May 2018 – Volume 38 – Issue 5
Internal limiting membrane peeling improves MH closure rates but can have several consequences on retinal structure and function. Adjuvants to aid peeling, instrumentation, technique, and experience may all alter the outcome. Hole size and other variables are important in assessing the requirement for peeling and potentially its extent. A variety of evolving alternatives to conventional peeling may improve outcomes and need further study
Although the review found increased risk of open-angle glaucoma with pars plana vitrectomy, the studies were heterogenous or inconsistent regarding ocular hypertension and intraocular pressure increase. Larger studies should be conducted in homogenous cohorts of patients undergoing macular surgery, excluding complex conditions such as retinal detachment or diabetic retinopathy.
Patients with smaller MHs and vitreomacular adhesion had superior final visual acuity and better restoration of the outer retinal structure after MH surgery
Preoperative CFT ( Central Foveal Thickness) is important for the visual prognosis of patients with vitreomacular traction. Preoperative CFT of these patients should be considered in surgical decisions
We found no significant difference in gas-foveal contact between the positioning groups ( face-down positioning (FDP) and nonsupine positioning (NSP) ) .
The role of positioning after idiopathic macular hole surgery seems to be better characterized from examining both patient positioning and gas fill objectively. We propose gas-foveal contact as a new outcome for evaluating positioning regimens.
In dome-shaped macula (DSM) , retinal sensitivity (Se) evaluation better reflects the central functional impairment than best-corrected visual acuity, particularly when some optical coherence tomography features, such as foveal subretinal fluid and higher bulge height, are present
Larger gamma and delta zones were correlated with larger optic disk and more marked vertical optic disk rotation, longer disk-fovea distance, higher number of chorioretinal lesions, and longer temporal vascular arcade diameter. Parapapillary gamma and delta zones may develop before chorioretinal lesions develop and enlarge
The IOP is lowest in the sitting position and highest in the prone position in both silicone oil and normal groups. Between both groups, the amount of IOP elevations is equivalent in each position compared with sitting with face forward.
Ophthalmologists should be aware that IOP is higher in the prone position and that it should be monitored accordingly
BIRD ATTACK OCULAR INJURIES
This study evaluated the eye injuries among 30 Iranian patients caused by bird attack. The most common bird attacking the patients was mynah bird, and the presence of endophthalmitis as well as lower baseline best-corrected visual acuity were significant risk factors for worse visual outcomes.
Transient improvement in visual acuity occurs when patients undergoing chronic ranibizumab are switched to aflibercept therapy for treatment of neovascular age-related macular degeneration.
The outer nuclear layer is thinner in eyes with pachychoroid pigment epitheliopathy than eyes with uncomplicated pachychoroid and eyes of healthy subjects. The degenerative process of pachychoroid spectrum diseases may begin with retinal pigment epithelium alterations before subretinal fluid accumulation.
This study was a prospective, double-blind, placebo-controlled evaluation of oral eplerenone for the treatment of chronic central serous chorioretinopathy.
The results demonstrated improved visual acuity measurements as well as anatomic outcomes, as shown by reductions in mean maximal subretinal fluid height, subfoveal fluid height, and central subfield thickness
In this study, 20 eyes with diabetic macular edema were treated with intravitreal bevacizumab. Central choroidal thickness significantly decreased after treatment and this reduction significantly correlated with central macular thickness reduction and vision improvement.
After treatment of diabetic macular edema with intravitreal injection of bevacizumab, CCT decreased and this reduction significantly correlated with CMT reduction and vision improvement.
Optical coherence tomography angiography (OCTA) revealed increased vessel tortuosity as severity of diabetic retinopathy (DR) was more in nonproliferative diabetic retinopathy (NPDR), but decreased vessel tortuosity in proliferative diabetic retinopathy (PDR). Vessel tortuosity determined using OCTA might be an indicator of severity of DR.
In conclusion, vessel tortuosity increased as DR
progressed, but decreased in PDR. Vessel tortuosity
may be a new quantitative marker of DR progression
in OCTA imaging.
Sixty eyes of 60 pseudophakic patients affected with idiopathic macular pucker were enrolled in this prospective, randomized clinical study to compare functional and anatomical outcomes between eyes that underwent 25-gauge vitrectomy and internal limiting membrane peeling (“Control group”) and eyes that received also intraoperative sustained-release dexamethasone (“DEX group”)
Intraoperative sustained-release dexamethasone implant, a powerful antiinflammatory agent with significant efficacy in vitrectomized eyes, did not result in a significant change in macular thickness and volume compared with the vitrectomy alone without dexamethasone implant at 6-month follow-up. These data support the hypothesis that its etiology does not seem to be mainly related to an inflammatory process
Microstructural abnormalities were frequently noted on OCT of CMV retinitis, including within the retina beyond the leading edge of retinitis identified by corresponding fundus imaging. Outer retinal abnormalities were noted more frequently than inner retinal abnormalities beyond the leading edge of retinitis. These findings provide insight into the effects of CMV retinitis on retinal microstructure and potentially on vision and highlight the potential utility of OCT for monitoring microprogression of macula-involving CMV retinitis
Endogenous candida endophthalmitis showed peculiar features on SD-OCT. Two distinct patterns of chorioretinal involvement influencing the final best-corrected visual acuity were identified. Spectral domain optical coherence tomography could be useful in the diagnosis, management, and outcome prediction in Endogenous candida endophthalmitis
Peculiar hyper-reflective preretinal aggregates obscuring the underlying retina because of a shadowing effect (“rain-cloud” sign) were noticed in all eyes with vitreous involvement. Two patterns of retinal and choroidal findings were identified: the first (six eyes) confined within the inner retinal layers (Intraretinal Pattern), the second (nine eyes) involving both retina (full thickness) and choriocapillaris (Chorioretinal Pattern). None of the eyes showed both patterns. None of the eyes, regardless the pattern, showed choroidal thickening.