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Delayed spontaneous closure of blue laser-induced full thickness macular hole
Nicola G. Ghazi,Wael A. Alsakran
- , 2019, DOI: 10.1016/j.ajoc.2019.01.003
Abstract: To report a blue laser-induced full thickness macular hole (FTMH) with delayed spontaneous closure without surgical intervention
Rapid macular hole formation and closure in a vitrectomized eye following rhegmatogenous retinal detachment repair
George Joseph Manayath,Ratnesh Ranjan,Udayasree Avadhani,Venkatapathy Narendran
- , 2018, DOI: 10.4103/ojo.OJO_35_2017
Abstract: The development of a full-thickness macular hole (FTMH) after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) repair is a rare occurrence. We report the first case of rapid MH formation with internal limiting membrane (ILM)-like hyper-reflective bridging membrane under silicone oil (SO) meniscus, noted on the first postoperative day (POD) postvitrectomy for RRD. A 57-year-old man presented with best-corrected visual acuity (BCVA) of perception of light with immature cataract and total RRD in the left eye. He underwent cataract extraction with intraocular lens implantation with uneventful PPV, endolaser to primary break, and 360° periphery followed by injection of 1000 Cst SO. On the first POD, retina was attached in all quadrants with SO in situ. However, a dark red spot was noted at macula which was confirmed as FTMH with a bridging linear hyper-reflectivity under SO meniscus on optical coherence tomography (OCT). Repeat OCT, at 2 weeks and 3 months, revealed closed MH under the SO meniscus with BCVA improving to 6/60. This is the first reported case of very rapid FTMH formation with an ILM-like linear hyper-reflectivity following vitrectomy for RRD and highlights the possible contributory role of multiple nonconventional factors for rapid FTMH development and fibrinous membrane-assisted closure under SO tamponade
特发性黄斑裂孔术后黄斑中心凹外层显微结构变化与视力的相关性
Correlation between Postoperative Visual Outcome and the Restoration of Foveal Microstructures after Idiopathic Full-Thickness Macular Hole Surgery  [PDF]
卢凤丽, 赵芃芃, 秦梅, 张琴, 张信哲
Hans Journal of Ophthalmology (HJO) , 2023, DOI: 10.12677/HJO.2023.121001
Abstract: 目的：通过OCT观察特发性全层黄斑裂孔(IFTMH)患眼术后的视网膜黄斑中心凹外层显微结构变化，并分析其与视力之间的相关性。方法：选取2019年5月至2020年10月在蚌埠医学院第一附属医院眼科就诊诊断为IFTMH的患者，共37例，37眼，均成功行手术修复。比较患眼在术前和术后1个月、3个月、6个月、12个月和24个月检查中的最佳矫正视力(BCVA)及OCT中黄斑中心凹外层显微结构变化。根据24个月末次随访的外界膜(ELM)、椭圆体带(EZ)、嵌合体带(IZ)愈合情况，将其分为3组：A组为ELM完整，EZ和IZ连接中断，共有11眼；B组为ELM、EZ完整，IZ连接中断，共有15眼；C组为ELM、EZ、IZ完全恢复，共有11眼。分析视力与黄斑中心凹ELM、EZ、IZ的连续性之间的相关性。结果：在37例37眼中，三组患者年龄、性别、眼别、症状持续时间、术前BCVA、术前裂孔最小径、基底径等差异无统计学意义(P > 0.05)，最后一次随访时，三组患眼BCVA之间差异有统计学意义(F = 24.257, P < 0.01)，其中C组视力恢复最佳，C组LogMAR BCVA从0.80 ± 0.12改善至0.08 ± 0.09。在术后1个月、3个月、6个月、12个月和24个月的随访中黄斑中心凹显微结构持续重建，ELM、EZ和IZ的缺损直径持续减少，BCVA持续好转，较术前具有统计学差异(P < 0.05)。重建过程由ELM先开始，依次为EZ、IZ。术后24个月BCVA与术前裂孔最小径、基底径、症状持续时间、术前BCVA、术前ELM缺损直径、术前EZ缺损直径、术前IZ缺损直径均呈正相关(r = 0.798, 0.601, 0.683, 0.732, 0.682, 0.695, 0.702, P < 0.01)。结论：IFTMH患眼术后黄斑中心凹光感受器持续重建，重建顺序依次为ELM、EZ、IZ，视力持续提高。同时，外层显微结构的重建程度与术后视力呈正相关。
Objective: To observe the microstructural changes of the outer layer of the macular central recess of the retina after surgery in eyes with idiopathic total macular fissure (IFTMH) by OCT and analyze the correlation between them and visual acuity. Methods: A total of 37 patients, 37 eyes, who attended the ophthalmology department of the First Affiliated Hospital of Bengbu Medical College with the diagnosis of IFTMH from May 2019 to October 2020 were selected and all of them were successfully repaired surgically. The best-corrected visual acuity (BCVA) and changes in the outer microstructure of the macular central recess on OCT were compared between the affected eyes at preoperative and postoperative examinations at 1 month, 3 months, 6 months, 12 months, and 24 months. According to the healing of the external limitinag membrane (ELM), ellipsoid zone (EZ), interdigitation zone (IZ) at the end follow-up at 24 months, they were divided into three groups: Group A had intact ELM, and the connection between EZ and IZ was interrupted, with