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.

scholarly journals Natural progression of lamellar macular holes in high myopia: a long-term follow-up study

2021 ◽  
Author(s):  
Mary Ho ◽  
Eugenie Mok ◽  
Felix Lai ◽  
Helena PY Sin ◽  
Shaheeda Mohamed ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Hole ◽  
High Myopia ◽  
Full Thickness ◽  
Macular Holes ◽  
Full Thickness Macular Hole ◽  
The Mean

Abstract Background To determine the long-term prognosis of lamellar macular holes (LMH) in highly myopic eyes. Methods This was a retrospective observational study. Patients with LMH associated with high myopia (>-6 dioptres) were examined at regular 6-month intervals for a minimum of 36 months to detect for any structural and functional deterioration. Assessment included visual acuity checking, fundal examination, and optical coherence tomography (OCT) scanning. The risk factors for visual deterioration and progression to full-thickness macular hole (MH) were analysed using Kaplan-Meier survival analysis. The main outcome measures included the changes in mean best-corrected visual acuities, evidence of lamellar hole progression on OCT scans and complication rates of full-thickness macular hole (FTMH), and foveal detachment (FD) development. Results A total of 37 highly myopic eyes with optical coherence tomography confirmed LMH were recruited from 36 patients. The mean age was 63.4 ± 9.8 years and the mean spherical equivalent refractive error was − 9.01 ± 3.6 D with axial length of 27.74 ± 1.45 mm. The mean follow-up duration was 57.6 ± 10.9 months. The mean baseline visual acuity was 0.272 logMAR ± 0.22. A gradual decline in visual acuity was noted, and the change reached statistical significance from 36 months onwards. Visual acuity was 0.648 ± 0.41 logMAR at 36 months (p = 0.034) and 0.604 ± 0.455 at 48 months (p = 0.046). Twelve eyes (32.4%) had foveoschisis at baseline. Coexistence of a lamellar macular hole with foveoschisis was shown to be a risk factor for the development of a FTMH or FD (p = 0.002). Conclusion LMH in highly myopic eyes was generally stable, while a small proportion of patients progressed to full-thickness MH. Patients with coexisting LMH, foveoschisis, and vitreomacular traction had a higher risk of visual decline and progression to full-thickness MH.

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 Bilateral idiopathic choroidal folds

2014 ◽  
Vol 155 (27) ◽  
pp. 1083-1086
Author(s):  
Milán Tamás Pluzsik ◽  
Miklós Schneider
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Fundus Photography ◽  
Fundus Examination ◽  
Optical Coherence ◽  
Blurred Vision ◽  
History Of ◽  
Choroidal Folds

Choroidal folds present as parallel bright and dark lines, which may be detected with funduscopy. Optical coherence tomography, red free fundus photography, autofluorescence and fluorescein angiography may be also helpful to establish the diagnosis. The authors present the case of a 70-year-old male who was evaluated because of a 1-month history of blurred vision on his right eye. Dilated fundus examination revealed choroidal folds in both eyes, which failed to affect visual acuity. No neurogical pathologies were found. There was no change in the patient condition durind a follow-up period of 6 months. The authors note that choroidal folds are often not recognized because they are usually asymptomatic. There are several possible causes which should be considered. The diagnosis of idiopathic choroidal folds is based on the exclusion of other pathologies. Observation of the patient’s visual acuity and monitoring for fundus changes are needed. Orv. Hetil., 2014, 155(27), 1083–1086.

scholarly journals Foveal-Sparing ILM Peeling in a Case with Vitreomacular Traction and Foveal Detachment

2021 ◽  
pp. 182-185
Author(s):  
Christoph Leisser ◽  
Oliver Findl
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Female Patient ◽  
Vitreomacular Traction ◽  
Full Thickness ◽  
Ilm Peeling ◽  
Foveal Detachment ◽  
Corrected Visual Acuity ◽  
Full Thickness Macular Hole ◽  
Foveal Sparing

A pseudophakic female patient, 80 years of age, presented with a vitreomacular traction and foveal detachment at her right eye. To avoid development of a full-thickness macular hole during surgery, foveal-sparing ILM peeling was performed. After surgery, distance-corrected visual acuity increased from 0.3 to 0.6 (Snellen) 3 months after surgery and fovea was re-attached again with restoration of the retinal layers.

scholarly journals Full-Thickness Macular Hole with Coats Disease: A Case Report

2020 ◽  
Vol 11 (2) ◽  
pp. 342-347
Author(s):  
Yuto Hashimoto ◽  
Yusuke Arai ◽  
Shinji Makino ◽  
Yuji Inoue ◽  
Hidenori Takahashi ◽  
...  
Keyword(s):  
Macular Hole ◽  
Argon Laser ◽  
Vascular Leakage ◽  
Full Thickness ◽  
Peripheral Vascular ◽  
Blurred Vision ◽  
Serous Macular Detachment ◽  
Full Thickness Macular Hole ◽  
Coats Disease

We report a case of full-thickness macular hole (FTMH) which developed during follow-up for Coats disease. To our knowledge, this is the first report on a case of FTMH which developed during follow-up for Coats disease. A 17-year-old boy was referred to our institution with blurred vision in his left eye. Fundus examination showed yellowish subretinal exudates with overlying telangiectatic retinal vessels in the temporal periphery in the left eye; the right eye was normal. Fluorescein angiography revealed diffusion indicative of temporal peripheral vascular leakage. We made a diagnosis of stage 2A Coats disease and performed argon laser photocoagulation (PC). Moreover, he received intravitreal injection of anti-vascular endothelial growth factor. At 30 months after the first visit, the best-corrected visual acuity (BCVA) of the left eye worsened to 20/50. We observed tensioned internal limiting membrane (ILM), serous macular detachment (SMD) and retinal thinning; the intraretinal exudate remained. We performed PC and at 36 months after the first visit, BCVA further declined to 20/63 in his left eye and FTMH was observed. We then performed a 27-gauge pars plana vitrectomy and ILM peeling following which the FTMH was found to have closed by 4 days after vitrectomy. SMD gradually decreased, and BCVA improved to 20/20. Chronic inflammation by peripheral vascular leakage and PC application might have caused FTMH. In this case, the vitrectomy for FTMH with Coats disease provided good visual and anatomic outcomes.

