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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: 0] [Impact Index Per Article: 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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Ramtohul P, Au A, Kunkler AL, Bacci T, Dolz-Marco R, Gallego-Pinazo R, Yannuzzi N, Sarraf D, Freund KB. CENTRAL BOUQUET HEMORRHAGE: Clinical and Multimodal Imaging Features. Retina 2024; 44:551-557. [PMID: 38109663 DOI: 10.1097/iae.0000000000004025] [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: 12/20/2023]
Abstract
PURPOSE To describe the clinical characteristics, multimodal imaging features, and anatomic basis of a distinctive pattern of deep retinal hemorrhages located in the central fovea, a presentation referred to as "central bouquet hemorrhage." METHODS Retrospective, observational, multicenter case series of eyes with central bouquet hemorrhage. Multimodal imaging features were reviewed and analyzed. RESULTS Ten eyes from 10 patients (4 women and 6 men), with a mean age of 55.6 ± 21.7 years (range 25-84 years) were included. Underlying etiologies were neovascular age-related macular degeneration (40%), lacquer cracks in pathological myopia (30%), macular telangiectasia Type 2 (10%), proliferative diabetic retinopathy (10%), and ocular trauma associated with angioid streaks (10%). On ophthalmoscopy, all eyes with central bouquet hemorrhage displayed a deep retinal hemorrhage with round margins in the central fovea and associated with petaloid hemorrhages radiating in the surrounding Henle fiber layer. Cross-sectional optical coherence tomography showed a well-delineated round hyperreflective lesion involving the central foveal Henle fiber layer/outer nuclear layer in all cases. Accompanying hyperreflective hemorrhages tracking along the obliquely oriented Henle fiber layer were present in all eyes. Resolution occurred in all patients, either spontaneously (30%) or after treatment with intravitreal anti-vascular endothelial growth factor injections (70%), and was associated with partial visual acuity improvement (from 20/113 to 20/36). CONCLUSION "Central bouquet hemorrhage" is a novel descriptive term describing a characteristic round pattern of intraretinal blood in the fovea associated with Henle fiber layer hemorrhage and encountered in a spectrum of macular disease.
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Affiliation(s)
- Prithvi Ramtohul
- Vitreous Retina Macula Consultants of New York, New York, New York
| | - Adrian Au
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Anne L Kunkler
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Tommaso Bacci
- Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena University Hospital, Siena, Italy
| | | | | | - Nicolas Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York
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Xiao Q, Li F, Jiang F, Zhang Z, Xu B. The prospects for early detection with optical coherence tomography (OCT) and OCT angiography in major depressive disorder. J Affect Disord 2024; 347:8-14. [PMID: 37984693 DOI: 10.1016/j.jad.2023.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Research has shown the diagnostic potential of optical coherence tomography (OCT) and OCT angiography (OCTA) in various psychiatric disorders. However, there is few research focusing on changes specific to Major Depressive Disorder (MDD), and the diagnostic value of OCT combined with OCTA parameters for MDD remains unclear. METHODS In this study, we investigated microvascular and morphology changes in the retina of MDD patients using a combination of OCTA and OCT parameters, and to examine their correlation with MDD mood and cognitive function in order to assess their diagnostic capability. RESULTS Our findings revealed a significant decline in macular vessel density (MVD) in the superficial retinal capillary plexus (SRCP) across all subfields, except the NO area. We also observed a significant positive correlation between fovea and Stroop-1, as well as between temporal inner (TI) and Stroop-3 in MDD patients. Furthermore, we identified a negative correlation between fovea and Self-Rating Depression Scale, as well as between Superior outer (SO) and Difficulties in Emotion Regulation Scale-C in MDD patients. LIMITATIONS The sample size was small. Anatomical variables in blood flow may contribute to variability between subjects and outcomes. CONCLUSIONS The diagnostic value of OCTA suggests their potential as valuable tools for monitoring and diagnosing MDD.
