Immunocytochemical and Ultrastructural Evidence of Glial Cells and Hyalocytes in Internal Limiting Membrane Specimens of Idiopathic Macular Holes

2011 ◽  
Vol 52 (11) ◽  
pp. 7822 ◽  
Author(s):  
Ricarda G. Schumann ◽  
Kirsten H. Eibl ◽  
Fei Zhao ◽  
Martin Scheerbaum ◽  
Renate Scheler ◽  
...  
Keyword(s):  
Glial Cells ◽  
Internal Limiting Membrane ◽  
Ultrastructural Evidence ◽  
Macular Holes ◽  
Idiopathic Macular Holes

scholarly journals Perspectives of Autologous Mesenchymal Stem-Cell Transplantation in Macular Hole Surgery: A Review of Current Findings

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Raffaele Nuzzi ◽  
Federico Tridico
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Internal Limiting Membrane ◽  
Mesenchymal Stem Cell Transplantation ◽  
Internal Limiting Membrane Peeling ◽  
Macular Holes ◽  
Feasible Alternative ◽  
Pars Plana ◽  
Surgical Failure ◽  
Idiopathic Macular Holes

The main treatment available for idiopathic macular holes is represented by pars plana vitrectomy with internal limiting membrane peeling. However, late-stage macular holes are affected by a higher risk of surgical failure. Although adjuvant techniques can be employed, a satisfactory functional recovery is difficult to achieve in refractory macular holes. Given their neuroprotective and antiapoptotic properties, mesenchymal stem cells (MSCs) may represent an appealing approach to treat these extreme cases. The purpose of this review is to highlight the findings regarding healing mechanisms exerted by mesenchymal stem cells and preliminary application in cases of refractory macular holes. When compared with MSCs, MSC-derived exosomes may represent a feasible alternative, given their reduced risk of undesired proliferation and easiness of use.

Step-by-step creation of internal limiting membrane fragment for surgical treatment of large idiopathic macular holes

2016 ◽  
Vol 132 (1) ◽  
pp. 23
Author(s):  
Yu. A. Belyy ◽  
A. V. Tereshchenko ◽  
D. O. Shkvorchenko ◽  
E. V. Erokhina ◽  
N. M. Shilov
Keyword(s):  
Surgical Treatment ◽  
Internal Limiting Membrane ◽  
Membrane Fragment ◽  
Macular Holes ◽  
Idiopathic Macular Holes

scholarly journals Outcomes of Inverted Internal Limiting Membrane Flap Technique for Large Idiopathic Macular Holes Surgery in Patients at A Tertiary Care Hospital

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Kiran Shakya ◽  
Ram Prasad Pokhrel ◽  
Om Krishna Malla
Keyword(s):  
Visual Acuity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Internal Limiting Membrane ◽  
Care Hospital ◽  
Base Diameter ◽  
Flap Technique ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
The Mean

Introduction: Large macular holes cause significant reduction in central visual acuity. The aim ofthe study is to find out short term anatomical and visual outcomes of inverted internal limitingmembrane flaps technique for large macular holes (base diameter>1000μm) surgery in patientsat a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in a tertiary care hospital fromJanuary 2018 to December 2018 after ethical clearance from the institutional review committee.The study was done in 12 patients with idiopathic macular holes (base diameter>1000μm), theywere repaired with 25 gauge pars plana vitrectomy with brilliant blue assisted large invertedinternal limiting membrane flap technique. Statistical analyses were performed using SPSS 19.0. Results: All twelve eyes had complete anatomical closure. Mean best corrected visualacuity preoperatively was 1.48 logMAR±0.246. The mean macular hole base diameter was1217.0±196.77μm. The mean age of patients was 68.75±4.97 years. Postoperatively,mean best corrected visual acuity was 0.978 logMAR±0.12. There were no postoperativecomplications. All the patients perceived decreased size of central scotoma. Conclusions: Inverted internal limiting membrane flaps for large macular holes is suitable methodfor closure of the very large hole, restoration of functional vision and decreased size of centralscotoma.

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.

Autologous internal limiting membrane transplant for recurrent idiopathic macular holes

2020 ◽  
pp. 112067212090639 ◽  
Author(s):  
Tommaso Rossi ◽  
Carlandrea Trillo ◽  
Guido Ripandelli
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Outer Segment ◽  
Internal Limiting Membrane ◽  
Control Group ◽  
Closure Rate ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Macular Holes ◽  
Idiopathic Macular Holes

Purpose: To report a series of recurrent idiopathic macular holes treated by means of a free autologous internal limiting membrane flap and compare visual and anatomic results to a control group undergoing further internal limiting membrane peeling and novel gas tamponade. Methods: Retrospective surgical series of 15 consecutive patients receiving autologous internal limiting membrane flap compared to 14 patients operated on for internal limiting membrane peeling enlargement. Autologous internal limiting membrane flap was created after brilliant blue G staining, internal limiting membrane lifting, perfluorocarbon bubble injection and creation of a wide internal limiting membrane free flap translocated underneath perfluorocarbon liquid, to the macular hole bed. Both groups were tamponated with 20% SF6 and positioned face down for 4 h a day for 3 days. Results: Macular hole closed in 14/15 (93.3%) patients of the autologous internal limiting membrane group and 9/14 (64.2%) controls (p < 0.05). Visual acuity increased from 0.05 ± 0.03 to 0.23 ± 0.13 Snellen in the autologous internal limiting membrane group and from 0.05 ± 0.03 to 0.14 ± 0.10 Snellen of controls (p < 0.05 for both). Vision of the autologous internal limiting membrane group improved more than controls at 1 month (p = 0.043) and 3 months (p = 0.045). Inner segment/outer segment interruption at 3 months was smaller in the autologous internal limiting membrane group than controls, reducing from 1230 ± 288 µm at baseline to 611 ± 245 and 547 ± 204 µm at 3 months versus 1196 ± 362, 745 ± 222 and 705 ± 223 µm, respectively (p < 0.05). Conclusion: Autologous internal limiting membrane flap can effectively close recurrent idiopathic macular holes with a higher closure rate, smaller residual inner segment/outer segment line interruption and higher visual acuity at 3 months than previous standard of care.

Differentiated Approach to Strategies of Surgical Treatment of Idiopathic Macular Holes

The Eye ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 12-16
Author(s):  
R. Z. Shamratov ◽  
L. Sh. Ramazanova ◽  
O. A. Napylova
Keyword(s):  
Surgical Treatment ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Pathological Process ◽  
Hole Diameter ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Anatomical Outcome ◽  
Clinical Cases

Background. 25G or 27G three-port vitrectomy, followed by staining and removal of the internal limiting membrane with vitreous cavity air or gas tamponade, is one of the main modern vitreoretinal surgery principles for primary macular holes. However, not all patients manage to obtain a functional outcome when the anatomical outcome is achieved. Purpose. To  present clinical cases of surgical treatment of idiopathic macular holes (IMH) exhibiting a differentiated approach.Matherials and methods. This article analyzes clinical cases of four patients with primary idiopathic macular holes, differing in terms of development, hole diameter and the presence of comorbidities. Results. The results of surgical treatment were evaluated 14 days and 1 month after surgery. In all clinical cases, surgical treatment resulted in a positive anatomical outcome by blocking a retinal defect. Best corrected visual acuity increased, on average, from 0.08 ± 0.05 to 0.4 ± 0.05.Conclusion. The analysis of the presented clinical cases clearly demonstrates the need for a timely and differentiated approach to the treatment of patients with IMH, that considers etiology of the pathological process, period of its existence as well as concomitant and general somatic pathologies.

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