Pub Date : 2024-07-27DOI: 10.1177/24741264241264937
Ariana Allen, Yuxi Zheng, Terry Lee, Suzanna Joseph, Xinxin Zhang, Henry L. Feng, Sharon Fekrat
Purpose: To evaluate the clinical and optical coherence tomography (OCT) characteristics associated with progression of vitreomacular traction (VMT) to a full-thickness macular hole (FTMH) and lamellar macular hole (LMH). Methods: A retrospective cohort study of patients with an OCT-confirmed diagnosis of idiopathic VMT and 6 or more months of follow-up was performed. Clinical data included age, sex, race, systemic comorbidities, hormone replacement therapy, corrected visual acuity (VA), subjective visual symptoms, OCT signs, and the presence of or progression to FTMH or LMH. Results: Of the 287 eyes with VMT, 48 (16.7%) progressed to MH. Twelve eyes (4.2%) progressed to LMH, and 36 eyes (12.5%) progressed to FTMH. Female sex ( P = .02), myopic refractive status in phakic eyes ( P = .02), subjective decreased VA ( P = .01), and the presence of an inner segment–outer segment junction disruption on OCT ( P = .003) were risk factors for progression from VMT to FTMH. Subjective metamorphopsia was a risk factor for progression to FTMH ( P = .001) and LMH ( P = .01). In a subgroup analysis, patients who had an FTMH in the fellow eye were significantly more likely to have VMT progress to FTMH in the study eye (24.0% vs 8.7%; P = .04). Having an LMH in the fellow eye was not a risk factor for progression to LMH in the study eye ( P = .47). Conclusions: Risk factors were found for the progression of VMT to MH that may be clinically relevant for risk-stratifying patients presenting with VMT.
目的：评估玻璃体黄斑牵引（VMT）发展为全厚黄斑孔（FTMH）和片状黄斑孔（LMH）的相关临床和光学相干断层扫描（OCT）特征。研究方法对经 OCT 确诊为特发性 VMT 并随访 6 个月或更长时间的患者进行回顾性队列研究。临床数据包括年龄、性别、种族、全身合并症、激素替代疗法、矫正视力（VA）、主观视觉症状、OCT征象以及是否存在或进展为FTMH或LMH。结果：在 287 例 VMT 患者中，48 例（16.7%）进展为 MH。12眼（4.2%）进展为LMH，36眼（12.5%）进展为FTMH。女性（P = 0.02）、隐形眼镜的近视屈光状态（P = 0.02）、主观视力下降（P = 0.01）以及 OCT 上出现内节-外节交界处破坏（P = 0.003）是 VMT 进展为 FTMH 的风险因素。主观偏盲是发展为 FTMH ( P = .001) 和 LMH ( P = .01) 的危险因素。在一项亚组分析中，同侧眼有 FTMH 的患者，其研究眼 VMT 发展为 FTMH 的几率明显更高（24.0% vs 8.7%; P = .04）。同侧眼有 LMH 并不是研究眼发展为 LMH 的风险因素 ( P = .47)。结论：研究发现了VMT进展为MH的风险因素，这些因素可能与临床上对VMT患者进行风险分级有关。
{"title":"Risk Factors for Progression of Vitreomacular Traction to Macular Hole","authors":"Ariana Allen, Yuxi Zheng, Terry Lee, Suzanna Joseph, Xinxin Zhang, Henry L. Feng, Sharon Fekrat","doi":"10.1177/24741264241264937","DOIUrl":"https://doi.org/10.1177/24741264241264937","url":null,"abstract":"Purpose: To evaluate the clinical and optical coherence tomography (OCT) characteristics associated with progression of vitreomacular traction (VMT) to a full-thickness macular hole (FTMH) and lamellar macular hole (LMH). Methods: A retrospective cohort study of patients with an OCT-confirmed diagnosis of idiopathic VMT and 6 or more months of follow-up was performed. Clinical data included age, sex, race, systemic