Evaluation of vision-related quality of life with autologous internal limiting membrane transplantation for refractory macular hole.

Abstract Background: To evaluate the vision-related quality of life of vitrectomy combined with autologous internal limiting membrane(ILM) transplantation for refractory macular hole． Methods: A prospective and nonrandomized clinical study was carried out. There were fourty eyes with refractory macular hole included and all eyes received 23G vitrectomy and ILM peeling with autologous ILM transplantation. Preoperative and postoperative basic conditions were recorded, including best corrected visual acuity (BCVA), intraocular pressure, central retinal thickness (CRT) measurement by Optical coherence tomography (OCT) examination, macular hole index (MHI) and operative complications. The Chinese version of visual-related quality of life scale -25 (CVRQoL-25) was used to evaluate the visual related quality of life of patients after operation. The correlation between the quality of life and the postoperative visual acuity and the size of the macular hole before operation was tested by Spearman rank correlation test. Results: All patients were followed up for three months after surgery, and 38 patients achieved anatomical closure. The mean postoperative logMAR BCVA was 1.09±0.33, which has significantly improved than that before operation (P=0.000). The vision-related quality of life of patients after surgery was closely related to the macular hole index (r=0.375, P=0.017), but was negatively correlated with the best corrected visual acuity before and after surgery (r=-0.495, P=0.001; r=-0.760，P=0.000). It was also found that the vision-related quality of life of patients positively correlated with the postoperative CRT ( r=0.414，P=0.008). Conclusions: The anatomical structure of refractory macular hole patients with ILM peeling combined with autologous ILM transplantation was largely reduced, and the visual acuity of the patients improved significantly. Meanwhile, the vision-related quality of life was significantly improved after surgery. Trial Registration: ChiCTR-INR-16008660, date of registration: 2016/06/17

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Evaluation of vision-related quality of life with autologous internal limiting membrane transplantation for refractory macular hole.

10.21203/rs.2.10310/v1 ◽

2019 ◽

Author(s):

Dongqing Yuan ◽

Weiwei Zhang ◽

Songtao Yuan ◽

Ping Xie ◽

Qinghuai Liu

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Macular Hole ◽

Internal Limiting Membrane ◽

Ilm Peeling ◽

Corrected Visual Acuity ◽

Hole Index ◽

Related Quality ◽

Best Corrected Visual Acuity

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Vision-related quality of life in patients treated for myopic choroidal neovascularization: A post hoc analysis of the OLIMPIC study

European Journal of Ophthalmology ◽

10.1177/1120672119853745 ◽

2019 ◽

Vol 30 (5) ◽

pp. 1069-1075

Author(s):

Gianni Virgili ◽

Mariacristina Parravano ◽

Francesco Viola ◽

Monica Varano

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Diabetic Retinopathy ◽

Choroidal Neovascularization ◽

Early Treatment ◽

Pathologic Myopia ◽

Corrected Visual Acuity ◽

Related Quality ◽

Best Corrected Visual Acuity

Purpose: To investigate vision-related quality of life in patients referred to the Italian Retina Services for intravitreal ranibizumab treatment for choroidal neovascularization due to pathologic myopia. Design: Post hoc analysis of a multicenter, interventional phase IIIb study (OLIMPIC). Methods: Patients with either previously untreated (naïve) or treated choroidal neovascularization due to pathologic myopia were enrolled. Vision-related quality of life was measured using the Italian version of the Impact of Vision Impairment Questionnaire with scores from 0 (no impact) to 5 (severe impact). Burden of illness data were collected regarding income, and personal and public resource use. Results: In the 200 included subjects, mean best-corrected visual acuity in the better eye was 68.3 Early Treatment Diabetic Retinopathy Study letters (standard deviation: 15.2) compared with 42.5 Early Treatment Diabetic Retinopathy Study letters (standard deviation: 23.3) in the worse eye. The proportion of better eyes affected by choroidal neovascularization was 147/200 (73.5%). In multivariable analyses, lower better eye, but not worse eye, best-corrected visual acuity was associated with lower vision-related quality of life (per 10 fewer letters, beta: + 0.17, p < 0.001). An annual income below 20,000 euros was also associated with lower vision-related quality of life (beta: + 0.38; standard error: 0.13, p = 0.004). Moreover, in univariate analyses, increasing income level was linearly associated with better presenting best-corrected visual acuity in the better eye (p < 0.003), with a difference of 15 Early Treatment Diabetic Retinopathy Study letters for patient income <20,000 euros compared with >70,000 euros. Conclusion: Italian patients with myopic choroidal neovascularization and a low income presented with lower better-eye best-corrected visual acuity and lower vision-related quality of life compared with those with a higher income. Future research should investigate disease awareness and candidacy issues that may influence the quality of life of patients.

