scholarly journals Microincision Vitrectomy Surgery in Vitreomacular Traction Syndrome of Retinitis Pigmentosa Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Enzo Maria Vingolo ◽  
Emanuele Gerace ◽  
Stefano Valente ◽  
Leopoldo Spadea ◽  
Marcella Nebbioso
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Vitreous Body ◽  
Vitreomacular Traction ◽  
Surgical Removal ◽  
Surface Adhesion ◽  
Ilm Peeling ◽  
Vitreomacular Traction Syndrome ◽  
Vitrectomy Surgery

Purpose. To investigate long-term retinal changes after microincision pars plana vitrectomy surgery (MIVS) and internal limiting membrane (ILM) peeling outcome in retinitis pigmentosa (RP) patients affected by vitreomacular traction syndrome (VMT) with higher vitreous surface adhesion or coexisting epiretinal membrane (ERM).Methods. Eight RP patients suffering from VMT were evaluated by means of best corrected visual acuity (BCVA), anterior and posterior binocular examination, spectral-domain optical coherence tomography (SD-OCT), MP-1 microperimetry (MP-1), and full-field electroretinogram (ERG), before MIVS and ILM peeling and during the 36-month follow-up. Patients were hospitalized for two days after the surgery. Surgical procedure was performed following this schedule: surgical removal of crystalline lens (MICS), MIVS with 23-gauge sutureless system trocars, core vitreous body removal, and balanced-sterile-salin-solution- (BSS-) air-gas (SF6) exchange.Results. All patients presented visual acuity (VA) increase after MIVS. None of the patients developed ocular hypertension or vitreomacular adhesions during the 3-year follow-up. MP-1 bivariate contour ellipse area (BCEA) was reduced in its dimensions and improved in all patients demonstrating a better fixation.Conclusions. MIVS could be the gold standard therapy in RP patients with VMT and higher vitreous surface adhesion or coexisting ERM if medical therapy is not applicable or not effective.

scholarly journals Ocular abnormalities in a large Western China patient cohort with Retinitis Pigmentosa

2020 ◽  
Author(s):  
Lian Tan ◽  
Yanling Long ◽  
Ziyang Li ◽  
Xi Ying ◽  
Jiayun Ren ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Western China ◽  
Vitreomacular Traction ◽  
Cystoid Macular Oedema ◽  
Epiretinal Membranes ◽  
Ocular Abnormalities ◽  
Vitreomacular Traction Syndrome ◽  
Macular Holes

Abstract Background: To report the prevalence of ocular abnormalities and investigate visual acuity in a large Western China cohort of retinitis pigmentosa (RP) patients.Methods: A retrospective study was performed, reviewing the medical records and ophthalmic examination reports of 2,127 eyes from 1,065 RP patients in one eye hospital. The authors investigated the prevalence of ocular abnormalities and the relationship between best corrected visual acuity (BCVA) and macular abnormalities.Results: Nyctalopia (58.2%) and blurred vision (27.1%) were the leading consultation causes. BCVA measurements in the better eyes at first clinical presentation showed that 304 patients (28.5%) were categorised as blind and 220 patients (20.7%) as low vision. The most common ocular abnormalities were cataracts (43.1%) and macular abnormalities (59.7%), including epiretinal membranes (51.1%), cystoid macular oedema (18.4%), vitreomacular traction syndrome (2.4%), macular holes (2.3%) and choroidal neovascular membranes (0.05%). Glaucoma was found in 35 eyes (1.6%). The proportions of epiretinal membranes (P = 0.001) and macular holes (P = 0.008) increased significantly with age. The proportions of vitreomacular traction syndrome (P = 0.003) and epiretinal membranes (P < 0.001) in pseudophakia and aphakia eyes were significantly higher than in eyes that had not received operations (including cataracts and clear lens). Cystoid macular oedema was significantly associated with poorer visual acuity in RP patients with clear lens (P = 0.002).Conclusion: Cataracts and macular abnormalities are common in RP patients. In the macular abnormalities, cystoid macular oedema may have a negative effect on BCVA in RP patients with clear lens.