comorbidities, hormone replacement therapy, corrected visual acuity (VA), subjective visual symptoms, OCT signs, and the presence of or progression to FTMH or LMH. Results: Of the 287 eyes with VMT, 48 (16.7%) progressed to MH. Twelve eyes (4.2%) progressed to LMH, and 36 eyes (12.5%) progressed to FTMH. Female sex ( P = .02), myopic refractive status in phakic eyes ( P = .02), subjective decreased VA ( P = .01), and the presence of an inner segment–outer segment junction disruption on OCT ( P = .003) were risk factors for progression from VMT to FTMH. Subjective metamorphopsia was a risk factor for progression to FTMH ( P = .001) and LMH ( P = .01). In a subgroup analysis, patients who had an FTMH in the fellow eye were significantly more likely to have VMT progress to FTMH in the study eye (24.0% vs 8.7%; P = .04). Having an LMH in the fellow eye was not a risk factor for progression to LMH in the study eye ( P = .47). Conclusions: Risk factors were found for the progression of VMT to MH that may be clinically relevant for risk-stratifying patients presenting with VMT.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141797673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-27DOI: 10.1177/24741264241263167
Suzanna Joseph, Joshua Woo, Cason B. Robbins, Alice Haystead, Sandra Stinnett, Dilraj S. Grewal, Sharon Fekrat
Introduction: To evaluate longitudinal peripapillary changes in cognitively normal older adults using optical coherence tomography (OCT) and OCT angiography (OCTA). Methods: Participants older than 50 years with no history of neurodegenerative disease or cognitive impairment were prospectively enrolled. OCT and OCTA images were obtained at the first visit and 2 years later. Results: The study comprised 189 eyes of 111 adults with a mean age (±SD) of 69.3 ± 5.8 years and mean follow-up of 2.1 ± 0.5 years. Woman experienced slower rate of decline than men in capillary perfusion density (0.000% ± 0.005% vs −0.002% ± 0.004%; P = .038) and retinal nerve fiber layer (RNFL) thickness (0.133 ± 1.617 µm vs −0.659 ± 1.431 µm; P = .008). At both timepoints, after controlling for sex, the capillary perfusion density ( P < .001), capillary flux index ( P < .001), and RNFL thickness ( P = .005) were lower in older participants. The mean capillary perfusion density was higher in women than in men at both timepoints ( P = .01 and P = .002, respectively), with no significant differences in the capillary flux index and RNFL thickness. Conclusions: In cognitively normal adults, there is a significant reduction in peripapillary capillary perfusion density, the capillary flux index, and RNFL thickness associated with aging beyond 50 years. Women had higher capillary perfusion density values with slower rates of change in capillary perfusion density and RNFL thickness. These values can serve as benchmarks, and variations could be suspicious for a pathologic process.
