scholarly journals Anatomical and functional significance of ectopic inner foveal layer (EIFL) in epiretinal membrane (ERM)

2021 ◽  
Vol 7 (2) ◽  
pp. 366-371
Author(s):  
Sunil Ganekal ◽  
Varun Ganekal

To compare the visual acuity outcomes after surgical treatment of epiretinal membranes (ERM) in cases with and without ectopic inner foveal layers (EIFL). : A total of 100 eyes of 98 patients with idiopathic ERM were retrospectively staged according to the newer OCT classification and divided into two groups on the basis of presence or absence of EIFL. The two groups were evaluated for various parameters including visual acuity, thickness of the EIFL, re-appearance of the foveal contour, outer retinal changes and complications before and after ERM peeling. Correlation analysis was done using chi square test and p-values were obtained for corresponding variables.: Of 100 eyes with ERM, 20% had stage 1, 29% had stage 2, 42% had stage3 & 9% had stage 4 disease. VA was worse in eyes with EIFL as compared those without it. Correlation of VA with EIFL thickness however was not significant. Surgical removal of ERM didn’t alter EIFL frequency though the thickness decreased. New EIFL appeared in 4% eyes and 35% demonstrated thickened fovea after surgery. Anatomical reappearance of foveal contour was poorer in eyes with EIFL. Outer retinal changes were more common in non EIFL eyes. Lamellar holes and nontractional cysts were more common in EIFL eyes.: EIFL is a significant prognostic tool to predict the visual outcome of surgery in cases of Epiretinal membrane. EIFL eyes did not regain foveal contour, had less outer retinal damage but were associated with poorer visual outcomes.

Author(s):  
Max P. Brinkmann ◽  
Stephan Michels ◽  
Carolin Brinkmann ◽  
Felix Rommel ◽  
Mahdy Ranjbar ◽  
...  

Abstract Background Clinical studies have shown that epiretinal membranes (ERM) as well as abnormalities of the central foveal bouquet (CB) can be classified in different stages according to their morphological appearance. Furthermore, visual acuity correlates with the different stages of these features. The present study evaluated how these findings change after the surgical removal of the ERM and their impact on functional outcomes. Methods In this retrospective study eyes with ERM were evaluated by SD-OCT scans before and after pars plana vitrectomy (PPV) with macular ERM and internal limiting membrane (ILM) peeling. CB abnormalities were classified according to their morphological appearance from stage 0 (no abnormalities) to stage 3 (acquired vitelliform lesion). ERMs were classified ranging from stage 0 (absence of ERM) to stage 4 (ERM with significant anatomic disruption of macula). Changes in morphology were correlated with visual acuity before and after surgery. Results 151 eyes were included into the study. Before surgery 27.2% (n = 41) of eyes showed CB abnormalities with stage 1 being the most common (11.9%, n = 18). Before surgery ERM was seen in all patients. The most common form was stage 1 (28.5%, n = 43), followed by stage 3 (27.8%, n = 42) and 2 (25.2%, n = 38). Only 18.5% (n = 28) presented with stage 4 ERM. The mean BCVA was 0.42 (logMAR) before and increased to 0.19 (logMAR) 8 weeks after vitrectomy (95% CI 0.20–0.28; p < 0.001). Patients who suffered from CB abnormalities had less increase in BCVA than patients who had no evidence of CB (0.28 vs. 0.14 logMAR; p < 0.001). Of all the patients with CB abnormalities at baseline, 68% had lower CB grading after the surgery (n = 28; 95% CI; p < 0.001). All patients showed an improvement of their ERM grading, with 98.7% reaching stage 0 (n = 151 vs. n = 149; 95% CI; p < 0.001). Conclusions The study indicates that the presence of CB abnormalities correlates with worse visual function. They are furthermore associated with worse visual outcomes after PPV with ERM and ILM peeling. These findings are valuable for deciding on PPV in patients with ERM.


2014 ◽  
Vol 21 (01) ◽  
pp. 167-172
Author(s):  
Lal Muhammad Khattak ◽  
Afzal Qadir ◽  
Umer Khan ◽  
Muhammad Kashif Kamran

Objective: To study the complications of ND: YAG laser capsulotomy. Design:Clinical trial. Setting: Department of Ophthalmology KHYBER Medical University Institute ofMedical Sciences Teaching Hospital Kohat Development Authority (KDA) Kohat. Period: Jan2007 to June 2008. Material and methods: A total number of 250 patients with posterior capsularopacification were studied and look for complications after ND: YAG Laser application. Onehundred and thirty five (54% )were male and one hundred fifteen( 46%) patients were female.63% of patients had right eye involvement while 37% had left eye were involved. Patients werethoroughly examined before and after the procedure. All patients were followed for minimum sixmonths after the procedure. Data was analyzed by SPSS version 16. Chi square test wascalculated for the significance of analysis. Results: After Nd YAG laser capsulotomy there wassignificant improvement in visual acuity of my patients. There was transient rise of IOP in 25 (10%)of patients. Mild anterior uveitis in 20 (8.0%) of patients. Intra-ocular Lens pitting or cracks in 30(12%) of cases. Macular edema in 20 (8.0%) of cases. Retinal detachment in 5 (2.0%) of cases.Conclusions: Nd YAG laser is safe, effective and non-invasive procedure outdoor procedure bywhich we can get better visual outcome. Which had also some serious complication for that wehave to avoid and educate the patient about the complications of procedure.


