scholarly journals Vitrectomy With Peeling the Internal Limiting Membrane for the Treatment of Macular Hole Following Ruptured Retinal Arterial Macroaneurysm: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhigao Liu ◽  
Shuya Wang ◽  
Yu Wang ◽  
Aihua Ma ◽  
Bojun Zhao
Keyword(s):  
Macular Hole ◽  
Posterior Vitreous Detachment ◽  
Internal Limiting Membrane ◽  
Case Presentation ◽  
Surgical Closure ◽  
Retinal Arterial Macroaneurysm ◽  
Corrected Visual Acuity ◽  
Pars Plana ◽  
Sudden Decrease ◽  
The Right

Background: This study aimed to report a case of vitrectomy with peeling the internal limiting membrane for the treatment of macular hole (MH) following ruptured retinal arterial macroaneurysm (RAMA).Case Presentation: A 65-year-old woman noticed a sudden decrease in vision in the left eye. She had no other ocular problems apart from a mild cataract in both eyes before. Her best-corrected visual acuity (BCVA) was 20/33 in the right eye, and 6/100 in the left eye. Fluorescein angiography (FFA) showed a retinal arterial macroaneurysm with telangiectatic retinal vascular changes in the inferior temporal macular region. Optical coherence tomography (OCT) examination demonstrated the presence of subretinal hemorrhage extending into the foveal area and incomplete posterior vitreous detachment. Because of the presence of submacular hemorrhage, some medicine was administrated and the patient was followed up. Then, 5 months later, the hemorrhage was absorbed. OCT examination exhibited a full-thickness MH with a macular epiretinal membrane. The size of the MH was 722 μm in diameter. She was then given a standard three-port pars plana vitrectomy (PPV), along with peeling of the internal limiting membrane (ILM) and filling the vitreous cavity with air. Anatomic closure of the MH was achieved after 4 weeks of the surgery by the examination of OCT. The BCVA was improved to 15/100.Conclusions: This case expanded our knowledge of the association of MH secondary to ruptured RAMA. We reported a case with successful surgical closure of the MH and improvement of BCVA.

scholarly journals Autologous Transplantation of the Internal Limiting Membrane for Refractory Macular Hole following Ruptured Retinal Arterial Macroaneurysm: A Case Report

2018 ◽  
Vol 9 (1) ◽  
pp. 119-125 ◽  
Author(s):  
Yumi Iwakawa ◽  
Hisanori Imai ◽  
Hiromi Kaji ◽  
Yuki Mori ◽  
Chihiro Ono ◽  
...  
Keyword(s):  
Case Report ◽  
Macular Hole ◽  
Autologous Transplantation ◽  
Internal Limiting Membrane ◽  
Effective Treatment Option ◽  
Retinal Arterial Macroaneurysm ◽  
Pars Plana ◽  
Sudden Decrease ◽  
The Right ◽  
A Current

Purpose: To report a case of macular hole (MH) secondary to a retinal arterial macroaneurysm (RAMA) which was successfully treated with an autologous transplantation of internal limiting membrane (ILM). Case Report: An 87-year-old female presented with a sudden decrease in central vision in the right eye. A fundus examination revealed a RAMA in the superonasal macular region, a subretinal hemorrhage (SRH), involving the macula, and a sub-ILM hemorrhage. A pars plana vitrectomy (PPV) was performed. Intraoperatively, an MH filled with coagulum was detected. We tried to blow off and drain the SRH with a current of BSS and a gentle suction with a 27-gauge vitreous cutter from the MH, but some amount of SRH at the bottom of the MH remained. The ILM was peeled off for 2 disc diameters around the MH. The vitreous cavity was filled with air at the end of the operation. Two weeks after the surgery, the MH was not closed. One month following the initial PPV, a second PPV was performed to achieve closure of the MH. Results: An autologous transplantation of ILM was performed as second PPV. Six months after the final surgery, the MH was successfully closed and the best-corrected decimal visual acuity was 0.6. Conclusions: Autologous ILM transplantation can be an effective treatment option for MH closure following RAMA rupture.

scholarly journals Eccentric Macular Hole after Pars Plana Vitrectomy for Idiopathic Macular Hole: A Case Report