scholarly journals Ten Years of Severe Vitreomacular Traction Syndrome without Functional Damage Demonstrated by Optical Coherence Tomography

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Michele Reibaldi ◽  
Teresio Avitabile ◽  
Maurizio Giacinto Uva ◽  
Francesco Occhipinti ◽  
Mario Toro ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Vitreomacular Traction ◽  
First Year ◽  
Optical Coherence ◽  
Vitreomacular Adhesion ◽  
Vitreomacular Traction Syndrome ◽  
History Of ◽  
Functional Features

Introduction.To describe anatomical and functional features in one patient with 10 years of severe vitreomacular traction syndrome (VTS) without functional damage demonstrated by optical coherence tomography (OCT).Patient and Methods.One patient with a history of 10 years VTS, with best-corrected visual acuity of 20/32, was followed up with OCT. Follow-up examinations, 3 months for the first year after diagnosis and every 6 months for the subsequent years, were performed.Results.Follow-up examinations showed no change anatomically and functionally. Far and near visual acuity was unchanged. OCT by Heidelberg Spectralis did not evidence differences from Stratus OCT images.Conclusion.VTS can be stable anatomically and functionally for 10 years. OCT is a valuable diagnostic tool in understanding the configuration of vitreomacular adhesion, followup, and eventually planning the surgical approach for operating on VTS.

scholarly journals Pneumatic induction of the posterior vitreous detachment - a minimally invasive method of treating vitreomacular traction syndrome

2017 ◽  
Vol 98 (5) ◽  
pp. 865-868
Author(s):  
D V Petrachkov ◽  
A V Zolotarev ◽  
P A Zamytskiy ◽  
E V Karlova ◽  
T A Podsevakina
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Posterior Vitreous Detachment ◽  
Vitreomacular Traction ◽  
Vitreous Detachment ◽  
Vitreomacular Traction Syndrome ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Best Corrected Visual Acuity

To study the efficacy of pneumatic induction of posterior vitreous detachment for the treatment of vitreomacular traction syndrome, the analysis of the results of surgical treatment of 10 patients (10 eyes) with vitreomacular traction syndrome was performed, among them 8 patients (8 eyes) had an accompanied immature age-related cataract and 2 patients (2 eyes) - pseudophakia. The average age of the patients was 64.1±4.6 years, among them 8 women and 2 men. The mean best corrected visual acuity on admission was 0.31±0.15, the average length of vitreomacular adhesion and retina thickness in the fovea by optical coherence tomography were 289.3±75.4 and 367.5±50.3 μm, respectively. Patients with pseudophakia underwent pneumatic induction of the posterior vitreous detachment, and patients with cataract underwent the same surgery in combination with phacoemulsification of the cataract and intraocular lens implantation. Within 1 month of follow-up, all patients had a complete posterior vitreous detachment and increased best corrected visual acuity. Intraocular pressure remained normal throughout the follow-up period in 9 out of 10 patients, 1 patient experienced hypertension on day 1 after the surgery, which required decompression during the gas expansion period. Further on, intraocular pressure was normalized and did not require therapy. Pneumatic induction of posterior vitreous detachment is an effective method of treatment of vitreomacular traction syndrome, which allows eliminating vitreomacular traction; the combination of pneumatic induction of the posterior vitreous detachment with phacoemulsification of cataract allows avoiding hypertension during and after operation and avoiding performing vitrectomy.

scholarly journals Clinical Application of Foldable Capsular Vitreous Bodies in the Treatment of Severe Ocular Trauma and Silicone Oil Dependent Eyes

2021 ◽  
Author(s):  
Hao Jiang ◽  
Chao Xue ◽  
Yanlin Gao ◽  
Ying Chen ◽  
Yan Wang
Keyword(s):  
Visual Acuity ◽  
Clinical Application ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Anterior Segment ◽  
Vitreous Body ◽  
Corneal Opacity ◽  
Ultrasound Biomicroscopy ◽  
Significant Difference

