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 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 A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed M. Bedda ◽  
Ahmed M. Abdel Hadi ◽  
Mohamed Lolah ◽  
Muhammad S. Abd Al Shafy
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
High Myopia ◽  
Terminal Part ◽  
Macular Hole Retinal Detachment ◽  
Myopic Macular Hole ◽  
The Mean ◽  
Visual Results

Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p<0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p=0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

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.

Vitrectomy with the inverted internal limiting membrane flap technique in eyes with full-thickness macular hole and dry age-related macular degeneration

2020 ◽  
pp. 112067212092137
Author(s):  
Zofia Michalewska ◽  
Jerzy Nawrocki
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Age Related Macular Degeneration ◽  
Full Thickness ◽  
Flap Technique ◽  
Age Related ◽  
Macular Holes ◽  
Full Thickness Macular Hole

Purpose To present effects of the inverted internal limiting membrane flap technique in full-thickness macular holes coexisting with dry age-related macular degeneration. Methods Our database was retrospectively reviewed in order to spot patients with the simultaneous diagnosis of dry age-related macular degeneration and full-thickness macular hole. Vitrectomy with the inverted internal limiting membrane flap technique was performed. Inclusion criteria were full-thickness macular hole, drusen, vitrectomy performed, and spectral domain optical coherence tomography (Copernicus HR, Optopol, Poland) or swept source optical coherence tomography (Triton, Topcon, Japan) before surgery, then 1 week (±3 days), 1 month (±1 week), 3 months (±1 month), 6 months (±1 month), 12 months (±2 months), and 18 months to 12 years after surgery. Main outcome measures Closure of macular hole and visual acuity at the final control. Results A total of 18 eyes of 12 patients (mean age: 68 years) were included. Mean minimum macular hole diameter was 493 μm. Mean maximum macular hole diameter was 1072 μm. Macular hole was closed in 16 eyes after first surgery and in all eyes after second surgery. Improvement of visual acuity was statistically significant ( P = 0.05), but there was no statistical significant correlation observed between initial macular hole diameters and final visual acuity ( P > 0.1). Conclusion The inverted internal limiting membrane flap technique improves anatomical and functional results in eyes with coexisting dry age-related macular degeneration and full-thickness macular holes. Final development of choroidal neovascularization or geographic atrophy is possible in rare cases.

Gliotic tissue simulating a macular neovascularization in full-thickness macular hole

2021 ◽  
pp. 112067212110295
Author(s):  
Chiara Vigano’ ◽  
Enrico Borrelli ◽  
Riccardo Sacconi ◽  
Maria Brambati ◽  
Francesco Bandello ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Macular Hole ◽  
Male Patient ◽  
Vascular Tissue ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Full Thickness ◽  
Macular Holes ◽  
Full Thickness Macular Hole

The authors report a case of a male patient affected by macular hole. In particular, a hyperreflective tissue was found on optical coherence tomography (OCT) examination in macular region, just above the retinal pigment epithelium (RPE). OCT angiography (OCTA) did not show the presence of vascular tissue, thus the hyperreflective material was ascribed to primary gliotic tissue. This case highlights the ability for Müller cells placed near macular holes to migrate up to the RPE and to produce gliotic tissue.

scholarly journals Krypton yellow laser for the treatment of macular hole in high myopia without retinal detachment

2008 ◽  
Vol 31 (6) ◽  
pp. 357
Author(s):  
Ji-Ping Cai ◽  
Jin-Wei Cheng ◽  
Xiao-Ye Ma ◽  
Yu-Zhen Li ◽  
You Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
High Myopia ◽  
Vitamin B1 ◽  
Macular Holes ◽  
Yellow Laser ◽  
Group A ◽  
The Mean ◽  
Group B

Purpose To evaluate the prophylactic effect of krypton yellow laser for the treatment of macular holes in high myopic eyes in order to reduce the risk of retinal detachment. Methods Twenty-seven eyes of 27 patients with high myopia and macular holes were randomly assigned to two groups. Fifteen patients (group A, 15 eyes) were subject to laser photocoagulation around the hole margin along with an oral placebo (vitamin B1), while 12 patients (group B, 12 eyes) were only given the oral placebo (vitamin B1). The incident rate of retinal detachment due to macular hole and the mean best-corrected visual acuity of the two groups before and after treatment were measured. The data were statistically tested by X2 test and Student’s t test. Results The incident rates of retina1 detachment in group A and group B were 20%(3/15) and 58.3%(7/12), respectively (X2=4.201, P0.05). The mean BCVA of group B on the initial examination was 24/200, while the mean BCVA at the final follow-up was 30/200 (P>0.05). No significant difference in initial visual acuity (P>0.05) or final visual acuity (P>0.05) was found between the two groups. Conclusion Krypton yellow laser photocoagulation could reduce the incidence of retinal detachment due to a macular hole in high myopia with acceptable functional results in this study.