2017 ◽  
Vol 8 (1) ◽  
pp. 116-119 ◽  
Author(s):  
Irini Chatziralli ◽  
George Theodossiadis ◽  
Maria Douvali ◽  
Alexandros A. Rouvas ◽  
Panagiotis Theodossiadis
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Pars Plana ◽  
23 Gauge ◽  
Retinal Hole ◽  
The Right

Introduction: Postoperative eccentric macular hole (MH) formation is an uncommon complication after pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for epiretinal membrane or MH treatment. Herein, we present a case of eccentric MH formation after PPV with ILM peeling for MH. Case Description: A 72-year-old female patient underwent 23-gauge PPV with ILM peeling for idiopathic MH in her right eye. The visual acuity was 6/24 in the right eye. One week postoperatively the retina was attached and the MH seemed to be closed, while visual acuity was 6/12. One month after PPV, there was a single eccentric retinal hole below the macula, which was detected at the fundoscopy and was confirmed by OCT. The visual acuity was 6/9 and the patient referred no symptoms. No further intervention was attempted, and at the 6-month follow-up the visual acuity and the size of the eccentric MH remained stable. Conclusions: Eccentric MHs can develop after PPV and are usually managed conservatively by observation.

scholarly journals Subfoveal triamcinolone acetonide following macular hole surgery

2013 ◽  
Vol 5 (1) ◽  
pp. 114-116
Author(s):  
A Jindal ◽  
A Bhawdekar ◽  
A Pathengay
Keyword(s):  
Macular Hole ◽  
Triamcinolone Acetonide ◽  
Harmful Effect ◽  
Posterior Vitreous Detachment ◽  
Internal Limiting Membrane ◽  
Visual Recovery ◽  
Vitreous Surgery ◽  
Macular Hole Surgery ◽  
Corrected Visual Acuity ◽  
Hole Closure

Background: Triamcinolone acetonide (TA) is commonly used in vitreous surgery to visualize the posterior hyaloid and internal limiting membrane. Some TA can accumulate in the macular hole during surgery which can persist postoperatively. Case: A 17-year-old boy underwent successful macular hole surgery with TA-assisted induction of posterior vitreous detachment. Sub-foveal deposit of TA was observed postoperatively, which got absorbed at 7 weeks with complete closure of the macular hole, and best corrected visual acuity improved from 20/100 preoperatively to 20/60. Conclusion: Residual TA after macular hole surgery may not hamper the anatomical and functional outcome. Similar cases have been reported in the literature and most of them show no harmful effect of TA on macular hole closure and visual recovery. Nepal J Ophthalmol 2013; 5(9):114-116 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7837

scholarly journals Diagnosis and Management of Bleeding Vitreous by Trauma Closed Eyeball

2019 ◽  
Vol 2 (2) ◽  
pp. 32-39
Author(s):  
Rika Anggraini ◽  
AK Ansyori ◽  
Ramzi Amin
Keyword(s):  
Pars Plana Vitrectomy ◽  
Posterior Vitreous Detachment ◽  
Vitreous Hemorrhage ◽  
Ophthalmological Examination ◽  
Case Presentation ◽  
Retinal Blood Vessels ◽  
Common Causes ◽  
Pars Plana ◽  
Clinically Significant ◽  
The Right

Introduction. Diagnosis of vitreous bleeding is generally straightforward and  it can be made through history, ophthalmological examination and fundoscopy. However, the management is determined by the underlying etiology. The most common causes as factors that cause opposite vitreous bleeding include retinopathy of proliferative diabetes, posterior vitreous detachment (PVD) and trauma in 59-88.5% of cases. Reported a case of vitreous hemorrhage due to closed eyeball trauma performed by pars plana vitrectomy and endolaser with significant vision improvement. Case Presentation. A male, 21 years old, student, lived in suburban, came to the Polyclinic of RSMH on July 2019. Approximately 1 month ago the patient complained that his right eye vision suddenly felt blurry after being hit by volleyball from the front from a distance of 1 meter while playing volleyball with his friends. Patients complain of the view of the right eye as if it were covered with a red shadow accompanied by pain around the right eye. Ophthalmological examination obtained vision of this patient is a wave of the hand that is 1/300 in the right eye and 6/6 in the left eye that shows the disorder is unilateral with a fairly poor decrease in vision. During intraoperative right eye hemorrhage was found to nearly cover the retina with the source of bleeding in peripheral retinal blood vessels which when found intraoperatively were not found extravasation or active bleeding. Conclusion. The operative action of pars plana vitrectomy gives a clinically significant result that is obtained very good sharp eyesight and from the examination results obtained echofree on vitreous. Proper timing is very important in determining the management of vitreous bleeding in order to get good results and minimize the risk of complications that can occur.

