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Clinical & Experimental Ophthalmology Dec 2016To determine the incidence of full thickness macular hole in the Tasmanian population.
PURPOSE
To determine the incidence of full thickness macular hole in the Tasmanian population.
DESIGN
A whole population retrospective case series in Tasmania, Australia.
METHODS
Patients diagnosed with full thickness macular hole (confirmed by optical coherence tomography (OCT) imaging) of both idiopathic and secondary causes were identified from April 2005 to April 2011 by a sole vitreoretinal surgeon servicing Tasmania. Baseline characteristics were recorded. The six-year incidence rate was calculated, based on the 2006 and 2011 Tasmanian census data. Incidence rates were age and sex standardized.
PARTICIPANTS
One hundred forty-seven eyes of 136 patients.
MAIN OUTCOME MEASURES
To determine the incidence (age and sex standardized) of full thickness macular holes in Tasmania, Australia.
RESULTS
Idiopathic macular holes comprised 128 (87.1%). There were 116 cases of idiopathic Full Thickness Macular Hole in one or both eyes between 1 April 2005 and 31 April 2011. The six-year incidence of idiopathic full-thickness macular holes was 24.3 per 100 000 people, 4.05 per 100 000 per year, with the highest six-year incidence observed among women aged 70-79 years.
CONCLUSION
This is the first global study to report OCT confirmed incidence rates of full thickness macular holes in a relatively static Australian population sub-group.
Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Female; Humans; Incidence; Male; Middle Aged; Retinal Perforations; Retrospective Studies; Sex Distribution; Tasmania; Tomography, Optical Coherence; Visual Acuity
PubMed: 27388943
DOI: 10.1111/ceo.12801 -
Turkish Journal of Ophthalmology Oct 2020To assess changes in reflectivity of the retinal pigment epithelium (RPE), ellipsoid zone (EZ), and external limiting membrane (ELM) on spectral domain-optical coherence...
OBJECTIVES
To assess changes in reflectivity of the retinal pigment epithelium (RPE), ellipsoid zone (EZ), and external limiting membrane (ELM) on spectral domain-optical coherence tomography (SD-OCT) images and the effects of reflectivity changes on visual acuity improvement after vitrectomy in macular hole patients.
MATERIALS AND METHODS
Twenty-four eyes of 24 patients with idiopathic full-thickness macular hole closed after vitrectomy were retrospectively reviewed. The "plot profile" function of the medical imaging software was used by a single masked physician to analyze RPE, EZ, and ELM reflectivity on OCT images at postoperative 1 month and 12 months.
RESULTS
Absolute and relative EZ reflectivity showed highly significant increases at postoperative 12 months compared to 1 month (p<0.001 and p<0.001, respectively). Absolute and relative EZ reflectivity changes from postoperative month 1 to month 12 after macular hole surgery were significantly correlated with best corrected visual acuity improvement (p=0.012 and p=0.020, respectively).
CONCLUSION
EZ reflectivity can be a predictor of functional and anatomical improvement after macular hole surgery.
Topics: Female; Follow-Up Studies; Humans; Male; Middle Aged; Postoperative Period; Recovery of Function; Retinal Perforations; Retinal Pigment Epithelium; Retrospective Studies; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity; Vitrectomy
PubMed: 33342195
DOI: 10.4274/tjo.galenos.2020.21456 -
Indian Journal of Ophthalmology Jan 2020Macular hole in the pediatric age group is usually post-traumatic unlike, the adult counterpart. Herein we describe a case of idiopathic macular hole occurring in a... (Review)
Review
Macular hole in the pediatric age group is usually post-traumatic unlike, the adult counterpart. Herein we describe a case of idiopathic macular hole occurring in a 9-year-old male who presented to us with complaints of diminution of vision in OD (oculus dextrus) for 2 months. The child underwent 25-gauge pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling. On follow-up his best-corrected visual acuity improved with type 1 closure of macular hole.
