Vitreomacular Interface Abnormalities in Myopic Foveoschisis: Correlation With Morphological Features and Outcome of Vitrectomy

Purpose: To compare the morphologic characteristics and response to surgery of myopic foveoschisis (MF) with different patterns of vitreomacular interface abnormalities (VMIAs).Methods: In this observational case series, 158 eyes of 121 MF patients with epiretinal membrane (ERM) or vitreomacular traction (VMT) based on optical coherence tomography (OCT) were enrolled. All the eyes were divided into two groups by the pattern of VMIAs: ERM and VMT group. Sixty-one eyes underwent pars plana vitrectomy (PPV) and were followed up for at least 6 months. The morphologic characteristics based on OCT and the surgical outcome were evaluated.Outcome: ERM and VMT were found in 47.47 and 52.53% of the cases, respectively. A higher rate of foveal detachment (61.4 vs. 26.7%; p < 0.001) and a higher rate of outer lamellar macular hole (45.8 vs. 21.3%; p = 0.001) were detected in the eyes with VMT compared with those with ERM. In contrast, a lower rate of inner lamellar macular hole (28.9 vs. 60.0%; p = 0.001) was detected in the eyes with VMT compared with those with ERM. The disruption of the external limiting membrane (ELM) was more common in the eyes with VMT than in those with ERM (45.8 vs. 21.3%; p = 0.001). PPV was performed in 61 eyes with a mean follow-up time of 23.55 ± 19.92 months. After surgery, anatomical resolution was achieved in 51 eyes (83.6%). At the final visit, the mean central foveal thickness (CFT) decreased significantly from 547.83 to 118.74 μm, and the mean LogMAR BCVA improved significantly from 0.92 to 0.57. The VMT group was associated with a higher proportion of eyes with visual acuity improvement postoperatively (p = 0.02) and had more a decrease of CFT (P = 0.007) compared with the ERM group.Conclusion: In the eyes with MF, outer retinal lesions occurred more frequently in the eyes with VMT, whereas inner retinal lesions occurred more frequently in the eyes with ERM. Tangential force generated by ERM may act as a causative factor for the inner retinal lesions in MF, and inward-directed force resulting from VMT may act as a causative factor for outer retinal lesions in MF.

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Long-Term Outcome of Vitrectomy with Suitable Internal Limiting Membrane Peeling and Air Tamponade for Highly Myopic Foveoschisis-Associated Lamellar Macular Hole

Journal of Ophthalmology ◽

10.1155/2020/2074037 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Jia-lin Wang ◽

Yan-ling Wang

Keyword(s):

Macular Hole ◽

Internal Limiting Membrane ◽

Lamellar Macular Hole ◽

Ilm Peeling ◽

Long Term Outcome ◽

Internal Limiting Membrane Peeling ◽

Membrane Peeling ◽

Myopic Foveoschisis ◽

Air Tamponade

Purpose. To investigate the outcome of pars plana vitrectomy (PPV) with suitable internal limiting membrane peeling (ILM) and air tamponade for patients with highly myopic foveoschisis-associated lamellar macular hole (MH). Methods. This retrospective interventional case series included 11 patients with highly myopic foveoschisis-associated lamellar MH who underwent PPV and indocyanine green-aided ILM peeling up to the temporal vascular arcades. Following air tamponade after surgery, all patients were instructed to maintain a face-down position. The patients were followed up for over 1 year and evaluated for MH closure and the best-corrected visual acuity before and after surgery. Results. The mean ± standard deviation values of patient age, axial length, and follow-up duration were 67.82 ± 6.54 years, 29.21 ± 1.95 mm, and 24.27 ± 8.11 months, respectively. After surgery, the lamellar MH closed in all eyes, and 10 eyes showed vision improvement at the 1-month, 3-month, and final follow-up evaluations. One patient showed decreased vision at 2 years after surgery, with patchy chorioretinal atrophy in the macular region. Myopic foveoschisis showed resolution in three eyes and alleviation in eight. Ten patients underwent cataract surgery during PPV. Conclusion. Extension of ILM peeling up to the temporal vascular arcades and air tamponade after PPV may improve the visual function and rate of MH closure for patients with highly myopic foveoschisis-associated lamellar MH.