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Affiliation(s)
- Qian Xiao
- Mental Health Center of Xiangya Hospital, Central South University, Changsha 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Fangling Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; Eye Center of Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, China; National Key Clinical Ophthalmology Specialist, Xiangya Hospital, Central South University, Changsha, China; Hunan Provincial Branch of the National Clinical Medical Research Center for Eye Diseases, Xiangya Hospital, Central South University, Changsha, China
| | - Furong Jiang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zhejia Zhang
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Bei Xu
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; Eye Center of Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, China; National Key Clinical Ophthalmology Specialist, Xiangya Hospital, Central South University, Changsha, China; Hunan Provincial Branch of the National Clinical Medical Research Center for Eye Diseases, Xiangya Hospital, Central South University, Changsha, China.
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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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Iovino C, Ramtohul P, Au A, Romero-Morales V, Sadda S, Freund KB, Sarraf D. Vitelliform maculopathy: Diverse etiologies originating from one common pathway. Surv Ophthalmol 2023; 68:361-379. [PMID: 36720370 DOI: 10.1016/j.survophthal.2023.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023]
Abstract
Vitelliform lesions (VLs) are associated with a wide array of macular disorders but are the result of one common pathway: retinal pigment epithelium (RPE) impairment and phagocytic dysfunction. VLs are defined by the accumulation of yellowish subretinal material. In the era of multimodal advanced retinal imaging, VLs can be further characterized by subretinal hyperreflectivity with optical coherence tomography and hyperautofluorescence with fundus autofluorescence. VLs can be the result of genetic or acquired retinal diseases. In younger patients, VLs usually occur in the setting of Best disease. Additional genetic causes of VL include pattern dystrophy or adult-onset vitelliform macular dystrophy. In older patients, acquired VLs can be associated with a broad spectrum of etiologies, including tractional, paraneoplastic, toxic, and degenerative disorders. The main cause of visual morbidity in eyes with VLs is the onset of macular atrophy and macular neovascularization. Histopathological studies have provided new insights into the location, nature, and lifecycle of the vitelliform material comprised of melanosomes, lipofuscin, melanolipofuscin, and outer segment debris located between the RPE and photoreceptor layer. Impaired phagocytosis by the RPE cells is the unifying pathway leading to VL development. We discuss and summarize the nature, pathogenesis, multimodal imaging characteristics, etiologies, and natural course of vitelliform maculopathies.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Prithvi Ramtohul
- Vitreous Retina Macula Consultants of New York, New York, NY, USA
| | - Adrian Au
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Veronica Romero-Morales
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - SriniVas Sadda
- Doheny Image Reading Center, Doheny Eye Institute, University of California Los Angeles (UCLA) Affiliated, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; Department of Ophthalmology, NYU Grossman School of New York, New York, NY, USA
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA; Greater Los Angeles Veterans Affairs Healthcare Center, Los Angeles, CA, USA.
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Influences of Central Bouquet Alterations on the Visual Outcome in Eyes Receiving Epiretinal Membrane Surgery. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11030926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Previous studies have shown that epiretinal membranes (ERMs) may be associated with abnormal outer retinal anatomy. However, long-term morphological and functional results of pars plana vitrectomy (PPV) with ERM and internal limiting membrane (ILM) peeling in eyes with central bouquet (CB) alterations have not yet been investigated. Methods: In a retrospective, consecutive study all patients underwent best corrected visual acuity (BCVA) testing and spectral domain optical coherence tomography (SD-OCT) before and after a mean of 20 months (range 3–70 months) postoperatively. CB abnormalities and ERMs were classified according to Govetto’s staging systems. Results: Of the 67 eyes, 22 (34%) showed CB abnormalities at baseline. The mean BCVA increased from 0.42 at baseline to 0.20 LogMAR at final follow-up (p < 0.001). Neither ERM stage (p = 0.06) nor CB stage (p = 0.939) at baseline were significant predictors of vision improvement following surgery. Conclusions: Our results show that baseline BCVA, but not classification of CB changes and ERM at baseline, seems to be a useful predictor for functional outcomes following PPV with ERM and ILM peeling in the long-term.
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