scholarly journals Inverted ILM Flap Technique in Idiopathic Full-Thickness Macular Hole Surgery: Functional Outcomes and Their Correlation with Morphologic Findings

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Paolo Carpineto ◽  
Enrico Borrelli ◽  
Luca Cerino ◽  
Daniele Guarini ◽  
Agbeanda Aharrh-Gnama ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Functional Outcomes ◽  
Internal Limiting Membrane ◽  
Full Thickness ◽  
Flap Technique ◽  
Macular Holes ◽  
Full Thickness Macular Hole ◽  
Effective Option ◽  
The Mean

Objectives. The inverted internal limiting membrane (ILM) flap technique has been shown to increase the success rate in large full-thickness macular holes (FTMHs) and in FTMHs associated with high myopia. The aim of our study was to confirm the efficacy and safety of inverted ILM flap technique in idiopathic FTMHs independent of their dimensions and to assess functional outcomes and their correlation to morphologic findings. Methods. Sixteen consecutive patients affected by idiopathic FTMH were enrolled in this prospective study. The preoperative mean (±SD) diameter of the FTMH was 422 (±106) µm. All patients underwent vitrectomy and ILM peeling with inverted ILM flap. At 1-, 3-, and 6-month postoperative visits, visual acuity measurement, indirect ophthalmoscopy, and microperimetry were performed, and the foveal contour and the integrity of the ellipsoid zone (EZ) and external limiting membrane (ELM) were investigated using spectral domain optical coherence tomography (SD-OCT). Results. At six months postoperatively, 15 out of 16 (93.75%) patients obtained FTMH closure. The mean best corrected visual acuity (BCVA) improved from 1.1 LogMAR to 0.3 LogMAR, and the mean retinal sensitivity (MS) improved from 7.2 to 23.4 dB. ELM defects were evident in 1 out of 16 (6.25%) eyes, and EZ defects were detected in 2 out of 16 (12,50%) eyes. A statistically significant relationship was observed between BCVA, MS, and EZ reconstitution at each follow-up visit. Conclusions. Results confirm that the inverted ILM flap technique is a safe and effective option for FTMH treatment and show a strong correlation between higher BCVAs and MSs and EZ reconstitution after surgery.

scholarly journals Development of Stage 4 Macular Hole after Spontaneous Closure in a Patient with Stage 2 Macular Hole and a Lamellar Macular Hole-Associated Epiretinal Proliferation

2021 ◽  
pp. 481-484
Author(s):  
Masahisa Watanabe ◽  
Harumasa Yokota ◽  
Hiroshi Aso ◽  
Hirotsugu Hanazaki ◽  
Junya Hanaguri ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Spontaneous Closure ◽  
Surgical Removal ◽  
Lamellar Macular Hole ◽  
Full Thickness ◽  
Stage 4 ◽  
Full Thickness Macular Hole ◽  
The Right ◽  
Hole Closure

Herein, we report the longitudinal observation of a case with reopening of the macular hole associated with a lamellar macular hole-associated epiretinal proliferation (LHEP) followed by spontaneous closure in patients with stage 2 idiopathic macular hole. A 64-year-old woman was referred for the decreased visual acuity (VA) and acute anorthopia in the right eye. Funduscopy and optical coherence tomography (OCT) showed stage 2 full-thickness macular hole without posterior vitreous detachment (PVD) and operculum formation. Her best-corrected visual acuity (BCVA) was 20/32. One month later, the diameter of the macular hole was getting small and VA improved. Six months later, the macular hole was treated spontaneously with the attached hyaloid membrane to the macula by OCT and the BCVA improved to 20/20. Fourteen months after the first visit, the BCVA decreased to 20/50 and the patient was diagnosed with stage 4 macular hole with complete PVD. OCT showed full-thickness macular hole with a LHEP in the right eye. After 25G-gauge vitrectomy with the peeling of internal limiting membrane (ILM) and LHEP, the macular hole was closed and BCVA finally improved to 20/25. Spontaneous macular hole closure without PVD may rarely occur in patients with LHEP. The surgical removal of ILM and LHEP may contribute to the successful macular hole closure after vitrectomy.

scholarly journals Macular Hole Progression after Intravitreal Bevacizumab for Hemicentral Retinal Vein Occlusion

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Manish Nagpal ◽  
Vikram Mehta ◽  
Kamal Nagpal
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Macular Hole ◽  
Retinal Vein Occlusion ◽  
Intravitreal Bevacizumab ◽  
Full Thickness ◽  
Detailed Review ◽  
Off Label ◽  
Vein Occlusion ◽  
Full Thickness Macular Hole

Macular edema secondary to retinal vein occlusion is commonly being treated with off-label intravitreal bevacizumab with good outcomes. A significant reduction in macular edema and improvement in visual acuity is seen following such a treatment with no serious adverse effects. In the reported case, a full-thickness macular hole was noticed one month after intravitreal bevacizumab for macular edema secondary to hemicentral retinal vein occlusion. On a detailed review of the pre- and postoptical coherence tomography scans, it was realized that there was a preexisting stage 2-3 macular hole which was masked by the hemorrhages and edema at the fovea and the macular hole had progressed following the injection.

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