{"title":"Longitudinal Assessment of Peripapillary Microvasculature Using Optical Coherence Tomography Angiography in Cognitively Normal Adults","authors":"Suzanna Joseph, Joshua Woo, Cason B. Robbins, Alice Haystead, Sandra Stinnett, Dilraj S. Grewal, Sharon Fekrat","doi":"10.1177/24741264241263167","DOIUrl":"https://doi.org/10.1177/24741264241263167","url":null,"abstract":"Introduction: To evaluate longitudinal peripapillary changes in cognitively normal older adults using optical coherence tomography (OCT) and OCT angiography (OCTA). Methods: Participants older than 50 years with no history of neurodegenerative disease or cognitive impairment were prospectively enrolled. OCT and OCTA images were obtained at the first visit and 2 years later. Results: The study comprised 189 eyes of 111 adults with a mean age (±SD) of 69.3 ± 5.8 years and mean follow-up of 2.1 ± 0.5 years. Woman experienced slower rate of decline than men in capillary perfusion density (0.000% ± 0.005% vs −0.002% ± 0.004%; P = .038) and retinal nerve fiber layer (RNFL) thickness (0.133 ± 1.617 µm vs −0.659 ± 1.431 µm; P = .008). At both timepoints, after controlling for sex, the capillary perfusion density ( P < .001), capillary flux index ( P < .001), and RNFL thickness ( P = .005) were lower in older participants. The mean capillary perfusion density was higher in women than in men at both timepoints ( P = .01 and P = .002, respectively), with no significant differences in the capillary flux index and RNFL thickness. Conclusions: In cognitively normal adults, there is a significant reduction in peripapillary capillary perfusion density, the capillary flux index, and RNFL thickness associated with aging beyond 50 years. Women had higher capillary perfusion density values with slower rates of change in capillary perfusion density and RNFL thickness. These values can serve as benchmarks, and variations could be suspicious for a pathologic process.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-27DOI: 10.1177/24741264241264361
Amani Davis, Jonah Blumenthal, S. Hoyek, Joseph F. Rizzo, Nimesh A. Patel
Purpose: To describe an atypical presentation of vitreous inflammation in a patient with malignant hypertension. Methods: A case was evaluated. Results: A patient presenting with a hypertensive emergency was found to have decreased vision in the setting of severe optic nerve head edema, extensive hard exudates, cotton-wool spots, and Elschnig spots in both eyes secondary to malignant hypertension as well as vitreous cells bilaterally. He was admitted to the pediatric intensive care unit for intravenous medications and observation. Conclusions: This case adds to the growing body of evidence suggesting that hypertensive urgency may be accompanied by inflammation.
{"title":"Atypical Presentation of Vitreous Inflammation in a Patient With Hypertensive Retinopathy","authors":"Amani Davis, Jonah Blumenthal, S. Hoyek, Joseph F. Rizzo, Nimesh A. Patel","doi":"10.1177/24741264241264361","DOIUrl":"https://doi.org/10.1177/24741264241264361","url":null,"abstract":"Purpose: To describe an atypical presentation of vitreous inflammation in a patient with malignant hypertension. Methods: A case was evaluated. Results: A patient presenting with a hypertensive emergency was found to have decreased vision in the setting of severe optic nerve head edema, extensive hard exudates, cotton-wool spots, and Elschnig spots in both eyes secondary to malignant hypertension as well as vitreous cells bilaterally. He was admitted to the pediatric intensive care unit for intravenous medications and observation. Conclusions: This case adds to the growing body of evidence suggesting that hypertensive urgency may be accompanied by inflammation.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141797346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-27DOI: 10.1177/24741264241264077
Silvia Medina-Medina, A. Ramírez-Estudillo, Sergio Rojas Juárez
Purpose: To describe the structural features of the autologous retinal transplant donor tissue area seen on optical coherence tomography (OCT). Methods: This observational prospective study included patients who had vitrectomy and autologous retinal graft surgery for a macular hole. OCT of the donor area was performed in the postoperative period after gas reabsorption (mean, 16.2 days ±9.8 [SD] after surgery; range, 7 to 28 days), and structural findings in the harvest area were recorded and analyzed. Results: Of the 12 eyes included in the series, most showed glial tissue or some migration of the inner nuclear layer (INL) in the donor area. Hyperreflective dots and epiretinal membranes were present in a few cases; 2 eyes showed denuded retinal epithelial pigment. Conclusions: OCT revealed changes in the donor area, predominantly filled with glial tissue, INL migration, and inflammatory signs, that mostly resolved during follow-up.
