang Li
- Southwest Eye Hospital/Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China
| | - Xi Ying
- Southwest Eye Hospital/Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China
| | - Jiayun Ren
- Southwest Eye Hospital/Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China
| | - Cheng Sun
- Southwest Eye Hospital/Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China
| | - Xiaohong Meng
- Southwest Eye Hospital/Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China. .,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
| | - Shiying Li
- Southwest Eye Hospital/Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China. .,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China.
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Kim B, Choi A, Park JH, Jeon S. Prevalence of epiretinal membrane in the phakic eyes based on spectral-domain optical coherence tomography. PLoS One 2021; 16:e0245063. [PMID: 33411853 PMCID: PMC7790294 DOI: 10.1371/journal.pone.0245063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
The prevalence of epiretinal membrane (ERM) and associated factors in the phakic eyes have not been fully elucidated yet. This cross-sectional study included 2,354 phakic eyes without retinal diseases or surgical history. Ocular parameters, such as uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), intraocular pressure (IOP), white-to-white corneal diameter (WTW), mean keratometric value (Km) of total corneal refractive power at 4-mm diameter (TCRP4), astigmatism of TCRP4, total corneal irregular astigmatism (TCIA), pupil diameter, axial length (AXL), anterior chamber depth (ACD), lens thickness (LT), and posterior vitreous detachment (PVD) were compared between ERM group and control group. Additionally, an age-matched control group was selected by individual matching and compared with the ERM group to eliminate the confounders. Multiple logistic regression analysis was performed to evaluate the factors associated with the presence of ERM. Among 2,354 eyes, 429 eyes (18.2%) had ERM based on spectral-domain optical coherence tomography. The ERM group showed higher prevalence of PVD, worse CDVA, higher astigmatism of TCRP4, higher TCIA, smaller pupil size, longer AXL, and thicker LT than control group (P < 0.001, P < 0.001, P = 0.011, P < 0.001, P = 0.023, P < 0.001, and P < 0.001, respectively). Only PVD, CDVA, SE, astigmatism of TCRP4, TCIA, and AXL maintained the significance when compared with the age-matched control group (P < 0.001, P = 0.026, P < 0.001, P = 0.001, P = 0.003, and P < 0.001, respectively). Multivariate logistic regression analysis showed that age, PVD, CDVA, and TCIA were independently associated with the presence of ERM (P < 0.001, P < 0.001, P = 0.011, and P = 0.002). The prevalence of ERM detected using SD-OCT was 18.2% in the middle aged phakic population. Eyes with TCIA, in addition to older age and PVD, were more likely to have ERM.
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Told R, Georgopoulos M, Reiter GS, Wassermann L, Aliyeva L, Baumann L, Abela-Formanek C, Pollreisz A, Schmidt-Erfurth U, Sacu S. Intraretinal microvascular changes after ERM and ILM peeling using SSOCTA. PLoS One 2020; 15:e0242667. [PMID: 33259500 PMCID: PMC7707569 DOI: 10.1371/journal.pone.0242667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/06/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To prospectively investigate retinal vascular changes in patients undergoing epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling using swept source optical coherence tomography angiography (SSOCTA). METHODS Consecutive patients were grouped based on ERM severity and followed using SSOCTA up to month 3 after surgical intervention. Superficial and deep foveal avascular zone (s/dFAZ) as well as foveal and parafoveal vessel density (VD) were correlated with ERM severity and visual acuity. Differences between groups were evaluated. RESULTS Significant correlations were found between ERM severity and baseline sFAZ, dFAZ and best corrected visual acuity (BCVA), central retinal subfield thickness (CST) and ΔCST (r = -0.52, r = -0.43, r = -0.42, r = 0.58, r = 0.39; all p<0.05). Vascular flow parameters did not correlate with age, peeling size, pseudophakia or CST, but correlated with intraretinal cysts presence. No associations of BCVA with any of the OCTA parameters across time were found. Significant differences between ERM severity groups 1 and 2 were found for sFAZ at baseline (p = 0.005) and at the 3-month follow-up (p = 0.014), and for dFAZ at baseline (p = 0.017). Superficial foveal and parafoveal VD were not significantly different between groups (all p>0.05). CONCLUSIONS This study clearly shows that ERM severity based on ERM staging has to be taken into account when undertaking studies in patients with idiopathic ERM using SSOCTA. Further, specific changes in the superficial and deep retinal vasculature in eyes undergoing ERM and ILM peeling were found. However, the clinical usefulness and prognostic value for post-surgical treatment BCVA of the SSOCTA-derived variables (sFAZ and dFAZ area, as well as foveal and parafoveal VD) used remains questionable.