a total of 11 eyes; in group B, the ELM and EZ were intact, and the IZ connection was interrupted, with 15 eyes in total. In group C, ELM, EZ and IZ recovered completely, with a total of 11 eyes. The correlation between visual acuity and the continuity of ELM, EZ, and IZ in the central macular recess was analyzed. Results: In 37 eyes of 37 cases, there were no statistically significant differences (P > 0.05) in age, gender, eye type, duration of symptoms, preoperative BCVA, minimal hole diameter, and base diameter between the three groups of patients. At the last follow-up, there was a statistically significant difference in BCVA between the three groups of affected eyes (F = 24.257,
Internal retinal layer thickness and macular migration after internal limiting membrane peeling in macular hole surgery
David C. Sousa,Diana M. Cristóvao,Manuel E. Monteiro-Grillo,Mun Y. Faria,Nuno P. Ferreira,Sofia Mano
- , 2018, DOI: 10.5301/ejo.5001066
Abstract: To provide a spectral-domain optical coherence tomography (SD-OCT)-based analysis of retinal layers thickness and nasal displacement of closed macular hole after internal limiting membrane peeling in macular hole surgery. In this nonrandomized prospective interventional study, 36 eyes of 32 patients were subjected to pars plana vitrectomy and 3.5 mm diameter internal limiting membrane (ILM) peeling for idiopathic macular hole (IMH). Nasal and temporal internal retinal layer thickness were assessed with SD-OCT. Each scan included optic disc border so that distance between optic disc border and fovea were measured. Thirty-six eyes had a successful surgery with macular hole closure. Total nasal retinal thickening (p<0.001) and total temporal retinal thinning (p<0.0001) were observed. Outer retinal layers increased thickness after surgery (nasal p<0.05 and temporal p<0.01). Middle part of inner retinal layers (mIRL) had nasal thickening (p<0.001) and temporal thinning (p<0.05). The mIRL was obtained by deducting ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness from overall thickness of the inner retinal layer. Papillofoveal distance was shorter after ILM peeling in macular hole surgery (3,651 ± 323 μm preoperatively and 3,361 ± 279 μm at 6 months; p<0.0001). Internal limiting membrane peel is associated with important alteration in inner retinal layer architecture, with thickening of mIRL and shortening of papillofoveal distance. These factors may contribute to recovery of disrupted foveal photoreceptor and vision improvement after IMH closure
Retinal thickness after vitrectomy and internal limiting membrane peeling for macular hole and epiretinal membrane
Kumagai K, Ogino N, Furukawa M, Hangai M, Kazama S, Nishigaki S, Larson E
Clinical Ophthalmology , 2012, DOI: http://dx.doi.org/10.2147/OPTH.S30288
Abstract: inal thickness after vitrectomy and internal limiting membrane peeling for macular hole and epiretinal membrane Original Research (2601) Total Article Views Authors: Kumagai K, Ogino N, Furukawa M, Hangai M, Kazama S, Nishigaki S, Larson E Published Date May 2012 Volume 2012:6 Pages 679 - 688 DOI: http://dx.doi.org/10.2147/OPTH.S30288 Received: 27 January 2012 Accepted: 06 March 2012 Published: 04 May 2012 Kazuyuki Kumagai1, Nobuchika Ogino1, Mariko Furukawa2, Masanori Hangai3, Shigeyasu Kazama1, Shirou Nishigaki4, Eric Larson5 1Shinjo Ophthalmologic Institute, Miyazaki, 2Department of Ophthalmology, Kami-iida First General Hospital, Nagoya, 3Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 4Nishigaki Eye Clinic, Nagoya, 5Miyazaki Prefectural Nursing University, Miyazaki, Japan Purpose: To determine the retinal thickness (RT), after vitrectomy with internal limiting membrane (ILM) peeling, for an idiopathic macular hole (MH) or an epiretinal membrane (ERM). Also, to investigate the effect of a dissociated optic nerve fiber layer (DONFL) appearance on RT. Methods: A non-randomized, retrospective chart review was performed for 159 patients who had successful closure of a MH, with (n = 148), or without (n = 11), ILM peeling. Also studied were 117 patients who had successful