{"title":"OCT Features of the Donor Area in Autologous Retinal Transplant Surgery for Macular Hole","authors":"Silvia Medina-Medina, A. Ramírez-Estudillo, Sergio Rojas Juárez","doi":"10.1177/24741264241264077","DOIUrl":"https://doi.org/10.1177/24741264241264077","url":null,"abstract":"Purpose: To describe the structural features of the autologous retinal transplant donor tissue area seen on optical coherence tomography (OCT). Methods: This observational prospective study included patients who had vitrectomy and autologous retinal graft surgery for a macular hole. OCT of the donor area was performed in the postoperative period after gas reabsorption (mean, 16.2 days ±9.8 [SD] after surgery; range, 7 to 28 days), and structural findings in the harvest area were recorded and analyzed. Results: Of the 12 eyes included in the series, most showed glial tissue or some migration of the inner nuclear layer (INL) in the donor area. Hyperreflective dots and epiretinal membranes were present in a few cases; 2 eyes showed denuded retinal epithelial pigment. Conclusions: OCT revealed changes in the donor area, predominantly filled with glial tissue, INL migration, and inflammatory signs, that mostly resolved during follow-up.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141797436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-27DOI: 10.1177/24741264241261440
Seyyedehfatemeh Ghalibafan, Louis Z. Cai, Brandon Graham Chou, Nimesh A. Patel, Abdulla R. Shaheen, Nicolas A. Yannuzzi
Purpose: To assess current trends in vitreoretinal surgical fellowship training for placement of secondary intraocular lenses (IOLs). Methods: A cross-sectional survey was administered to vitreoretinal surgical fellowship graduates who completed their program between 2019 and 2023. Results: Completed responses were obtained from 70 (22.5%) of 311 eligible recipients. Training settings included academic (80%), hybrid academic/private practice (15%), and private practice (5%). During their fellowship, the majority of respondents reported 10 or fewer cases using anterior chamber (AC) IOLs (69%), 5 to 50 cases using scleral-sutured IOLs (64%), and 5 to 25 cases using sutureless scleral-fixated IOLs (52%). Most fellows (79%) did not have exposure to iris-fixated IOL placement during fellowship training. The Akreos AO60 (78%) and Envista MX60 (10%) IOLs were the most common choice for scleral-sutured placement. Most fellows (67%) placed fewer than 10 secondary IOLs through scleral tunnels. Overall, scleral-sutured IOL placement (Akreos Gore-Tex [polytetrafluoroethylene] sutured, 49%) and scleral-fixated IOLs (modified Yamane, 45%) were the preferred and most comfortable surgical techniques for recent graduates after completing training. There was a significant association between surgical case volume during fellowship training and self-reported competency for each type of secondary IOL ( P ≤ .005). Conclusions: The majority of vitreoretinal surgical fellows receive limited training in the placement of AC IOLs or construction of scleral tunnels during their fellowship. Aligned with their experience during fellowship, recent graduates generally prefer implanting scleral-fixated or scleral-sutured IOLs. Analysis of trainees’ exposure to various techniques and postgraduate surgical preferences may identify areas for improvement in surgical education.
{"title":"Cross-Sectional Survey of Vitreoretinal Surgery Fellowship Training in Secondary Intraocular Lens Placement","authors":"Seyyedehfatemeh Ghalibafan, Louis Z. Cai, Brandon Graham Chou, Nimesh A. Patel, Abdulla R. Shaheen, Nicolas A. Yannuzzi","doi":"10.1177/24741264241261440","DOIUrl":"https://doi.org/10.1177/24741264241261440","url":null,"abstract":"Purpose: To assess current trends in vitreoretinal surgical fellowship training for placement of secondary intraocular lenses (IOLs). Methods: A cross-sectional survey was administered to vitreoretinal surgical fellowship graduates who completed their program between 2019 and 2023. Results: Completed responses were obtained from 70 (22.5%) of 311 eligible recipients. Training settings included academic (80%), hybrid academic/private practice (15%), and private practice (5%). During their fellowship, the majority of respondents reported 10 or fewer cases using anterior chamber (AC) IOLs (69%), 5 to 50 cases using scleral-sutured IOLs (64%), and 5 to 25 cases using sutureless scleral-fixated IOLs (52%). Most fellows (79%) did not have exposure to iris-fixated IOL placement during fellowship training. The Akreos AO60 (78%) and Envista MX60 (10%) IOLs were the most common choice for scleral-sutured placement. Most fellows (67%) placed fewer than 10 secondary IOLs through scleral tunnels. Overall, scleral-sutured IOL placement (Akreos Gore-Tex [polytetrafluoroethylene] sutured, 49%) and scleral-fixated IOLs (modified