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Clinical characteristics of the lamellar macular hole according to two subtypes: a retrospective analysis

10.21203/rs.2.9501/v1 ◽

2019 ◽

Author(s):

Se Young Kim ◽

Myung Hun Yoon ◽

Hee Seung Chin

Keyword(s):

Macular Hole ◽

Clinical Characteristics ◽

Morphological Characteristics ◽

Progression Rate ◽

Lamellar Macular Hole ◽

Foveal Thickness ◽

Central Foveal Thickness ◽

The Mean ◽

Observation Period

Abstract Background: The present study compared anatomical parameters and clinical characteristics of two subtypes of lamellar macular hole (LMH): tractional and degenerative. Methods: This retrospective chart-review study included patients who were monitored for more than 6 months after the initial diagnosis of LMH, from January 2011 to January 2018. Changes in the following morphological characteristics across the study period and between the two subtypes were assessed: the mean central foveal thickness, maximum outer retina diameter (MOD), and maximum inner retina diameter (MID). Differences in the following clinical parameters between the two conditions was also assessed: best corrected visual acuity (BCVA), anatomical progression rate, rate of surgery, and mean period before surgery. Results: This study included 51 eyes of 49 patients with a mean follow-up period of 18.94 months in the study: 33 tractional eyes and 18 degenerative eyes. The difference in the mean central foveal thickness between the two groups at baseline and the end of follow-up tended toward significance. MID was not significantly different between the two subtypes at either time point. MOD was significantly different between two subtypes at baseline and the end-of-follow up (tractional, 1131.62 μm, 1358.18 μm; degenerative, 708.88 μm, 697.83 μm; p < 0.01 for both). The changes in the retinal diameters across the observation period were significantly increased in degenerative eyes, and tractional eyes featured a significant increase in MOD across the study period. BCVA was not significantly different between the two subtypes at baseline and the last follow up. Anatomical progression rate of tractional eyes ( 81.8%) was significantly higher than that of degenerative eyes (27.7%) (p = 0.01). The presence of ERM was significantly different between two subtypes (tractional, 96.9%; degenerative, 22.2%; p < 0.001). Ellipsoid defect, rate of receiving surgery, and mean observation period before surgery were not significant different between the two subtypes. Conclusion: Analyzing two LMH subtypes according to their clinical and morphologic features, the present study identified characteristics unique to each. Treatment of LMH patients will require different approaches based on the subtype exhibited by the patient.

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Scanning Laser Ophthalmoscopy in diagnostics of lamellar macular hole with premacular proliferation (preliminary results)

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2019-6-32-35 ◽

2019 ◽

pp. 32-35

Author(s):

K. Zhogolev ◽

◽

K. Penzeva ◽

I. Panova ◽

◽

...

Keyword(s):

Macular Hole ◽

Scanning Laser ◽

Scanning Laser Ophthalmoscopy ◽

Lamellar Macular Hole ◽

Preliminary Results

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Vascularized Epiretinal Proliferation Associated with Lamellar Macular Hole

Ophthalmology Retina ◽

10.1016/j.oret.2020.12.026 ◽

2021 ◽

Vol 5 (4) ◽

pp. 373

Author(s):

Etienne Boulanger ◽

Elise Philippakis ◽

Ismael Chehaibou

Keyword(s):

Macular Hole ◽

Lamellar Macular Hole

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Development of Stage 4 Macular Hole after Spontaneous Closure in a Patient with Stage 2 Macular Hole and a Lamellar Macular Hole-Associated Epiretinal Proliferation

Case Reports in Ophthalmology ◽

10.1159/000513132 ◽

2021 ◽

pp. 481-484

Author(s):

Masahisa Watanabe ◽

Harumasa Yokota ◽

Hiroshi Aso ◽

Hirotsugu Hanazaki ◽

Junya Hanaguri ◽

...

Keyword(s):

Visual Acuity ◽

Macular Hole ◽

Spontaneous Closure ◽

Surgical Removal ◽

Lamellar Macular Hole ◽

Full Thickness ◽

Stage 4 ◽

Full Thickness Macular Hole ◽

The Right ◽

Hole Closure

Herein, we report the longitudinal observation of a case with reopening of the macular hole associated with a lamellar macular hole-associated epiretinal proliferation (LHEP) followed by spontaneous closure in patients with stage 2 idiopathic macular hole. A 64-year-old woman was referred for the decreased visual acuity (VA) and acute anorthopia in the right eye. Funduscopy and optical coherence tomography (OCT) showed stage 2 full-thickness macular hole without posterior vitreous detachment (PVD) and operculum formation. Her best-corrected visual acuity (BCVA) was 20/32. One month later, the diameter of the macular hole was getting small and VA improved. Six months later, the macular hole was treated spontaneously with the attached hyaloid membrane to the macula by OCT and the BCVA improved to 20/20. Fourteen months after the first visit, the BCVA decreased to 20/50 and the patient was diagnosed with stage 4 macular hole with complete PVD. OCT showed full-thickness macular hole with a LHEP in the right eye. After 25G-gauge vitrectomy with the peeling of internal limiting membrane (ILM) and LHEP, the macular hole was closed and BCVA finally improved to 20/25. Spontaneous macular hole closure without PVD may rarely occur in patients with LHEP. The surgical removal of ILM and LHEP may contribute to the successful macular hole closure after vitrectomy.

