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1.
Retina ; 37(4): 782-788, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27533771

RESUMEN

PURPOSE: The evaluation of long-term results of vitreoretinal surgery and retinal capillary hemangioblastoma (RCH) resection in patients with complicated retinal detachment (RD) secondary to RCHs. METHODS: Twelve eyes of 12 patients were operated on with vitreoretinal surgery, including occlusion of afferent and efferent feeder vessels with endodiathermy and endolaser photocoagulation, and subsequent resection of RCHs. The long-term anatomical and visual outcomes were retrospectively evaluated. RESULTS: Total exudative RD was detected in six eyes and subtotal exudative RD was found in the remaining six eyes. A tractional component was present in eight eyes, and four eyes had pure exudative RD. Laser treatment had been previously applied to four eyes but vitreoretinal surgery was the primary treatment in eight eyes. A total of 19 RCHs were resected. The quadrant location of RCHs was superior temporal in six, superior nasal in five, inferior nasal in five, and inferior temporal in three. The dimensions of the RCHs ranged between 1 and 4 disk diameters (DD) (1-DD in 1 eye, 1.5-DD in 3, 2-DD in 10, 2.5-DD in 3, 3-DD in 1, and 4-DD in 1). Preoperative mean logarithm of the minimum angle of resolution visual acuity was 1.9 ± 1.0 (3.0-0.7) (20/1,588 ± 20/200 [20/20,000-20/100]). Silicone oil and C3F8 was applied to four and eight eyes, respectively. The median postoperative follow-up was 30.5 (18-48) months. Single operation and final anatomical success was obtained in 9 and 11 eyes, respectively. Mean logarithm of the minimum angle of resolution visual acuity in the postoperative 18th month and at the final visit were 1.05 ± 0.8 (3.0-0.2) (20/224 ± 20/125 [20/20,000-20/32]) and 0.96 ± 0.8 (3.0-0.2) (20/182 ± 20/125 [20/20,000-20/32]), respectively. New RCHs occurred in eight eyes. Rubeosis iridis was not present in any of the eyes. CONCLUSION: Promising anatomical and visual outcomes were obtained after vitreoretinal surgery and resection of RCHs in eyes with complicated RD secondary to RCH. However, life-long follow-up is needed to recognize recurrent RD seen even in the early period or recurrences of RCHs seen in the long-term period.


Asunto(s)
Hemangioblastoma/cirugía , Neoplasias de la Retina/cirugía , Cirugía Vitreorretiniana/métodos , Enfermedad de von Hippel-Lindau/complicaciones , Adulto , Capilares , Femenino , Hemangioblastoma/etiología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Retina/etiología , Estudios Retrospectivos , Agudeza Visual
2.
J Pediatr Hematol Oncol ; 36(7): e423-5, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25247888

RESUMEN

Aceruloplasminemia is a rare autosomal recessive disease that affects the iron metabolism of the body. When there is a lack of ceruloplasmin ferroxidase activity, iron accumulates, especially in the brain, pancreas, liver, and retina. The first symptom is generally a persistent hypochromic microcytic anemia with a mild high-serum ferritin level. The affected patients are usually recognized at later ages, when the neurological symptoms appear. The neurological outcome has an adverse effect on the prognosis, which may result in fatality. Therefore, early diagnosis and intervention may prevent a devastating neurological damage. Here, we report a case of aceruloplasminemia in a teenage girl with hypochromic microcytic anemia.


Asunto(s)
Anemia Hipocrómica/genética , Ceruloplasmina/deficiencia , Ceruloplasmina/genética , Trastornos del Metabolismo del Hierro/genética , Enfermedades Neurodegenerativas/genética , Adolescente , Anemia Hipocrómica/sangre , Anemia Hipocrómica/diagnóstico , Ceruloplasmina/metabolismo , Codón sin Sentido , Femenino , Ferritinas/sangre , Genes Recesivos , Humanos , Trastornos del Metabolismo del Hierro/sangre , Trastornos del Metabolismo del Hierro/diagnóstico , Enfermedades Neurodegenerativas/sangre , Enfermedades Neurodegenerativas/diagnóstico , Turquía
3.
Retin Cases Brief Rep ; 17(4): 466-470, 2023 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-37364210

