scholarly journals Lamellar Macular Holes: The Role of Microperimetry in Functional Assessment

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Simone Donati ◽  
Paola Della Valle ◽  
Elias Premi ◽  
Marco Mazzola ◽  
Laura Lo Presti ◽  
...  

Introduction. The aim of our observational cross-sectional study was to evaluate the association between visual function and anatomical characteristics of LMH, considering in particular different subtypes of LMH and their features. Materials and Methods. This observational clinical study has been conducted in the Ophthalmology Clinic, ASST-Sette Laghi, University of Insubria of Varese-Como, Italy. Included patients underwent a complete ophthalmological examination, as well as MP1 microperimetry evaluation and optical coherence tomography (OCT). Two experienced masked observers evaluated OCT imaging in order to assess the integrity of the photoreceptor layer (interdigitation zone and ellipsoid zone: IZ/EZ) and the external limiting membrane (ELM). Results. Twenty-five patients affected by an LMH were evaluated. Eighteen eyes of 18 patients met the study criteria and were included. Based on morphological and functional data, LMHs were divided into two subgroups: tractional (tLMH) and degenerative (dLMH). We identified 11 tLMHs and seven dLMHs. Functional parameters showed a significative difference in visual acuity and retinal sensitivity between the two groups, respectively: (sample median and the interquartile range) 0.0 (0.0; 0.09) LogMAR vs 0.15 (0.09; 0.52) LogMAR and 16.2 (14.2; 17.7) dB vs 10.0 (7.5; 11.8) dB (p<0.05). Fixation was predominantly central in 90.9% of tLMH vs 71.4% of dLMH and stable in 81.8% tLMH vs 42.9% dLMH, but the differences were not statistically significant. Tractional and degenerative LMHs showed no significant differences in central foveal thickness. Conversely, LMH depth and horizontal diameters appeared different between the two groups. Tractional LMH showed a greater depth 257 (205; 278) μm vs 190 (169; 249) μm, whereas degenerative LMH showed a greater horizontal diameter 653 (455; 750) μm vs 429 (314; 620) μm (p<0.05). IZ/EZ line was unaffected in 81.8% of tLMHs eyes versus 14.3% of dLMHs eyes (p<0.05). Visual acuity and retinal sensitivity were higher in eyes with integrity of both IZ/EZ and ELM compared to those with a disruption of one or both layers (p<0.05). Conclusion. Two different subtypes of LMH showed peculiar functional aspects due to their morphological features. Tractional LMHs revealed higher visual acuity and retinal sensibility due to the relative preservation of the outer retinal layers compared to degenerative LMHs. Moreover, we underlined the importance of microperimetry to better identify functional defects in macular degenerative pathologies.

2013 ◽  
Vol 5 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Mohammadreza Ahmadpour-Baghdadabad ◽  
Masoudreza Manaviat ◽  
Ahmad Shojaoddiny-Ardekani

Introduction: Diabetic Macular Edema (DME) is an important cause of vision loss in diabetic retinopathy. Optical Coherence Tomography (OCT) is a non-invasive modality that produces high-resolution images of retinal layers. Objective: To evaluate the prevalence of DME patterns and their association with risk factors and visual acuity. Materials and Methods: In this cross-sectional study, type 2 diabetics with macular edema referred to our center during a ten-month period underwent OCT. Patients with macular edema due to causes other than diabetes and with OCT images of improper quality were excluded from the study. Four distinct patterns were found in the OCT images. A questionnaire including age, sex, duration of diabetes, serum TG and cholesterol, HbA1c, BMI and visual acuity, as well as the findings of OCT images were filled for the subjects. Results: Eighty-six eyes from 46 patients were evaluated. The most and the least common patterns were sponge-like retinal swelling (SLRS) and posterior hyaloidal traction (PHT) found in 64.0% and 5.8% of the subjects, respectively. A sub-retinal fluid pattern was more common in males (p=0.011) and in patients with serum TG > 200mg/dl (p=0.037). There were significant associations between central foveal (r=0.45, p<0.001), nasal (r=0.35, p=0.001) and temporal (r=0.32, p=0.003) thicknesses with visual acuity. Moreover, the highest thickness (462.4±119.2μm) and also the worst visual acuity (1.0±0.5logMAR) pertained to the cystoid macular edema (CME) pattern. Conclusion: Our study showed that the most common OCT pattern of DME is the sponge-like retinal swelling, while posterior hyaloidal traction has the lowest prevalence. A higher foveal thickness and a lower visual acuity are seen in the CME pattern. Nepal J Ophthalmol 2013; 5(10): 190-194 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8727


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Solmaz Abdolrahimzadeh ◽  
Vito Fenicia ◽  
Maurizio Maurizi Enrici ◽  
Pasquale Plateroti ◽  
Dora Cianfrone ◽  
...  

