scholarly journals Hole Diameter Ratio for Prediction of Anatomical Outcomes in Stage III or IV Idiopathic Macular Holes 

2020 ◽  
Author(s):  
Yue Qi ◽  
Yanping Yu ◽  
Qisheng You ◽  
Zengyi Wang ◽  
Jing Wang ◽  
...  
Keyword(s):  
Case Series ◽  
Diameter Ratio ◽  
Hole Diameter ◽  
Stage Iii ◽  
Maximum Diameter ◽  
Type I ◽  
Closure Rate ◽  
Macular Holes ◽  
Case Series Study ◽  
Idiopathic Macular Holes

Abstract Purpose: To determine whether preoperative hole diameter ratio (HDR) is a predictive factor for postoperative anatomical outome for stage III or IV idiopathic macular holes (IMHs).Methods: One-hundred and one eyes with stage III or IV IMH were included in this retrospective case series study.
All cases were treated with vitrectomy combined with internal limiting membrane (ILM) peeling and room air tamponade. The macular hole (MH) minimum and maximum diameter was measured on preoperative optical coherence tomography (OCT) images. The HDR was defined as the minimum to maximum diameter ratio. Results: Eighty-one eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The preoperative minimal diameter (703.6±116.1mm vs. 597.6±120.1mm, P<0.01) and HDR (0.6±0.1 vs. 0.5±0.1, P=0.01) were both significantly smaller in postoperative closed eyes. The closure rate of IMHs with HDR<0.6 was significantly higher than those with HDR³0.6 (90.2% vs. 65.0%P=0.002) .Conclusions: Preoperative HDR<0.6 is predictive for a good postoperative anatomical outcome in stage III or IV IMHs.

scholarly journals Hole Diameter ratio (HDR) for prediction of anatomical outcomes in stage III and IV idiopathic macular holes

2020 ◽  
Author(s):  
Yue Qi ◽  
Yanping Yu ◽  
Zengyi Wang ◽  
Jing Wang ◽  
Wu Liu
Keyword(s):  
Predictive Factor ◽  
Diameter Ratio ◽  
Hole Diameter ◽  
Stage Iii ◽  
Maximum Diameter ◽  
Ilm Peeling ◽  
Macular Holes ◽  
Air Tamponade ◽  
Idiopathic Macular Holes ◽  
Anatomical Outcome

Abstract Summary: In this study, we reviewed 101 eyes with stage III or IV IMHs treated by PPV combined with ILM peeling and room air tamponade, took the ratio of minimum diameter to maximum diameter (hole diameter ratio, HDR) as the predictive factor and found HDR<0.6(“A” type IMH) can be a predictive factor for a good anatomical outcome.Purpose: To identify hole diameter ratio (HDR) as the predictive factor for unclosed stage III and IV idiopathic macular holes (IMHs) by the use of preoperative optical coherence tomography (OCT).Methods: 101 eyes with stage III or IV IMH were included in this retrospective case series study.
All cases were treated with vitrectomy combined with ILM peeling and room air tamponade. The MH minimum and maximum diameter, the ratio of the minimum to the maximum diameter (which defined as HDR) were performed. Results: 81 eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The minimal diameter of IMHs (703.6±116.1um VS 597.6±120.1um, P<0.01) and HDR (0.6±0.1 VS 0.5±0.1, P=0.01) were both significantly different between two groups. The cutoff value of the receiver operating characteristic curve was 0.6. The IMH with the HDR that less than 0.6 were defined as “A” type IMH and the others were defined as “H” type IMH. The closure rate of two type IMHs were 90.2% and 65.0% respectively. It had significant differences. (P=0.002) Conclusions: HDR<0.6(“A” type IMH) can be a predictive factor for a good anatomical outcome in stage III and IV IMHs after vitrectomy combined with LM peeling and room air tamponade.

scholarly journals Hole diameter ratio for prediction of anatomical outcomes in stage III or IV idiopathic macular holes

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yue Qi ◽  
Yanping Yu ◽  
Qisheng You ◽  
Zengyi Wang ◽  
Jing Wang ◽  
...  
Keyword(s):  
Diameter Ratio ◽  
Hole Diameter ◽  
Stage Iii ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Anatomical Outcomes

scholarly journals Combined Idiopathic Macular Hole Vitrectomy with Phacoemulsification without Face-Down Positioning

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Fumihiko Yagi ◽  
Seiji Takagi ◽  
Goji Tomita
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Functional Results ◽  
Idiopathic Macular Hole ◽  
Closure Rate ◽  
Postoperative Visual Acuity ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
The Mean ◽  
Final Closure