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Efficacy of inverted internal limiting membrane flap for large idiopathic macular holes

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.2.689 ◽

2019 ◽

Vol 35 (2) ◽

Author(s):

Haroon Tayyab ◽

Asad Aslam Khan ◽

Sana Jahangir

Keyword(s):

Visual Acuity ◽

Macular Hole ◽

Internal Limiting Membrane ◽

Creative Commons ◽

Corrected Visual Acuity ◽

Macular Holes ◽

Idiopathic Macular Holes ◽

Best Corrected Visual Acuity ◽

Hole Closure ◽

Sd Oct

Objective: To evaluate the effectiveness of inverted internal limiting membrane flap in large idiopathic macular holes. Methods: Twelve patients diagnosed with idiopathic macular holes larger than 400um underwent 23 gauge Pars Plana Vitrectomy (PPV) with inverted internal limiting flap and gas tamponade at Al-Ehsan Eye Welfare Eye Hospital, Lahore from February 2017 to February 2018. All cases were diagnosed on Spectral Domain Optical Coherence Tomography (SD-OCT) and were followed up for 6 months. At every follow-up, best corrected visual acuity and SD-OCT was done. Results: We achieved macular hole closure in 91.6% (11/12) patients with idiopathic macular holes larger than 400um. Five out of 12 patients underwent combined phacoemulsification and PPV. One patient has flat hole closure which was considered failure. One patient was excluded from the study due to per-operative flap loss. This patient was not included in final data analysis of 12 patients. There was statistically significant gain in best corrected visual acuity after successful macular hole closure. We did not report any untoward events during or in the post-operative period. Conclusion: Inverted internal limiting flap is an effective method for repairing large macular holes. How to cite this:Tayyab H, Khan AA, Jahangir S. Efficacy of inverted internal limiting membrane flap for large idiopathic macular holes. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.689 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Early outcomes of macular hole surgery on visual acuity, retinal anatomy and vision-related quality of life

Acta Ophthalmologica ◽

10.1111/aos.12646 ◽

2015 ◽

Vol 93 (5) ◽

pp. e402-e403 ◽

Cited By ~ 2

Author(s):

Ulla Lahtela ◽

Janne Ylisoivio ◽

Tapani Palosaari ◽

Nina Hautala

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Macular Hole ◽

Macular Hole Surgery ◽

Related Quality

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Conbercept for Treatment of Neovascular Age-Related Macular Degeneration and Visual Impairment due to Diabetic Macular Edema or Pathologic Myopia Choroidal Neovascularization: A Systematic Review and Meta-Analysis

Frontiers in Pharmacology ◽

10.3389/fphar.2021.696201 ◽

2021 ◽

Vol 12 ◽

Author(s):

Pengxiang Zhou ◽

Siqian Zheng ◽

Ente Wang ◽

Peng Men ◽

Suodi Zhai

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Macular Degeneration ◽

Macular Edema ◽

Age Related Macular Degeneration ◽

Pathologic Myopia ◽

Corrected Visual Acuity ◽

Age Related ◽

Best Corrected Visual Acuity

Background: Conbercept is a new anti-vascular endothelial growth factor (VEGF) drug. Here, we systematically conducted the efficacy, safety, compliance, and pharmacoeconomic evaluation of intravitreal conbercept (IVC) compared with other treatments in patients with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or pathologic myopia choroidal neovascularization (pmCNV).Methods: Databases of PubMed, Embase, Cochrane Library, ClinicalTrials.gov, SinoMed, China National Knowledge Infrastructure, and WanFang Data were systematically searched from the inception to July 27, 2021. Randomized clinical trials and pharmacoeconomic studies comparing IVC with control groups in adults with nAMD, DME, or pmCNV were reviewed and selected. Meta-analyses were performed using the fixed-effects model when pooled data were homogeneous. Heterogeneous data were analyzed using the random-effects model. Primary outcomes included visual improvement rate, mean change in visual acuity or best corrected visual acuity, and pharmacoeconomic outcomes. Additional outcomes were the mean change in fundus examination values, adverse events (AEs), quality-of-life measures, and number of injections.Results: Among 3,591 screened articles, 22 original studies with 1,910 eyes of patients were finally included. For nAMD and DME, IVC was significantly associated with better visual acuity or best corrected visual acuity improvement and fundus quantitative measures than placebo, laser photocoagulation (LP), or intravitreal triamcinolone acetonide (IVT). However, IVC showed non-inferior efficacy to intravitreal ranibizumab (IVR) according to low quality of evidence, and there was lack of trials comparing the priority of IVC to other anti-VEGF regimens. No definitive increased risk of ocular or non-ocular AEs were observed in the study groups. All patients with AEs recovered after symptomatic treatments, and no severe AEs occurred. Patients treated with IVC might have higher quality-of-life scores than those in IVR in nAMD or LP in DME. Additionally, IVC showed cost–utility advantages in nAMD and cost-effectiveness advantages than IVR in pmCNV in China.Conclusion: IVC is well-tolerated and effective for improving vision acuity and quantitative measures in fundus condition in patients with nAMD and DME compared with LP, IVT, and placebo, but gains comparable efficacy to IVR. However, well-designed, large-sample, and long-term evaluation of IVC shall be conducted in additional studies worldwide.