Topics: Child; Humans; Macula Lutea; Male; Retinal Perforations; Tomography, Optical Coherence; Visual Acuity; Vitrectomy
PubMed: 31856539
DOI: 10.4103/ijo.IJO_354_19 -
Indian Journal of Ophthalmology Oct 2022
Topics: Humans; Retina; Retinal Detachment; Retinal Perforations; Retrospective Studies; Tomography, Optical Coherence; Vitrectomy
PubMed: 36190057
DOI: 10.4103/ijo.IJO_1732_22 -
Graefe's Archive For Clinical and... Mar 2024To report the characteristics and the visual and anatomical outcomes of secondary macular holes (SMHs) diagnosed after rhegmatogenous retinal detachment (RRD) repair and...
PURPOSE
To report the characteristics and the visual and anatomical outcomes of secondary macular holes (SMHs) diagnosed after rhegmatogenous retinal detachment (RRD) repair and their associated factors.
METHODS
Retrospective, interventional case series. All consecutive patients who were diagnosed with SMH after RRD repair at Beijing Tongren eye center from January 2016 to April 2021 were included. Patients who had their primary RRD repair in other hospitals and were referred to our center after diagnosis of SMH were also included. The minimum follow-up time after RRD repair was 6 months.
RESULTS
37 SMHs were diagnosed within a series of 5696 RRDs. Including 24 eyes referred from other hospitals after the diagnosis of SMH, 61 eyes were included. The type of primary RRD repair surgery included 22/61 (36%) eyes with scleral buckling procedure (SBP) and 39/61 (64%) eyes with pars plana vitrectomy (PPV). 21/61 (34%) eyes had recurrent RD. The median time to SMH diagnosis was 150 days (range, 7 ~ 4380 days). Macular hole (MH) closure was achieved in 77% eyes. Visual acuity (VA) improvement of at least 2 lines of Snellen's visual acuity was observed in 51% eyes. Final MH closure status was associated with preoperative MH diameter (for every 50 μm increment) (P = 0.046, OR = 0.875, 95%CI: 0.767 ~ 0.998). VA improvement was associated with final MH closure status (P = 0.009, OR = 8.742, 95%CI: 1.711 ~ 44.672). Final VA (logMAR) was associated with recurrent RD (P < 0.001, B = 0.663, 95%CI: 0.390 ~ 0.935), preoperative MH diameter (P = 0.001, B = 0.038, 95%CI: 0.017 ~ 0.058), VA at the time of SMH diagnosis (P < 0.001, B = 0.783, 95%CI: 0.557 ~ 1.009) and final MH closure status (P = 0.024, B = -0.345, 95%CI: -0.644 ~ -0.046). For patients without recurrent RD, VA improvement and final VA was associated with final MH closure status (P = 0.016 and P < 0.001, respectively), while for patients with recurrent RD, VA improvement or final VA did not associate with final MH closure status (P > 0.05).
CONCLUSION
For SMH diagnosed after RRD repair, final MH closure status was associated with preoperative MH diameter. Recurrent RD, larger preoperative MH diameter, worse VA at the time of SMH diagnosis and failed MH closure are predictive factors for worse final VA. Visual outcome is associated with final MH closure status in patients without recurrent RD, but not as so in patients with recurrent RD.
Topics: Humans; Retinal Perforations; Retinal Detachment; Retrospective Studies; Scleral Buckling; Retina
PubMed: 37878036
DOI: 10.1007/s00417-023-06259-y -
Retinal Cases & Brief Reports Jan 2024The aim of this study is to describe the clinical and multimodal imaging findings in patients with macular atrophy after macular hole surgery assisted by Membrane Blue... (Observational Study)
Observational Study
PURPOSE
The aim of this study is to describe the clinical and multimodal imaging findings in patients with macular atrophy after macular hole surgery assisted by Membrane Blue Dual.
METHOD
This study is a monocenter, retrospective, observational case series that included patients who presented with macular atrophy following macular hole surgery.