scholarly journals Successful Technique for Closure of Macular Hole Retinal Detachment Using Autologous Retinal Transplant

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Juan Abel Ramirez-Estudillo ◽  
Geovanni Rios-Nequis ◽  
Martin Jimenez-Rodríguez ◽  
Hugo Valdez-Flores ◽  
Ximena Ramirez-Galicia
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Donor Site ◽  
Surgical Methods ◽  
Macular Hole Retinal Detachment ◽  
History Of ◽  
Dye Staining ◽  
Pars Plana ◽  
Sudden Decrease ◽  
The Right

Macular hole retinal detachment (MHRD) for the most part develops in highly myopic eyes. Several surgical methods have been introduced to treat MHRD. We describe our experience with the autologous retinal transplant in patient with MHRD. A 49-year-old female presented with a 2-week history of a sudden decrease in the central vision in the right eye (RE). A 3-port, 25-gauge pars plana vitrectomy was performed with the ILM dye staining and peeling. Endodiathermy was applied around a 1.5-disc diameter neurosensory donor site in the supertemporal retina. The graft was cut with standard 25-gauge curved scissors. Perfluoro-n-octane (PFO) was instilled. The free graft was gently handled until its packing into the macular hole. Two months following the initial PPV, the macular hole was closed, and vision improved from 0.05 to 0.25 logMAR.

scholarly journals Case of Macular Hole Secondary to Ocular Toxoplasmosis Treated Successfully by Vitrectomy with Inverted Internal Limiting Membrane Flap

2021 ◽  
pp. 363-368
Author(s):  
Mizuki Ikeda ◽  
Takayuki Baba ◽  
Yuri Aikawa ◽  
Jiro Yotsukura ◽  
Hirotaka Yokouchi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Ocular Toxoplasmosis ◽  
Slit Lamp ◽  
Blurred Vision ◽  
Full Thickness Macular Hole ◽  
Old Japanese ◽  
Pars Plana ◽  
The Right

We report a case of ocular toxoplasmosis that developed a full-thickness macular hole (FTMH) which was successfully treated by pars plana vitrectomy combined with an inverted internal limiting membrane (ILM) flap. A 49-years-old Japanese man was aware of blurred vision in his right eye. Slit-lamp biomicroscopy, ophthalmoscopy, and optical coherence tomography (OCT) of the right eye showed that there was a grayish-white subretinal lesion at the macula accompanied by retinal exudation and mild vitreous flare and iritis. An increase in the level of serum IgM for toxoplasma led to a diagnosis of ocular toxoplasmosis. He developed a FTMH adjacent to the lesion 2 weeks after administering sulfamethoxazole/trimethoprim, and his decimal visual acuity was 0.15. Because the FTMH remained 3 months after the resolution of inflammation and his metamorphopsia persisted, vitrectomy with an inverted ILM flap was performed. After the surgery, the visual acuity improved to 0.2 with the closure of the FTMH confirmed by OCT. A FTMH in an eye with ocular toxoplasmosis was successfully closed by vitrectomy with an inverted ILM flap.

scholarly journals Bilateral Macular Hole Related to Tamoxifen Low-Dose Toxicity

2020 ◽  
Vol 11 (3) ◽  
pp. 528-533 ◽  
Author(s):  
Nuria Torrell Belzach ◽  
José Ignacio Vela Segarra ◽  
Jaume Crespí Vilimelis ◽  
Mohammed Alhayek
Keyword(s):  
Macular Hole ◽  
Low Dose ◽  
Standard Procedure ◽  
Internal Limiting Membrane ◽  
Optimal Choice ◽  
Tissue Loss ◽  
Functional Improvement ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

