scholarly journals Optical Coherence Tomography Imaging After Surgical Closure of Pediatric Traumatic Macular Holes

2018 ◽  
Vol 2 (2) ◽  
pp. 104-106 ◽  
Author(s):  
Nikisha Kothari ◽  
Kimberly D. Tran ◽  
Sarah P. Read ◽  
Audina M. Berrocal

Purpose: To date, little attention has been directed to retinal photoreceptor migration after traumatic macular hole surgical repair in the pediatric population. The purpose of this study was to evaluate optical coherence tomography (OCT) findings in the foveae of pediatric patients with history of traumatic macular hole surgical repair. Methods: Retrospective case series of 3 eyes in 3 pediatric patients with traumatic macular hole surgical repair. Spectral domain OCT images were obtained pre- and postoperatively. Results: We report 3 cases of restoration of the ellipsoid zone with good visual acuity outcomes following macular hole closure. Conclusion: Optical coherence tomography findings of an intact ellipsoid zone may be a predictor of visual acuity and explain better surgical outcomes in the pediatric population.

2020 ◽  
Vol 12 ◽  
pp. 251584141989745 ◽  
Author(s):  
Hamid Safi ◽  
Pasha Anvari ◽  
Dariush Naseri ◽  
Hamideh Shenazandi ◽  
Pegah Kazemi ◽  
...  

Purpose: To evaluate the correlation of the visual acuity and diabetic retinopathy stage using optical coherence tomography and optical coherence tomography angiography metrics. Methods: In this prospective study, optical coherence tomography and optical coherence tomography angiography images of patients with different stages of diabetic retinopathy were obtained. In optical coherence tomography angiography images, the size of foveal avascular zone, central macular thickness, and vessel density at superficial and deep capillary layers of the macula were measured. In optical coherence tomography images, the presence of intraretinal cyst, disorganization of retinal inner layer, and ellipsoid zone and external limiting membrane disruption were evaluated. The associations between the variables with visual acuity and diabetic retinopathy stage were analyzed. Results: In total, 68 eyes of 38 patients with a mean age of 58.96 ± 10.59 years were included. In total, 34 eyes were categorized as non-proliferative diabetic retinopathy, 14 as active, and 20 as regressed proliferative diabetic retinopathy. Univariate analysis showed deep parafoveal vessel density, central macular thickness, ellipsoid zone disruption, disorganization of retinal inner layer, and external limiting membrane disruption had a significant relationship with visual acuity. However, in multivariate analysis, only central macular thickness and ellipsoid zone disruption had significant association with visual acuity ( p = 0.02 and p = 0.01, respectively). There was a significant difference in deep parafoveal vessel density ( p = 0.04), but not in foveal avascular zone area, between different stages of diabetic retinopathy. Conclusion: In this study, the foveal avascular zone area did not correlate with visual acuity and different stages of diabetic retinopathy. Structural abnormalities on optical coherence tomography images with especial focus on outer retinal disruption provided more reliable predictors for visual acuity outcomes in patients with diabetic retinopathy.


2019 ◽  
pp. 112067211988898 ◽  
Author(s):  
Xiaolu Yang ◽  
Lauren A Dalvin ◽  
Li-Anne S Lim ◽  
Arman Mashayekhi ◽  
Jerry A Shields ◽  
...  

Purpose: To describe the outcome of ultra-low-dose (boom-boom) radiotherapy for choroidal lymphoma. Methods: Retrospective series of three consecutive patients with biopsy-proven choroidal lymphoma treated with ultra-low-dose radiotherapy. Results: The three patients (two male, one female) of mean age 70 years (range, 64–74 years) demonstrated presenting visual acuity in the affected eye between 20/40 and 20/50. The choroidal lymphoma was unilateral in all cases and presented with multifocal yellow patchy choroidal infiltration, located in all four quadrants and measuring mean 2.9 mm (range, 1.9–4.0 mm) in thickness by ultrasonography. Anterior epibulbar extension of 5 mm diameter was noted in one case. By enhanced depth imaging optical coherence tomography, the choroidal infiltration demonstrated classic undulating appearance (n = 3), with subretinal fluid (n = 2) and intraretinal edema (n = 1). There was no systemic lymphoma in any case. Biopsy was performed in all three cases and was diagnostic (n = 1) or suggestive (n = 2) of B-cell lymphoma. Management involved ultra-low-dose radiotherapy (4 Gy delivered in two fractions, “boom-boom”). On follow-up (mean = 14 months, range = 6–24 months), complete tumor regression on ophthalmoscopy was documented in all three cases, with enhanced depth imaging optical coherence tomography and ultrasonography demonstrating evidence of lymphoma resolution and visual acuity improvement to 20/25–20/40. There were no radiation complications. Conclusion: In this small case series, ultra-low-dose (boom-boom) radiotherapy was effective for choroidal lymphoma with favorable response and minimal side effects.


Author(s):  
Jiwei Tao ◽  
Huan Chen ◽  
Jiafeng Yu ◽  
Dan Cheng ◽  
Yiqi Chen ◽  
...  