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Association between stress and bilateral symmetrical alopecia in free-ranging Formosan macaques in Mt. Longevity, Taiwan

Scientific Reports ◽

10.1038/s41598-021-90725-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chen-Chih Chen ◽

Ai-Mei Chang ◽

Ming-Shan Tsai ◽

Yen-Hua Huang ◽

Kurtis Jai-Chyi Pei ◽

...

Keyword(s):

Total Population ◽

Causative Factor ◽

Population Status ◽

Adrenocortical Activity ◽

High Incidence ◽

Normal Hair ◽

The Mean ◽

The Individual ◽

Free Ranging ◽

The Impact

AbstractSince 2013, a high incidence of bilateral symmetrical alopecia has been observed in free-ranging Formosan macaques (Macaca cyclopis) in Mt. Longevity, Taiwan. We hypothesized that stress induces alopecia in this population. To verify our hypothesis, we evaluated the histopathological characteristics of skin biopsy and used a validated enzyme immunoassay (EIA) for fecal glucocorticoid metabolite (FGM) analysis, which act as an indicator of stress experienced by the individual. Follicular densities were lower (2.1–3.0 mm2) in individuals with symmetrical alopecia than in those with normal hair conditions (4.7 mm2). Furthermore, anagen to catagen/telogen ratios were lower in individuals with alopecia (0–1.4) than in those with normal hair (4.0). The histopathological characteristics of alopecia were similar to those of telogen effluvium, which indicates that stress is one of the possible etiologies. On the basis of the analytical and biological validation of EIAs for FGM analysis, 11β-hydroxyetiocholanolone was considered suitable for monitoring adrenocortical activity in both sexes of Formosan macaques. The mean concentrations (standard error; sample size) of 11β-hydroxyetiocholanolone were 2.02 (0.17; n = 10) and 1.41 (0.10; n = 31) μg/g for individuals with and without alopecia, respectively. Furthermore, the results of logistic regression analysis show that 11β-hydroxyetiocholanolone (p = 0.012) concentration was positively associated with alopecia. Thus, stress was the most likely to trigger symmetrical alopecia in Formosan macaques in Mt. Longevity. Although stress can decrease the fitness of an individual, considering the population status of Formosan macaques in Taiwan is stable and alopecia was only observed in our study area, which is isolated from other populations, the impact on the total population of Formosan macaque in Taiwan is limited. Nonetheless, stress-induced immunosuppression and alopecia might affect the local abundance and increase zoonosis risk due to frequent human–macaque contact in Mt. Longevity. Future studies are suggested to focus on the causative factor of stress and the effects of stress and alopecia on the health and welfare in the Formosan macaques.

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

Journal of Ophthalmology ◽

10.1155/2017/6742164 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 2

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.

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Autologous Lens Capsule Flap Transplantation for Persistent Macular Holes

Journal of Ophthalmology ◽

10.1155/2021/8148792 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Sławomir Cisiecki ◽

Karolina Bonińska ◽

Maciej Bednarski

Keyword(s):

Macular Hole ◽

Functional Outcomes ◽

Lens Capsule ◽

Operative Techniques ◽

Basal Diameter ◽

Macular Holes ◽

Capsular Flap ◽

Potential Alternative ◽

The Mean ◽

Hole Closure

Purpose. To analyze the anatomical and functional outcomes after autologous lens capsule transplantation in patients with persistent macular hole. Methods. This is a retrospective observational study of five eyes of five patients treated with vitrectomy and autologous lens capsular flap transplantation. Complete ophthalmic examination was performed preoperatively and seven days and 1, 3, 6, 12, and 18 months after surgery. Results. Successful macular hole closure was achieved in all patients. The mean minimum macular hole diameter before the surgery was 666.8 µm, and the mean basal diameter was 1086.4 µm. The mean visual acuity before lens capsular flap transplantation was 20/200, while after surgery, it was 20/125. Conclusions. Autologous lens capsular flap transplantation is a potential alternative treatment for patients with large persistent macular holes after other operative techniques have failed.

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