Conversion from type 2 to type 1 macular hole closure after surgery in high myopia

2021 ◽  
Vol 14 (8) ◽  
pp. e243551
Author(s):  
Ramesh Venkatesh ◽  
Arpitha Pereira ◽  
Nikitha Gurram Reddy ◽  
Naresh Kumar Yadav
Keyword(s):  
Macular Hole ◽  
High Myopia ◽  
Silicone Oil ◽  
Internal Limiting Membrane ◽  
Final Visit ◽  
Closed Type ◽  
The Right ◽  
Spontaneous Conversion

We describe a case of spontaneous conversion from type 2 macular hole (MH) closure to type 1 closure following MH surgery in high myopia. A 42-year-old male patient with myopia was diagnosed with full-thickness MH and localised neurosensory detachment. His best-corrected vision in the right eye was 20/120, N18. He underwent pars plana vitrectomy with internal limiting membrane peeling and silicone oil tamponade. Nine days after surgery, optical coherence tomography (OCT) showed type 2 MH closure and presence of epiretinal tissue. At 6 weeks of follow-up, there was spontaneous conversion from type 2 to type 1 closure of MH with a thin epimacular tissue bridging across the fovea and vision improving to 20/80. At 3 months after surgery, silicon oil removal was done. OCT showed a closed type 1 MH and visual acuity of 20/80 at the final visit. Early spontaneous conversion in closure can occur over time, leading to better anatomical and visual outcomes.

Spontaneous Closure of a Macular Hole in Macular Telangiectasia Type 2

2020 ◽  
pp. 247412642095890
Author(s):  
Varun Chandra ◽  
Rohan Merani ◽  
Alex P. Hunyor ◽  
Mark Gillies
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Spontaneous Closure ◽  
Full Thickness ◽  
External Limiting Membrane ◽  
Macular Telangiectasia ◽  
History Of ◽  
Macular Telangiectasia Type 2 ◽  
The Right

Purpose: Spontaneous closure of a macular hole in macular telangiectasia type 2 (MacTel) with vision improvement is described. Methods: A case report is presented. Results: A 71-year-old man presented with a 1-week history of distorted vision in his left eye. Left visual acuity (LVA) was 20/80. Optical coherence tomography showed an almost full-thickness left macular hole with an intact internal limiting membrane drape. Small inner retinal cavitations were present at the right macula; multimodal imaging confirmed MacTel. Managed conservatively, at 5 months the patient’s LVA had improved to 20/60, the defect was no longer full thickness, and the external limiting membrane had reconstituted. At the right macula, the inner cavitations grew and outer cavitations developed, but the external limiting membrane remained intact. At 32 months, right VA was 20/20 and LVA was 20/40. Conclusions: This case of MacTel with spontaneous closure of a macular hole was associated with an overlying internal limiting membrane drape.

scholarly journals Prognostic factors affecting macular hole closure types

2021 ◽  
Vol 13 ◽  
pp. 251584142110090
Author(s):  
Gülşah Gümüş ◽  
Gökhan Demir ◽  
Beril Tülü Aygün ◽  
Ali Demircan ◽  
Zeynep Alkın ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Duration Of Symptoms ◽  
Significant Difference ◽  
Neurosensory Retina ◽  
Closure Group ◽  
Hole Closure

Purpose: In this study, we aimed to evaluate the relationship between macular hole closure types assessed by optical coherence tomography (OCT) and the preoperative prognostic factors. Materials and methods: In total, 183 patients who underwent pars plana vitrectomy and internal limiting membrane peeling for idiopathic macular hole between August 2014 and August 2019 were reviewed retrospectively. The preoperative measurements of the macular hole including minimum linear diameter (MLD), basal hole diameter (BHD) and hole height (HH) were measured on OCT images. The patients were divided into two closure types on the basis of postoperative OCT findings (type 1 closure: retinal edges were flat and there was no defect of the neurosensory retina on the fovea; type 2 closure: retinal edges were flat and there was a defect of the neurosensory retina on the fovea). The difference of prognostic factors such as age; duration of symptoms; preoperative best-corrected visual acuity (BCVA); preoperative macular hole measurements, including MLD, BHD and HH; and rate of reopening between two types were statistically analysed. Results: The mean age of patients was 66.33 ± 8.09 years (range: 48–88 years). According to OCT imaging, 117 eyes (63.9%) were classified into the type 1 closure group, and 66 eyes (36.1%) were classified into the type 2 closure group. There were no significant differences between two groups in age, duration of symptoms and preoperative BCVA ( p = 0.694, p = 0.092 and p = 0.15). MLD and BHD were significantly larger, and reopening was significantly more common in type 2 group ( p < 0.05, p = 0.04 and p < 0.005); however, there was no significant difference in HH between two groups ( p = 0.239). Conclusion: Preoperative horizontal measurements of macular hole may help to determine postoperative visual expectations and anatomical success, and predict the possibility of reopening.