RESULTS
Among the patients included in this study, four were operated for idiopathic macular hole and one for total retinal detachment associated with macular hole. In all patients, the internal limiting membrane was brittle and adherent, and multiple stains were required. One month postoperatively, all patients showed a reduced visual acuity except the patient with total retinal detachment. At fundus examination all patients showed patchy atrophy with a mottled hypopigmented and hyperpigmented appearance in the macular region. Optical coherence tomography scans demonstrated a closed macular hole with retinal thinning, disruption of the external retinal layers, and irregular retinal pigment epithelium thickening. Fundus autofluorescence showed a well-defined area of both hypoautofluorescence and hyperautofluorescence involving the macular area.
CONCLUSION
Macular atrophy after Membrane Blue Dual-assisted internal limiting membrane peeling represents a severe complication that vitreoretinal surgeons should be aware of and that should be taken into account in preoperative evaluation and surgical procedure planning. To reduce the risk of this complication, we recommend to ensure the best conditions of visibility, to reduce as much as possible the intensity and the distance of the endoillumination from the retina, and to use as little dye as possible.
Topics: Humans; Retinal Perforations; Retinal Detachment; Retrospective Studies; Vitrectomy; Atrophy; Tomography, Optical Coherence; Basement Membrane; Epiretinal Membrane
PubMed: 36007253
DOI: 10.1097/ICB.0000000000001331 -
Acta Ophthalmologica Jun 2016To evaluate the impact of postoperative posturing with or without face-down on the anatomical and functional outcomes of macular hole surgery. (Comparative Study)
Comparative Study Meta-Analysis Review
PURPOSE
To evaluate the impact of postoperative posturing with or without face-down on the anatomical and functional outcomes of macular hole surgery.
METHODS
A literature-based meta-analysis was conducted to identify studies relevant to posturing following macular hole surgery (MHS). PubMed and Web of Science databases were used to retrieve articles up to 1 June 2015. The primary measures included MH closure and ideal vision acuity improvement. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated in Review Manager.
RESULTS
Four randomized control trials (RCTs) comprising 251 cases were included in the final meta-analysis. No face-down posturing (FDP) after MHS revealed lower anatomic success rate compared to face-down posturing (OR = 0.33, 95% CI [0.13, 0.81], p = 0.02). For holes smaller than 400 μm in size, the subgroup meta-analysis indicated no significant effect of FDP on successful hole closure (OR = 0.29, 95% CI [0.01, 7.34], p = 0.45). However, when holes were larger than 400 μm, it seemed less effective on MH closure following surgery in no FDP group (OR = 0.23, 95% CI [0.07, 0.71]), and this was statistically significant (p = 0.01).
CONCLUSIONS
Our work found that no FDP was not inferior to its face-down counterpart for the success of MHS when macular holes were smaller than 400 μm in size. For macular holes larger than 400 μm, statistical analysis proved that FDP might be necessary. More well-conducted randomized control trials are needed to verify our findings.
Topics: Endotamponade; Fluorocarbons; Humans; Prone Position; Retinal Perforations; Vitrectomy
PubMed: 26385613
DOI: 10.1111/aos.12844 -
Graefe's Archive For Clinical and... Jul 2022We conducted a systematic review to evaluate the outcome of macular hole (MH) treatment in eyes with uveitis. (Review)
Review
OBJECTIVE
We conducted a systematic review to evaluate the outcome of macular hole (MH) treatment in eyes with uveitis.
DATA SOURCE
We searched PubMed and Embase databases from inception through August 15, 2021.
STUDY SELECTION
We included eyes with MHs secondary to uveitis that were managed medically or underwent pars plana vitrectomy (PPV). We excluded eyes with idiopathic MH and those secondary to causes other than uveitis.