Abstract Background: Recently, a new type of foldable capsular vitreous body (FCVB) has been developed for clinical application to fill the vitreous cavity with vitreous substitutes. It may be an ideal substitute for the vitreous body in eyes with severe retinal detachment. The aim of this study was to assess the application of a foldable capsular vitreous body (FCVB) in the treatment of severe ocular trauma and silicone oil (SO) dependent eyes.Methods: A retrospective analysis was performed on the clinical application of FCVB in the treatment of severe ocular trauma and SO dependent eyes. The results of best-corrected visual acuity and intraocular pressure (IOP) evaluation, B-scan ultrasonography or color Doppler ultrasonography, ultrasound biomicroscopy, and anterior segment photography were recorded during follow-up. A paired t-test was used to compare the difference in IOP before and after FCVB implantation. Results: Seven eyes of seven patients were included in the 6 months follow-up. In all cases, B-scan ultrasonography and ultrasound biomicroscopy showed that FCVB adapted closely to the globe wall and ciliary body, thus supporting the retina. Visual acuity did not improve, except in one case from LP to HM. The mean±SD IOP was 9.29±1.60mmHg prior to FCVB implantation and 10.43±0.98mmHg after implantation, with no significant difference between these measurements (P=0.066). Five of the seven patients developed differing degrees of corneal opacity and keratopathy. Conclusions: FCVB implantation may be a safe and effective method for the treatment of severe ocular trauma and SO dependent eyes. However, corneal opacity and keratopathy are potential serious complications after surgery. Appropriate case selection and proper surgical time require further investigation.

Long-term ophthalmic anatomical and functional outcomes after surgical removal of intraorbital foreign bodies

2019 ◽  
pp. 112067211988558
Author(s):  
Aditi Mehta Grewal ◽  
Manpreet Singh ◽  
Deepti Yadav ◽  
Manpreet Kaur ◽  
Jyoti Singh ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Functional Outcomes ◽  
Foreign Bodies ◽  
Surgical Removal ◽  
Movement Restriction ◽  
Foreign Body Removal ◽  
Computed Tomographic ◽  
Functional Factors

Purpose: To analyze the anatomical and functional ophthalmic parameters after the surgical removal of various intraorbital foreign bodies. Methods: A retrospective analysis of medical records was performed featuring detailed history, ophthalmic examination, orbital computed tomographic scans, treatment details, and outcomes. The analyzed anatomical factors included extraocular movements, the position of the eyeball (proptosis, dystopia, and enophthalmos), and fullness of orbital sulci. The functional assessment was based on visual acuity, pupillary reactions, and diplopia. The outcomes were defined as complete, partial, and failure after a minimum follow-up of 1 year. Results: Of 32 patients, the organic and inorganic intraorbital foreign bodies were surgically removed from 18 (56.25%) and 14 (43.75%) orbits, respectively. At presentation, anatomically the extraocular movement restriction, proptosis/dystopia/enophthalmos, and orbital sulcus fullness were noted in 26 (81.25%), 24 (75%), and 15 (46.88%), respectively. Functionally, diminished visual acuity, diplopia, and pupil abnormalities were seen in 27 (84.38%), 14 (43.75%), and 8 (25%), respectively. After intraorbital foreign body removal at a mean follow-up of 14 months, the improvement of anatomical factors (same sequence) were observed in 8 (30.77%), 20 (83.33%), and 12 (80%), respectively. In functional factors (same sequence), the improvement was noted in none (0%), 13 (92.86%), and 5 (62.5%), respectively. Hence, the majority of patients (n = 20, 62.5%) achieved partial success, while 8 (25%) had complete success. Four (12.5%) had treatment failure despite similar management protocols. Conclusion: The anatomical outcomes are better than the functional outcomes after surgical removal of the intraorbital foreign bodies. The visual acuity does not improve considerably after the surgical removal of intraorbital foreign bodies. Overall, the wooden intraorbital foreign bodies have poorer anatomical and functional prognosis.

