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Bansal A, Naidu SC, Figueiredo N, Alrabiah M, Hamli H, Wong DTW, Muni RH, Altomare F. 38-Gauge Cannula-Based Endodrainage of Posteriorly Trapped Intraoperative Subretinal Fluid during Vitrectomy for Retinal Detachment. Ophthalmol Retina 2024:S2468-6530(24)00122-2. [PMID: 38527570 DOI: 10.1016/j.oret.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Aditya Bansal
- Department of Ophthalmology and Visual Sciences, University of Kentucky, Lexington, Kentucky
| | - Sumana C Naidu
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Natalia Figueiredo
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - Mahmoud Alrabiah
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - Hesham Hamli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - David T W Wong
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada; Kensington Vision and Research Centre, University of Toronto, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada; Kensington Vision and Research Centre, University of Toronto, Toronto, Ontario, Canada
| | - Filiberto Altomare
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada; Ocular Oncology Services, Princes Margaret Cancer Hospital, University of Toronto, Toronto, Ontario, Canada.
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Oquendo PL, Figueiredo N, Francisconi CLM, Juncal V, Marafon S, Naidu SC, Pecaku A, Demian S, Melo IM, Longwell J, Muni RH. Validation of M-CHARTS for Quantitative Assessment of Metamorphopsia Following Rhegmatogenous Retinal Detachment Repair. Retina 2024:00006982-990000000-00599. [PMID: 38354405 DOI: 10.1097/iae.0000000000004071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
PURPOSE To validate the quantitative assessment of metamorphopsia in rhegmatogenous retinal detachment(RRD) using M-CHARTS by determining its correlation with subjective reporting of metamorphopsia with a validated metamorphopsia questionnaire(modified MeMoQ). METHODS Research Ethics Board approved, prospective observational study carried out at St. Michael's Hospital, Toronto, Canada. Patients with primary, unilateral RRD and healthy controls were included. Metamorphopsia at 3-months was assessed with modified MeMoQ and M-CHARTS. RESULTS 100 patients(50 with RRD,50 controls) were included. 70%(35/50) of the RRD group had metamorphopsia with M-CHARTS and 80%(40/50) with MeMoQ. The modified MeMoQ and total M-CHARTS scores were significantly higher in patients with RRD compared to controls(p<0.0001). Cronbach's alpha reliability coefficient was 0.934 in the RRD group. Horizontal, vertical, and total M-CHARTS scores were significantly correlated with MeMoQ scores(rs=0.465,p=0.0007;rs=0.405,p=0.004;rs=0.475,p=0.0005,respectively). M-CHARTS was 72.7% sensitive and 94.6% specific for detection of metamorphopsia(positive score≥0.2), with an area under the ROC curve=0.801. A stronger correlation was found in patients who scored ≥0.2 on the M-CHARTS and reported metamorphopsia with the MeMoQ(rs=0.454,p=0.001). CONCLUSION We have validated M-CHARTS as a tool to quantitatively assess metamorphopsia in patients with RRD, which is significantly correlated with patient-reported outcomes using the metamorphopsia questionnaire(MeMoQ). A total score of ≥0.2 with M-CHARTS was more strongly correlated with MeMoQ.
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Affiliation(s)
- Paola L Oquendo
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Natalia Figueiredo
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | - Verena Juncal
- Department of Ophthalmology, University of Western Ontario
| | - Samara Marafon
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sumana C Naidu
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Aurora Pecaku
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sueellen Demian
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Isabela Martins Melo
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jack Longwell
- Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Institute, Toronto, Ontario, Canada
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Bansal A, Naidu SC, Marafon SB, Kohler JM, In S, Mahendrakar PA, Garima, Kashyap H, Susavar P, Bhende M, Ryan EH, Muni RH. Retinal Displacement after Scleral Buckle versus Combined Buckle and Vitrectomy for Rhegmatogenous Retinal Detachment: ALIGN Scleral Buckle versus Pars Plana Vitrectomy with Scleral Buckle. Ophthalmol Retina 2023; 7:788-793. [PMID: 37217137 DOI: 10.1016/j.oret.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/09/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE To assess the risk of retinal displacement after scleral buckle (SB) versus pars plana vitrectomy with SB (PPV-SB). DESIGN Multicenter prospective nonrandomized clinical trial. METHODS The study took place at VitreoRetinal Surgery in Minneapolis, Minnesota, Sankara Nethralaya in Chennai, India, and St. Michael's Hospital in Toronto, Canada from July 2019 to February 2022. Patients who underwent successful SB or PPV-SB for fovea-involving rhegmatogenous retinal detachment with gradable postoperative fundus autofluorescence (FAF) imaging were included in the final analysis. Two masked graders assessed FAF images 3 months postoperatively. Metamorphopsia and aniseikonia were assessed with M-CHARTs and the New Aniseikonia Test, respectively. The primary outcome was the proportion of patients with retinal displacement detected with retinal vessel printings on FAF in SB versus PPV-SB. RESULTS Ninety-one eyes were included in this study, of which 46.2% (42 of 91) had SB and 53.8% (49 of 91) underwent PPV-SB. Three months postoperatively, 16.7% (7 of 42) in the SB group and 38.8% (19 of 49) in the PPV-SB group had evidence of retinal displacement (difference = 22.1%; odds ratio = 3.2; 95% confidence interval [CI], 1.2-8.6; P = 0.02) on FAF. The statistical significance of this association