1
|
Marolo P, Borrelli E, Caselgrandi P, Parisi G, Gelormini F, Ricardi F, Ceroni L, Fallico M, Toro MD, Ventre L, Reibaldi M. Comparison of Functional, Structural, and Microvascular Features in Different Stages of Idiopathic Epiretinal Membrane. J Clin Med 2024; 13:3188. [PMID: 38892898 PMCID: PMC11172683 DOI: 10.3390/jcm13113188] [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: 04/22/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Idiopathic epiretinal membrane (ERM) often leads to visual symptoms such as metamorphopsia and decreased central vision. This study aimed to evaluate functional, structural, and microvascular characteristics in patients with different stages of idiopathic ERM who were candidates for surgery, with a focus on identifying potential indicators for surgical timing. Methods: A retrospective cohort study was conducted on consecutive patients with unilateral idiopathic ERM who were candidates for surgery. Patients underwent comprehensive ophthalmological assessments, including OCT grading, reading performance evaluation, and OCT angiography. Data analysis included comparisons between different ERM stages for functional, structural, and microvascular parameters. Results: A total of 44 eyes were included, classified into four ERM stages according to the Govetto grading system. Functional parameters, including distance and near visual acuity, worsened significantly with higher ERM stages, particularly in the transition from Stage 3 to Stage 4. Structural assessments revealed significant increases in central macular thickness (CMT) from Stage 3 to Stage 4. No significant differences were observed in microvascular features across different ERM stages. Conclusions: This study highlights the significant functional and anatomical impact of OCT staging in idiopathic ERM, particularly during the transition from Stage 3 to Stage 4, characterized by notable reductions in visual acuity and increases in CMT. These findings underscore the importance of considering both functional and structural parameters in surgical decision-making for ERM management. However, further research with larger cohorts is needed to confirm these observations and inform clinical practice.
Collapse
Affiliation(s)
- Paola Marolo
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Enrico Borrelli
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Paolo Caselgrandi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Guglielmo Parisi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Francesco Gelormini
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Federico Ricardi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Luca Ceroni
- Department of Psychology, University of Turin, 10124 Turin, Italy;
| | - Matteo Fallico
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy;
| | - Mario Damiano Toro
- Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
- Eye Clinic, Public Health Department, Federico II University, 80131 Naples, Italy
| | - Luca Ventre
- Department of Ophthalmology, Beauregard Hospital, 11100 Aosta, Italy;
| | - Michele Reibaldi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| |
Collapse
|
2
|
Rossi T, Querzoli G, Cosimi P, Ripandelli G, Steel DH, Romano MR. TANGENTIAL RETINAL DISPLACEMENT INCREASES AFTER MACULAR PUCKER SURGERY: An Apparent Nonsense. Retina 2024; 44:610-617. [PMID: 37973044 DOI: 10.1097/iae.0000000000004001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE To measure the tangential retinal displacement and vision before and after macular pucker surgery and study if pars plana vitrectomy with epiretinal membrane peeling allows the reconstitution of previous anatomy or else it results in a different configuration. METHODS Retrospective series of patients undergoing pars plana vitrectomy for epiretinal membrane, with >6-month follow-up before and after surgery, complete with best-corrected visual acuity, optical coherence tomography, M-Charts, and infrared retinography. Tangential retinal displacement between earliest visit (T E ), time of surgery (T 0 ), and latest available visit (T L ) of the examined retina, concentric circles at 0.5, 1.5, and 4.5 mm radii, and the central horizontal and vertical meridians were measured. Tangential displacement was calculated as the optical flow of consecutive infrared photographs. RESULTS The study comprised 32 patients: 15 men and 17 women. Average preoperative and postoperative follow-up were 23.4 ± 27.9 months and 19.2 ± 11.8 months, respectively. Best-corrected visual acuity reduced before surgery (0.69 ± 0.16 Snellen to 0.46 ± 0.17; P < 0.001) and increased after (0.866 ± 0.16 Snellen; P < 0.001). Horizontal and vertical metamorphopsia increased between before surgery but only horizontal metamorphopsia significantly reduced after. Average tangential displacement before surgery was 35.6 ± 29.9 µ m versus 56.6 ± 41.3 µ m after ( P = 0.023). Preoperative and postoperative displacement within the fovea was less than over the entire area ( P < 0.001). CONCLUSION Retinal tangential displacement between diagnosis and surgery (T E - T 0 ) is less than the displacement occurring after surgery (T 0 - T L ). Postoperative displacement does not represent the restoration of the anatomy existing before the disease ensued but rather the resulting equilibrium of newly deployed forces.
