scholarly journals Electrogenesis of Retina and Optic Nerve after Vitrectomy for the Primary Full-Thickness Macular Hole

2019 ◽  
Vol 16 (1) ◽  
pp. 46-55
Author(s):  
A. N. Kulikov ◽  
E. N. Nikolaenko ◽  
V. V. Volkov ◽  
V. F. Danilichev
Keyword(s):  
Optic Nerve ◽  
Macular Hole ◽  
Silicone Oil ◽  
Bipolar Cells ◽  
Full Thickness ◽  
The Third ◽  
Full Thickness Macular Hole ◽  
Cone System ◽  
Air Tamponade ◽  
Retinal Cone

Purpose. To study the dynamics of electrophysiological parameters of the retina and optic nerve after vitrectomy for a primary fullthickness macular hole.Patients and Methods. Electrophysiological examination was performed in 40 patients (40 eyes) before vitrectomy, on the 1st, 3rd, 7th, 14th, 30th, 60th, 180th day after the operation. Three groups of patients were formed depending on the intraocular tamponade: the first group — air tamponade, the second group — gas (C3F8) tamponade, the third group — silicone oil tamponade.Results. In the first, second and third groups significant decrease in the retinal and optic nerve electrogenesis was revealed on the 1st day (p < 0.001) after vitrectomy. By the end of observation period all electrophysiological indices in the first, second and third groups recover to normal levels, excluding the retinal cone system and optic nerve parameters in the third group. Electrophysiological indices recovered twice as slow in the second group, compared to the first group, due to C3F8 gas tamponade inhibitory effect. In the first and second groups the photoreceptors recovered twice as fast as bipolar cells.Conclusions. Vitrectomy causes significant inhibition of photoreceptors, bipolar and ganglion cells electrogenesis. The duration of vitrectomy is a significant negative factor determining retinal and optic nerve electrogenesis inhibition in the postop. Intraocular C3F8 gas, silicon oil tamponade (compared to air tamponade) is a significant adverse factor affecting retinal and optic nerve electrogenesis inhibition in the postop. The primary full-thickness macular hole diameter is a significant factor in inhibiting electrogenesis of the retinal cone system. Photoreceptors have a greater rehabilitation ability than bipolar cells.

Elimination of vitreomacular traction syndrome in eyes, that were previously surgically treated due to retinal detachment

2021 ◽  
pp. 40-47
Author(s):  
G.K. Zhurgumbayeva ◽  
◽  
D.R. Kyrykbayev ◽  
F.M. Umarov ◽  
◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Silicone Oil ◽  
Retinal Thickness ◽  
Full Thickness ◽  
Hole Formation ◽  
Ilm Peeling ◽  
Surgical Interventions ◽  
Vitreomacular Traction Syndrome ◽  
Full Thickness Macular Hole

Aims. Evaluate the efficiency of ILM peeling in the treatment of VMTS on eyes previously treated for retinal detachment. Materials and methods. 4 participants diagnosed with VMTS were enrolled in this study. There were 2 male and 2 female patients aged 30-64 y.o. who were previously surgically treated for their retinal detachment. 3 patients had rhegmatogenous and 1 patient had traumatic tractional retinal detachment with the mean duration of 5.75 years. 3 eyes undergone scleral buckling following subretinal fluid drainage, 1 eye underwent cataract phacoemulsification with an implantation of IOL + closed vitrectomy + pneumatic retinopexy + endolaser retinal photocoagulation + silicone oil, insertion following silicone oil removal from the vitreous cavity. All patients had some degree of myopia as well as peripheral retinal degenerations. 2 patients were diagnosed with epiretinal fibrosis and 2 other with stage 2 small full-thickness macular hole. Mean BCVA before surgery was 0.078, mean central retinal thickness was 390,25 um, small full-thickness macular hole diameter was about 320 um. Before the surgery, all patients undergone cycloscopy, where there were no indications for the additional laser photocoagulation. 3 patients underwent posterior vitrectomy 25G and 1 patient had 25G ports placed on his eye with the peeling of ILM and usage of pneumatic retinopexy, 2 eyes underwent cataract phacoemulsification with IOL implantation. Results and discussion. All surgical interventions were done without any complications. Since there were conjunctival scars left after the previous surgeries, conjunctiva did not show any displacement during the sclerotomy procedures, which led to the formation of post-sclerotomy holes. This fact forced us to make knot sutures, which resulted in foreign body sensations in our patients during the post-op period. Intraoperatively, all patients had their ILM removed, which was proved by OCT in the post-op period. Mean BCVA after operations was 0.3. Mean Central retinal thickness was 314 um based on OCT data in the post-op period. Patients were recommended to undergo cycloscopy 1 month after the surgery and then twice every year. There were no retinal detachment relapse observed in the post-op period. Conclusion: 1. Removal of ILM in patients, that were previously operated due to retinal detachment, is considered as an effective method in the treatment of VMTS. It is clinically manifested as visual acuity improvement, retinal thickness reduction, lamellar hole closure and the absence of full thickness macular hole formation risk in the early and late post-op periods. No retinal detachment relapses were observed. 2. Presence of conjunctival scars following previous retinal detachment surgical interventions leads to the hole formation following sclerotomy procedures, which causes foreign body sensations in patients during the post-op period. 3. Endovitreal surgical intervention for the retinal detachment should include ILM peeling to prevent formation of VMTS in the post-op period. Key words: vitreomacular traction syndrome (VMTS), Internal limiting membrane (ILM), rhegmatogenous retinal detachment ( RRD), optic coherence tomography (OCT).