Yamane, 45%) were the preferred and most comfortable surgical techniques for recent graduates after completing training. There was a significant association between surgical case volume during fellowship training and self-reported competency for each type of secondary IOL ( P ≤ .005). Conclusions: The majority of vitreoretinal surgical fellows receive limited training in the placement of AC IOLs or construction of scleral tunnels during their fellowship. Aligned with their experience during fellowship, recent graduates generally prefer implanting scleral-fixated or scleral-sutured IOLs. Analysis of trainees’ exposure to various techniques and postgraduate surgical preferences may identify areas for improvement in surgical education.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1177/24741264241265180
Janani Sreenivasan, A. R. Anand, Shobit Varma, Garima
Purpose: To describe a case of postoperative Nocardia endophthalmitis that proved to be challenging. Methods: A 64-year-old woman presented with a clinical picture of postoperative endophthalmitis, which was managed by vitrectomy with intraocular lens explantation. Nocardia puris, sensitive to amikacin, cotrimoxazole (trimethoprim–sulfamethoxazole), and ciprofloxacin, was isolated in culture. The patient received intracameral and intravenous amikacin. On the sixth postoperative day, the infection appeared controlled; however, a macular infarction developed. One month later, the patient presented with recurrent infection (iris nodule and vitritis). After consultation with an infectious disease specialist, oral trimethoprim–sulfamethoxazole and oral moxifloxacin were started. Treatment continued for 6 months. Results: At the 3-month and 6-month follow-ups, the iris nodules had regressed in size with no new visible lesions. The vitreous cavity was clear, and the retina was attached; however, the best-corrected visual acuity was poor because of the macular infarction. Conclusions: This case highlights the importance of obtaining a microbiological diagnosis with sensitivity in cases of Nocardia endophthalmitis and its use in the aggressive management of the infection, including frequent monitoring for recurrences.
{"title":"Challenging Case of Postoperative Nocardia Endophthalmitis","authors":"Janani Sreenivasan, A. R. Anand, Shobit Varma, Garima","doi":"10.1177/24741264241265180","DOIUrl":"https://doi.org/10.1177/24741264241265180","url":null,"abstract":"Purpose: To describe a case of postoperative Nocardia endophthalmitis that proved to be challenging. Methods: A 64-year-old woman presented with a clinical picture of postoperative endophthalmitis, which was managed by vitrectomy with intraocular lens explantation. Nocardia puris, sensitive to amikacin, cotrimoxazole (trimethoprim–sulfamethoxazole), and ciprofloxacin, was isolated in culture. The patient received intracameral and intravenous amikacin. On the sixth postoperative day, the infection appeared controlled; however, a macular infarction developed. One month later, the patient presented with recurrent infection (iris nodule and vitritis). After consultation with an infectious disease specialist, oral trimethoprim–sulfamethoxazole and oral moxifloxacin were started. Treatment continued for 6 months. Results: At the 3-month and 6-month follow-ups, the iris nodules had regressed in size with no new visible lesions. The vitreous cavity was clear, and the retina was attached; however, the best-corrected visual acuity was poor because of the macular infarction. Conclusions: This case highlights the importance of obtaining a microbiological diagnosis with sensitivity in cases of Nocardia endophthalmitis and its use in the aggressive management of the infection, including frequent monitoring for recurrences.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141806444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1177/24741264241262104
Thiago José Muniz Machado Mazzeo, G. C. Barbosa, Renato Silva Filho, Raimunda Cristina Mendonça Freire, Cleide Guimarães Machado, André Marcelo Vieira Gomes
Purpose: To describe the successful closure of an idiopathic macular hole (MH) with topical therapy after surgery failed. Methods: A case report was evaluated and prospective literature review performed. Results: After surgery to correct an MH in a 57-year-old female patient failed, topical therapy was initiated. MH closure was successful using this modality. Conclusions: There are few reports in the literature describing successful closure of an idiopathic full-thickness MH with topical therapy after initial surgery fails. This reinforces the importance of the “hydration” hole in this disease. Characterization with optical coherence tomography may help determine which patients could benefit from topical treatment for MH closure and avoid costly and invasive surgical procedures.