Collapse
Affiliation(s)
| | - Giorgio Querzoli
- DICAAR Faculty of Engineering, University of Cagliari, Cagliari, Italy
| | | | | | - David H Steel
- Newcastle University, Newcastle, United Kingdom; and
| | - Mario R Romano
- Department of Biomedical Science, Humanitas University, Milan, Italy
| |
Collapse
|
3
|
Scarinci F, Querzoli G, Cosimi P, Ripandelli G, Romano MR, Cacciamani A, Munk MR, Rossi T. RETINAL TECTONICS AFTER MACULAR PUCKER SURGERY: Thickness Changes and En Face Displacement Recovery. Retina 2024; 44:102-110. [PMID: 37695945 DOI: 10.1097/iae.0000000000003928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
PURPOSE To study visual function, retinal layer thickness changes, and tangential displacement after pars plana vitrectomy for epiretinal membrane. METHODS Retrospective series of patients undergoing pars plana vitrectomy for epiretinal membrane, with 6-month follow-up including best-corrected visual acuity, optical coherence tomography, M-charts, epiretinal membrane grading, and infrared fundus photograph at time 0 (T0, preop) at months 1 (T1), 3 (T3), and 6 (T6) postop (±1 week). Retinal layer thickness and tangential ( en face ) retinal displacement between successive times for the entire retinal surface and the central horizontal and vertical meridian were also measured. En face displacement was calculated as optical flow of consecutive images. RESULTS Average best-corrected visual acuity improved from 0.28 ± 0.08 logarithm of Minimum Angle of Resolution at T0 to 0.16 ± 0.25 at T6 ( P = 0.05), best-corrected visual acuity improvement correlated with best corrected visual acuity (BCVA) at T0 ( P < 0.001). Vertical metamorphopsia decreased from 1.33° ± 0.70° at T0 to 0.82° ± 0.69° at T6 ( P < 0.05). Foveal thickness reduced from 453 ± 53 µ m at T0 to 359 ± 31 µ m at T6 ( P < 0.05) and reduction correlated with best-corrected visual acuity improvement ( P < 0.05). Foveal layers decreased ( P < 0.05) in all cases. The mean en face deformation was 155.82 ± 50.17 µ m and mostly occurred in the first month: T0-T1 displacement was 83.59 ± 30.28 µ m, T1-T3 was 36.28 ± 14.45 µ m, while T3-T6 was 39.11 ± 22.79 µ m ( P < 0.001) on average. Perifoveal and parafoveal deformation correlated with optical coherence tomography foveal thickness reduction at all time intervals (1, 3, and 6 months: P < 0.01). CONCLUSION Epiretinal membrane peeling affects all retinal layer thickness and results in new force balance across the entire retina and tangential displacement. Both en face and in-depth changes correlate with visual function.
Collapse
Affiliation(s)
| | | | | | | | - Mario R Romano
- Department of Biomedical Science, Humanitas University, Milan, Italy
| | | | - Marion R Munk
- Augenarzt-Praxisgemeinschaft Gutblick AG, Pfäffikon. Switzerland
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and
- Department of Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland
| | | |
Collapse
|
4
|
Li Q, Yang K, Ji Q, Jiang J, Zong R, Zhang Y, Qian Y, Che X, Suo J, Wang Z. Idiopathic Epiretinal Membrane Surgery in Patients Aged Over 80 Years: Efficacy and Safety. Clin Ophthalmol 2023; 17:3365-3372. [PMID: 37941775 PMCID: PMC10629405 DOI: 10.2147/opth.s437815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
Purpose To evaluate the efficacy and safety of idiopathic epiretinal membrane (ERM) surgery in patients aged over 80 years. Methods Consecutive patients who underwent pars plana vitrectomy (PPV) combined with ERM and internal limiting membrane (ILM) peeling with retrobulbar anesthesia were recruited. Based on age, the patients were divided into the elderly group (≥ 80 years of age) and the control group (< 80 years of age). The best-corrected visual acuity (BCVA) and surgical complications were regarded as the main measurement indicators. Results This study included 43 eyes from 43 patients aged 80 to 91 years and 86 eyes from 86 patients aged 54 to 79 years. Surgical intervention substantially improved BCVA both in the elderly and control groups (p = 0.005 and p < 0.001, respectively). Statistical analyses showed no significant difference in the incidence of surgical complications between the two groups (p = 0.631). The operations in either group were not delayed or canceled for the reason of complications of retrobulbar anesthesia, severe anxiety, or physical discomfort in the perioperative period. Moreover, no patient required a second operation. Also, no stroke, myocardial infarction, or death occurred during the follow-up period. All the surgical complications were treated satisfactorily. Conclusion Our outcomes indicate that PPV combined with ERM and ILM peeling with retrobulbar anesthesia is effective and safe in elderly patients aged 80 years or older. Based on age alone, we believe that advancing age should not be the risk factor for idiopathic ERM surgery.