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Affiliation(s)
- Reinhard Told
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Michael Georgopoulos
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Gregor Sebastian Reiter
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Lorenz Wassermann
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Leyla Aliyeva
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Lukas Baumann
- Department of Medical Statistics Vienna, Medical University of Vienna, Vienna, Austria
| | - Claudette Abela-Formanek
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Andreas Pollreisz
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Ursula Schmidt-Erfurth
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
| | - Stefan Sacu
- Department of Ophthalmology and Optometry, Vienna Trial Center (VTC), Medical University of Vienna, Vienna, Austria
- * E-mail:
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Delyfer M, Legout P, Le Goff M, Blaizeau M, Rougier M, Schweitzer C, Korobelnik J, Delcourt C. Prevalence of epiretinal membranes in the ageing population using retinal colour images and SD-OCT: the Alienor Study. Acta Ophthalmol 2020; 98:e830-e838. [PMID: 32304162 DOI: 10.1111/aos.14422] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/08/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE To analyse and compare the prevalence of epiretinal membranes (ERMs) obtained using either standard retinal colour images or spectral-domain optical coherence tomography (SD-OCT) in a population-based setting of French elderly subjects. METHODS Six hundred twenty-four subjects of the Alienor cohort aged 75 years or older underwent both colour fundus imaging and SD-OCT examinations. The ERMs were graded from retinal images and SD-OCT macular scans in a masked fashion. On SD-OCT images, the early ERMs, mature contractile ERMs without foveal modifications and mature contractile ERMs with foveal alterations were distinguished. RESULTS 610 (97.8%) subjects had gradable SD-OCT examinations, and 511 (81.9%) had gradable fundus images in at least one eye. According to colour photographs, 11.6% of participants had definite ERMs. From SD-OCT images, 52.8% of the subjects had early ERMs, 7.4% had mature ERMs without foveal involvement, and 9.7% had mature ERMs with foveal alterations. Regardless of the imaging method used, the ERMs were more often observed in pseudophakic eyes than in phakic eyes. Comparison of ERM assessment using fundus photographs versus SD-OCT images demonstrated that the specificity of retinal colour images was good (>89.3%), whereas the sensitivity remained low even though it increased with ERM severity on SD-OCT images. CONCLUSIONS Spectral-domain optical coherence tomography (SD-OCT) examinations have high feasibility in this elderly population and are much more sensitive than standard colour images for ERM assessments, especially in the early stages of the disease. Our results further highlight the need to use SD-OCT instead of colour retinal photographs for the classification of ERMs in epidemiological studies.
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Affiliation(s)
- Marie‐Noëlle Delyfer
- Inserm Bordeaux Population Health Research Center, team LEHA UMR 1219 Univ. Bordeaux Bordeaux France
- Department of Ophthalmology Bordeaux University Hospital Bordeaux France
| | - Pierre Legout
- Inserm Bordeaux Population Health Research Center, team LEHA UMR 1219 Univ. Bordeaux Bordeaux France
- Department of Ophthalmology Bordeaux University Hospital Bordeaux France
| | - Mélanie Le Goff
- Inserm Bordeaux Population Health Research Center, team LEHA UMR 1219 Univ. Bordeaux Bordeaux France
| | - Marion Blaizeau
- Department of Ophthalmology Bordeaux University Hospital Bordeaux France
| | | | - Cédric Schweitzer
- Inserm Bordeaux Population Health Research Center, team LEHA UMR 1219 Univ. Bordeaux Bordeaux France
- Department of Ophthalmology Bordeaux University Hospital Bordeaux France
| | - Jean‐François Korobelnik
- Inserm Bordeaux Population Health Research Center, team LEHA UMR 1219 Univ. Bordeaux Bordeaux France
- Department of Ophthalmology Bordeaux University Hospital Bordeaux France
| | - Cécile Delcourt
- Inserm Bordeaux Population Health Research Center, team LEHA UMR 1219 Univ. Bordeaux Bordeaux France
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49
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Vallejo-Garcia JL, Romano M, Pagano L, Montericcio A, Borgia A, Morenghi E, Vinciguerra P. OCT changes of idiopathic epiretinal membrane after cataract surgery. Int J Retina Vitreous 2020; 6:37. [PMID: 32774888 PMCID: PMC7401209 DOI: 10.1186/s40942-020-00239-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 07/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background We reviewed our experience in the management of cataract and idiopatic epiretinal membrane surgeries at the Humanitas Research Institute-Milan, Italy- over the past 3 years. Methods We conducted a single center retrospective observational case series of patients that underwent sequential cataract and idiopatic epiretinal membrane (ERM) surgeries from 2012-2015 in Humanitas Research Institute. Full data was obtained for 53 eyes of 57 patients. Patients with ERM secondary to uveitis or trauma or associated with simultaneous retinal detachment were excluded. Diabetic retinopathy, glaucoma, age-related macular degeneration, and myopia of more than 6 diopters were exclusion criteria as well. Results Cataract surgery was not associated with an ERM stage progression at one month follow up, but caused retinal inflammation that resulted in a significant increase in central macular thickness (CMT), macular volume (MV), central macular edema (CME), IS/OS disruption (IS/OS) and neurosensory detachment (NSD). However, there was no significant change in Best corrected visual acuity (BCVA). Conclusion We suggest that patients undergoing cataract surgery in the presence of epiretinal membranes need tight follow up to treat and control eventual macular inflammatory changes and eventual prompt vitrectomy if BCVA is threatened.