The clinical efficacy of one or two intravitreal injections of a continued deliverance dexamethasone 700 μg implant in ten patients with persistent macular edema following uncomplicated phacoemulsification was evaluated. Complete ophthalmological examination and spectral domain optical coherence tomography were carried out. Follow-up was at day 7 and months 1, 2, 4, 6, 8, and 12. At baseline mean best corrected visual acuity was 62 Early Treatment Diabetic Retinopathy Study Chart letters, which showed statistically significant improvement at each follow-up, except at month 6, to reach 79 letters at month 12 (P=0.018). Prior to treatment mean central foveal thickness was 622 μm, which showed statistically significant improvement at each follow-up to reach a mean value of 282 μm (P=0.012) at month 12. Five patients received a second dexamethasone implant at month 7. Two patients were excluded from the study at months 4 and 8. Intraocular pressure remained stable during the study period with the exception of mild increase in two patients requiring topical therapy. In conclusion there was statistically significant improvement of best corrected visual acuity and mean central foveal thickness with one or two intravitreal dexamethasone implants over 12 months.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amithavikram R. Hathibelagal ◽  
Yasmeen Mulani ◽  
Vivek Pravin Dave

AbstractTo evaluate the changes in functional vision in patients with resolved endophthalmitis. This was a cross-sectional study. The study included 20 patients with resolved endophthalmitis and best-corrected visual acuity of 20/100 or better. Visual acuity (VA), contrast threshold (CT), red/green (RG) and yellow/blue (YB) colour vision and 15 Hz flicker modulation threshold (FMT) were assessed using standard psychophysical techniques. The median age was 54 years. The median visual acuity was 0.27 (~ 20/40—Snellen Equivalent) ((interquartile range [IQR]), 0.30) logMAR). The median log contrast threshold (CT) was − 1.13 (IQR, 0.36) log units (normative value for age-matched CT: − 1.61 log units). The median red/green (RG) and yellow/blue (YB) thresholds were 11.52 (IQR, 26.19) and 9.45 (IQR, 16.20) CAD units respectively, which were at least 5 times higher than age-matched normative RG and YB thresholds. The median central cone- mediated FMT was 17.64% (IQR, 23.40%), which was much higher compared to age-matched FMT (5.48% [IQR, 3.47]). Linear regression revealed significant relationship between contrast thresholds and foveal thickness (y = 0.001x−1.47, R2 = 0.20, p = 0.048). Though endophthalmitis may resolve with a good visual acuity, deficits in visual functions like chromatic discrimination, cone-mediated flicker and contrast sensitivity persist.


2020 ◽  
pp. 112067212092727
Author(s):  
Marko Lukic ◽  
Gwyn Williams ◽  
Zaid Shalchi ◽  
Praveen J Patel ◽  
Philip G Hykin ◽  
...  

Purpose To assess visual and optical coherence tomography–derived anatomical outcomes of treatment with intravitreal aflibercept (Eylea®) for diabetic macular oedema in patients switched from intravitreal ranibizumab (Lucentis®). Design Retrospective, cohort study. Participants Ninety eyes (of 67 patients) receiving intravitreal anti–vascular endothelial growth factor therapy were included. Methods This is a retrospective, real-life, cohort study. Each patient had visual acuity measurements and optical coherence tomography scans performed at baseline and 12 months after the first injection of aflibercept was given. Main Outcome Measures We measured visual acuities in Early Treatment Diabetic Retinopathy Study letters, central foveal thickness and macular volume at baseline and at 12 months after the first aflibercept injection was given. Results Ninety switched eyes were included in this study. The mean (standard deviation) visual acuity was 63 (15.78) Early Treatment Diabetic Retinopathy Study letters. At baseline, the mean (standard deviation) central foveal thickness was 417.7 (158.4) μm and the mean macular volume was 9.96 (2.44) mm3. Mean change in visual acuity was +4 Early Treatment Diabetic Retinopathy Study letters (p = 0.0053). The mean change in macular volume was −1.53 mm 3 in SW group (p = 0.21), while the change in central foveal thickness was −136.8 μm (p = 0.69). Conclusion There was a significant improvement in visual acuity and in anatomical outcomes in the switched group at 12 months after commencing treatment with aflibercept for diabetic macular oedema.


Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1157
Author(s):  
María D. Díaz-Barreda ◽  
Isabel Bartolomé-Sesé ◽  
Ana Boned-Murillo ◽  
Antonio Ferreras ◽  
Elvira Orduna-Hospital ◽  
...  