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Reconstructing Foveola by Foveolar Internal Limiting Membrane Non-Peeling and Tissue Repositioning for Lamellar Hole-Related Epiretinal Proliferation

Scientific Reports ◽

10.1038/s41598-019-52447-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Tzyy-Chang Ho ◽

Allen Yi-Lun Ho ◽

Muh-Shy Chen

Keyword(s):

Visual Acuity ◽

Clinical Characteristics ◽

Internal Limiting Membrane ◽

Lamellar Macular Hole ◽

Ilm Peeling ◽

Corrected Visual Acuity ◽

Tangential Traction ◽

Group 2 ◽

Lamellar Hole ◽

Group 1

Abstract Differences in the pathogenesis and clinical characteristics between lamellar macular hole (LMH) with and without LMH-associated epiretinal proliferation (LHEP) can have surgical implications. This study investigated the effects of treating LHEP by foveolar internal limiting membrane (ILM) non-peeling and epiretinal proliferative (EP) tissue repositioning on visual acuity and foveolar architecture. Consecutive patients with LHEP treated at our institution were enrolled. The eyes were divided into a conventional total ILM peeling group (group 1, n = 11) and a foveolar ILM non-peeling group (group 2, n = 22). In group 2, a doughnut-shaped ILM was peeled, leaving a 400-μm-diameter ILM without elevated margin over the foveola after EP tissue repositioning. The EP tissue was elevated, trimmed, and inverted into the LMH. Postoperatively, the LMH was sealed in all eyes in group 2, with significantly better best-corrected visual acuity (−0.26 vs −0.10 logMAR; p = 0.002). A smaller retinal defect (p = 0.003), a more restored ellipsoid zone (p = 0.002), and a more smooth foveal depression (p < 0.001) were achieved in group 2. Foveolar ILM non-peeling and EP tissue repositioning sealed the LMH, released the tangential traction, and achieved better visual acuity. The presumed foveolar architecture may be reconstructed surgically. LMH with LHEP could have a combined degenerative and tractional mechanism.

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Surgical management of a case of contractile peripapillary staphyloma with retinal detachment and macular hole

European Journal of Ophthalmology ◽

10.1177/1120672120920227 ◽

2020 ◽

pp. 112067212092022

Author(s):

Sofía H Vidal ◽

Diego Bueso Ponce ◽

Juan Esteban Unigarro ◽

Sergio Arrascue Limo ◽

Carlos Abdala Caballero

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Hole ◽

Retinal Pigment ◽

Silicon Oil ◽

Corrected Visual Acuity ◽

Intraocular Gas ◽

Best Corrected Visual Acuity ◽

Peripapillary Staphyloma

A healthy 4-year-old male presented a fundus examination with a unilateral contractile peripapillary staphyloma surrounded by redundant retina and retinal pigment epithelium atrophy. Five years later, best-corrected visual acuity decreased to hand motion due to a retinal detachment with macular hole. One month after first vitrectomy, scleral buckle and intraocular gas, retina re-detached. Second surgery was performed with silicon oil tamponade and lensectomy without intraocular lens (IOL). Subretinal silicon oil was detected at the third month of follow-up when vitrectomy, inferior retinectomy, and laser photocoagulation of temporal border of staphyloma with silicon oil tamponade were performed. The retina remained attached and best-corrected visual acuity was 20/600 with intraocular silicon oil. A fourth surgery was performed for emulsified silicon oil extraction replaced with intraocular gas. At 6 months of follow-up, the retina re-detached again. This is a challenging vitreoretinal surgery in which re-detachments were due to retinal folds around the contractile staphyloma that raised macular hole. This is the first report of the combined presentation of contractile peripapillary staphyloma, retinal detachment and macular hole with a long-time follow-up period of years.

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