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Ophthalmology and Therapy Feb 2022To evaluate and compare the efficacy and safety of YAG laser vitreolysis in treating symptomatic vitreous floaters of complete posterior vitreous detachment (PVD) and...
INTRODUCTION
To evaluate and compare the efficacy and safety of YAG laser vitreolysis in treating symptomatic vitreous floaters of complete posterior vitreous detachment (PVD) and non-PVD.
METHODS
In this prospective cohort study, 51 eyes with symptomatic floaters were treated with YAG laser vitreolysis. Participants were divided into complete PVD and non-PVD groups. Objective visual quality measures including the Strehl ratio (SR), internal spherical aberration (SA), internal comatic aberration (CA), internal high-order aberration (HOA), area ratio of modulation transfer function (MTFa) and Vitreous Floaters Symptom Questionnaire (VFSQ-13) scores were used to compare the efficacy of YAG laser vitreolysis treatment between two groups.
RESULTS
The mean age of all patients was 56.80 ± 10.82 years old. In total, 36 of 51 (70.59%; 95% CI 58.10-83.10) patients reported their symptoms as significant or complete improvement after YAG laser vitreolysis treatment. Post-treatment MTFa, internal SA and internal HOA were significantly better compared to baseline (26.19 ± 14.73 vs. 29.19 ± 17.98, p = 0.013; 0.05 ± 0.05 vs. 0.04 ± 0.04, p = 0.031 and 0.23 ± 0.22 vs. 0.16 ± 0.07, p = 0.044; respectively) in all eyes. Twenty-nine of 51 (56.86%) eyes had floaters of non-PVD type. Significant or complete subjective improvements in the PVD group and non-PVD group were 72.73% and 68.97% (p = 0.344), respectively.
CONCLUSIONS
Improved subjective and objective visual quality in participants with symptomatic floaters following YAG laser vitreolysis was found in both groups. The efficacy of YAG laser vitreolysis was comparable in floaters of complete PVD and non-PVD types.
PubMed: 34778916
DOI: 10.1007/s40123-021-00422-6 -
Ophthalmic Surgery, Lasers & Imaging... Nov 2021This is an observational case series of two patients who developed direct retinal damage following neodymium-doped yttrium-aluminum-garnet (YAG) laser treatment for...
This is an observational case series of two patients who developed direct retinal damage following neodymium-doped yttrium-aluminum-garnet (YAG) laser treatment for symptomatic vitreous floaters. The first patient developed a vitreous hemorrhage and subsequent branch retinal vein occlusion from laser damage to a major retinal venule. The second patient developed a temporal scotoma from a full-thickness retinal break in the posterior pole requiring laser retinopexy. Direct YAG laser damage to the posterior pole can cause permanent visual deficits. .
Topics: Aluminum; Eye Diseases; Humans; Laser Therapy; Lasers, Solid-State; Vitrectomy; Vitreous Body; Yttrium
PubMed: 34766848
DOI: 10.3928/23258160-20211014-02 -
Clinical & Experimental Optometry Aug 2022Contrast thresholds under photopic and mesopic luminance conditions are compromised in subjects with vitreous degeneration. A plausible explanation is needed for the...
CLINICAL RELEVANCE
Contrast thresholds under photopic and mesopic luminance conditions are compromised in subjects with vitreous degeneration. A plausible explanation is needed for the visual discomfort expressed by patients suffering from symptomatic vitreous degeneration.
BACKGROUND
The current study investigates the effect of symptomatic vitreous degeneration on photopic and mesopic contrast at high spatial frequencies.
METHODS
An age-matched sample of 115 subjects, comprising 30 subjects with symptomatic vitreous floaters (cases) and 85 healthy subjects (controls), was included in this study. Visual acuity and flicker thresholds were measured for all participants. Photopic and mesopic functional contrast thresholds at 10 cycles per degree were measured for all participants to assess the effect of floaters on contrast. Further, to determine the effect of posterior vitreous detachment on contrast, the sample was divided into three groups: cases with posterior vitreous detachment (n = 12); cases without posterior vitreous detachment (n = 18); and controls (n = 85), and their contrast thresholds were compared.
RESULTS
Photopic and mesopic contrast thresholds were lower by 37.4% and 27.5%, respectively, when the cases were compared with the controls (p = 0.028 and p < 0.001 for photopic and mesopic contrast thresholds, respectively). Photopic contrast was lower by 64.0% in cases with posterior vitreous detachment compared with controls (p = 0.001). Compared with controls, mesopic contrast was lower in cases with posterior vitreous detachment and in cases without posterior vitreous detachment by 30.3% and 25.6%, respectively (p = 0.014 and p = 0.017 for cases with and without posterior vitreous detachment, respectively).
