Long-term outcome of internal limiting membrane peeling with and without foveal sparing in myopic foveoschisis

2018 ◽  
Vol 29 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Mohammed Mamdouh Elwan ◽  
Ayman Elsayed Abd Elghafar ◽  
Sherein Mahmoud Hagras ◽  
Waleed Ali Abou Samra ◽  
Sameh Mohamed Saleh

Purpose: To compare between vitrectomy with internal limiting membrane peeling over the whole macula and preservation of the epi-foveal internal limiting membrane in myopic foveoschisis. Patients and methods: A prospective controlled non- randomized comparative study included patients with myopic foveoschisis recruited between 2013 and 2017. Patients were allocated into two groups: group A included patients who underwent vitrectomy with complete macular internal limiting membrane peeling and group B included those who underwent preservation of the epi-foveal membrane. Pre- and postoperative best corrected visual acuity and macular optical coherence tomography were obtained and compared. Results: There was no statistically significant difference between the two groups regarding the preoperative baseline data. The difference between the two groups was insignificant as regard postoperative best corrected visual acuity (p = 0.18) and central foveal thickness (p =0.504). There was statistically significant improvement in final best corrected visual acuity within each group (p < 0.0001). Central foveal thickness significantly decreased postoperatively within each group (p < 0.001). No macular holes or other visual-threatening complications were recorded in either group. Conclusion: Vitrectomy with complete internal limiting membrane peeling resulted in comparable outcomes to those achieved with preservation of the epi-foveal membrane in treating cases with myopic foveoschisis. There was no statistically significant difference in final visual acuity between the two groups. No macular holes were recorded in either group.

2020 ◽  
Vol 12 ◽  
pp. 251584142092713 ◽  
Author(s):  
Eleni Christodoulou ◽  
Georgios Batsos ◽  
Petros Galanis ◽  
Christos Kalogeropoulos ◽  
Andreas Katsanos ◽  
...  

Purpose: The aim of this study is to analyze the effect of internal limiting membrane peeling in removal of idiopathic epiretinal membranes through meta-analysis. Methods: We searched PubMed for studies published until 30 April 2018. Inclusion criteria included cases of idiopathic epiretinal membranes, treated with vitrectomy with or without internal limiting membrane peeling. Exclusion criteria consisted of coexisting retinal pathologies and use of indocyanine green to stain the internal limiting membrane. Sixteen studies were included in our meta-analysis. We compared the results of surgical removal of epiretinal membrane, with or without internal limiting membrane peeling, in terms of best-corrected visual acuity and anatomical restoration of the macula (central foveal thickness). Studies or subgroups of patients who had indocyanine green used as an internal limiting membrane stain were excluded from the study, due to evidence of its toxicity to the retina. Results: Regarding best-corrected visual acuity levels, the overall mean difference was –0.29 (95% confidence interval: –0.319 to –0.261), while for patients with internal limiting membrane peeling was –0.289 (95% confidence interval: –0.334 to –0.244) and for patients without internal limiting membrane peeling was –0.282 (95% confidence interval: –0.34 to –0.225). Regarding central foveal thickness levels, the overall mean difference was –117.22 (95% confidence interval: –136.70 to –97.74), while for patients with internal limiting membrane peeling was –121.08 (95% confidence interval: –151.12 to –91.03) and for patients without internal limiting membrane peeling was –105.34 (95% confidence interval: –119.47 to –96.21). Conclusion: Vitrectomy for the removal of epiretinal membrane combined with internal limiting membrane peeling is an effective method for the treatment of patients with idiopathic epiretinal membrane.


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.


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

Abstract Backgroud: 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 ≦ 0.046 logMAR (Good group) to 35 patients with 0.10 - 0.52 logMAR (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 for patients with BCVA ≦ 0.046 logMAR was effective for improvement of HM, BCVA, and QOL and prevented worsening of aniseikonia.


