scholarly journals Artificial Intelligence and OCT Angiography in Full Thickness Macular Hole. New Developments for Personalized Medicine

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2319
Author(s):  
Stanislao Rizzo ◽  
Alfonso Savastano ◽  
Jacopo Lenkowicz ◽  
Maria Cristina Savastano ◽  
Luca Boldrini ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Visual Acuity ◽  
Macular Hole ◽  
Predictive Accuracy ◽  
Predictive Performance ◽  
Full Thickness ◽  
Cross Sectional ◽  
Vascular Plexus ◽  
Single Center Study ◽  
Full Thickness Macular Hole

Purpose: To evaluate the 1-year visual acuity predictive performance of an artificial intelligence (AI) based model applied to optical coherence tomography angiography (OCT-A) vascular layers scans from eyes with a full-thickness macular hole (FTMH). Methods: In this observational cross-sectional, single-center study, 35 eyes of 35 patients with FTMH were analyzed by OCT-A before and 1-year after surgery. Superficial vascular plexus (SVP) and deep vascular plexus (DVP) images were collected for the analysis. AI approach based on convolutional neural networks (CNN) was used to generate a continuous predictive variable based on both SVP and DPV. Different pre-trained CNN networks were used for feature extraction and compared for predictive accuracy. Results: Among the different tested models, the inception V3 network, applied on the combination of deep and superficial OCT-A images, showed the most significant differences between the two obtained image clusters defined in C1 and C2 (best-corrected visual acuity [BCVA] C1 = 49.10 [±18.60 SD] and BCVA C2 = 66.67 [±16.00 SD, p = 0.005]). Conclusions: The AI-based analysis of preoperative OCT-A images of eyes affected by FTMH may be a useful support system in setting up visual acuity recovery prediction. The combination of preoperative SVP and DVP images showed a significant morphological predictive performance for visual acuity recovery.

scholarly journals 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

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.

scholarly journals Macular Hole Progression after Intravitreal Bevacizumab for Hemicentral Retinal Vein Occlusion

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Manish Nagpal ◽  
Vikram Mehta ◽  
Kamal Nagpal
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Macular Hole ◽  
Retinal Vein Occlusion ◽  
Intravitreal Bevacizumab ◽  
Full Thickness ◽  
Detailed Review ◽  
Off Label ◽  
Vein Occlusion ◽  
Full Thickness Macular Hole

Macular edema secondary to retinal vein occlusion is commonly being treated with off-label intravitreal bevacizumab with good outcomes. A significant reduction in macular edema and improvement in visual acuity is seen following such a treatment with no serious adverse effects. In the reported case, a full-thickness macular hole was noticed one month after intravitreal bevacizumab for macular edema secondary to hemicentral retinal vein occlusion. On a detailed review of the pre- and postoptical coherence tomography scans, it was realized that there was a preexisting stage 2-3 macular hole which was masked by the hemorrhages and edema at the fovea and the macular hole had progressed following the injection.

Artificial Intelligence and Oct Angiography in Full Thickness Macular Hole. New Developments for Personalized Medicine

2021 ◽  
Author(s):  
Stanislao Rizzo ◽  
Alfonso Savastano ◽  
Jacopo Lenkowicz ◽  
Maria Cristina Savastano ◽  
Luca Boldrini ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Personalized Medicine ◽  
Macular Hole ◽  
Oct Angiography ◽  
Full Thickness ◽  
New Developments ◽  
Full Thickness Macular Hole

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.

scholarly journals Correlation between Postoperative Area of High Autofluorescence in Macula and Visual Acuity after Macular Hole Closure

2017 ◽  
Vol 27 (6) ◽  
pp. 781-785 ◽  
Author(s):  
Peng Zhang ◽  
Qingli Shang ◽  
Jingxue Ma ◽  
Yuhua Hao ◽  
Cunxi Ye
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Linear Regression Analysis ◽  
Full Thickness ◽  
Macular Function ◽  
Basal Diameter ◽  
Full Thickness Macular Hole ◽  
Function Recovery ◽  
Postoperative Length ◽  
Positive Correlations

Purpose To determine the correlation between the preoperative basal diameter of macular hole, the postoperative area of high autofluorescence (AF) in macula, and visual acuity in full-thickness macular hole. Methods Forty-nine patients with full-thickness macular hole who underwent vitrectomy and C3F8 filling were reviewed. The preoperative diameter of macular hole, the 6 months postoperative area of high AF in macula if it existed, the length of inner segment/outer segment (IS/OS) defect, and visual acuity were obtained. The correlation between them was determined. Results At postoperative 6 months, the rate of high AF in macula was 63.3%. There were statistical differences between with and without high AF groups in postoperative best-corrected visual acuity (BCVA) (t = -2.751, p = 0.008), preoperative basal diameter of macular hole (t = -4.946, p = 0.00001), and postoperative length of IS/OS defect (t = -8.351, p<0.00001). Simple linear regression analysis showed high positive correlations between preoperative basal diameter of macular hole and area of high AF (p<0.00001, r = 0.893), postoperative length of IS/OS defect and area of high fundus AF (FAF) (p<0.00001, r = 0.779), and negative correlations between area of high AF and postoperative BCVA (p = 0.037, r = 0.375). There was low correlation between diameter of macular hole and postoperative BCVA (p = 0.112). Conclusions The preoperative basal diameter of macular hole and postoperative length of IS/OS defect decides the postoperative area of high AF in macula to some degree, and the postoperative area of high AF in macula can be an evaluating indicator for poor macular function recovery.