CONCLUSION
: Subjects with vitreous degeneration have diminished photopic and mesopic contrast thresholds compared with controls. This finding highlights the negative impact of vitreous degeneration on the quality of vision.
Topics: Color Vision; Contrast Sensitivity; Humans; Mesopic Vision; Vision Disorders; Vitreous Detachment
PubMed: 34751082
DOI: 10.1080/08164622.2021.1981116 -
Translational Vision Science &... Oct 2021To investigate the impact of supplementation with a targeted micronutrient formulation on the visual discomfort associated with vitreous degeneration. (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To investigate the impact of supplementation with a targeted micronutrient formulation on the visual discomfort associated with vitreous degeneration.
METHODS
In this clinical trial, 61 patients with symptomatic vitreous floaters were randomized to consume daily, the active supplement consisting of 125 mg L-lysine, 40 mg vitamin C, 26.3 mg Vitis vinifera extract, 5 mg zinc, and 100 mg Citrus aurantium or placebo for 6 months. Change in visual discomfort from floaters, assessed with the Floater Disturbance Questionnaire, was the primary outcome measure. Secondary outcome measures included best-corrected visual acuity, letter contrast sensitivity, photopic functional contrast sensitivity with positive and negative contrast polarity, and quantitative vitreous opacity areas.
RESULTS
After supplementation, the active group reported a significant decrease in their visual discomfort from floaters (P < 0.001), whereas the placebo group had no significant change in their visual discomfort (P = 0.416). At 6 months, there was a significant decrease in vitreous opacity areas in the active group (P < 0.001) and an insignificant increase in vitreous opacity areas in the placebo group (P = 0.081). Also, there was a significant improvement in photopic functional contrast sensitivity with positive contrast polarity in the active group after supplementation (P = 0.047).
CONCLUSIONS
The findings of this study indicate improvements in vision-related quality of life and visual function of patients suffering from vitreous floaters after supplementation with a formulation of antioxidative and antiglycation micronutrients. Notably, these improvements were confirmed by the decrease in vitreous opacity areas in the active group.
TRANSLATIONAL RELEVANCE
This targeted dietary intervention should be considered to support patients with symptomatic vitreous degeneration.
Topics: Humans; Micronutrients; Quality of Life; Vision Disorders; Visual Acuity; Vitreous Body
PubMed: 34647961
DOI: 10.1167/tvst.10.12.19 -
Survey of Ophthalmology 2022Ocriplasmin is used to treat vitreomacular traction (VMT), with or without full-thickness macular hole (MH). We systematically reviewed the evidence on ocriplasmin's... (Meta-Analysis)
Meta-Analysis Review
Ocriplasmin for treatment of vitreomacular traction and macular hole: A systematic literature review and individual participant data meta-analysis of randomized, controlled, double-masked trials.
Ocriplasmin is used to treat vitreomacular traction (VMT), with or without full-thickness macular hole (MH). We systematically reviewed the evidence on ocriplasmin's effect on vitreomacular adhesion resolution (VMAR), MH closure, vitrectomy, and best-corrected visual acuity (BCVA) and investigated the effect of baseline covariates on outcome. We applied individual participant data meta-analyses to the entire population and to subgroups defined by MH or epiretinal membrane (ERM) presence. Safety data were pooled and tabulated. Five randomized controlled trials (1,067 participants) were included. Six months after treatment, ocriplasmin achieved higher rates of VMAR and MH closure versus control, lowered vitrectomy odds, and increased the likelihood of a ≥10-letter BCVA increase. VMAR rates were lower when ERM, broad VMA (> 1500 µm), diabetic retinopathy, or pseudophakia were present and higher in younger participants, women, and eyes with MHs. Ocriplasmin-treated participants experienced more short-term visual impairment that was not predictive of final BCVA, as well as vitreous floaters, photopsia, photophobia, eye pain, blurred vision, and dyschromatopsia. The most common serious adverse events for ocriplasmin and control, respectively, were MH progression (22.5%, 17.3%), new MH (1.5%, 3.4%) and retinal detachment (0.8%, 1.2%). Ocriplasmin promotes VMAR and MH closure. Transient visual phenomena are not uncommon.
Topics: Female; Fibrinolysin; Humans; Intravitreal Injections; Peptide Fragments; Retinal Diseases; Retinal Perforations; Tomography, Optical Coherence; Traction; Treatment Outcome; Vision Disorders; Visual Acuity; Vitreous Body; Vitreous Detachment
PubMed: 34480895
DOI: 10.1016/j.survophthal.2021.08.003 -
Vestnik Oftalmologii 2021Accumulations of pathological amyloid protein in the vitreous can be a pathognomonic morphological sign of systemic amyloidosis, which is characterized by deposition of...