Purpose. To evaluate the outcome of combined vitrectomy with phacoemulsification without postoperative face-down positioning for idiopathic macular holes (MHs).Design. Retrospective, observational case series.Participants. Forty-two eyes of 42 patients with MH.Methods. We studied 42 eyes of 42 cases followed up for 6 months postoperatively. MH closure rate and preoperative and postoperative visual acuity (VA) were evaluated.Main Outcome Measures. MH closure rate and VA were evaluated after combined vitrectomy with phacoemulsification without postoperative face-down positioning.Results. Of the 42 holes, 40 (95.2%) were initially closed, and the final closure rate was 100%. Compared with preoperative VA, the mean VA was significantly improved at 1 month and the improvement was maintained for at least 6 months postoperatively.Conclusions. Combined vitrectomy with phacoemulsification without postoperative face-down positioning produced favorable anatomic and functional results for MH repair. Improvement in VA can be expected for up to at least 6 months postoperatively.

Morphofunctional analysis of the retina in the surgical treatment of idiopathic macular holes

2021 ◽  
pp. 48-52
Author(s):  
A.S. Zotov ◽  
◽  
A.S. Balalin ◽  
S.V. Balalin ◽  
S.M. Purshak ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Treatment ◽  
Macular Hole ◽  
Practical Importance ◽  
Functional Results ◽  
Hole Diameter ◽  
Optical Coherence ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Morphofunctional Analysis

Purpose. To evaluate the role of microperimetry and optical coherence tomography (OCT) in the morphofunctional analysis of the retina after surgical treatment of idiopathic macular holes (IMH). Materials and methods. A retrospective study of 33 patient's treatment results (33 eyes) with IMH was carried out. All patients underwent minimally invasive with 25G or 27G vitrectomy. Best corrected visual acuity (BCVA), macular photosensitivity, fixation stability, macular neuroepithelial (NE) volume and minimal macular hole diameter were analyzed. Follow-up period: 6 months. Results. A complete closure of the macular hole was achieved in all cases post-op. The patients had reliable improvement of BCVA, retinal photosensitivity and decrease of macular NE volume. Based on a multifactor correlation analysis with the purpose to predict the results of surgical treatment, the dependence of post-op BCVA on the pre-op photosensitivity of the retina and the minimal diameter of the macular hole was revealed. Conclusions. Microperimetry and OCT are modern non-invasive research methods allowing to estimate anatomical and functional results of surgical IMH treatment. The study of retinal photosensitivity in the macula and minimal macular hole diameter pre-op allows to predict post-op BCVA, which has a practical importance. Keywords: idiopathic macular hole, vitrectomy, microperimetry, optical coherence tomography.

Broad internal limiting membrane peeling with adjunctive plasma–thrombin for repair of large macular holes

2020 ◽  
pp. 112067212092021
Author(s):  
Kyle A Bolo ◽  
Stanley Chang
Keyword(s):  
Case Series ◽  
Internal Limiting Membrane ◽  
Adjunctive Treatment ◽  
Retinal Layer ◽  
Retrospective Case ◽  
Closure Rate ◽  
Autologous Plasma ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Macular Holes

Purpose To assess the potential efficacy of broad internal limiting membrane peeling with adjunctive plasma–thrombin instillation to treat large macular holes and to make qualitative comparisons to internal limiting membrane peeling without adjunctive treatment and internal limiting membrane peeling with inverted and free internal limiting membrane flaps. Methods A systematic literature review and a retrospective case series. Participants in the case series (N = 39) had idiopathic macular holes larger than 400 µm as measured on spectral-domain optical coherence tomography and underwent pars plana vitrectomy, internal limiting membrane peeling, placement of autologous plasma and bovine thrombin over the hole, and gas tamponade. Repeat imaging and clinical data were collected from 1, 2, 3, 6, and 12 months postoperatively. Results Macular hole closure rate was 97%; 82% had U-type closures. At 12 months, 11% had defects in the external limiting membrane and 22% in the ellipsoid zone. This closure rate is similar to prior studies of internal limiting membrane flaps, while the U-type closure rate and retinal layer restoration compare favorably to those reported for internal limiting membrane peeling alone and internal limiting membrane flaps; 75% experienced a three-line improvement in visual acuity by 6 months, which exceeds results by either method. Conclusion Plasma–thrombin instillation over macular holes may be a less-complicated alternative adjunct to internal limiting membrane flaps that can achieve similar outcomes when combined with internal limiting membrane peeling.