RESUMEN

PURPOSE: To present the surgical outcome and long-term follow-up of 2 cases who underwent intravitreal bevacizumab injection for retinopathy of prematurity (ROP) and subsequently developed full thickness macular hole and endophthalmitis. METHODS: Case report. PATIENTS: The first case is a premature girl who was delivered 650 g at the 27th week of postmenstrual age (PMA) because of preeclampsia and received intravitreal 0.16 mg bevacizumab bilaterally at the 38th PMA with the diagnosis of ROP. She was referred with endophthalmitis 10 days after injection in the left eye. Endophthalmitis resolved with pars plana vitrectomy that was performed the following day. The second case is a premature girl who was delivered at the 30th week of PMA weighing 1,230 g and received intravitreal 0.16 mg bevacizumab injections bilaterally at the 39th PMA with a diagnosis of ROP. Retinopathy of prematurity regressed in the follow-up; however, full thickness macular hole was noted in the right eye on the first week of the injection. Pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade were performed at the 41st PMA week. Full thickness macular hole persisted despite pars plana vitrectomy whereas glaucoma emerged during the follow-up. CONCLUSION: Development of endophthalmitis and macular hole may occur after intravitreal injections in cases with ROP.


Asunto(s)
Endoftalmitis , Perforaciones de la Retina , Retinopatía de la Prematuridad , Recién Nacido , Femenino , Humanos , Bevacizumab/uso terapéutico , Inhibidores de la Angiogénesis/uso terapéutico , Retinopatía de la Prematuridad/diagnóstico , Retinopatía de la Prematuridad/tratamiento farmacológico , Retinopatía de la Prematuridad/cirugía , Perforaciones de la Retina/cirugía , Retina , Inyecciones Intravítreas , Vitrectomía , Endoftalmitis/diagnóstico , Endoftalmitis/etiología , Endoftalmitis/tratamiento farmacológico , Estudios Retrospectivos
4.
Eur J Ophthalmol ; 33(1): 398-407, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35924358

RESUMEN

PURPOSE: To provide consensus on the clinical use of intravitreal dexamethasone (DEX) implant for the treatment of diabetic macular edema (DME) in Turkey. METHODS: A panel of 22 retina experts prepared 77 statements of recommendation, and 80 retinal specialists practicing in Turkey were chosen to vote either in support or against each one. A Delphi-based method was used through which the ophthalmologists were able to view all of the results anonymously after two rounds and modify their subsequent answers. The survey was conducted via a mini website, and statements without consensus were resent to the specialists with the latest vote results a week later. RESULTS: A total of 72 ophthalmologists answered the first and second round questions. After the first stage, consensus was achieved on 55 of the statements, leaving 22 without agreement. After the second stage, consensus was reached on 11 of the remaining statements. Strong consensus was achieved on statements regarding the etiopathogenesis of DME and the first-line indications and safety of the DEX implant procedure. The panel recommended the use of DEX implant for patients with an arterial thromboembolic event in the last three months and also agreed that pro re nata DEX implant treatment not only provides better outcomes for DME patients but also reduces the treatment burden for those who could not receive an adequate number of anti-vascular endothelial growth factor (VEGF) injections. CONCLUSION: This study provides clinical consensus and recommendations about the use of DEX implant in the clinical practice of DME management in Turkey.


Asunto(s)
Diabetes Mellitus , Retinopatía Diabética , Edema Macular , Humanos , Edema Macular/diagnóstico , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Dexametasona , Inhibidores de la Angiogénesis/uso terapéutico , Técnica Delphi , Turquía , Factor A de Crecimiento Endotelial Vascular , Implantes de Medicamentos/uso terapéutico , Inyecciones Intravítreas , Glucocorticoides , Resultado del Tratamiento , Diabetes Mellitus/tratamiento farmacológico
5.
Turk J Ophthalmol ; 52(3): 212-215, 2022 06 29.
Artículo en Inglés | MEDLINE | ID: mdl-35770365

RESUMEN

A 39-year-old woman with progressive bilateral visual decline was diagnosed as having Bietti crystalline dystrophy in 2008. The disease course was monitored with optical coherence tomography until 2021. During the last routine eye examination in 2021, a full-thickness, slightly eccentric, visually asymptomatic macular hole with an intact foveola was noted in the left eye. No surgical treatment was recommended. The pathogenesis of full-thickness macular hole remained unclear as there were only subtle signs of prior very mild macular edema and vitreomacular interface abnormality. A degenerative process was also possible.