Accumulations of pathological amyloid protein in the vitreous can be a pathognomonic morphological sign of systemic amyloidosis, which is characterized by deposition of insoluble fibrillar protein aggregates (amyloid) in various organs and tissues. The article describes a clinical case of a female 65-year-old patient with bilateral vitreous floaters and histologically confirmed vitreous amyloidosis on the right eye. The patient had undergone YAG laser vitreolysis of the right eye 3 years ago on the Ultra Q Reflex system («Ellex», Australia) to treat an atypical Weiss ring. Diagnosis of vitreous amyloidosis was confirmed using the following equipment: video slit lamp SL9900 («CSO», Italy), optical coherence tomography system Solix («Optovue», USA), B-scan Plus («Accutome», USA), microscope CX41RF («Olympus Corporation», Japan). Due to significant visual deterioration in the right eye, the patient underwent vitrectomy. Microscopic examination of the surgical sample showed the presence of amyloid deposits revealed by the brick-red specific staining with congo red dye and apple-green birefringence of the stained areas in polarized light.
Topics: Aged; Amyloidosis; Eye Diseases; Female; Humans; Lasers, Solid-State; Vitrectomy; Vitreous Body
PubMed: 34410063
DOI: 10.17116/oftalma202113704198 -
The International Journal of Risk &... 2022The majority of antidepressants inhibit serotonin reuptake and include the selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors...
BACKGROUND
The majority of antidepressants inhibit serotonin reuptake and include the selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and the serotonin reuptake inhibiting tricyclic antidepressants.
OBJECTIVE
The objective of this study was to investigate and describe the range and impact of reported adverse visual effects linked to serotonin reuptake inhibiting antidepressants.
METHODS
Using data from a global database of patient spontaneous reports of drug adverse events, we systematically identified eligible reports of visual problems linked to the use of serotonin reuptake inhibiting antidepressants. We analyzed these data using simple descriptive statistics to present the range and impact.
RESULTS
We identified 124 reports of visual problems. Reports originate from 18 countries and involve 11 different drugs. The most commonly reported symptoms were vision blurred/visual acuity reduced (n = 79, 63.7%), night blindness (n = 22, 17.7%), vitreous floaters (n = 21, 16.9%), photophobia (n = 19, 15.3%), diplopia (n = 15, 12.1%), palinopsia (n = 13, 10.5%), visual field defect (n = 12, 9.7%), photopsia (n = 11, 8.9%) and visual snow syndrome (n = 11, 8.9%). 74 patients indicated that the side effect was bad enough to affect everyday activities, 62 had sought health care, and 50 indicated that their work had been affected. 49 patients reported an enduring vision problem after discontinuation of treatment.
CONCLUSIONS
The data suggest that serotonin reuptake inhibiting antidepressants can produce a range of adverse effects on vision that in some cases can be long-lasting after discontinuation of the drug. Further efforts are needed to understand the mechanisms involved, the incidence among those prescribed these medications, and identify any risk or mitigation factors.
Topics: Antidepressive Agents; Antidepressive Agents, Tricyclic; Humans; Patient Reported Outcome Measures; Serotonin; Selective Serotonin Reuptake Inhibitors
PubMed: 34366298
DOI: 10.3233/JRS-210018 -
European Journal of Ophthalmology May 2022Assess the mid and peripheral neuroretina and vitreoretinal interface using a novel Navigated Single-Capture 3D and Cross-Sectional Wide-Field Swept-Source Optical... (Observational Study)
Observational Study
PURPOSE
Assess the mid and peripheral neuroretina and vitreoretinal interface using a novel Navigated Single-Capture 3D and Cross-Sectional Wide-Field Swept-Source Optical Coherence Tomography (WF SS-OCT) technology with correlation to Multi-Wavelength Ultra-Widefield Imaging (MW UWFI) and Histopathology reference.
METHODS
Retrospective observational study. A total of 74 patients (148 eyes) were imaged using WF SS-OCT and Navigated Single-Capture twelve 23 mm cross-sectional radial scan pattern at 15° intervals. Image diagnosis included: congenital hypertrophy of the retinal pigment epithelium, choroidal nevus, ora serrata pearls, retinal tuft, lattice, snail track, cobblestone degeneration, retinal hole, retinal tear, degenerative retinoschisis, peripheral laser retinopexy, white without pressure, vitreous floaters, subclinical peripheral rhegmatogenous retinal detachment (RD), and tractional RD in proliferative diabetic retinopathy. WF SS-OCT images were correlated with MW UWFI and histopathological references where available.
RESULTS
WF SS-OCT successfully imaged structural features in all diagnoses with significant improvement in diagnostic capability and increased the diagnosis of specific features such as vitreoretinal attachment, full thickness hole or tear and subretinal fluid. Histopathological correlation was available for five (5) different peripheral retinal pathologies imaged by both WF SS-OCT and MW UWFI and good anatomical correlation was observed in all diagnosis.