scholarly journals Full Thickness Macular Hole Closure after Exchanging Silicone-Oil Tamponade with C3F8 without Posturing

2011 ◽  
Vol 2 (2) ◽  
pp. 166-169 ◽  
Author(s):  
Tina Xirou ◽  
Vasiliki Xirou ◽  
George Mangouritsas ◽  
Elias Feretis ◽  
Stamatina A. Kabanarou
Keyword(s):  
Macular Hole ◽  
Silicone Oil ◽  
Full Thickness ◽  
Full Thickness Macular Hole ◽  
Silicone Oil Tamponade ◽  
Hole Closure

scholarly journals Large, Spontaneous Macular Hole with Posterior Pole Detachment in a Patient with Best Vitelliform Macular Dystrophy

2019 ◽  
Vol 10 (2) ◽  
pp. 221-226
Author(s):  
Shamfa Peart ◽  
Amoy Ramsay ◽  
Qazi Assad Khan ◽  
Tony Leong ◽  
Patel Gordon-Bennett
Keyword(s):  
Macular Hole ◽  
Silicone Oil ◽  
Internal Limiting Membrane ◽  
Posterior Pole ◽  
Macular Dystrophy ◽  
Full Thickness ◽  
Vitelliform Macular Dystrophy ◽  
Best Vitelliform Macular Dystrophy ◽  
Full Thickness Macular Hole ◽  
History Of

Purpose: To describe the visual and anatomical outcomes in a patient with a full-thickness macular hole and Best vitelliform macular dystrophy. Methods: The authors present a case of a large spontaneous macular hole with associated posterior pole detachment in a patient with a history of Best vitelliform macular dystrophy including clinical course and surgical outcome. Patient: The patient presented with a history of blurred central vision. He was known to have Best vitelliform macular dystrophy. Examination revealed BCVA 6/36 (0.78 logMAR) and a full-thickness macular hole (1,102 µm) with a shallow posterior pole detachment extending to the vascular arcades. He underwent phacovitrectomy with silicone oil tamponade. Internal limiting membrane (ILM) peel was prohibited due to a very adherent posterior hyaloid membrane (PHM). Results: The patient developed type 2 closure. He had oil removal in 14 months combined with PHM and ILM peel. Two months postoperatively, he had further reduction of the foveal defect and the retina remained flat. Final BCVA was 6/24 (0.60 logMAR). Conclusion: Macular holes with Best disease are rare and are thought to be due to rupture of a cyst in the vitelliform stage or atrophy in later stages. This case outlines that closure of the macular hole, flattening of the detachment, and improvement in visual acuity is possible with vitrectomy and ILM peeling.

Postoperative features of the macular zone structure after surgical treatment of large full-thickness macular hole using various surgical techniques

2021 ◽  
pp. 130-134
Author(s):  
D.V. Petrachkov ◽  
◽  
L. Alkharki ◽  
A.G. Matyuschenko ◽  
V.M. Filippov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Macular Hole ◽  
Functional Results ◽  
Full Thickness ◽  
Zone Structure ◽  
Full Thickness Macular Hole ◽  
Air Tamponade ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Purpose. Comparative assessment of the retinal macular zone structure after surgical treatment of full-thickness macular hole (FTMH) by various methods. Material and methods. Patients with Gass stage III-IV FTMH were divided into 3 groups. Group 1 patients (20 eyes) underwent a standard operation (subtotal vitrectomy (sVE), aspiration convergence of the FTMH edges, gas-air tamponade of the vitreous cavity). Patients in group 2 (20 eyes), after sVE and ILM peeling, autologous conditioned plasma (ACP) were applied to FTMH area followed by air tamponade. Patients of group 3 (20 eyes) after sVE underwent FTMH closure using an inverted ILM flap with the rupture edges approached, followed by air tamponade. Results. The increase in BCVA after 1 month averaged from 0.23±0.1 to 0.41±0.13, (p<0.05) in patients in group 1, in group 2 from 0.15±0, 07 to 0.75±0.09, (p<0.05), in patients in group 3 from 0.14±0.05 to 0.78±0.08, (p<0.05). Anatomical results: in group 1, 17 patients who received standard surgical treatment, a month after surgery, had a satisfactory anatomical result (complete closure of the FTMH with restoration of the correct retinal architectonics in the foveal zone). In 3 patients, additional endovitreal intervention was required with successful FTMH closure. In all patients in group 2, according to OCT data, 5 days after the operation, hyperreflective tissue was detected in the FTMH area ("platelet plug"). When OCT was performed 1 month later, in all cases, the platelet plug resolved, and in all cases, restoration of the foveal profile architectonics was observed. In group 3, the closure of the FTMH on the 5th day of observation was recorded in all patients. When performing OCT after 1 month, complete closure of the neuroepithelium layer was recorded in all cases: in 13 patients - U-shaped closure and in 7 cases – V-shaped. The functional results in both groups were comparable; there was no statistical difference between them. Conclusion: The data obtained demonstrate the morphological features of the retinal foveolar zone postoperative restoration. There was no significant difference in functional results between study groups. Key words: full-thickness macular hole, vitreoretinal surgery, internal limiting membrane, inverted ILM flap, autologous conditioned plasma, optical coherence tomography.