removal of an ERM, with (n = 104), or without (n = 13), ILM peeling. The RT of the nine Early Treatment Diabetic Retinopathy Study areas was measured by spectral domain optical coherence tomography (SD-OCT). In the MH-with-ILM peeling and ERM-with-ILM peeling groups, the RT of the operated eyes was compared to the corresponding areas of normal fellow eyes. The inner temporal/inner nasal ratio (TNR) was used to assess the effect of ILM peeling on RT. The effects of DONFL appearance on RT were evaluated in only the MH-with-ILM peeling group. Results: In the MH-with-ILM peeling group, the central, inner nasal, and outer nasal areas of the retina of operated eyes were significantly thicker than the corresponding areas of normal fellow eyes. In addition, the inner temporal, outer temporal, and inner superior retina was significantly thinner than in the corresponding areas of normal fellow eyes. Similar findings were observed regardless of the presence of a DONFL appearance. In the ERM-with-ILM peeling group, the retina of operated eyes was significantly thicker in all areas, except the inner and outer temporal areas. In the MH-with-ILM peeling group, the TNR was 0.86 in operated eyes, and 0.96 in fellow eyes (P < 0.001). In the ERM-with-ILM peeling group, the TNR was 0.84 in operated eyes, and 0.95 in fellow eyes (P < 0.001). TNR in operated eyes of the MH-without-ILM peeling group was 0.98, which was significantly greater than that of the MH-with-ILM peeling group (P < 0.001). TNR in the operated eyes of the ERM-without-ILM peeling group was 0.98, which was significantly greater than that of ERM-with-ILM peeling group (P < 0.001).
Macular Thickness by Optical Coherence Tomography in Normal Togolese Melanoderma Subjects: A Case Study of 338 Eyes  [PDF]
Kossi Dzidzinyo, Akoete Djagnikpo, Koffi Didier Ayena, Kokou Vonor, Mawouli Ayodele Santos, Kassoula Batomaguela Nonon-Saa, Kokou Messan Amedome, Adam Nouhou-Diori, Nidain Maneh, Komi Balo
Open Journal of Ophthalmology (OJOph) , 2022, DOI: 10.4236/ojoph.2022.121005
Abstract: Objective: Maculopathies are more and more frequent. For the follow-up of its evolution and therapy, it seems important for us to determine the baseline in normal subjects by Optical Coherence Tomography (OCT). The goal here is to determine the acceptable range of macular thickness in normal black subjects in Lomé. Methodology: This is a retrospective study over a 6-month period. It did not include all patients with retinopathy of any cause, maculopathy, and glaucoma. The analyzed variables were the average macular thickness, the central macular thickness, and the total macular volume. Results: Out of the 433 macular OCT performed, 191 patients were selected; a total of 338 eyes. These included 96 men and 95 women. A sex ratio was 1.01. The median age was 44.1 years with extremes ranging from 10 to 70 years. The average macular thickness was 263.4 μm for the right eye and 263.7 μm for the left eye. The central macular thickness was 174.1 μm for the right eye and 173.3 μm for the left eye. The total macular volume was 7.4 in both eyes. Discussion: No significant statistical difference existed between the two sexes. The average macular thickness found in this study was within the range of normality observed in the literature, which is between 216 and 288 μm. Conclusion: The average macular thickness of the normal subject in Lomé was 263.4 μm.
Surgical management of macular holes-indications and complications
Stamenkovi？ Miroslav
Acta Chirurgica Iugoslavica , 2012, DOI: 10.2298/aci1203085s
Abstract: Macular hole surgery is very demand surgery performed due to fullthickness macular rupture characterized by abscence of all retinal layers. Indications for surgery includes stages 3 and 4 regarding to Gass classification. Some authors sugest surgery for stage 2 but results are promissing only in anatomical reconstruction. Complications are evident such as cataract, late macular reopening, retinal tears and detachment, visual field defect etc. With improving surgical techniques, the rate of complications became lower.