Asunto(s)
Enfermedades de la Retina , Perforaciones de la Retina , Adulto , Distrofias Hereditarias de la Córnea , Femenino , Estudios de Seguimiento , Humanos , Enfermedades de la Retina/complicaciones , Perforaciones de la Retina/diagnóstico , Perforaciones de la Retina/etiología , Tomografía de Coherencia Óptica/métodos
6.
Indian J Ophthalmol ; 70(1): 131-137, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34937224

RESUMEN

PURPOSE: To compare functional outcomes and complication rates of two scleral fixated intraocular lens implantation (SFIOL) techniques. METHODS: In this retrospective study, there were 30 eyes of 30 patients who underwent SFIOL implantation for dislocation of the IOL or crystalline lens. Group 1 (n = 17) comprised patients who received scleral-fixated polymethylmethacrylate (PMMA) IOL implantation through a self-sealing sclerocorneal tunnel with the suture burial technique, and group 2 (n = 13) comprised patients who received scleral-fixated foldable acrylic IOL implantation with a cartridge using a self-sealing clear corneal incision (CCI) with knotless Z-suture technique between 2014 and 2019. Surgical outcomes concerning safety, efficiency, visual function, induced astigmatism with vector analysis, and complications were compared. RESULTS: The indications were dislocated crystalline lens (n = 5/30), dislocated IOL (n = 17/30), and dropped nucleus (n = 8/30). The mean follow-up time was 50.65 ± 14.02 months in group 1 and 15.69 ± 3.71 months in group 2 (P < 0.001). The postoperative visual acuity improvement was statistically significant in both groups (P < 0.001). Surgically induced astigmatism was significantly higher in group 1 (2.68 ± 1.04 D) compared with group 2 (1.6 ± 1.0 D) at month 12 (P = 0.001). Postoperative complications included suture exposure (n = 1 in group 1) and cystoid macular edema (n = 1 in group 1; n = 1 in group 2). CONCLUSION: Both SFIOL techniques are safe and effective in the absence of adequate capsular support. However, the knotless Z-suture technique appears to be superior to the suture burial technique with regard to suture exposure-related complications. In addition, self-sealing CCI appears to be superior to self-sealing sclerocorneal tunnel with regard to surgically induced astigmatism.


Asunto(s)
Implantación de Lentes Intraoculares , Lentes Intraoculares , Humanos , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Esclerótica/cirugía , Técnicas de Sutura , Suturas
7.
Can J Ophthalmol ; 57(2): 75-81, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-34303641

RESUMEN

OBJECTIVE: To quantify microstructutal alterations in the macula and peripapillary retinal nerve fibre layer (RNFL) in patients recovered from coronavirus disease 2019 (COVID-19) using spectral domain optic coherence tomography (SD-OCT). DESIGN: Retrospective, observational. PARTICIPANTS: This comparative, cross-sectional study included patients who recovered from COVID-19 (Group 1) and age- and sex-matched normal controls (Group 2). METHODS: A comprehensive ophthalmic examination, including best-corrected visual acuity and biomicroscopic anterior and posterior segment examination was performed. SD-OCT analysis of the macula and peripapillary RNFL was obtained for each participant. In addition, patient demographics and comorbidities were recorded. RESULTS: 238 eyes of 122 subjects (Group 1: n = 63; Group 2: n = 59) were included. The incidence of coexisting comorbidity was higher in Group 1 (n = 26/63, 41.3%) compared with Group 2 (n = 12/59, 20.3%) (p = 0.013). The central foveal thickness (CFT) was significantly higher in Group 1 (271.0±26.8 µm) than Group 2 (263.2±22.0 µm) (p = 0.015). The average outer nuclear layer (ONL) thickness at central fovea in Group 1 (85.4±13.3 µm) was significantly thicker than that in Group 2 (81.4±15.2 µm) (p = 0.035). The mean peripapillary RNFL thickness of Group 1 (102.6±8.8 µm) and Group 2 (100.9±8.3 µm) were similar (p = 0.145). The mean choroidal thickness of groups at the fovea and at 1500 µm nasal and temporal to the fovea were not significantly different (p > 0.05 for all). CONCLUSION: Significant thickness alterations in individual retinal layers and CFT was detected in post-COVID-19 patients. The increase in CFT and ONL thickness might be attributed to direct infection or viral-induced inflammatory response of retina.