Posterior scleral reinforcement using genipin-cross-linked sclera for macular hole retinal detachment in highly myopic eyes

2018 ◽  
Vol 102 (12) ◽  
pp. 1701-1704 ◽  
Author(s):  
Shuang-Qian Zhu ◽  
An-Peng Pan ◽  
Lin-Yan Zheng ◽  
Yue Wu ◽  
An-Quan Xue
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
High Myopia ◽  
Corrected Visual Acuity ◽  
Macular Hole Retinal Detachment ◽  
Posterior Scleral Reinforcement ◽  
The Mean ◽  
Best Corrected Visual Acuity

Background/aimsTo investigate the surgical outcomes of posterior scleral reinforcement (PSR) using genipin-cross-linked sclera to treat macular hole retinal detachment (MHRD) in highly myopic eyes.MethodsNineteen patients with high myopia (19 eyes) with MHRD were treated sequentially with genipin-cross-linked PSR and were followed at least for 1 year after the surgery. The best corrected visual acuity (BCVA), axial length (AL), optical coherence tomography (OCT) outcomes and the complications were evaluated.ResultsMacular hole was closed in 73.7% of the eyes, foveal reattachment rate was 100%. The mean logMAR BCVA improved from 1.27±0.55 preoperatively to 0.88±0.55 postoperatively. The preoperative AL (29.88±1.97 mm) was decreased (27.73±1.84 mm) after the operation (p<0.001).ConclusionsFor at least a 1-year period of follow-up, PSR with genipin-cross-linked sclera should be considered as a preferred surgical approach to treat MHRD in highly myopic eyes, especially when foveal retinoschisis is also documented.

Long-term functional and anatomical evolution in surgically closed macular holes with internal limiting membrane peeling

2019 ◽  
Vol 30 (5) ◽  
pp. 1112-1119
Author(s):  
Pauline Eymard ◽  
Yannick Le Mer
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Retinal Thickness ◽  
Internal Limiting Membrane ◽  
Macular Thickness ◽  
Full Thickness ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Full Thickness Macular Hole

Introduction: The aim of this study was to describe the long-term evolution of macular retinal thickness and visual acuity in patients who present surgically closed full-thickness macular hole, operated by vitrectomy with internal limiting membrane peeling. Methods: A retrospective observational study of patients operated for full-thickness macular hole with closure of the hole and at least 6 months of post-operative follow-up was performed. All patients had pars plana vitrectomy, peeling of the internal limiting membrane, gas filling and positioning. Comparison of the early post-operative (in the first 5 months) visual acuity and spectral-domain optical coherence tomography-measured macular thickness with late post-operative data (between 6 months and 6 years) was performed. Foveal retinal thickness and temporal and nasal retinal thickness between 1 and 3 mm from the centre were recorded. Results: In total, 35 eyes of 34 patients were included, with an early post-operative measure realized at a mean of 1.8 months and a late measure done at a mean of 25.5 months (7–73 months). Foveal thickness stayed unchanged (282 vs 288 µm), nasal parafoveal thickness remained increased compared to normal and stayed constant (345 vs 345 µm) and temporal parafoveal macular thickness was decreased (313 vs 308 µm) ( p = 0.028). Best-corrected visual acuity was improved by the surgery and the gain increased over time. Conclusion: Internal limiting membrane peeling improves anatomical success of full-thickness macular hole, but this procedure is not without long-term scalable consequences on macular thickness on the temporal quadrant (thinning) as on the nasal quadrant (thickening).

scholarly journals Solar maculopathy. Results of five years of follow-up

2013 ◽  
Vol 94 (6) ◽  
pp. 901-903 ◽  
Author(s):  
R F Akhmetshin ◽  
E A Abdulaeva ◽  
S N Bulgar
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Treatment Initiation ◽  
Optical Coherence ◽  
Retinal Edema ◽  
Permanent Damage ◽  
Long Run ◽  
The Mean

Aim. To investigate the clinical features of solar maculopathy in a long run by optical coherence tomography. Methods. 31 patients (40 eyes) complaining on scotoma appeared after sun gazing without protection were referred to an advisory clinic of Republican Clinical Hospital of Ophtalmology, Kazan. The mean age of patients was 25.2 years, mean visual acuity - 0.72. In addition to the standard examinations, all patients underwent optical coherence tomography. The patients were followed up for up to 5 years. The examinations were performed before the treatment initiation and repeated on the 15th, 30th and 90th day after the treatment completion. 7 patients (8 eyes) were followed up for 5 years. Results. According to the results of optical coherence tomography, focal retinal edema was found in 9 patients (18 eyes) at the first week. Patients received antioedematic drugs and antioxidants. According to the results of optical coherence tomography a lamellar defect has been formed in fovea centralis on 15th day of treatment. Mean visual acuity improved to 0.78. On 30th and 90th days of treatment, lamellar defect persisted, visual acuity remained unchanged. After 5 years, 7 patients (8 eyes) were re-examined. The mean visual acuity was 0.78, the lamellar defect was still observed by optical coherence tomography. No macular degenerative and dystrophic changes were observed in followed up patients. Conclusion. Sunlight causes permanent damage of the retina. In the first week after the sunburn, marked focal retinal edema in the foveolar area was observed on the tomography, with further formation of a lamellar defect that was not accompanied by degenerative changes in the long-term period. Optical coherence tomography is an informative method of diagnosing solar maculopathy.

Sign in / Sign up

Export Citation Format

Share Document