RESUMEN
PURPOSE: To report the clinical course and images of optical coherence tomography of an eye with a stage 2 macular hole which closed spontaneously. DESIGN: Observational case report. METHODS: Serial optical coherence tomographic images were obtained. RESULTS: A 67-year-old woman received a diagnosis of stage 2 idiopathic macular hole in her right eye. The diagnosis was made with a tomographic image of a full-thickness dehiscence of the neurosensory retina at the fovea. The posterior hyaloid membrane was adhering to the edge of the dehiscence. Four weeks later, the closure of the macular hole was ascertained with optical coherence tomography. The posterior hyaloid membrane was fully separated from the fovea. CONCLUSION: A stage 2 macular hole may close spontaneously with the separation of the hyaloid membrane.
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Técnicas de Diagnóstico Oftalmológico , Perforaciones de la Retina/fisiopatología , Anciano , Femenino , Humanos , Interferometría/métodos , Luz , Remisión Espontánea , Perforaciones de la Retina/clasificación , Perforaciones de la Retina/diagnóstico , Tomografía/métodos , Agudeza Visual , Cicatrización de HeridasAsunto(s)
Enfermedades de la Coroides/tratamiento farmacológico , Coroides/irrigación sanguínea , Enfermedades Vasculares Periféricas/tratamiento farmacológico , Desprendimiento de Retina/cirugía , Perforaciones de la Retina/cirugía , Epitelio Pigmentado de la Retina/patología , Anciano , Extracción de Catarata , Enfermedades de la Coroides/complicaciones , Colorantes , Angiografía con Fluoresceína , Humanos , Verde de Indocianina , Implantación de Lentes Intraoculares , Masculino , Enfermedades Vasculares Periféricas/complicaciones , Fotoquimioterapia , Desprendimiento de Retina/diagnóstico , Desprendimiento de Retina/etiología , Perforaciones de la Retina/diagnóstico , Perforaciones de la Retina/etiología , Tomografía de Coherencia Óptica , Agudeza Visual , VitrectomíaRESUMEN
PURPOSE: To study the visual prognosis in eyes with symptomatic retinal arterial macroaneurysm (RAM). METHODS: Medical records were retrospectively reviewed for 62 patients (65 eyes) with symptomatic RAM. RESULTS: The median visual acuity at presentation was 0.4 for eyes with vitreous hemorrhage (n=6), 0.01 for eyes with premacular hemorrhage (n=9), 0.1 for eyes with submacular hemorrhage without premacular hemorrhage (n=16), 0.02 for eyes with submacular hemorrhage with premacular hemorrhage (n=16), and 0.3 for eyes with macular edema (n=18). The median value of the final visual acuity was 0.6 for vitreous hemorrhage, 0.7 for premacular hemorrhage, 0.1 for submacular hemorrhage without premacular hemorrhage, 0.1 for submacular hemorrhage with premacular hemorrhage, and 0.5 for macular edema. CONCLUSIONS: The visual prognosis for eyes with symptomatic RAM depends on the macular pathology. Eyes with vitreous hemorrhage or premacular hemorrhage recover good vision, while the vision in those with submacular hemorrhage with or without premacular hemorrhage generally remains poor. New interventions including submacular surgery or pneumatic displacement of submacular hematoma should be evaluated in a future study in terms of visual prognosis for these eyes.
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Aneurisma/fisiopatología , Aneurisma/cirugía , Coagulación con Láser , Arteria Retiniana , Anciano , Anciano de 80 o más Años , Aneurisma/complicaciones , Edema/etiología , Femenino , Humanos , Mácula Lútea , Masculino , Persona de Mediana Edad , Pronóstico , Enfermedades de la Retina/etiología , Hemorragia Retiniana/etiología , Agudeza Visual , Hemorragia Vítrea/etiologíaRESUMEN
PURPOSE: To study the relationship between foveal sensitivity and visual acuity in eyes with macular disorders exhibiting macular thickening. METHODS: We studied the relationship between foveal sensitivity, obtained as the "foveal threshold" by use of Humphrey perimetry, and best-corrected visual acuity, converted to the logarithm of the minimum angle of resolution (logMAR), for 117 eyes with epiretinal membrane (ERM), 197 eyes with retinal vein occlusion associated with macular edema (RVOME), and 158 eyes with central serous chorioretinopathy (CSC). RESULTS: Foveal sensitivity and logMAR correlated significantly for the eyes with ERM, RVOME, and CSC. Although mean foveal sensitivity was no different among the three diseases, mean logMAR was lower in eyes with CSC, i.e., visual acuity was better, than in those with ERM or RVOME (P < 0.001). CONCLUSIONS: Light sense (foveal sensitivity) is related to spatial resolution (logMAR) at the center of the fovea, in eyes with ERM, RVOME, and CSC at different strengths depending on the disease. Less pronounced reduction of visual acuity compared with foveal sensitivity in eyes with CSC could explain the tendency of these patients to complain of dimness rather than acuity loss.
