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

Author(s):  
A.S. Zotov ◽  
◽  
A.S. Balalin ◽  
S.V. Balalin ◽  
S.M. Purshak ◽  
...  

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.

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Lynn L. Huang ◽  
David H. Levinson ◽  
Jonathan P. Levine ◽  
Umar Mian ◽  
Irena Tsui

Purpose. To describe the characteristics of idiopathic macular holes (MH) on optical coherence tomography (OCT) and correlate OCT with clinical assessment.Design. Cross-sectional chart review and OCT assessment.Participants. Sixty-seven eyes with a clinically diagnosed idiopathic MH with available OCT data.Methods. A retrospective chart review and OCT assessment.Results. Based on OCT grading, 40 eyes had a full-thickness macular hole (FTMH) and 21 eyes had a lamellar macular hole (LMH). Clinical exam and OCT assessment agreed in 53 (87%) eyes when assessing the extent of MH. Six eyes (14.6%) in the FTMH group, and 3 eyes in the LMH group (14.3%) had persistent vitreomacular traction. Thirty-seven eyes (92.5%) in the FTMH group and 11 eyes (52.4%) in the LMH group had associated intraretinal cysts. Two eyes (5.0%) in the FTMH group and zero eyes in the LMH group had subretinal fluid. Intraretinal cysts were found to be more frequently associated with FTMH than with LMH (P<0.001).Conclusion. This paper described OCT findings in a group of patients with clinically diagnosed MH. A high level of correlation between clinical assessment and OCT findings of LMH and FTMH was observed, and intraretinal cysts were often present in FTMH.


Ophthalmology ◽  
2012 ◽  
Vol 119 (12) ◽  
pp. 2600-2608 ◽  
Author(s):  
Keisuke Mori ◽  
Junji Kanno ◽  
Peter L. Gehlbach ◽  
Shin Yoneya

The Eye ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 12-16
Author(s):  
R. Z. Shamratov ◽  
L. Sh. Ramazanova ◽  
O. A. Napylova

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.


2011 ◽  
Vol 2 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Atsushi Hayashi ◽  
Takaaki Yagou ◽  
Tomoko Nakamura ◽  
Kazuya Fujita ◽  
Miyako Oka ◽  
...  

Author(s):  
E.A. Krupina ◽  
◽  
O.A. Pavlovsky ◽  
E.A. Larina ◽  
◽  
...  

Purpose. Evaluation of the results of the use of Autologous Conditioned Plasma in Management refractory macular hole. Materials and methods. We examined рatient B., 56 years old, with a refractory macular hole (MH), which did not close after two operations. Earlier, the patient underwent cataract phacoemulsification with IOL implantation. Along with traditional methods of examination, optical coherence tomography was performed. Before the operation, Autologous Conditioned Рlasma (ACP) was prepared by centrifuging the patient's blood. After removing the silicone oil, the AСР was injected of the MH zone. The operation was completed with a gas-air tamponade. After the operation, recommended position was "face down" for a day. Results. In the early postoperative period, during biomicroscopy, MH was closure. 2 weeks after surgery, on optical coherence tomography (OCT) there MH was closure. Her best-corrected visual acuity (BCVA) the maximum corrected was 0.01 to 0.15. Patient said about the improvement in the quality of vision and a decrease in metamorphopsies. Conclusion. The use of AСР in the Management of refractory MH is an effective method with good anatomical and functional results. Keywords: refractory macular hole, Autologous Conditioned Plasma, optical coherence tomography, anatomical result.


2018 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jesus H. Gonzalez-Cortes ◽  
Juan J. Toledo-Negrete ◽  
Yunuen Bages-Rousselon ◽  
Manuel A. de Alba-Castilla ◽  
Jesus Mohamed-Hamsho

1999 ◽  
Vol 128 (5) ◽  
pp. 621-627 ◽  
Author(s):  
Masahito Imai ◽  
Hiroyuki Iijima ◽  
Teruhiko Gotoh ◽  
Shigeo Tsukahara

2020 ◽  
Vol 17 (3) ◽  
pp. 368-374
Author(s):  
R. R. Faizrakhmanov ◽  
E. A. Larina ◽  
O. A. Pavlovskii

Macular holes are the most often pathology leading to reduced vision among persons after 60 years. The macular hole is the acquired disease which is a defect of a foveola part of retina on all thickness from an internal limiting membrane to an external segment of a photoreceptor layer. The standard method of treatment is surgery method: a microinvasive vitrectomy with membrane peeling in macular area. There is a number of the techniques increasing efficiency of operative intervention. Even in case of successful surgical intervention macular holes are not always closed.The purpose: development and assessment of morphological parameters of the central retina with a new surgical method of closing earlier operated macula hole using a free flap.Material and methods. 40 patients (40 eyes, 28 women and 12 men) had participated in this study. All patients were operated about macular hole with negative anatomic result. By technology which were used earlier, patients were divided into 3 studied groups (with PRP mass using, with introverted flap using, with mechanical matching of edges of a hole). The main method of research was the optical coherent tomography. All patients were operated by an original technique. It’s purpose was a closing of earlier operated rigid macular hole using a free flap.Results. The defect of a photoreceptor component was closed with an additional expansion of earlier created macular rexis in patients of the 1st and 3rd groups at reoperation. The earlier created flap of an internal limiting membrane was used in patients of the 2nd group. In the analysis of dependence of change of visual acuity from morphological parameters of a macular hole after primary surgical treatment the inverse correlation relation from diameter of a macular hole on small and big radiuses is revealed. The highest visual acuity after a reoperation was reached at patients of the second group.Conclusions. It is necessary to consider the technique which was used earlier, diameter of a macular hole on small and big radiuses, postoperative edema in a parafovea zone for planning the surgical treatment and a forecast of functional results. 


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