scholarly journals Foveal-Sparing ILM Peeling in a Case with Vitreomacular Traction and Foveal Detachment

2021 ◽  
pp. 182-185
Author(s):  
Christoph Leisser ◽  
Oliver Findl
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Female Patient ◽  
Vitreomacular Traction ◽  
Full Thickness ◽  
Ilm Peeling ◽  
Foveal Detachment ◽  
Corrected Visual Acuity ◽  
Full Thickness Macular Hole ◽  
Foveal Sparing

A pseudophakic female patient, 80 years of age, presented with a vitreomacular traction and foveal detachment at her right eye. To avoid development of a full-thickness macular hole during surgery, foveal-sparing ILM peeling was performed. After surgery, distance-corrected visual acuity increased from 0.3 to 0.6 (Snellen) 3 months after surgery and fovea was re-attached again with restoration of the retinal layers.

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 Pre-operative predicting factor in visual outcome after macular hole surgery

2020 ◽  
Vol 36 (5) ◽  
Author(s):  
Lubna Feroz ◽  
Syed Fawad Rizvi ◽  
Saliha Naz ◽  
Tanweer Hassan Khan
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Visual Outcome ◽  
Internal Limiting Membrane ◽  
Full Thickness ◽  
Macular Hole Surgery ◽  
Creative Commons ◽  
Full Thickness Macular Hole ◽  
Hole Index ◽  
Predicting Factor

Objective: To determine the effectiveness of macular hole index (MHI) as a predicting factor of visual outcome after full thickness macular hole surgery. Methods: This quasi-experimental study was conducted at LRBT Free Base Eye Hospital, Karachi from January 2018 to March 2019. Total 45 eyes of 45 patients with full thickness macular hole (FTMH) underwent preoperative Best Corrected Visual Acuity (BCVA) assessment with logMar chart and Optical Coherence Tomography (OCT) scanning, with measurement of base diameter and macular hole height. Values were calculated for the macular hole index (MHI), which was taken as the predictive factor. All patients had undergone 25+G trans-conjunctival three ports pars plana vitrectomy, internal limiting membrane peeling, and endo-tamponade of C3F8 (14%). The final visual outcome of all the patients was noted. Results: Forty-five patients were included for the study, out of which 10 (22.2%) were male and 35 (77.7%) were female. Age ranged from 45-70 years (mean age 57.20±6.47 years). The mean pre-operative visual acuity was 2.46±1.15 logMar and was 3.88±2.00 logMar, post-operatively. Moreover, 27(60.0%) out of 45 patients achieved BCVA (gain of 2 lines of the logMar chart). The average macular hole index was 1.55±0.50 and out of 45, 25 patients had MHI ≥0.5. It was found that patients with macular hole index ≥0.50 showed clinically significant improvement in BCVA in comparison to those who have macular hole index <0.50. Conclusion: Macular hole index can be used to predict functional success in macular hole surgery. doi: https://doi.org/10.12669/pjms.36.5.1995 How to cite this:Feroz L, Rizvi SF, Naz S, Khan MTH. Pre-operative predicting factor in visual outcome after macular hole surgery. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1995 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Full-Thickness Macular Hole Progressing from Lamellar Macular Hole with Epiretinal Proliferation

2021 ◽  
pp. 134-141
Author(s):  
Salim Zafar Asaad
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Epiretinal Membrane ◽  
Lamellar Macular Hole ◽  
Full Thickness ◽  
Eye Surgery ◽  
Full Thickness Macular Hole ◽  
Eye Examination ◽  
The Right

Foveoschisis in association with contractile epiretinal membrane is frequently misdiagnosed as lamellar macular hole (LMH). The progression of true LMH with associated epiretinal proliferation to full-thickness macular hole (FTMH) is probably underestimated. We report a case of bilateral FTMH progressing from LMH with epiretinal proliferation. A 72-year-old male presented with increased blurring of vision in left eye. Visual acuity was 20/40 in right and 20/50 in left eye. Examination showed FTMH with epiretinal proliferation in left eye and LMH with epiretinal proliferation in right eye. Surgery of the left eye achieved successful closure of macular hole with improvement in vision. He presented again a month later with further deterioration of vision in right eye. Examination revealed FTMH in right eye with epiretinal proliferation. Surgery of the right eye also achieved optimum functional and morphological results. This case demonstrates that LMH with epiretinal proliferation may have a propensity to progress to FTMH.

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