2019 ◽  
Vol 104 (3) ◽  
pp. 422-431 ◽  
Author(s):  
Carol L Shields ◽  
Sanika Udyaver ◽  
Lauren A Dalvin ◽  
Li-Anne S Lim ◽  
Hatice T Atalay ◽  
...  

PurposeTo assess visual outcomes of Coats disease by classification stage.MethodsA retrospective review was conducted on consecutive patients with Coats disease, classified according to Shields classification and with available Snellen visual acuity before and after treatment.ResultsThere were 160 eyes with Coats disease (stage 1 (n=2) vs stage 2A (n=17) vs stage 2B (n=22) vs stage 3A1 (n=26) vs stage 3A2 (n=40) vs stage 3B (n=42) vs stage 4 (n=9) vs stage 5 (n=2)). By comparison, more advanced stage showed greater frequency of poor presenting visual acuity (<20/200) (0% vs 0% vs 50% vs 35% vs 38% vs 83% vs 100% vs 100%, p<0.001) and higher mean intraocular pressure (17 vs 15 vs 15 vs 15 vs 15 vs 15 vs 37 vs 26, p<0.001). More advanced stage was less likely managed with laser photocoagulation (100% vs 87% vs 48% vs 62% vs 74% vs 35% vs 0% vs 0%, p<0.001) and more likely with cryotherapy (0% vs 47% vs 81% vs 81% vs 82% vs 88% vs 50% vs 100%, p=0.001). More advanced stage was associated with lower frequency of visual acuity ≥20/40 (100% vs 71% vs 5% vs 42% vs 23% vs 5% vs 0% vs 0%, p<0.001) and greater frequency of visual acuity <20/200 (0% vs 12% vs 36% vs31 % vs 45% vs 88% vs 0% vs 100%, p<0.001).ConclusionVisual acuity in eyes with Coats disease parallels staging with more advanced stage demonstrating poorer visual acuity at presentation and final visit.


2021 ◽  
Vol 20 ◽  
pp. 153473542098834
Author(s):  
Abdolazim Sedighi Pashaki ◽  
Kamal Mohammadian ◽  
Saeid Afshar ◽  
Mohammad Hadi Gholami ◽  
Abbas Moradi ◽  
...  

Objective: Fatigue associated with malignant conditions and their treatments is a disabling condition. This trial assessed the anti-fatigue effects of melatonin coadministration during adjuvant treatment of patients with the breast cancer. Material and Methods: Patients with breast cancer were randomly assigned to receive melatonin or placebo during adjuvant chemotherapy and radiotherapy. Thirty-seven patients were randomly enrolled in each group. The mean ages of patients in the intervention and control groups were 50.47 ± 10.79 and 46.05 ± 10.55 years, respectively ( P = .223). The intervention group received oral melatonin (18 mg/day) from 1 week before until 1 month after the adjuvant radiotherapy. The level of fatigue was assessed before and after intervention using Brief Fatigue Inventory (BFI) in both groups. To analyze data, the Student’s t-test and the Chi-square test were used at a significance level of P ≤ .05. Results: The BFI score was similar before the intervention in both groups, however, after the intervention, it was significantly lower in the melatonin group ( P < .001). Moreover, the frequency of severe fatigue in the melatonin group was significantly lower than in the placebo group after intervention (42.1% vs 83.3%, P < .001). Conclusion: Coadministration of melatonin during adjuvant chemotherapy and radiotherapy of women with breast cancer decreased the levels of fatigue associated with the malignant condition and its treatments.


2021 ◽  
pp. 481-484
Author(s):  
Masahisa Watanabe ◽  
Harumasa Yokota ◽  
Hiroshi Aso ◽  
Hirotsugu Hanazaki ◽  
Junya Hanaguri ◽  
...  

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.