Asunto(s)
COVID-19 , Disco Óptico , COVID-19/epidemiología , Estudios Transversales , Humanos , Fibras Nerviosas , Nervio Óptico , Células Ganglionares de la Retina , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos , Agudeza Visual
8.
Ophthalmologica ; 225(4): 222-7, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21389739

RESUMEN

PURPOSE: To compare the efficacy of intravitreal and sub-Tenon (ST) posterior triamcinolone injection in the treatment of bilateral diabetic diffuse macular edema (DDME). METHODS: 28 eyes of 14 diabetic patients with bilateral DDME were included in this prospective randomized study. One eye of each individual received a sub-Tenon (ST) posterior triamcinolone injection (ST group), whereas the fellow eye received an intravitreal triamcinolone injection (IV group). All eyes were treated with supplementary focal laser after the injections. Cases were evaluated 1, 2, 3 and 6 months after the initial treatment. RESULTS: Both groups had visual improvement and macular edema reduction following the injections. This temporary effect was prominent for 24 weeks in the IV group and for 8 weeks in the ST group. Edema resorption and visual improvement were more pronounced in the IV group, although this difference was not statistically significant. No major complications were observed except for moderate and reversible intraocular pressure elevation in some cases. CONCLUSION: Both intravitreal and ST injections of triamcinolone appear to yield a significant visual recovery and prompt resolution of DDME. The beneficial outcome appears to be more longstanding with intravitreal injection.


Asunto(s)
Retinopatía Diabética/complicaciones , Glucocorticoides/administración & dosificación , Edema Macular/tratamiento farmacológico , Triamcinolona Acetonida/administración & dosificación , Adulto , Anciano , Retinopatía Diabética/diagnóstico , Retinopatía Diabética/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intravítreas , Edema Macular/diagnóstico , Edema Macular/etiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Cápsula de Tenon , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Agudeza Visual
9.
Curr Eye Res ; 46(9): 1363-1369, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33445962

RESUMEN

Purpose: To investigate the macular function and morphology after temporal inverted internal limiting membrane (ILM) flap technique with and without staining of the ILM flap in contact with the retinal pigment epithelium (RPE).Materials and Methods: This retrospective study included 30 patients with idiopathic macular hole (MH), who underwent 27 G vitrectomy and temporal inverted ILM flap technique with brillant blue G (BBG) assisted ILM staining. In Group 1 (n = 16), a large bubble of perfluorocarbon liquid (PFCL) measuring approximately 6-disc diameters was used to cover the hole and central part of the ILM flap whereas in Group 2 (n = 14), only a small drop of PFCL to merely cover the MH was used. Complete ophthalmic examination including microperimetry (MP), optical coherence tomography (OCT) was performed preoperatively, 6 months after surgery.Results: MH closure was achieved in all the eyes in both groups. The sizes of ellipsoid zone (EZ) and external limiting membrane (ELM) defect significantly decreased after surgery relative to the baseline width in both groups (p < .05 for all). The mean improvement in visual acuity (p = .896) and retinal sensitivity was similiar between groups (p = .409). Accordingly, the postoperative mean lengths of the EZ (p = .254) and ELM disruption (p = .406) on OCT scans were similiar between groups. However, 3 of the eyes in Group 2 developed cystoid macular edema between postoperative month-1 and month-6.Conclusion: The crescent-shaped selective staining of the ILM flap could prevent prolonged retinal toxicity of vital dyes in inverted ILM flap technique. Further studies involving larger number of patients with longer follow up are needed to determine the impact of this technique in the management of vital dye toxicity.


Asunto(s)
Membrana Basal/cirugía , Perforaciones de la Retina/cirugía , Epitelio Pigmentado de la Retina/patología , Coloración y Etiquetado/métodos , Colgajos Quirúrgicos , Vitrectomía/métodos , Anciano , Membrana Basal/patología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Perforaciones de la Retina/diagnóstico , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos , Agudeza Visual
10.
Eur J Ophthalmol ; 31(2): 649-655, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32628517