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 20 (3) ◽  
pp. 105-109
Author(s):  
Da Yeong Kim ◽  
Sung Kun Chung ◽  
Ki Seok Kim ◽  
Jie Hyun Youm

Purpose: To investigate the functional and structural recovery period of idiopathic epiretinal membranes after phacovitrectomy with posterior capsulectomy.Methods: From March 2012 to January 2015, 57 patients diagnosed with idiopathic epiretinal membranes with cataracts who underwent combined vitrectomy and cataract surgery with pars plana posterior capsulectomy were enrolled. The best-corrected visual acuity and central foveal thickness were analyzed retrospectively.Results: The average best-corrected visual acuity before surgery was 0.30 ± 0.23 logarithm of minimal angle of resolution (logMAR), and the mean central foveal thickness was 442 ± 93 μm. As of the 12-month follow-up, the average postoperative best-corrected visual acuity had improved to 0.08 ± 0.11 logMAR, and the central foveal thickness after surgery had decreased to 386 ± 58 μm at 12 months.Conclusions: After removing the potential influence of cataracts and posterior capsular opacity, the recovery of idiopathic epiretinal membranes continued up to 12 months after surgery.


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.


2017 ◽  
Vol 18 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Gordana Andjelic ◽  
Svetlana Jovanovic ◽  
Snezana Pesic ◽  
Milos Mitrasevic ◽  
Jasmina Stojanovic ◽  
...  

AbstractTo investigate the efficacy of a posterior sub-Tenon’s capsule triamcinolone injection for treating eyes with non-infectious posterior and intermediate uveitis.A total of 31 eyes from 20 patients with non-infectious posterior uveitis and 18 eyes from 10 patients with non-infectious intermediate uveitis that inadequately responded to treatment with systemic corticosteroids and second-line immunosuppressive agents were enrolled in the study. All patients received a posterior sub-Tenon’s injection of 20 mg/ml triamcinolone. The parameters we examined included the following: best corrected visual acuity, central foveal thickness, fluorescein angiography score and intraocular pressure.The mean best corrected visual acuity was significantly improved from the control visit, 0.15±0.30 logMAR (Snellen equivalent 0.7), compared to the baseline measurements, 0.60±0.30 logMAR (Snellen equivalent 0.25; P<0.05). The mean central foveal thickness (CFT) and the mean score for fluorescein angiography (FA) were significantly decreased from the baseline (CFT: 320±34 μm; FA mean score: 5.9±1.9) compared to the twelve-week control visit (CFT: 235±30 μm; FA mean score: 1.2±1.1; P<0.001). Five eyes had intraocular pressure spikes that required a topical anti-glaucomatous treatment.A posterior sub-Tenon’s injection of triamcinolone can significantly improve visual acuity and decrease macular oedema in patients with non-infectious posterior and intermediate uveitis. Complications were minimal, and there were no eyes that required surgical treatment for elevated intraocular pressure. The results suggest that the posterior sub-Tenon’s injection of triamcinolone is an important form of therapy for non-infectious posterior and intermediate uveitis.


2021 ◽  
Vol 80 (1) ◽  
Author(s):  
Aazambir S. Brar ◽  
Vivek B. Wani ◽  
Arvind L. Tenagi

Background: The treatment of diabetic macular oedema (DMO) by intravitreal injection (IVI) of approved anti-vascular endothelial growth factor (VEGF) is costly and hence off label use of bevacizumab is practiced in spite of concerns about its safety.Aim: To examine the effect of three IVI of bevacizumab given monthly, on best corrected visual acuity (BCVA) and central foveal thickness (CFT) of eyes with DMO.Setting: Charity hospital attached to a medical college in India.Methods: Patients with centre involving DMO with BCVA ≤ 6/9 and CFT ≥ 260 microns were recruited prospectively, and three IVI bevacizumab given monthly (from a common vial). At four months BCVA and CFT were assessed and compared with baseline data. Side effects, if any, were recorded. Best corrected visual acuity was converted to logMAR units for statistical analysis. Student’s t-test were conducted to see statistically significant changes in BCVA and CFT.Results: A total of 50 eyes of 38 patients received three monthly IVI bevacizumab. Best corrected visual acuity (logMAR) improved from baseline mean of 0.80 ± 0.49 to final mean of 0.51 ± 0.36, which was significant (p = 0.0001). The mean baseline CFT (μm) improved from 448.40 ± 149.47 to 368.76 ± 131.49, which was significant (p = 0.0001). No cases of endophthalmitis were reported. Various factors such as diabetes duration and HbA1c (hemoglobinA1c) value were not found to be significant for the improvement in BCVA and CFT.Conclusion: Intravitreal injection bevacizumab given as three monthly injections was safe, economical and effective in the management of DMO.


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