Optical Coherence Tomography’s Contribution to the Diagnosis of the Pathologies of the Vitreoretinal Interface in Lomé  [PDF]
Kossi Dzidzinyo, Hubert Yamdeu, Koffi Didier Ayena, Kokou Vonor, Nidain Maneh, Kokou Messan Amedome, Kassoula Batomaguela Nonon Saa, Koko Roger Kuaovi, Yawa Nagbe, Meba Banla, Komi Balo
Open Journal of Ophthalmology (OJOph) , 2018, DOI: 10.4236/ojoph.2018.83022
Abstract: Purpose: To identify the pathologies of the vitreoretinal interface by Optical Coherence Tomography OCT of the retina in Lomé. Methodology: This is a retrospective analytical study, carried out in a specialized liberal center in Lomé. It was based on the analysis of OCT images of the retina, carried out with patients between October 2012 and October 2014. The variables collected were the socio-demographic characteristics, which were the various pathologies of the vitreoretinal interface. Results: 303 eyes of 164 patients were analyzed. The population was predominantly female (sex ratio = 0.95) aged 9 to 84 years with an average of 52.93 years. 121 eyes (39.9%) had posterior vitreous detachment with 66.1% in the 50 - 70 age group. 42 eyes (13.86%) presented vitreomacular traction with 66.6% in the 50 - 70 age group. 31 eyes (10.23%) presented an epi-retinal membrane with 61.2% in the 50 - 70 age group. 33 eyes (10.89%) had a full-thickness macular hole with 69.6% in the 50 - 70 age group. 4 eyes had a lamellar hole and 1 eye had a pseudo hole. Conclusion: OCT is an excellent tool for non-invasive exploration of the vitreoretinal interface. It gives precise information on the various pathologies of this interface. The need to evaluate the functional impact of these abnormalities, calls for other studies, especially prospective studies to assert their reality of those disease.
Efficacy of Alzer® and Diamel, Nutritional Supplements, in the Prevention of Severe Diabetic Macular Edema  [PDF]
Juana Elvira Maciques Rodríguez, Maria Emoé Pérez Mu？oz, Eduardo Cabrera Rode, Laura Rosa Redondo Pi？o, Raísa Beltrán Sainz, Teresa González Calero, Manuel Licea Puig, Juan Lence Anta, Rosaralis Paneca Santiesteban, Yordanka Marrero álvarez, Eduardo Sanz Navares
Open Journal of Ophthalmology (OJOph) , 2020, DOI: 10.4236/ojoph.2020.104034
Abstract: Introduction: Macular edema is the main cause of low vision in diabetic patients. Laser photocoagulation continues to be the treatment of choice in conjunction with the use of steroids and anti-angiogenics, but these treatments include possible ocular complications. The nutritional supplement Alzer (whose primary active ingredient is Ginkgo biloba, a powerful antioxidant that acts on vascular factors and oxidative damage, which are two of the mechanisms implicated in the pathogenesis of diabetic macular edema), which has been used on other non-diabetic macular conditions, along with the Diamel nutritional supplement has been shown to be effective on glycemic control and could represent a treatment alternative for mild to moderate macular edema by reducing the thickness of the macular retina and preventing the progression of other more advanced clinical presentations that are harder to treat. Objective: Identify the effect of Alzer along with Diamel in reduction of the thickness of the macular retina among patients with mild to moderate diabetic macular edema. Materials and Methods: A phase II double-blind clinical trial was conducted in 64 patients with non-severe diabetic macular edema over the course of non-proliferative diabetic retinopathy, who attended the ophthalmology service of the Institute of Endocrinology of Havana from January 2016 to December 2016. The treatment was randomly assigned to two groups: one received Alzer plus Diamel (n = 32) and the other group received Alzer placebo + Diamel placebo (n =
Spontaneous closure of stage IV idiopathic full-thickness macular hole and late reopening as a lamellar macular hole: a case report
Miriam García Fernández, Joaquín Castro Navarro
Journal of Medical Case Reports , 2012, DOI: 10.1186/1752-1947-6-169
Abstract: A 67-year-old Spanish man was referred to our hospital with a complaint of decreased vision in his right eye and metamorphopsia for approximately 11？months. He did not report any trauma. Diagnosis was based on fundoscopic and optical coherence tomography. They revealed a stage IV full-thickness idiopathic macular hole and a small epiretinal membrane. Three months later the hole spontaneously closed, and two years later we appreciated its reopening as a lamellar macular hole.The contraction of the epiretinal membrane could have contributed to cystic spaces and their fusion, subsequently, to the formation of a lamellar macular hole. To the best of our knowledge this is the first report in the literature of a spontaneously closed full-thickness idiopathic macular hole with reopening as a partial thickness macular defect.
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