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Coriorretinopatía Serosa Central/fisiopatología , Membrana Epirretinal/fisiopatología , Fóvea Central/fisiología , Edema Macular/fisiopatología , Oclusión de la Vena Retiniana/fisiopatología , Agudeza Visual/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Coriorretinopatía Serosa Central/cirugía , Femenino , Angiografía con Fluoresceína , Humanos , Coagulación con Láser , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Pruebas del Campo Visual , Campos Visuales/fisiología , Adulto JovenRESUMEN
PURPOSE: We aimed to study the temporal aspects of the postoperative reduction of retinal thickness in eyes with epiretinal membrane after vitrectomy with peeling of the epiretinal membrane and internal limiting membrane. METHODS: In a retrospective study performed as a non-comparative, interventional case series, 16 eyes from 15 patients with idiopathic epiretinal membrane who underwent vitrectomy and removal of the epiretinal membrane were followed up using optical coherence tomography measurements. Retinal thickness in the macular area was assessed by the foveal thickness and macular volume in a circle 6 mm in diameter. RESULTS: Scattergrams of the foveal thickness and macular volume were best fitted with exponential curves. The average time constants of the exponential curve for foveal thickness and macular volume changes were 31 days (range 4-109 days) and 36 days (range 5-100 days), respectively. The average expected final values for foveal thickness and macular volume were 334 microm (range 206-408 microm) and 7.53 mm(3) (range 6.57-8.66 mm(3)), respectively, which were significantly greater than those in normal controls (p < 0.0001, t-test). CONCLUSIONS: Retinal thickness decreases rapidly immediately after surgical removal of the epiretinal membrane and the reduction rate gradually slows thereafter. Approximation of the exponential curve provides an estimation of final retinal thickness after surgical removal of the epiretinal membrane; final thickness is expected to be greater than in normal eyes.
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Membrana Epirretinal/cirugía , Retina/patología , Anciano , Anciano de 80 o más Años , Femenino , Fóvea Central/patología , Fondo de Ojo , Humanos , Mácula Lútea/patología , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Retrospectivos , Factores de Tiempo , Tomografía de Coherencia Óptica , VitrectomíaAsunto(s)
Oftalmopatías/etiología , Migración de Cuerpo Extraño/etiología , Hidrogeles , Desprendimiento de Retina/cirugía , Curvatura de la Esclerótica/instrumentación , Cuerpo Vítreo/patología , Adulto , Oftalmopatías/diagnóstico , Oftalmopatías/cirugía , Migración de Cuerpo Extraño/diagnóstico , Migración de Cuerpo Extraño/cirugía , Humanos , Presión Intraocular , Masculino , Agudeza VisualRESUMEN
PURPOSE: To study the efficacy of additional intravitreal gas injection for unclosed macular holes within 2 weeks after surgery with internal limiting membrane peeling. METHODS: We reviewed the results for five consecutive eyes receiving additional intravitreal gas injection for unclosed macular holes within 2 weeks after initial macular hole surgery with internal limiting membrane peeling. The initial surgery consisted of standard pars plana vitrectomy with phacoemulsification and intraocular lens implantation, indocyanine green-assisted peeling of the retinal internal limiting membrane, and fluid-gas exchange with 20% sulfur hexafluoride. The patients were instructed to assume face down positioning for > or =7 days after surgery. If an unclosed macular hole was found after the residual gas volume decreased to <30% of the eyeball volume, fluid-gas exchange was performed using 15% octafluoropropane. RESULTS: All five eyes receiving additional intravitreal gas 7 to 14 days after vitrectomy had complete macular hole closure with macular flattening, as shown by optical coherence tomography 1 month after the additional gas injection. Visual acuity improved (range, 20/100 to 20/30). A minimum of 9 months of follow-up revealed no reopening or serious complications. CONCLUSION: Additional gas injection during the early postoperative period is recommended for eyes with unclosed macular holes that have undergone vitrectomy with internal limiting membrane peeling.