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Affiliation(s)
- Jose Luis Vallejo-Garcia
- Humanitas Clinical and Research Center, Humanitas University, Via Manzoni 56, 20089 Rozzano, Milan, 20089 Italy
| | - Mary Romano
- Humanitas Clinical and Research Center, Humanitas University, Via Manzoni 56, 20089 Rozzano, Milan, 20089 Italy.,Multidisciplinary Department of Medical, Surgical and Dental Sciences University of Campania Luigi Vanvitelli, Neaples, Italy
| | - Luca Pagano
- Humanitas Clinical and Research Center, Humanitas University, Via Manzoni 56, 20089 Rozzano, Milan, 20089 Italy.,Department of Ophthalmology, Istituto Clinico Humanitas, Via Alessandro Manzoni 56, 20089 Rozzano, MI Italy
| | - Alessio Montericcio
- Humanitas Clinical and Research Center, Humanitas University, Via Manzoni 56, 20089 Rozzano, Milan, 20089 Italy
| | - Alfredo Borgia
- Humanitas Clinical and Research Center, Humanitas University, Via Manzoni 56, 20089 Rozzano, Milan, 20089 Italy
| | - Emanuela Morenghi
- Humanitas Clinical and Research Center, Humanitas University, Via Manzoni 56, 20089 Rozzano, Milan, 20089 Italy
| | - Paolo Vinciguerra
- Humanitas Clinical and Research Center, Humanitas University, Via Manzoni 56, 20089 Rozzano, Milan, 20089 Italy
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50
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Association of retinal vessel density with retinal sensitivity in surgery for idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2020; 258:1911-1920. [PMID: 32494873 DOI: 10.1007/s00417-020-04754-0] [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: 02/24/2020] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 01/25/2023] Open
Abstract
PURPOSE The success of surgical treatment for idiopathic epiretinal membrane (ERM) is measured by postoperative best-corrected visual acuity (BCVA), metamorphopsia, and foveal retinal sensitivity (RS).This study searched for predictive biomarkers of surgical success by determining the association between foveal RS and various aspects of vessel density (VD) in the fovea of patients with ERM. METHODS The study examined 25 eyes of 25 patients with ERM who underwent 27-gauge microincision vitrectomy surgery (MIVS). RS was measured with microperimetry (MP-3; NIDEK) at four central points in the fovea with an interpoint distance of 2°. VD was measured with SD-OCT (RS 3000; NIDEK) within the 1-mm2 square defined by the 4 RS points at various depths, including the superficial and deep retinal capillary plexus (SCP and DCP, respectively). RESULTS Though VD did not change throughout the follow-up period, BCVA and RS significantly improved 1 and 3 months after surgery, respectively (both P < 0.0017). Postoperative RS at 6 months was positively correlated with postoperative DCP VD at 1, 3, and 6 months (r = 0.62, P = 0.001; r = 0.40, P = 0.049; r = 0.53, P = 0.007, respectively), but not with SCP VD at any time point. Multiple regression analysis confirmed that postoperative RS at 6 months was associated with postoperative DCP VD at 1 month (P = 0.03). CONCLUSION Higher postoperative DCP VD at 1 month contributed to better postoperative foveal RS at 6 months. Early postoperative VD in the fovea might be a useful predictive biomarker of late postoperative RS in the fovea in ERM patients.
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