scholarly journals Rhegmatogenous retinal detachment and full-thickness macular hole induced by lightning

2020 ◽  
Vol 1 (4) ◽  
pp. 301-307
Author(s):  
Qian Zhi Haw ◽  
Francesca Martina Vendargon ◽  
Kiet Phang Ling
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Anterior Uveitis ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Hand Movement ◽  
Posterior Vitreous Detachment ◽  
Full Thickness ◽  
Blurred Vision ◽  
Full Thickness Macular Hole

A 31-year-old gentleman was remotely struck by lightning and complained of blurred vision in his left eye. He was diagnosed with left eye anterior uveitis and full-thickness macular hole (FTMH), and subsequently referred for vitreoretinal intervention. On examination, his left-eye vision was hand movement. Anterior uveitis had resolved with no cells in the anterior chamber. Posterior subcapsular cataract 2+ was noted. There was a FTMH and partial posterior vitreous detachment (PVD) confirmed by optical coherence tomography (OCT). Right eye was normal with 6/6 vision. At one- month follow-up, the macular hole was closed spontaneously but localised rhegmatogenous retinal detachment (RRD) was noted in the inferior retina with macula-on. There were multiple holes in the inferior equatorial region surrounded by hyper- and hypopigmented retinal atrophy. The patient underwent phacoemulsification, intraocular lens implantation, vitrectomy, and gas tamponade (C3F8 14%). At one week postoperative, he had recurrent retinal detachment with multiple new atrophic holes noted. He underwent a second vitrectomy with silicone oil tamponade. Best-corrected visual acuity (BCVA) in his left eye two months after surgery was 6/45 and the retina had reattached.

scholarly journals Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min-Woo Lee ◽  
Tae-Yeon Kim ◽  
Yong-Yeon Song ◽  
Seung-Kook Baek ◽  
Young-Hoon Lee
Keyword(s):  
Macular Hole ◽  
Axial Length ◽  
Outer Nuclear Layer ◽  
Plexiform Layer ◽  
Retinal Layer ◽  
Inner Plexiform Layer ◽  
Full Thickness ◽  
Ellipsoid Zone ◽  
Full Thickness Macular Hole ◽  
Fellow Eyes

AbstractTo analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after full-thickness macular hole (FTMH) surgery. Patients who underwent surgery for FTMH were included. Spectral-domain optical coherence tomography (SD-OCT) was performed preoperatively and postoperatively at 1, 3, 6, 9, and 12 months. A total of 32 eyes were enrolled. Ganglion cell layer, inner plexiform layer, and inner nuclear layer showed significant reductions over time after surgery (P = 0.020, P = 0.001, and P = 0.001, respectively), but were significantly thicker than those of fellow eyes at 12 months postoperatively. The average recovery duration of the external limiting membrane (ELM), outer nuclear layer (ONL), and EZ was 1.5, 2.1, and 6.1 months, respectively. Baseline best-corrected visual acuity (BCVA) (P = 0.003), minimum linear diameter (MLD) (P = 0.025), recovery of EZ (P = 0.008), and IRL thickness (P < 0.001) were significant factors associated with changes in the BCVA. Additionally, axial length (P < 0.001), MLD (P = 0.020), and IRL thickness (P = 0.001) showed significant results associated with EZ recovery. The IRL gradually became thinner after FTMH surgery but was still thicker than that of the fellow eye at 12 months postoperatively. The recovery of ELM and ONL may be a prerequisite for the EZ recovery. The BCVA change was affected by baseline BCVA, MLD, recovery of EZ, and IRL thickness. Additionally, axial length, MLD, and IRL thickness were significantly associated with EZ recovery.

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