scholarly journals Exhibiting Residual Subretinal Fluid after High Myopic Macular Hole Retinal Detachment Surgery

2021 ◽  
Vol 62 (12) ◽  
pp. 1672-1678
Author(s):  
Sung Joon Kim ◽  
Jae Jung Lee ◽  
Ik Soo Byon ◽  
Ji Eun Lee ◽  
Sung Who Park
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Internal Limiting Membrane ◽  
Closure Rate ◽  
Visual Prognosis ◽  
Membrane Peeling ◽  
Macular Hole Retinal Detachment ◽  
The Right

Purpose: To report a case of poor visual prognosis complicated by residual subretinal fluid after use of the internal limiting membrane flap technique to treat macular hole retinal detachment in a patient with high myopia.Case summary: A 55-year-old male stated that he had experienced a transparent circle in the central visual field of the right eye for 1 month. His best-corrected visual acuity (BCVA) was 0.32 and the axial length of the right eye was 32.57 mm. Fundus examination revealed a macular hole with retinal detachment localized to the posterior pole. We performed vitrectomy, membrane peeling, internal limiting membrane peeling with inverted internal limiting membrane flap, and silicone oil injection. On day 1 after surgery, the macular hole was closed, but subretinal fluid was noticed in the macula. At 3 months after surgery, the BCVA was 0.16 and the silicone oil was removed. At 14 months after the first surgery, the subretinal fluid was completely absorbed, but leopard-pattern pigment degeneration became prominent and the macula exhibited ellipsoid zone disruption. The BCVA decreased to 0.1.Conclusions: In patients exhibiting macular hole retinal detachment in the context of high myopia, an inverted internal limiting membrane flap may increase the macular hole closure rate but disturb subretinal fluid drainage. As persistent subretinal fluid may cause permanent retinal damage with a poor visual prognosis, the surgical method must be carefully chosen.

scholarly journals Viscoat Assisted Inverted Internal Limiting Membrane Flap Technique for Large Macular Holes Associated with High Myopia

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Zongming Song ◽  
Mei Li ◽  
Junjie Liu ◽  
Xuting Hu ◽  
Zhixiang Hu ◽  
...  
Keyword(s):  
High Myopia ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Flap Technique ◽  
Initial Surgery ◽  
Macular Holes ◽  
Minimum Angle ◽  
The Mean

Purpose. To investigate the surgical outcomes of Viscoat® assisted inverted internal limiting membrane (ILM) flap technique for large macular holes (MHs) associated with high myopia.Design. Prospective, interventional case series.Methods. Fifteen eyes of 15 patients with high myopia underwent vitrectomy and Viscoat assisted inverted ILM flap technique to treat MH without RD. Patients were followed up over 6 months. The main outcome measures were MH closure evaluated by optical coherence tomography (OCT) and best-corrected visual acuities (BCVAs).Result. MH closure was observed in all eyes (100%) following the initial surgery. Type 1 closure was observed in 13 eyes (86.7%); type 2 closure was observed in the remaining 2 eyes (13.3%). Compared to the preoperative baseline, the mean BCVA (logarithm of the minimum angle of resolution) improved significantly at 3 months and 6 months after surgery (P=0.025, 0.019, resp.). The final BCVA improved in 10 eyes (66.7%), remained unchanged in 3 eyes (20.0%), and worsened in 2 eyes (13.3%).Conclusion. Vitrectomy combined with Viscoat assisted inverted ILM flap technique is an effective treatment for large MHs in highly myopic eyes. It may increase the success rate of the initial surgery and enhance the anatomical and functional outcomes.