RESUMEN

PURPOSE: To quantitatively evaluate structural changes associated with inner retinal dimples (IRDs) and qualitatively classify the internal limiting membrane (ILM) flap configuration after temporal inverted ILM flap technique using spectral domain optical coherence tomography (SD-OCT). METHODS: Twenty-three eyes of 23 patients with successfully closed idiopathic, large (>400 µm) macular hole were enrolled. Patients were treated with pars plana vitrectomy followed by temporal inverted ILM flap technique. A complete ophthalmologic examination including cross sectional and en face OCT in addition to multicolor blue reflectance imaging of confocal scanning laser ophthalmoscopy (cSLO) was performed preoperatively and at postoperative month-12. The location, number, depth, and width of the IRDs were analyzed using blue reflectance images of multicolor cSLO and en face OCT. The ILM flap is also classified as smooth, wrinkled, and folded with en face OCT. RESULTS: The mean number of IRDs visualized on en face OCT (n = 23.08 ± 22.05) was statistically significantly higher compared with multicolor cSLO blue reflectance module (5.91 ± 10.58; p < 0.001). The mean depth of IRDs measured on en face OCT was 8.08 ± 3.1 µm (3-14 µm) which referred to the nerve fiber layer. The final visual acuity was associated with neither ILM flap configuration (p = 0.408), nor number of the IRDs on en face OCT (p = 0.112). CONCLUSION: En face OCT is a novel imaging modality that offers improved visualization and accuracy in identifying the features of the IRDs and the ILM flap. Additionally, it provides clear visualization of the vitreoretinal interface to distinguish whether ILM was peeled or not in the initial surgery.


Asunto(s)
Membrana Basal/cirugía , Retina/cirugía , Perforaciones de la Retina/cirugía , Colgajos Quirúrgicos , Agudeza Visual , Vitrectomía/métodos , Adolescente , Adulto , Anciano , Membrana Basal/diagnóstico por imagen , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Oftalmoscopía , Retina/diagnóstico por imagen , Perforaciones de la Retina/diagnóstico , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos , Adulto Joven
11.
Eur J Ophthalmol ; 31(2): 679-687, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31801368

RESUMEN

PURPOSE: To compare the functional, anatomical, and morphological results of conventional internal limiting membrane peeling versus temporal inverted internal limiting membrane flap technique for the treatment of macular holes larger than 400 µm. DESIGN: Retrospective, comparative case series. METHODS: A total of 33 patients were included, of whom 18 were treated with internal limiting membrane peeling (Group 1) and 15 were treated with temporal inverted internal limiting membrane flap technique (Group 2). Complete ophthalmic examination, such as microperimetry and optical coherence tomography, was performed preoperatively and at 12 months after surgery. RESULTS: The closure rates accomplished in Groups 1 and 2 were 72.2% and 100%, respectively (p = 0.036). The mean improvement in best-corrected visual acuity was logMAR 0.49 ± 0.17 in Group 1 and logMAR 0.91 ± 0.15 in Group 2 (p = 0.037). U-shaped closure was achieved in one eye in Group 1 and 12 eyes in Group 2 (p < 0.001). Complete restoration of external limiting membrane and ellipsoid zone rates were significantly higher in Group 2 (p = 0.027 and p = 0.001, respectively). CONCLUSION: The single-layered temporal inverted internal limiting membrane flap technique improves not only anatomical and morphological but also functional outcomes of surgery for large macular holes. Furthermore, this technique seems to minimize the risk of iatrogenic trauma to the nasal part of the fovea and the corresponding papillomacular bundle fibers.


Asunto(s)
Membrana Basal/cirugía , Perforaciones de la Retina/cirugía , Colgajos Quirúrgicos , Agudeza Visual , Vitrectomía/métodos , Anciano , Membrana Basal/diagnóstico por imagen , Angiografía con Fluoresceína/métodos , Fóvea Central/patología , Fondo de Ojo , Humanos , Masculino , Perforaciones de la Retina/diagnóstico , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos
12.
Eye (Lond) ; 35(8): 2164-2172, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33564140