2005 ◽  
Vol 17 (2) ◽  
pp. 276 ◽  
Author(s):  
J. Pryor ◽  
S. Romo ◽  
D.D. Varner ◽  
K. Hinrichs ◽  
C.R. Looney

In commercial bovine in vitro fertilization (IVF) companies, there is a continuous need to improve results. Efforts to maximize in vitro embryo production have included modifications in the use of sperm separation gradients. The development of commercially available sperm centrifugation gradients represents a new possibility of increasing the number of viable sperm that can be obtained from low concentration (fresh or frozen, sexed or unsexed) semen samples in order to improve the efficiency of the IVF system to make embryo production as efficient as possible. The objective of this study was to compare two different separation gradients, as follows: Group 1: Percoll (Sigma, St. Louis, MO, USA), in 45% and 90% gradients; Group 2: EquiPure (Nidacon, Gathenburg, Sweden), in top and bottom layers. Before and after separation, sperm were evaluated at 200× magnification for total motility, and then stained to assess viability at 400× with fast-green/eosin stain (Sigma). Sperm separation was performed using frozen/thawed semen from one bull. Semen was separated by centrifugation at 200g for 30 min in both density gradients. Results obtained from Groups 1 and 2 were compared by chi-square test. Sperm separation with Percoll yielded lower numbers of sperm (average sperm concentration after separation of 92 × 106, vs. 159 × 106 sperm/mL for EquiPure; P < 0.05) but resulted in higher motility (60% vs. 39%, respectively; P < 0.05) of separated sperm. Rates of live sperm cells were not significantly different between groups (69.5% vs. 70%, respectively; P > 0.1). These results indicate that the commercial separation medium EquiPure may be associated with higher sperm concentration levels but with lowered sperm motility when compared to Percoll for bovine sperm separation. However, Equipure provided similar percentages of live sperm when compared to Percoll, which is currently used in our laboratory.


2021 ◽  
Vol 11 (3) ◽  
pp. 926
Author(s):  
Max Philipp Brinkmann ◽  
Stephan Michels ◽  
Carolin Brinkmann ◽  
Mario Damiano Toro ◽  
Nicole Graf Johansen ◽  
...  

Background: Previous studies have shown that epiretinal membranes (ERMs) may be associated with abnormal outer retinal anatomy. However, long-term morphological and functional results of pars plana vitrectomy (PPV) with ERM and internal limiting membrane (ILM) peeling in eyes with central bouquet (CB) alterations have not yet been investigated. Methods: In a retrospective, consecutive study all patients underwent best corrected visual acuity (BCVA) testing and spectral domain optical coherence tomography (SD-OCT) before and after a mean of 20 months (range 3–70 months) postoperatively. CB abnormalities and ERMs were classified according to Govetto’s staging systems. Results: Of the 67 eyes, 22 (34%) showed CB abnormalities at baseline. The mean BCVA increased from 0.42 at baseline to 0.20 LogMAR at final follow-up (p < 0.001). Neither ERM stage (p = 0.06) nor CB stage (p = 0.939) at baseline were significant predictors of vision improvement following surgery. Conclusions: Our results show that baseline BCVA, but not classification of CB changes and ERM at baseline, seems to be a useful predictor for functional outcomes following PPV with ERM and ILM peeling in the long-term.


2017 ◽  
Vol 33 (4) ◽  
pp. 282-287 ◽  
Author(s):  
Fabricio R Santiago ◽  
Mario Piscoya ◽  
Yung-Wei Chi

Objective To evaluate patients’ self-perception of cosmetic improvement before and after they were presented with pre- and postprocedure photographs after sclerotherapy with 75% dextrose. Methods Treatments included sclerotherapy of reticular and varicose veins using 75% dextrose. All treated limbs were photographed and classified according to Clinical, Etiology, Anatomy, and Pathology classification and Venous Clinical Severity Score pre- and posttreatment. The patients were queried before and after viewing the photos during these visits and indicated if they were very unsatisfied, dissatisfied, satisfied, or very satisfied. Nonparametric kappa correlation coefficient and a Chi square test were used to measure associations among agreement (p < 0.05 indicated statistical significance). The paired Wilcoxon test was used to compare statistical differences in mean Venous Clinical Severity Scores measured at different times (p < 0.05 indicated statistical significance). Data were analyzed using STATA software (version 12). Results Individuals were more satisfied with the results of sclerotherapy after exposure to images portraying their limbs two months after the procedure (p = 0.0028). This effect was maintained six months after sclerotherapy (p = 0.0027). Conclusion Patient exposure to pre- and postsurgical photographs is a simple intervention with the potential of improving patient satisfaction up to six months after treatment with sclerotherapy.


2019 ◽  
Vol 19 (10) ◽  
pp. 40c
Author(s):  
Ruijing Xia ◽  
Binbin Su ◽  
Tianyu Chen ◽  
Jia Zhou ◽  
Hua Bi ◽  
...  

2021 ◽  
Vol 5 (11) ◽  
pp. 1030-1036
Author(s):  
Galih Aktama ◽  
Henky Agung Nugroho ◽  
Muhammad David Perdana Putra

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.


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