Purpose: To introduce the application of intraoperative optical coherence tomography (iOCT) in pars plana vitrectomy (PPV) for various vitreoretinal diseases, and to report the 4-year assessment of feasibility and utility in Chinese population. Methods: Retrospective case series of patients who underwent PPV and iOCT scan at Eye Hospital of Wenzhou Medical College from January 2016 to January 2020. Clinical characteristics were documented before operation, and we intraoperatively recorded the time and results of iOCT scanning, specific surgical maneuvers performed, the consistency with the planned strategies before surgery, the type of OCT images obtained, and adverse events (AEs). The surgeon feedback was collected to evaluate the utility of iOCT during surgery. Results: 339 eyes successfully completed iOCT scan, with an average scanning time of [Formula: see text][Formula: see text]min, including 59 cases of idiopathic macular hole (iMH), 134 cases of idiopathic epiretinal membrane (iERM), 33 cases of lamellar macular hole (LMH), 40 cases of high myopic maculopathy, 13 cases of vitreous macular traction (VMT), 60 cases of dense vitreous hemorrhage (VH). The iOCT findings were not consistent with examination under the operating microscope in 49 cases (14.5%), including 29 cases (8.6%) which changed the operation strategies during surgery. The Hole-door phenomenon arose in 20 cases (33.9%) of iMH and 3 cases (25%) of high myopic MH after ILMs peeling. Moreover, the residue ERM was observed in nine cases (6.7%) of iERM and two cases (14.3%) in high myopic ERM after ILMs peeling. Some new surgical methods could also be confirmed using iOCT. Conclusion: The application of iOCT has a significant clinical functionality in vitreoretinal surgery, providing the surgeon with a new surgical understanding, guiding the selection of a more reasonable operative procedure during surgery, predicting postoperative recovery and improving postoperative outcomes.


2021 ◽  
Author(s):  
Gilad Rabina ◽  
Anfisa Ayalon ◽  
Michael Mimouni ◽  
Nir Stanescu ◽  
Elad Moisseiev ◽  
...  

Purpose: To investigate the correlation between optical coherence tomography (OCT) findings and visual acuity outcomes after treatment with intravitreal bevacizumab (IVB) injections for age related macular degeneration (AMD) patients with peripapillary choroidal neovascularization (PPCNV). METHODS: A retrospective case series of consecutive patients diagnosed with PPCNV secondary to AMD. All patients were treated with IVB injections with a follow-up time of one year. Data collected included best corrected visual acuity (BCVA), automated and manually measured OCT parameters. RESULTS: A total of 68 eyes were diagnosed with PPMV. Of them, 30 eyes of 30 patients aged 84.3±6.9 years of which 63.3% female gender were included. Baseline BCVA was 0.46±0.62 logMAR (Snellen 20/57), average choroidal thickness was 193.2±22 µm and mean number of IVB injections was 7.2±1.9. After one year BCVA was 0.56±0.78 logMAR (Snellen 20/72) (p=0.28). Eyes with greater central retinal thickness (r=-0.36, p=0.05), greater subretinal hyperreflective material (SHRM) area (r=-0.37, p=0.05) and greater sub retinal fluid (SRF) area (r=-0.73, p<0.001) had a significantly smaller improvement in BCVA. Eyes with pigment epithelium detachment (PED) (0.68±0.90 versus 0.21±0.12, p=0.03) had a significantly worse BCVA. CONCLUSIONS: Our data suggests that AMD related PPCNV with greater foveal thickness, PED size, SHRM and SRF areas have worse final BCVA prognosis.


2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Edward Casswell ◽  
Guillermo Fernandez-Sanz ◽  
Danny Mitry ◽  
Sheila Luk ◽  
Rahila Zakir

Ocriplasmin is a protease which has been approved for the treatment of symptomatic vitreomacular adhesion (VMA). A 63-year-old presented with blurred vision in the left eye and a best corrected visual acuity of 6/18. Optical coherence tomography revealed VMA with an underlying macular hole and she subsequently underwent a left intravitreal ocriplasmin injection. One week after the injection, VMA had been released but with enlargement of the macular hole and a drop in her BCVA to 6/60. This persisted at 1 month after the injection. It is important to warn patients that ocriplasmin may lead to an enlargement of their macular hole with resultant loss in visual acuity.


2019 ◽  
Vol 4 (1) ◽  
pp. 22-27
Author(s):  
Nikisha Kothari ◽  
Sarah P. Read ◽  
Caroline R. Baumal ◽  
Antonio Capone ◽  
Emmanuel Chang ◽  
...  

Purpose: Pediatric macular holes occur often related to trauma and rarely require surgical intervention. The purpose of the present study was to evaluate outcomes of microincisional vitrectomy surgery. Methods: A multicenter retrospective consecutive case series was conducted of pediatric patients undergoing surgery for macular hole repair. Results: A total of 31 eyes from 8 centers were included in this study. The mechanism of macular hole development was blunt trauma in 30 eyes (97%) and industrial laser in 1 eye (3%). The rate of anatomic closure after primary vitrectomy was 81% (25 eyes); the final anatomic closure rate after a secondary vitrectomy was 94% (29 eyes). There was a statistically significant improvement in visual acuity from initial presentation (20/164) to final follow-up (20/100) ( P = .009). Conclusions: Microincisional vitrectomy surgery for pediatric macular holes results in substantial anatomic success and modest improvement in visual acuity.


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