{"title":"Successful Closure of an Idiopathic Macular Hole With Topical Therapy After Failed Surgery","authors":"Thiago José Muniz Machado Mazzeo, G. C. Barbosa, Renato Silva Filho, Raimunda Cristina Mendonça Freire, Cleide Guimarães Machado, André Marcelo Vieira Gomes","doi":"10.1177/24741264241262104","DOIUrl":"https://doi.org/10.1177/24741264241262104","url":null,"abstract":"Purpose: To describe the successful closure of an idiopathic macular hole (MH) with topical therapy after surgery failed. Methods: A case report was evaluated and prospective literature review performed. Results: After surgery to correct an MH in a 57-year-old female patient failed, topical therapy was initiated. MH closure was successful using this modality. Conclusions: There are few reports in the literature describing successful closure of an idiopathic full-thickness MH with topical therapy after initial surgery fails. This reinforces the importance of the “hydration” hole in this disease. Characterization with optical coherence tomography may help determine which patients could benefit from topical treatment for MH closure and avoid costly and invasive surgical procedures.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141808290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1177/24741264241262102
Michael Balas, Mark A. Mandell, Parnian Arjmand
Purpose: To describe a case of retinal arterial macroaneurysm, a rare, focal arterial dilatation that is commonly found temporally within the first 3 orders of retinal arterial bifurcations. Methods: An observational case report was evaluated. Results: A 49-year-old man with prediabetes and hypercholesteremia presented with decreasing vision and a paracentral scotoma in the right eye. His ocular history was insignificant. There was significant intraretinal and subretinal fluid with perifoveal exudates. After 2 intravitreal injections of aflibercept for a tentative diagnosis of branch retinal vein occlusion, there was no improvement. Intravenous fluorescein angiography showed a small retinal arterial macroaneurysm less than 60 µm from the foveal avascular zone that was treated with low-power focal laser photocoagulation. This resulted in complete resolution of the macular edema with significant improvement in visual acuity. Conclusions: This rare and successfully treated case of an exudative juxtafoveal retinal arterial macroaneurysm highlights the importance of multimodal imaging in establishing an accurate diagnosis.
{"title":"Juxtafoveal Retinal Arterial Macroaneurysm Diagnosed on Ancillary Imaging","authors":"Michael Balas, Mark A. Mandell, Parnian Arjmand","doi":"10.1177/24741264241262102","DOIUrl":"https://doi.org/10.1177/24741264241262102","url":null,"abstract":"Purpose: To describe a case of retinal arterial macroaneurysm, a rare, focal arterial dilatation that is commonly found temporally within the first 3 orders of retinal arterial bifurcations. Methods: An observational case report was evaluated. Results: A 49-year-old man with prediabetes and hypercholesteremia presented with decreasing vision and a paracentral scotoma in the right eye. His ocular history was insignificant. There was significant intraretinal and subretinal fluid with perifoveal exudates. After 2 intravitreal injections of aflibercept for a tentative diagnosis of branch retinal vein occlusion, there was no improvement. Intravenous fluorescein angiography showed a small retinal arterial macroaneurysm less than 60 µm from the foveal avascular zone that was treated with low-power focal laser photocoagulation. This resulted in complete resolution of the macular edema with significant improvement in visual acuity. Conclusions: This rare and successfully treated case of an exudative juxtafoveal retinal arterial macroaneurysm highlights the importance of multimodal imaging in establishing an accurate diagnosis.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141806655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1177/24741264241263457
Aniruddha Agarwal, Nicola G. Ghazi, Ibraheem El Ghrably, Claudio Iovino, Enrico Peiretti, Yasmine Alcibahy, N. Menia, Jay K. Chhablani, Francesco Pichi, Dilraj S. Grewal
