Removal of the Crystalline Lens in Sixty-three Cases of High Myopia

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.

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CLINICAL CASE OF LONG-TERM RESULTS OF KERATO-REFRACTIVE SURGERIES IN A PATIENT WITH A HIGH MYOPIA

The Journal of scientific articles Health and Education millennium ◽

10.26787/nydha-2226-7425-2019-21-4-14-16 ◽

2019 ◽

Vol 21 (4) ◽

pp. 14-16

Author(s):

M.A. Frolov ◽

◽

P.A. Gonchar ◽

V.A. Biletskaya ◽

E.S. Belyaeva ◽

...

Keyword(s):

High Myopia ◽

Clinical Case ◽

Long Term Results

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Repeatability of Spectral Domain Optical Coherence Tomography Measurements in High Myopia

Journal of Glaucoma ◽

10.1097/ijg.0000000000000385 ◽

2016 ◽

Vol 25 (5) ◽

pp. e526-e530 ◽

Cited By ~ 3

Author(s):

Harsha L. Rao ◽

Addepalli U. Kumar ◽

Sampath R. Bonala ◽

Kadam Yogesh ◽

Bodduluri Lakshmi

Keyword(s):

Optical Coherence Tomography ◽

High Myopia ◽

Spectral Domain ◽

Optical Coherence

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Development and validation of a deep learning system to screen vision-threatening conditions in high myopia using optical coherence tomography images

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317825 ◽

2020 ◽

pp. bjophthalmol-2020-317825

Author(s):

Yonghao Li ◽

Weibo Feng ◽

Xiujuan Zhao ◽

Bingqian Liu ◽

Yan Zhang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Deep Learning ◽

High Myopia ◽

Large Scale ◽

Learning System ◽

Youden Index ◽

Optical Coherence ◽

Test Dataset ◽

Independent Test ◽

Independent Test Dataset

Background/aimsTo apply deep learning technology to develop an artificial intelligence (AI) system that can identify vision-threatening conditions in high myopia patients based on optical coherence tomography (OCT) macular images.MethodsIn this cross-sectional, prospective study, a total of 5505 qualified OCT macular images obtained from 1048 high myopia patients admitted to Zhongshan Ophthalmic Centre (ZOC) from 2012 to 2017 were selected for the development of the AI system. The independent test dataset included 412 images obtained from 91 high myopia patients recruited at ZOC from January 2019 to May 2019. We adopted the InceptionResnetV2 architecture to train four independent convolutional neural network (CNN) models to identify the following four vision-threatening conditions in high myopia: retinoschisis, macular hole, retinal detachment and pathological myopic choroidal neovascularisation. Focal Loss was used to address class imbalance, and optimal operating thresholds were determined according to the Youden Index.ResultsIn the independent test dataset, the areas under the receiver operating characteristic curves were high for all conditions (0.961 to 0.999). Our AI system achieved sensitivities equal to or even better than those of retina specialists as well as high specificities (greater than 90%). Moreover, our AI system provided a transparent and interpretable diagnosis with heatmaps.ConclusionsWe used OCT macular images for the development of CNN models to identify vision-threatening conditions in high myopia patients. Our models achieved reliable sensitivities and high specificities, comparable to those of retina specialists and may be applied for large-scale high myopia screening and patient follow-up.

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