Vitrectomy for Vitreous Opacities

Pars plana vitrectomy (PPV) surgery in vitreous opacities is an effective treatment method that increases patient satisfaction. However, due to the risks associated with PPV surgery, its application in vitreous floaters is controversial. Instead, performing sutureless, minimally invasive PPV surgery with 25 gauge trocars on floaters may reduce the risks. For surgical treatment, it is important to select appropriate patients, evaluation of the risk and benefit balance of PPV, and application the treatment.

Intravitreal moxifloxacin in acute post-phacoemulsification endophthalmitis: a case report

Background: Vancomycin and ceftazidime are commonly used intravitreal antibiotics to treat acute post-phacoemulsification endophthalmitis. However, they are not commercially available in appropriate therapeutic dose for intravitreal injection. Moxifloxacin is a broad-spectrum antibiotic that is commercially available in appropriate therapeutic dose for intravitreal injection, thus providing a rationale for its use in acute post-phacoemulsification endophthalmitis.Case presentation: A 46-year-old female presented with blurred vision, redness, and pain in the right eye 5 days after phacoemulsification. Visual acuity was hand movement and conjunctival and circumcorneal injection, corneal oedema, anterior chamber reaction, and vitreous opacities were observed. The patient was treated with intravitreal moxifloxacin 500 μg/0.1 ml, vitrectomy, and topical and oral antibiotics. Visual acuity improved to 6/15 and follow-up at 5 weeks did not reveal any signs of intraocular inflammation.Conclusion: Intravitreal moxifloxacin is an alternative in the treatment of acute post-phacoemulsification endophthalmitis.

Analysis of Parainflammation in Chronic Glaucoma Using Vitreous-OCT Imaging

Glaucoma causes blindness due to the progressive death of retinal ganglion cells. The immune response chronically and subclinically mediates a homeostatic role. In current clinical practice, it is impossible to analyse neuroinflammation non-invasively. However, analysis of vitreous images using optical coherence tomography detects the immune response as hyperreflective opacities. This study monitors vitreous parainflammation in two animal models of glaucoma, comparing both healthy controls and sexes over six months. Computational analysis characterizes in vivo the hyperreflective opacities, identified histologically as hyalocyte-like Iba-1+ (microglial marker) cells. Glaucomatous eyes showed greater intensity and number of vitreous opacities as well as dynamic fluctuations in the percentage of activated cells (50–250 microns2) vs. non-activated cells (10–50 microns2), isolated cells (10 microns2) and complexes (>250 microns2). Smaller opacities (isolated cells) showed the highest mean intensity (intracellular machinery), were the most rounded at earlier stages (recruitment) and showed the greatest change in orientation (motility). Study of vitreous parainflammation could be a biomarker of glaucoma onset and progression.

Optimized technology of YAG-laser vitreolysis of occurrence of the vitreous body

Introduction. Vitreous opacities are quite common, occurring in 76% of cases and significantly reducing quality of life in 33% of them. YAG-laser vitreolysis is considered as an alternative treatment option for patients with floating vitreous opacities. Purpose. To develop an optimized YAG-laser vitreolysis technology based on the assessment of the acoustic density of the vitreous opacities. Material and methods. The results of YAG-laser vitreolysis of vitreous opacities in 318 patients (318 eyes) were analyzed. A photo-optical method has been developed for visualizing opacities of the vitreous body, registering the area of opacities and the dimming intensity index. A method has been developed for the personalized selection of laser energy taking into account the acoustic density of the vitreous opacities. Results. After performing multi-stage laser treatment, a significant decrease in the area of opacities and the dimming intensity index, an increase in the threshold of retinal photosensitivity according to microperimetry data and a decrease in the acoustic density of opacities were noted. Conclusions. Application of optimized YAG-laser vitreolysis technology for vitreous opacities allows to achieve the best values of clinical and functional parameters (p<0.05). Key words: vitreous body opacities, photo-optical method, efficiency of YAG-laser vitreolysis

Internal limiting membrane detachment in acute central retinal artery occlusion: a novel prognostic sign seen on OCT

Background To present a series of acute central retinal artery occlusion (CRAO) cases showing internal limiting membrane detachment (ILMD) on optical coherence tomography (OCT) and to describe the possible etiopathogenesis and outcomes associated with it. Methods Demographic and OCT features of patients with acute CRAO were analysed retrospectively. OCT parameters noted were posterior vitreous opacities, ILMD, inner retinal layer stratification, hyperreflectivity and thickening, cystoid macular edema, neurosensory detachment. Eyes were grouped into Group (1) CRAO with ILMD; Group (2) CRAO with no ILMD. Results A total of 28 eyes of acute CRAO who had undergone OCT scans at the time of the acute episode were identified. Out of these, ILMD was noted in 5 eyes. The study findings suggested that cases of acute CRAO with ILMD are associated with poor presenting visual acuity and have more severe signs of retinal hypoperfusion on OCT, like inner retinal thickening, inner retinal hyperreflectivity and loss of inner retinal layer stratification. Patients with ILMD have poor final visual acuity and thinning and atrophy or necrosis of the inner retinal layers. Conclusion ILMD can occur in acute CRAO due to total retinal artery occlusion and severe retinal hypoperfusion. The presence of ILMD on OCT can be considered a sign of poor prognosis in cases of acute CRAO. Trial registration: Not applicable.

Automatic detection of pathological myopia using machine learning

Pathological myopia is a severe case of myopia, i.e., nearsightedness. Pathological myopia is also known as degenerative myopia because it ultimately leads to blindness. In pathological myopia, certain myopia-specific pathologies occur at the eye’s posterior i.e., Foster-Fuchs’s spot, Cystoid degeneration, Liquefaction, Macular degeneration, Vitreous opacities, Weiss’s reflex, Posterior staphyloma, etc. This research is aimed at developing a machine learning (ML) approach for the automatic detection of pathological myopia based on fundus images. A deep learning technique of convolutional neural network (CNN) is employed for this purpose. A CNN model is developed in Spyder. The fundus images are first preprocessed. The preprocessed images are then fed to the designed CNN model. The CNN model automatically extracts the features from the input images and classifies the images i.e., normal image or pathological myopia. The best performing CNN model achieved an AUC score of 0.9845. The best validation loss obtained is 0.1457. The results show that the model can be successfully employed to detect pathological myopia from the fundus images.