Intradural Extramedullary Lesions in Cervical Spine in Neurofibromatosis

2021 ◽  
pp. 22
Author(s):  
Rana Moshref
Keyword(s):  
Multidisciplinary Approach ◽  
Cervical Lesions ◽  
Cervical Mass ◽  
Gradual Onset ◽  
Autosomal Dominant Fashion ◽  
Intradural Extramedullary ◽  
The Right ◽  
Spastic Quadriparesis

Introduction: Neurofibromatosis (NF) is isolated into three diseases: NF type 1, type 2, and schwannoma. NF type 2 could be a disorder that's found roughly in 1/25,000–33,000 births with a mutation in gene 22q11.2, and it is passed through eras in an autosomal dominant fashion. Diagnosis is made with both clinical and radiological features. A few clinical features have been characterized in conclusion counting Manchester criteria. There is a scarce number of NF type 2 patients diagnosed with cervical lesions which are 25 in number. We report a case of an intradural extramedullary cervical lesion in a patient later diagnosed with NF type 2. Case Report: A 30-year-old male presenting with gradual onset and progressive course of spastic quadriparesis of six months’ duration was admitted through the emergency unit. MRI spine showed intradural extramedullary masses in the right side of C4 and left side of C6. The patient underwent cervical intradural excision of two masses under general anesthesia with neuromonitoring. The tumor was sent for histopathology and reported as NF type 2. Conclusion: NF is a common entity, but the diagnosis of cervical mass is judicious to avoid any complication in neurological function. It further needs a multidisciplinary approach and screening modalities.

Keratoprostheses in silicone oil-filled eyes: long-term outcomes

2018 ◽  
Vol 103 (6) ◽  
pp. 781-788 ◽  
Author(s):  
Geetha Iyer ◽  
Bhaskar Srinivasan ◽  
Shweta Agarwal ◽  
Ruchika Pattanaik ◽  
Ekta Rishi ◽  
...  
Keyword(s):  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Retrospective Chart Review ◽  
Protective Role ◽  
Visual Rehabilitation ◽  
Two Factors

PurposeTo analyse the functional and anatomical outcomes of different types of keratoprostheses in eyes with retained silicone oil following vitreoretinal surgery.MethodsRetrospective chart review of patients operated with any type of permanent keratoprosthesis (Kpro) in silicone oil-filled eyes between March 2003 and June 2017 were analysed.Results40 silicone oil-filled eyes underwent keratoprostheses, of which 22 were type 1 and 18 were type 2 Kpros (Lucia variant—nine, modified osteo odonto kerato prosthesis (MOOKP)—four, Boston type 2—three and osteoKpro—two) with a mean follow-up of 61.54 , 42.77, 45.25 , 25 and 37 months, respectively. Anatomic retention of the primary Kpro was noted in 33 eyes (82.5%). A best-corrected visual acuity of better than 20/200 and 20/400 was achieved in 26 (65%)+32 (80%) eyes. Retroprosthetic membrane (RPM) was the most common complication noted in 17 eyes (42.5%). Perioptic graft melt was noted in 4 of 22 eyes of the type 1 Kpro (2 (10.5%) without associated ocular surface disorder (OSD)) and in 1 eye each of Boston and Lucia type 2 Kpro. Laminar resorption occurred in one eye each of the MOOKP and OKP groups. Endophthalmitis and glaucoma did not occur in any eye.ConclusionAppropriately chosen keratoprosthesis is a viable option for visual rehabilitation in eyes post vitreoretinal surgery with retained silicone oil-induced keratopathy not amenable to conventional penetrating keratoplasty. Kpro melt among type 1 Kpro did not occur in 89.5% eyes without associated OSD (19 of 22 eyes), despite the lack of aqueous humour and presence of RPM (4 eyes), two factors considered to play a significant role in the causation of sterile melts. Of interest to note was the absence of infection in any of these eyes. The possible protective role of oil from endophthalmitis is interesting, though yet to be ascertained.

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