Autologous internal limiting membrane transplant for recurrent idiopathic macular holes

2020 ◽  
pp. 112067212090639 ◽  
Author(s):  
Tommaso Rossi ◽  
Carlandrea Trillo ◽  
Guido Ripandelli
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Outer Segment ◽  
Internal Limiting Membrane ◽  
Control Group ◽  
Closure Rate ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Macular Holes ◽  
Idiopathic Macular Holes

Purpose: To report a series of recurrent idiopathic macular holes treated by means of a free autologous internal limiting membrane flap and compare visual and anatomic results to a control group undergoing further internal limiting membrane peeling and novel gas tamponade. Methods: Retrospective surgical series of 15 consecutive patients receiving autologous internal limiting membrane flap compared to 14 patients operated on for internal limiting membrane peeling enlargement. Autologous internal limiting membrane flap was created after brilliant blue G staining, internal limiting membrane lifting, perfluorocarbon bubble injection and creation of a wide internal limiting membrane free flap translocated underneath perfluorocarbon liquid, to the macular hole bed. Both groups were tamponated with 20% SF6 and positioned face down for 4 h a day for 3 days. Results: Macular hole closed in 14/15 (93.3%) patients of the autologous internal limiting membrane group and 9/14 (64.2%) controls (p < 0.05). Visual acuity increased from 0.05 ± 0.03 to 0.23 ± 0.13 Snellen in the autologous internal limiting membrane group and from 0.05 ± 0.03 to 0.14 ± 0.10 Snellen of controls (p < 0.05 for both). Vision of the autologous internal limiting membrane group improved more than controls at 1 month (p = 0.043) and 3 months (p = 0.045). Inner segment/outer segment interruption at 3 months was smaller in the autologous internal limiting membrane group than controls, reducing from 1230 ± 288 µm at baseline to 611 ± 245 and 547 ± 204 µm at 3 months versus 1196 ± 362, 745 ± 222 and 705 ± 223 µm, respectively (p < 0.05). Conclusion: Autologous internal limiting membrane flap can effectively close recurrent idiopathic macular holes with a higher closure rate, smaller residual inner segment/outer segment line interruption and higher visual acuity at 3 months than previous standard of care.

Differentiated Approach to Strategies of Surgical Treatment of Idiopathic Macular Holes

The Eye ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 12-16
Author(s):  
R. Z. Shamratov ◽  
L. Sh. Ramazanova ◽  
O. A. Napylova
Keyword(s):  
Surgical Treatment ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Pathological Process ◽  
Hole Diameter ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Anatomical Outcome ◽  
Clinical Cases

Background. 25G or 27G three-port vitrectomy, followed by staining and removal of the internal limiting membrane with vitreous cavity air or gas tamponade, is one of the main modern vitreoretinal surgery principles for primary macular holes. However, not all patients manage to obtain a functional outcome when the anatomical outcome is achieved. Purpose. To  present clinical cases of surgical treatment of idiopathic macular holes (IMH) exhibiting a differentiated approach.Matherials and methods. This article analyzes clinical cases of four patients with primary idiopathic macular holes, differing in terms of development, hole diameter and the presence of comorbidities. Results. The results of surgical treatment were evaluated 14 days and 1 month after surgery. In all clinical cases, surgical treatment resulted in a positive anatomical outcome by blocking a retinal defect. Best corrected visual acuity increased, on average, from 0.08 ± 0.05 to 0.4 ± 0.05.Conclusion. The analysis of the presented clinical cases clearly demonstrates the need for a timely and differentiated approach to the treatment of patients with IMH, that considers etiology of the pathological process, period of its existence as well as concomitant and general somatic pathologies.

scholarly journals Intravitreal Ranibizumab Injection for the Treatment of Retinopathy of Prematurity

2019 ◽  
Vol 28 (6) ◽  
pp. 526-532 ◽  
Author(s):  
Tariq Aldebasi ◽  
Muataz A. Guma ◽  
Rabia Bashir ◽  
Saif Al Saif ◽  
Waleed A. Altwaijri ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Single Injection ◽  
Case Series ◽  
Severe Hypoglycemia ◽  
Stage Iii ◽  
Complete Regression ◽  
Intravitreal Ranibizumab ◽  
Retrospective Case ◽  
Case Series Study ◽  
Medical City