CONCLUSIONS
Navigated Single-Capture 3D and Cross-Sectional WF SS-OCT provides detailed anatomic information of the mid and peripheral neuroretina and vitreoretinal interface, allowing early recognition of vision-threatening features that may influence clinical management, particularly in an era of telemedicine or when there is limited or no access to Indirect Ophthalmoscopy with 360° Scleral Indentation.
Topics: Cross-Sectional Studies; Diabetic Retinopathy; Fluorescein Angiography; Humans; Retina; Retinal Degeneration; Retinal Detachment; Retinal Perforations; Tomography, Optical Coherence
PubMed: 34218694
DOI: 10.1177/11206721211026100 -
Ophthalmic Surgery, Lasers & Imaging... Jun 2021To evaluate the safety and efficacy of 1.0 mg risuteganib in subjects with nonexudative age-related macular degeneration (AMD). (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND AND OBJECTIVE
To evaluate the safety and efficacy of 1.0 mg risuteganib in subjects with nonexudative age-related macular degeneration (AMD).
PATIENTS AND METHODS
This was a phase 2a, prospective, double-masked, sham-controlled study. Eyes with nonexudative (dry) AMD and Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) between 20/40 and 20/200 were included. Subjects were randomized to intravitreal 1.0 mg risuteganib or sham injection. At Week 16, subjects in the risuteganib group received a second 1.0-mg dose and the sham group crossed over to receive a dose of 1.0 mg risuteganib and were evaluated at Week 28. The primary endpoint was proportion of subjects with 8 letters ETDRS or more BCVA gain from baseline to Week 28 in the risuteganib group versus baseline to Week 12 for the sham group. BCVA was tested and subjects were observed for adverse events (AEs) every 4 weeks until completion of the study at 32 weeks.
RESULTS
Forty-five subjects (risuteganib, n = 29; sham, n = 16) were enrolled in the study, of whom 39 (risuteganib, n = 25; sham, n = 14) completed the study and were included in the per protocol efficacy analysis. At baseline, mean age was 78.8 and 75.9 years and mean BCVA was 67.1 and 64.4 letters in the sham and risuteganib groups, respectively. The primary endpoint was met by 48% of the risuteganib group at Week 28 and 7% of the sham group at Week 12 ( = .013). Of the risuteganib subjects, 20% gained 15 letters or more at Week 28, whereas no patients in the sham group at Week 12 achieved this visual acuity gain. The only ocular treatment-related treatment-emergent AE was vitreous floaters, which spontaneously recovered without sequelae. No drug-related serious AE was reported.
CONCLUSIONS
Risuteganib demonstrated significant BCVA improvement in patients with non-exudative AMD. No drug-related AEs were seen during a 32-week observation period. .
Topics: Angiogenesis Inhibitors; Diabetic Retinopathy; Double-Blind Method; Humans; Intravitreal Injections; Prospective Studies; Treatment Outcome; Visual Acuity
PubMed: 34185587
DOI: 10.3928/23258160-20210528-05 -
Scientific Reports Apr 2021To describe the eyes with vitreous floaters and to analyze the development of acute symptomatic posterior vitreous detachment (PVD). A retrospective review of medical...
To describe the eyes with vitreous floaters and to analyze the development of acute symptomatic posterior vitreous detachment (PVD). A retrospective review of medical records was performed on patients with the vitreous floater developed for the first time of their life. Peripapillary vitreous opacity (pVO) was searched in Ultra-wide field (UWF) scanning laser ophthalmoscopy and PVD stage was assessed through spectral-domain optical coherence tomography (SD-OCT). 196 patients (55 males and 141 females), who were 58.4 (± 9.1) years old, visited a retinal clinic 9.4 (± 9.1) days after they experienced vitreous floaters. In 196 eyes, pVO was noticed in 122 eyes (62.2%) at UWF. In 106 eyes where SD-OCT data were available, PVD was noticed in 100 eyes (94.3%). Symptomatic eyes showed more advanced stage of PVD (p < 0.001) than symptom free eyes. Eyes with floaters were more myopic (- 0.7 ± 2.2D vs - 0.5 ± 1.9D, p = 0.02), and had lower intraocular pressure (IOP) (14.7 ± 3.2 mmHg vs 15.2 ± 3.0 mmHg, p = 0.02) than the other symptom free eyes. In patients with first floater symptoms, PVD was in progress in most of the eyes not only the symptomatic eyes but also on the contralateral symptom free eyes. Eyes with vitreous floaters were more myopic and had lower IOP than the opposite symptom free eyes.
Topics: Acute Disease; Adult; Aged; Female; Humans; Lasers; Male; Middle Aged; Ophthalmoscopy; Retrospective Studies; Tomography, Optical Coherence; Vitreous Body; Vitreous Detachment
PubMed: 33903657
DOI: 10.1038/s41598-021-88371-9