scholarly journals Comparison of Anatomical and Visual Outcomes between Idiopathic and Myopic Macular Holes Using the Internal Limiting Membrane or Inverted Internal Limiting Membrane Flap Technique

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Federico Peralta Iturburu ◽  
Claudia Garcia-Arumi ◽  
Maria Bové Alvarez ◽  
Jose Garcia-Arumi
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Small Sample Size ◽  
Internal Limiting Membrane ◽  
Small Sample ◽  
Ilm Peeling ◽  
Visual Outcomes ◽  
Macular Holes ◽  
Idiopathic Macular Holes

Purpose. To compare the results of vitrectomy with those of internal limiting membrane (ILM) peeling or inverted ILM flap for treating myopic or idiopathic macular hole. Methods. Thirty-nine eyes of 39 patients undergoing vitrectomy with ILM peeling for macular hole (25 idiopathic and 14 myopic) and 27 eyes of 27 patients undergoing vitrectomy with inverted ILM flap (15 idiopathic and 12 myopic) were included. Outcome measures were macular hole closure by optical coherence tomography and visual acuity at 6 months. Results. Closure was achieved in 25 (100%) idiopathic and 12 (86%) myopic macular holes in the ILM peeling group and in 14 (93%) idiopathic and 11 (91.77%) macular holes in the inverted ILM flap group. There were no statistically significant differences in restoration of the external limiting membrane and ellipsoid zone between the groups. Median best-corrected visual acuity (logarithm of minimal angle of resolution) at the end of follow-up was 0.22 (20/32 Snellen) in idiopathic and 0.4 (20/50) in myopic (P=0.042) patients in the ILM peeling group and 0.4 (20/50) in idiopathic and 0.4 (20/50) in myopic (P=0.652) patients in the inverted ILM flap group. Conclusion. Both techniques were associated with high closure rates in myopic and idiopathic macular holes, with somewhat better visual outcomes in idiopathic cases. The small sample size may have provided insufficient power to support the superiority of one technique over the other in the two groups.

Usher syndrome in a patient with Ellis–van Creveld syndrome

2019 ◽  
Vol 30 (2) ◽  
pp. NP38-NP40
Author(s):  
Francesco Romano ◽  
Giorgia Carlotta Albertini ◽  
Alessandro Arrigo ◽  
Pier Pasquale Leone ◽  
Francesco Bandello ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Usher Syndrome ◽  
Fundus Photography ◽  
Optical Coherence ◽  
Genetic Tests ◽  
Ellis Van Creveld Syndrome ◽  
Atypical Presentations

Purpose: To describe a case of Ellis–van Creveld syndrome with concomitant Usher syndrome. Methods: A 24-year-old lady with a diagnosis of Ellis–van Creveld syndrome came to our attention in 2015 complaining of nyctalopia. She underwent yearly ophthalmologic examinations, including visual acuity, dilated fundoscopy, optical coherence tomography and colour fundus photography. Results: On the day of her first examination, her visual acuity was 20/20, whereas fundus examination revealed diffuse peripheral retinal atrophy with pigmented bone spicules, waxy pallor of the disc and macular sparing in both eyes, compatible with retinitis pigmentosa. Due to the severe retinitis pigmentosa phenotype for the age and the concomitant neurosensory hearing loss, ancillary electrophysiological and genetic tests were requested. At the end of follow-up, visual function remained stable, with electroretinogram tests confirming the peripheral dysfunction. Interestingly, next generation sequencing test revealed a mutation in USH2A gene, suggestive of an overlapping Usher syndrome. On optical coherence tomography angiography, all plexuses appeared altered, with some degree of impairment also in the choriocapillaris of the spared macula. Conclusion: Our report emphasizes the advantage of new genetic tests to investigate atypical presentations of known retinal disorders found in syndromic settings. In addition, we speculate that the underlying ciliopathy might possibly aggravate the phenotype of this case of Usher syndrome.