increased after adjustment for extent of retinal detachment, baseline logarithm of the minimum angle of resolution, lens status, and sex in a multivariate regression analysis (P = 0.01). Retinal displacement was detected in 22.5% (6 of 27) of patients in the SB group with external subretinal fluid drainage and 6.7% (1 of 15) of patients without external drainage (difference = 15.8%; odds ratio = 4.0; 95% CI, 0.4-36.9; P = 0.19). Mean vertical metamorphopsia, horizontal metamorphopsia (MH), and aniseikonia were similar between patients in the SB and PPV-SB groups. There was a trend to worse MH in patients with retinal displacement versus those without retinal displacement (P = 0.067). CONCLUSIONS Scleral buckle is associated with less retinal displacement compared with PPV-SB, indicating that traditional PPV techniques cause retinal displacement. There is a trend toward increased risk of retinal displacement in SB eyes that underwent external drainage compared with SB eyes without drainage, which is consistent with our understanding that the iatrogenic movement of subretinal fluid, such as that which occurs intraoperatively during external drainage with SB, may induce retinal stretch and displacement if the retina is then fixed in the stretched position. There was a trend to worse MH at 3 months in patients with retinal displacement. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Aditya Bansal
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
| | - Sumana C Naidu
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
| | - Samara B Marafon
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
| | - James M Kohler
- VitreoRetinal Surgery in Minneapolis, Minneapolis, Minnesota
| | - Shilpa In
- Bhagwan Mahavir Vitreoretinal services, Medical Research Foundation, Sankara Netralaya, Chennai, India
| | - Priyanka A Mahendrakar
- Bhagwan Mahavir Vitreoretinal services, Medical Research Foundation, Sankara Netralaya, Chennai, India
| | - Garima
- Bhagwan Mahavir Vitreoretinal services, Medical Research Foundation, Sankara Netralaya, Chennai, India
| | - Himanshu Kashyap
- Bhagwan Mahavir Vitreoretinal services, Medical Research Foundation, Sankara Netralaya, Chennai, India
| | - Pradeep Susavar
- Bhagwan Mahavir Vitreoretinal services, Medical Research Foundation, Sankara Netralaya, Chennai, India
| | - Muna Bhende
- Bhagwan Mahavir Vitreoretinal services, Medical Research Foundation, Sankara Netralaya, Chennai, India
| | - Edwin H Ryan
- VitreoRetinal Surgery in Minneapolis, Minneapolis, Minnesota
| | - Rajeev H Muni
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada; Kensington Vision and Research Centre, University of Toronto, Canada; Keenan Research Centre for Biomedical Science/ Li Ka Shing Knowledge Institute, Toronto, Canada.
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Naidu SC, Kohly RP, Margolin E. Optic nerve drusen causing hemorrhages in three retinal layers. Can J Ophthalmol 2023:S0008-4182(23)00038-8. [PMID: 36803931 DOI: 10.1016/j.jcjo.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/27/2023] [Indexed: 02/18/2023]
Affiliation(s)
- Sumana C Naidu
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON
| | - Radha P Kohly
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON
| | - Edward Margolin
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON.
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Naidu SC, Yu CW, Arjmand P, Kohly RP. Wellness perspectives in the Department of Ophthalmology and Vision Sciences at the University of Toronto. Can J Ophthalmol 2022; 58:e107-e109. [PMID: 36539193 DOI: 10.1016/j.jcjo.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Sumana C Naidu
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Caberry W Yu
- Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Parnian Arjmand
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON Canada
| | - Radha P Kohly
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON Canada.
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Affiliation(s)
- Sumana C Naidu
- Temerty Faculty of Medicine (Naidu); Department of Ophthalmology and Vision Sciences (Kaplan, Sundaram, Kohly), University of Toronto; Kensington Eye Institute (Kaplan); Department of Medicine, Division of Infectious Diseases (Daneman), and of Medicine, Division of Neurology (Sundaram), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont
| | - Alexander J Kaplan
- Temerty Faculty of Medicine (Naidu); Department of Ophthalmology and Vision Sciences (Kaplan, Sundaram, Kohly), University of Toronto; Kensington Eye Institute (Kaplan); Department of Medicine, Division of Infectious Diseases (Daneman), and of Medicine, Division of Neurology (Sundaram), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont
| | - Nick Daneman
- Temerty Faculty of Medicine (Naidu); Department of Ophthalmology and Vision Sciences (Kaplan, Sundaram, Kohly), University of Toronto; Kensington Eye Institute (Kaplan); Department of Medicine, Division of Infectious Diseases (Daneman), and of Medicine, Division of Neurology (Sundaram), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont
| | - Arun N E Sundaram
- Temerty Faculty of Medicine (Naidu); Department of Ophthalmology and Vision Sciences (Kaplan, Sundaram, Kohly), University of Toronto; Kensington Eye Institute (Kaplan); Department of Medicine, Division of Infectious Diseases (Daneman), and of Medicine, Division of Neurology (Sundaram), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont
| | - Radha P Kohly
- Temerty Faculty of Medicine (Naidu); Department of Ophthalmology and Vision Sciences (Kaplan, Sundaram, Kohly), University of Toronto; Kensington Eye Institute (Kaplan); Department of Medicine, Division of Infectious Diseases (Daneman), and of Medicine, Division of Neurology (Sundaram), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.
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