RESULTS
Of 27 articles, we identified 86 eyes with MH secondary to uveitis that received either conservative medical treatment alone or PPV with adequate follow-up. The mean (± SD) age of patients included in this review was 46.6 (± 16.8) years; 60.5% were males. The most common etiology of uveitis was Behçet's disease (34.6%) and toxoplasmosis (19.7%). The most common anatomical location of uveitis was posterior (59.3%) followed by panuveitis (35.2%). The mean (± SD) baseline LogMAR vision was 1.1 (± 0.5). Conservative medical treatment was employed in 34.9%, while PPV was performed in 65.1% of eyes. Overall, the mean (SD) LogMAR vision improved from 1.1 (± 0.5) at baseline to 0.7 (± 0.5) after treatment. Inflammation-related MHs were closed in 40% of eyes after conservative therapy and in 87.5% of eyes after PPV. Visual improvement occurred in most eyes (83.9%) that had successful closure of their MH.
CONCLUSIONS
Visual improvement occurs in most eyes that had successful closure of their inflammation-related MH. Conservative medical control of uveitis may lead to closure of inflammation-related MHs and is an important step prior to surgery, if required. Surgical intervention for inflammation-related MHs is associated with good functional and anatomical results.
Topics: Adult; Female; Humans; Inflammation; Male; Middle Aged; Retinal Perforations; Retrospective Studies; Treatment Outcome; Uveitis; Visual Acuity; Vitrectomy
PubMed: 35175410
DOI: 10.1007/s00417-022-05590-0 -
Acta Ophthalmologica Nov 2020To investigate the long-term surgical outcomes of macular hole retinal detachment (MHRD) following vitrectomy with macular plug in highly myopic eyes.
PURPOSE
To investigate the long-term surgical outcomes of macular hole retinal detachment (MHRD) following vitrectomy with macular plug in highly myopic eyes.
METHODS
Thirty-five cases of highly myopic eyes with MHRD in 35 patients who underwent an initially successful vitrectomy with macular plug and were followed up for at least 3 years were reviewed. The anatomical outcomes were evaluated by fundus examination, fundus photographs and optical coherence tomography (OCT). Myopic features after the surgery were differentiated according to recommendations of the Meta-analysis of Pathologic Myopia (META-PM) Study Group. The best-corrected visual acuities (BCVAs) before and after surgery were analysed as the functional outcome. Main outcome measures time-course changes in BCVA and complications.
RESULTS
The mean patient age was 61.0 ± 11.4 years. The follow-up was 45.2 ± 8.6 months (ranged from 36 to 71 months). The mean axial length was 29.3 ± 1.2 mm. All eyes demonstrated attached retina, but 2 eyes (5.7%) developed reopened macular holes until the last follow-up. Complications of postoperative rhegmatogenous retinal detachment were detected in 2 eyes (5.7%) within 1 year and retina reattached after the secondary vitrectomy. Three cases (8.6%) of prolonged subretinal fluid lasting more than 1 year were detected but finally absorbed completely. Comparing 1-3 years postoperatively, myopic features showed significant progression of myopic maculopathy category (p = 0.035). Functionally, significantly improved BCVA could be maintained postoperatively between 6 months and 3 years. However, vision of 14 eyes (40.0%) worsened within 1-3 years postoperatively, and visual deterioration was associated with progression of myopic maculopathy (p = 0.004) and pre-existing disease of glaucoma (p = 0.006).
CONCLUSIONS
A vitrectomy combined with macular plug provided favourable outcomes in the long term, over the ≥3-year follow-up period.
Topics: Endotamponade; Female; Follow-Up Studies; Humans; Male; Middle Aged; Myopia, Degenerative; Refraction, Ocular; Retinal Detachment; Retinal Perforations; Retrospective Studies; Tomography, Optical Coherence; Visual Acuity; Vitrectomy
PubMed: 32243725
DOI: 10.1111/aos.14418 -
Ophthalmic Surgery, Lasers & Imaging... Sep 2023
Topics: Humans; Retinal Perforations; Dexamethasone
PubMed: 37642411
DOI: 10.3928/23258160-20230809-02