scholarly journals UTILITY OF INTRAOPERATIVE OPTICAL COHERENCE TOMOGRAPHY DURING VITRECTOMY SURGERY FOR VITREOMACULAR TRACTION SYNDROME

Retina ◽  
2014 ◽  
Vol 34 (7) ◽  
pp. 1341-1346 ◽  
Author(s):  
Justis P. Ehlers ◽  
Tiffany Tam ◽  
Peter K. Kaiser ◽  
Daniel F. Martin ◽  
Gina M. Smith ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Vitreomacular Traction ◽  
Optical Coherence ◽  
Vitreomacular Traction Syndrome ◽  
Intraoperative Optical Coherence Tomography ◽  
Vitrectomy Surgery

Immediate Release of Vitreomacular Traction After Pneumatic Vitreolysis Followed by the Drinking Bird Technique

2019 ◽  
Vol 4 (4) ◽  
pp. 320-324
Author(s):  
Neesurg Mehta ◽  
Lalita Gupta ◽  
Michael Jansen ◽  
Richard Rosen ◽  
Jessica Lee
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Immediate Release ◽  
Vitreomacular Traction ◽  
Full Thickness ◽  
Blurred Vision ◽  
Full Thickness Macular Hole ◽  
Feasible Option ◽  
Head Bobbing

Purpose: To report a case of release of vitreomacular traction (VMT) in a patient with a full thickness macular hole (FTMH) immediately following pneumatic vitreolysis (PV) combined with head bobbing movements. Methods: A 71-year-old female with VMT and an FTMH presented with blurred vision for 2 months to the level of 20/400. At her 1-month follow-up visit, PV was performed using C3F8 gas and she was instructed to perform the drinking bird technique for ten minutes. Results: Optical coherence tomography performed ten minutes after PV with head bobbing showed VMT release and a smaller FTMH. Visual acuity improved to 20/150 immediately afterwards and to 20/80 two months later. Conclusions: Using the drinking bird technique for a continuous period of time immediately following PV may encourage rapid VMT release. PV may be a feasible option for patients with VMT and FTMH who do not want surgery.

Vitrectomy in the Management of Vitreomacular Traction Syndrome

2018 ◽  
Vol 2 (2) ◽  
pp. 91-95
Author(s):  
Zofia Michalewska ◽  
Jerzy Nawrocki
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Internal Limiting Membrane ◽  
Long Term Results ◽  
Vitreomacular Traction ◽  
Study Group ◽  
Vitreous Detachment ◽  
Vitreomacular Traction Syndrome ◽  
The Mean ◽  
Final Visual Outcome

Purpose: To estimate long-term results after vitrectomy with internal limiting membrane peeling in vitreomacular traction syndrome (VMTS), as well as to estimate factors influencing final visual outcome. Methods: Medical records of all patients who underwent pars plana vitrectomy for idiopathic VMTS from 2007 through 2015 were assessed. Spectral domain optical coherence tomography was performed preoperatively and at least 6 months after surgery. The mean horizontal and vertical diameters of the vitreomacular traction (VMT) were measured. The area of vitreomacular attachment was calculated. Results: Twenty-four eyes of 22 patients (mean age, 74 years) were included in this study. Mean visual acuity improved significantly from 0.26 Snellen (0.69 logMAR) to 0.39 Snellen (0.43 logMAR) in the mean of 29 months after surgery (7-90 months; median, 25 months; P = .02, paired t test). Visual acuity improved in 18 eyes, remained unchanged in 2 cases, and decreased postoperatively in 4 eyes. Multiple regression analysis did not reveal any factors significant for determining final visual acuity. However, when regrouping the patients according to the International Vitreomacular Traction Study Group, we observed that final visual acuities were statistically significantly better in eyes with focal vitreous detachment compared to broad vitreous detachment ( P = .04). Conclusions: Despite the fact that VMT is a 3-dimensional disease, the calculated area of attachment was not greater than the vertical diameter of attachment. According to the current study, the classification of VMT proposed by the VMT Study Group might be an important tool in predicting the final visual outcome after vitrectomy.

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