Bilateral macular hole is a rare secondary effect of tamoxifen, a condition which is probably underdiagnosed. We describe the case of a 63-year-old woman who had received low-dose treatment with tamoxifen for 10 years. She presented with a best-corrected visual acuity of 20/40 in both eyes and bilateral macular hole with posterior hyaloid attachment. No reflective deposits were observed. A 23-gauge pars plana vitrectomy with internal limiting membrane peeling and gas tamponade was performed in the right eye with no anatomical or functional improvement. The most accepted mechanism of macular hole related to tamoxifen is Müller cell toxicity with retinal tissue loss. Therefore, it seems that the standard procedure used in idiopathic macular hole is not the optimal choice, due to a different pathogenic mechanism.

scholarly journals Valsalva Retinopathy Associated with Sexual Activity

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Khalid Al Rubaie ◽  
J. Fernando Arevalo
Keyword(s):  
Visual Acuity ◽  
Sexual Activity ◽  
Vision Loss ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Sudden Loss ◽  
Initial Visual Acuity ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

Foveal microstructure and visual outcomes of myopic macular hole surgery with or without the inverted internal limiting membrane flap technique

2018 ◽  
Vol 103 (10) ◽  
pp. 1495-1502 ◽  
Author(s):  
Xu-Ting Hu ◽  
Qin-Tuo Pan ◽  
Jing-Wei Zheng ◽  
Zong-Duan Zhang
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Closure Rate ◽  
Flap Technique ◽  
Hyperreflective Foci ◽  
Retinal Reattachment ◽  
Pars Plana ◽  
Myopic Macular Hole

PurposeThe aim of this study was to determine the effect of the inverted internal limiting membrane (ILM) flap technique on the macular hole (MH) closure and foveal microstructure recovery of patients with highly myopic MH.MethodsPars plana vitrectomy and gas tamponade with the inverted ILM flap technique (19 eyes) or with the ILM peeling technique (21 eyes) were performed in patients with highly myopic MH with or without retinal detachment. The rate of MH closure and retinal reattachment, the reconstructive anatomical change of the foveal microstructure and the best-corrected visual acuities (BCVA) of the two groups were compared.ResultsThe anatomic closure rate was statistically significantly higher in the inverted group (100%) than in the peeling group (66.7%; p=0.009). All eyes with MH retinal detachment had successful retinal reattachment in these two groups. However, the rate of the external limiting membrane (ELM) and ellipsoid zone (EZ) (p=0.020), as well as gliosis (p=0.049) in macular area, detected by OCT, was significantly greater in the inverted group than in the peeling group. The postoperative BCVA was significantly better in the eyes with ELM, EZ (p=0.031) and gliosis (p=0.008), but without hyperreflective foci (p=0.001).ConclusionsThese findings demonstrate that the inverted ILM flap technique has better efficacy than the ILM peeling technique for patients with myopic MH in closure rate, foveal microstructure and postoperative BCVA.

Pathophysiology, Classification, Clinical Diagnosis and Treatment of Primary Epiretinal Membrane

2018 ◽  
pp. 262-267
Keyword(s):  
Clinical Examination ◽  
Epiretinal Membrane ◽  
Posterior Vitreous Detachment ◽  
Internal Limiting Membrane ◽  
Non Invasive ◽  
Diagnosis And Classification ◽  
Pars Plana ◽  
Vitreomacular Interface

Epiretinal membrane (ERM), also known as macular pucker, premacular fibroplasia, premacular gliosis, or cellophane maculopathy is a common vitreoretinal interface pathology that can result in mild to moderate visual impairment with an impact on the quality of life. ERM can be classified as primary “idiopathic” or secondary. Most ERMs occur in individuals older than 50 years, and the prevalence of ERM increases as age increases. The pathological mechanisms are not entirely known, however, the posterior vitreous detachment is thought to be key. Diagnosis and classification of ERM are based on clinical examination findings. However, high resolution spectral domain-optic coherence tomographies (SD-OCTs) have proven to be more sensitive than clinical examination for the diagnosis of numerous disorders of the vitreomacular interface, including ERM. SD-OCTs enable the pre-and postoperative comparison of macular structures in a non-invasive examination. In treatment, surgical intervention entails pars plana vitrectomy with ERM removal with or without internal limiting membrane (ILM) removal. Good visual recovery was present in most patients after surgery.

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