Background: We study the retinal function measured by macular integrity assessment microperimetry (MAIA) and structural changes assessed by scanning swept source optical coherence tomography (SS-OCT) between healthy individuals and patients undergoing pars plana vitrectomy (PPV) after rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study. Early Treatment Diabetic Retinopathy Study (ETDRS) grids were measured by SS-OCT and compared with the MAIA parameters. Results: Thirty-eight eyes with RRD (19 macula-on and 19 macula-off) were compared with 113 healthy eyes. The retinal sensitivity and average total threshold were reduced in all sectors in the RRD group; macular integrity index was increased. Macular thicknesses in total retina and ganglion cell layer (GCL)++ protocols were higher in the RRD group in nasal outer (NO) and central (C) sectors and only in C sector for GCL+ protocol. Thicknesses were lower in total retina, GCL++ protocols in the temporal outer (TO) sector and in the GCL+ protocol in NO sector. Best-corrected visual acuity (BCVA) correlated moderately with retinal sensitivity in all sectors and in just several sectors with time between the date of surgery and the test. The central nasal (CN) sector thickness and the average total threshold were higher in the macula-on subgroup. Conclusions: RRD and subsequent surgery results in functional and structural changes, especially in individuals with macular detachment.


2012 ◽  
Vol 20 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Mark W. Swanson ◽  
Eric Bodner ◽  
Patricia Sawyer ◽  
Richard M. Allman

Little is known about the effect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision, and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross-sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations while controlling for potential confounders. In multivariate analyses, each lower step in visual acuity below 20/50 was significantly associated with reduced odds of having a higher level of physical activity, OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults.


2019 ◽  
Author(s):  
Hiroyuki Nakashizuka ◽  
Yorihisa Kitagawa ◽  
Yu Wakatsuki ◽  
Koji Tanaka ◽  
Koichi Furuya ◽  
...  

Abstract Purpose: To evaluate the efficacy of epiretinal membrane removal in patients with good best-corrected visual acuity (BCVA) for improving visual function and quality of life (QOL). Methods: This prospective case study compared 37 subjects with preoperative BCVA≦logMAR0.046 (Good group) to 35 patients with logMAR BCVA 0.52–0.10 (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months. Results: MH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health. Conclusions: Early epiretinal surgery was effective for MH, BCVA, aniseikonia, and QOL.


2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Khashayar Mehdizadehkashi ◽  
Shahla Chaichian ◽  
Abolfazl Mehdizadehkashi ◽  
Ebrahim Jafarzadepour ◽  
Zeinab Tamannaie ◽  
...  

In this research, we represent the changes in visual acuity during pregnancy and after delivery. Changes as myopic shift start during second trimester and will be stopped after delivery; however it is obtained that women will have the same refractive error as what they had in the first trimester, after postpartum. So, any change in their spectacle prescription during this period is forbidden. As a result, not only changing in hormones can cause myopic shift in vision, but also overweight has its retributive role. What we are trying to do is to notify gynecologists and optometrists to be aware of these changes, so as to leave spectacle prescription writing to the session after postpartum period.


2011 ◽  
Vol 14 (12) ◽  
pp. 2236-2244 ◽  
Author(s):  
Myriam Fillion ◽  
Mélanie Lemire ◽  
Aline Philibert ◽  
Benoît Frenette ◽  
Hope Alberta Weiler ◽  
...  

AbstractObjectiveTo examine the associations between near and distant visual acuity and biomarkers of Hg, Pb, n-3 fatty acids and Se from the local diet of fish-eating communities of the Tapajós River in the Brazilian Amazon.DesignVisuo-ocular health and biomarkers of Hg (hair, whole blood, plasma), Pb (whole blood), Se (whole blood and plasma) and n-3 fatty acids (plasma total phospholipids) were assessed in a cross-sectional study.SettingLower Tapajós River Basin (State of Pará, Brazil), May to July 2006.SubjectsTwo hundred and forty-three adults (≥15 years) without diagnosed age-related cataracts or ocular pathologies.ResultsNear visual acuity was negatively associated with hair Hg and positively associated with %DHA, with a highly significant Log Hg × age interaction term. Stratifying for age showed that while young people presented good acuity, for those aged ≥40 years, clinical presbyopia was associated with hair Hg ≥ 15 μg/g (OR = 3·93, 95 % CI 1·25, 14·18) and %DHA (OR = 0·37, 95 % CI 0·11, 1·11). A similar age-related pattern was observed for distant visual acuity in relation to blood Pb, but the evidence was weaker.ConclusionsThese findings suggest that Hg and Pb may affect visual acuity in older persons, while DHA appears to be protective for near visual acuity loss. In this population, with little access to eye care, diet may have an important influence on visuo-ocular ageing.


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