Purpose: To compare the efficacy and safety of color channel optimization with 3-dimensional (3D) heads-up vitrectomy (3D HUD group) vs standard operating microscope vitrectomy (control group) for macular surgery. Methods: This retrospective multicenter comparative study comprised patients having 25-gauge pars plana vitrectomy for macular hole, epiretinal membrane (ERM), or vitreomacular traction. The minimum follow-up was 6 months. Surgeons completed a subjective questionnaire after each case. The main outcome measures were safety related (dye reinjection rate, macular ERM or internal limiting membrane [ILM] peeling time, endoillumination intensity). Other outcome measures included total surgical time, surgical outcomes, and subjective surgeon-related parameters. Results: The study included 74 eyes (36 in 3D HUD group; 38 in control group). There were no statistical differences in baseline parameters between groups. Significantly more eyes in the control group than in the 3D HUD group required dye reinjection (23.7% vs 5.6%; P = .03). Less time was required for ERM and ILM peeling in the 3D HUD group (both P < .01); however, the total surgical time was the same between groups. Eyes in the 3D HUD group required lower endoillumination ( P < .001). There were no between-group differences in the rates of complications. Surgeons said depth perception was better in the control group (P < .001), with no differences in comfort or visibility. Conclusions: 3D heads-up–based color channel optimization for macular surgeries is safe and effective. Although it may have safety advantages, it did not affect the visual or anatomic outcomes or total surgical time and did not improve surgeon comfort or visibility.
{"title":"Use of Color Channel Optimization in 3D Heads-Up Vitrectomy vs Standard Operating Microscope for Macular Surgeries","authors":"Aniruddha Agarwal, Nicola G. Ghazi, Ibraheem El Ghrably, Claudio Iovino, Enrico Peiretti, Yasmine Alcibahy, N. Menia, Jay K. Chhablani, Francesco Pichi, Dilraj S. Grewal","doi":"10.1177/24741264241263457","DOIUrl":"https://doi.org/10.1177/24741264241263457","url":null,"abstract":"Purpose: To compare the efficacy and safety of color channel optimization with 3-dimensional (3D) heads-up vitrectomy (3D HUD group) vs standard operating microscope vitrectomy (control group) for macular surgery. Methods: This retrospective multicenter comparative study comprised patients having 25-gauge pars plana vitrectomy for macular hole, epiretinal membrane (ERM), or vitreomacular traction. The minimum follow-up was 6 months. Surgeons completed a subjective questionnaire after each case. The main outcome measures were safety related (dye reinjection rate, macular ERM or internal limiting membrane [ILM] peeling time, endoillumination intensity). Other outcome measures included total surgical time, surgical outcomes, and subjective surgeon-related parameters. Results: The study included 74 eyes (36 in 3D HUD group; 38 in control group). There were no statistical differences in baseline parameters between groups. Significantly more eyes in the control group than in the 3D HUD group required dye reinjection (23.7% vs 5.6%; P = .03). Less time was required for ERM and ILM peeling in the 3D HUD group (both P < .01); however, the total surgical time was the same between groups. Eyes in the 3D HUD group required lower endoillumination ( P < .001). There were no between-group differences in the rates of complications. Surgeons said depth perception was better in the control group (P < .001), with no differences in comfort or visibility. Conclusions: 3D heads-up–based color channel optimization for macular surgeries is safe and effective. Although it may have safety advantages, it did not affect the visual or anatomic outcomes or total surgical time and did not improve surgeon comfort or visibility.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141807940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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