Collapse
Affiliation(s)
- Qingjian Li
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Kunhuan Yang
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, People’s Republic of China
- Fujian Engineering and Research Center of Eye Regenerative Medicine, Xiamen, Fujian, People’s Republic of China
- Eye Institute of Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen University School of Medicine, Xiamen, Fujian, People’s Republic of China
| | - Qianlin Ji
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jing Jiang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Rongrong Zong
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, People’s Republic of China
- Fujian Engineering and Research Center of Eye Regenerative Medicine, Xiamen, Fujian, People’s Republic of China
- Eye Institute of Xiamen University, Xiamen, Fujian, People’s Republic of China
- Xiamen University School of Medicine, Xiamen, Fujian, People’s Republic of China
| | - Yu Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Yiwen Qian
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Xin Che
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jinshan Suo
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Zhiliang Wang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Alabdulkader B, Alshubaili H, Alhashmi A. Challenges in Reading Arabic among Children with Dyslexia. Optom Vis Sci 2021; 98:929-935. [PMID: 34460454 DOI: 10.1097/opx.0000000000001744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE There are limited studies assessing reading performance and children's difficulties with dyslexia especially when reading Arabic, a language that has a substantially different script from English and other Latin-based languages. PURPOSE This study aimed to (1) measure reading performance in children with dyslexia by acuity level and (2) conduct an indirect comparison between the effects of dyslexia on Arabic versus English readers. METHODS Twenty children aged 9 to 12 years with dyslexia and 30 controls aged 9 to 11 years were included in the study. Reading performance was evaluated using maximum reading speed, reading acuity, and critical print size (CPS). Two Arabic charts, the Balsam Alabdulkader-Leat chart and the International Reading Speed Texts chart, were used to evaluate reading performance. The number of errors was calculated and plotted against print size. RESULTS ANOVA revealed a significant difference between the two groups in all reading performance measures (P < .05). Reading speed for children with dyslexia was significantly lower than that for the control group (33 vs. 90 standard-length words per minute). Critical print sizes were 0.25 and 0.10 logMAR for children with dyslexia and the control group, respectively. Reading acuity was worse for children with dyslexia in comparison with the control group. Error number above the CPS was significantly higher in children with dyslexia than in the control group. CONCLUSIONS Reading speed measures were lower for children with dyslexia compared with controls. Children with dyslexia required larger CPS to read at their maximum speed, indicating that larger print sizes may improve reading with greater speed. The difference in reading performance measures between controls and children with dyslexia is higher when reading Arabic than when reading English. This suggests that the intricate Arabic script and crowding may more strongly affect children with dyslexia reading Arabic.
Collapse
Affiliation(s)
| | - Hayfa Alshubaili
- Optometry and Vision Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Areej Alhashmi
- Optometry and Vision Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
7
|
Switching to Brolucizumab in Neovascular Age-Related Macular Degeneration Incompletely Responsive to Ranibizumab or Aflibercept: Real-Life 6 Month Outcomes. J Clin Med 2021; 10:jcm10122666. [PMID: 34204266 PMCID: PMC8235134 DOI: 10.3390/jcm10122666] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the effect of switching treatment in eyes with neovascular age-related macular degeneration (nAMD) and treatment intervals of ≤6 weeks to brolucizumab. Methods: In this prospective series, eyes with persisting retinal fluid under aflibercept or ranibizumab every 4–6 weeks were switched to brolucizumab. Visual acuity (BCVA), reading acuity (RA), treatment intervals, central subfield thickness (CST), and the presence of intra- and subretinal fluid were recorded over 6 months. Results: Seven of 12 eyes completed the 6 month follow-up and received 4.4 ± 0.5 brolucizumab injections within 28.0 ± 2.8 weeks. Treatment intervals increased from 5.3 ± 0.9 weeks to 9.0 ± 2.8 weeks (95% confidence interval of extension (CI): 1.6 to 5.9). BCVA improved from 67.8 ± 7.2 to 72.2 ± 7.5 (95% CI: −0.3 to 9.1) ETDRS letters, RA improved from 0.48 ± 0.15 to 0.31 ± 0.17 LogRAD (95% CI: 0.03 to 0.25), and CST improved from 422.1 ± 97.3 to 353.6 ± 100.9 µm (95% CI: −19.9 to 157.1). Treatment was terminated early in five eyes (two intraocular inflammations with vascular occlusion without vision loss, one stroke, and two changes in the treatment plan). Conclusions: Improvement in visual performance and longer treatment intervals in our series over 6 months indicate the potential of brolucizumab to reduce the treatment burden in nAMD, while two instances of intraocular inflammation were encountered.
Collapse
|