Objectives: To evaluate the efficacy of a single injection of 0.3 mg intravitreal ranibizumab for the treatment of retinopathy of prematurity (ROP). Methods:We conducted this retrospective case series study at King Abdul Aziz Medical City, Riyadh, Saudi Arabia. Seventy-four eyes of 37 preterm infants with ROP stage III with plus disease in zone I, posterior zone II, and aggressive posterior ROP received a single injection of 0.3 mg intravitreal ranibizumab. The favorable outcome measure was complete regression of the disease with normal vascularization of the retina of those infants. Results: The gestational age of the 37 included cases was in the range of 23–28 weeks and their body weight at birth was between 510 and 1,235 g except for one case with 2,550 g under oxygen therapy <7days with severe hypoglycemia. All eyes showed a favorable response in terms of regression of plus disease from the first day after treatment, followed by regression of stage III retinopathy. All patients developed complete vascularization over variable periods of time. Conclusion: One injection of 0.3 mg intravitreal ranibizumab is effective in treating ROP stage III mainly in zones I and II.

scholarly journals Autologous Retinal Transplant for Macular Hole

2021 ◽  
Vol 15 (1) ◽  
pp. 292-298
Author(s):  
Sergio E. Hernández Da Mota ◽  
Virgilio Morales-Cantón ◽  
Sergio Rojas-Juárez ◽  
Antonio López-Bolaños ◽  
Abel Ramírez-Estudillo ◽  
...  
Keyword(s):  
Macular Hole ◽  
Multifocal Electroretinogram ◽  
Case Series ◽  
Macular Hole Surgery ◽  
Closure Rate ◽  
Retinal Transplantation ◽  
Ovid Medline ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Hole Closure

We aim to review scientific literature concerning published studies on autologous retinal transplantation to treat macular hole patients. The following databases were searched: Medline and Medline Non-Indexed Items, Embase (1990–2020), Ovid Medline® (1990 to November 2020), Embase (1990 to November 2020), Ovid Medline® and Epub Ahead of Print, in-Process and Web of Science (all years). Search keywords included “autologous”, “retinal transplant”, “autologous neurosensory retinal free flap” “transplantation”, “macular hole”, and “macular hole surgery”. Eighteen case series and single case reports were reviewed. Preoperative and final best-corrected visual acuity, microperimetry and multifocal electroretinogram findings, macular hole closure rate, preoperative and postoperative ellipsoid zone, and external limiting membrane defects were obtained and analyzed. Indications of autologous retinal transplantation for macular hole surgery included refractory macular holes, conventional techniques, and large macular holes. The number of cases included in the different case series ranged from 2 to 130 cases, and prior macular hole surgeries of the patients ranged from 0 to 3. Overall, the published case series of autologous retinal transplants have reported a macular hole closure rate of 66.7 to 100%, as well as a significant improvement in best-corrected visual acuity. The most frequently reported complications included considerable intraoperative bleeding and postoperative dislocation of the graft. The presence of functionality in the graft area has also been documented by microperimetry and multifocal electroretinogram. In conclusion, the autologous retinal transplantation technique for macular hole patients has emerged as another surgical option, with a high macular hole closure rate and visual improvement.

scholarly journals Pre- and Post-operative Differences Between Genders in Idiopathic Macular Holes

2020 ◽  
Author(s):  
Jing Wang ◽  
Yanping Yu ◽  
Xida Liang ◽  
Zengyi Wang ◽  
Biying Qi ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Age Of Onset ◽  
Closure Rate ◽  
Recovery Duration ◽  
Macular Holes ◽  
Younger Age ◽  
Stage 4 ◽  
Before And After ◽  
Idiopathic Macular Holes ◽  
23 Gauge

Abstract Background: To compare idiopathic macular holes (IMHs) between male and female before and after surgery.Methods: Patients with IMHs of stage 3 and stage 4 who underwent 23-gauge vitrectomy were retrospectively enrolled. Pre-operative clinical features like age of onset, and best-corrected visual acuity (BCVA) were reviewed. Optical coherence tomography parameters including minimum linear diameter (MLD), central macular thickness and some other indexes were measured and calculated. Main surgical outcomes included the primary closure rate, the highest BCVA during follow-up, and the recovery duration. All the metrics mentioned above were compared between genders with appropriate statistical methods. Results: A total of 298 eyes from 280 patients (male: 51; female: 229) were enrolled. Compared with men, women demonstrated a significantly higher ratio of stage3/stage4 (P=0.045), larger horizontal MLD (P=0.009), but similar surgical outcomes except for a relatively longer recovery duration (P=0.024). For stage 3 IMHs, women exhibited significantly younger age of onset (P=0.023), larger MLD (P=0.003), and smaller height of the hole (P=0.029). However, for stage 4 IMHs, all the pre- and post-operative metrics showed no differences between genders.Conclusions: Female IMHs seem to demonstrate an earlier age of onset and larger size of hole, especially in IMHs of stage 3. However, these differences, which may owe to normal gender-related variations, have limited influence on the surgical outcomes.

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