RESUMEN

BACKGROUND/OBJECTIVES: To assess the effect of ectopic inner foveal layers (EIFL) based staging scheme, foveal avascular zone (FAZ) alterations and other microstructural optical coherence tomography (OCT) findings on visual function for patients undergoing idiopathic epiretinal membrane (iERM) surgery. SUBJECTS/METHODS: In this retrospective study, patients who underwent 27 G pars plana vitrectomy (PPV) for idiopathic ERM with a minimum follow-up of 12 months were included. Preoperative and postoperative OCT scans, FAZ area measurements on en face OCT angiography images and mean retinal sensitivity (MRS) using microperimetry were recorded in all cases. The correlation of FAZ area, EIFL and other OCT parameters with preoperative and postoperative best-corrected visual acuity (BCVA) was analysed. RESULTS: In all, 112 eyes of 112 patients were included. Visual acuity improvement was statistically significant in all four stages; however, differences between Stages 2, 3 and 4 ERMs remained significant (p < 0.05). The presence and thickness of the EIFL was associated with worse baseline (p = 0.013; p = 0.005, respectively) and final (p < 0.001 for both) BCVA. The presence of cystoid macular oedema was associated with worse BCVA at baseline (p = 0.027) and postoperative month-6 (p = 0.04). The mean FAZ area was significantly reduced in all stages of ERM compared with the fellow eyes (p < 0.05 for all). Postoperative retinal sensitivity improvement was statistically significant in Stage 1 and Stage 2. CONCLUSION: The presence of EIFL is an independent predictor of worse postoperative BCVA. Accordingly, despite significant BCVA improvements in all stages of ERM, visual acuity gain remains limited in eyes with Stage 3 and Stage 4 ERM.


Asunto(s)
Membrana Epirretinal , Mácula Lútea , Membrana Epirretinal/cirugía , Humanos , Estudios Retrospectivos , Tomografía de Coherencia Óptica , Vitrectomía
13.
Curr Eye Res ; 46(12): 1923-1930, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34138662

RESUMEN

Purpose: To compare conventional 360° internal limiting membrane (ILM) peeling and temporal inverted ILM flap technique with regard to postoperative foveal displacement.Methods: Patients who underwent 23 G vitrectomy with either 360° ILM peeling (Group 1) or temporal inverted ILM technique (Group 2) for idiopathic macular hole with a minimum follow up of 12 months were included. The metamorphopsia rates and distances between fovea and 3 retinal landmarks: the first retinal vascular bifurcation or crossover located superonasal and inferonasal to the fovea and ciliary vessel at the temporal margin of the disc, were compared on MultiColor SLO and near-infrared reflectance images. In addition, papillofoveal distance was measured on B-scan optical coherence tomography (OCT).Results: A total of 57 eyes were recruited (Group 1, n = 25; Group 2, n = 32). The visual acuity at month-1 was significantly higher in Group 2 than Group 1 (p = .007). A significant postoperative foveal displacement towards the disc was observed in Group 1 and Group 2 (p < .001 and p = .002 respectively). Shortening of the papillofoveal distance was greater in Group 1 than Group 2 at all postoperative visits (p < .05 for all). Furthermore, significant changes in papillofoveal distance continued until 6 months in Group 1 (p < .05 for all), whereas no significant changes occurred in Group 2 after month-1 (p > .05 for all). The complaints of metamorphopsia was significantly higher in Group 1 (n = 18/25) compared with Group 2 (n = 10/32) (p = .002).Conclusion: Temporal inverted ILM flap appear to be superior to 360° ILM peeling with regard to faster visual rehabilitation, lower rates of subjective metamorphopsia and less foveal displacement.


Asunto(s)
Membrana Basal/cirugía , Fóvea Central/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Desprendimiento de Retina/etiología , Perforaciones de la Retina/cirugía , Colgajos Quirúrgicos/efectos adversos , Vitrectomía/efectos adversos , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Complicaciones Posoperatorias/diagnóstico , Desprendimiento de Retina/diagnóstico , Perforaciones de la Retina/diagnóstico , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos
14.
Turk J Ophthalmol ; 51(1): 38-44, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33631914

RESUMEN

Objectives: To evaluate the functional and morphological outcomes of vitrectomy in combination with intravitreal 5% C3F8 tamponade and subretinal injections of tissue plasminogen activator (tPA) and anti-vascular endothelial growth factor (anti-VEGF) in patients with submacular hemorrhage (SMH) and to investigate the preoperative prognostic factors. Materials and Methods: This retrospective study included 30 patients (16 women, 14 men) diagnosed with SMH secondary to neovascular age-related macular degeneration (AMD). Preoperative SMH thickness and area, ellipsoid zone integrity, and postoperative reduction in the amount of subfoveal blood on optical coherence tomography and fundus photographs were assessed. Furthermore, visual acuity (VA), hemorrhage duration, and the need for additional intravitreal anti-VEGF injections were recorded. Results: The patients' mean age was 73.33±8.23 years. Mean VA improved from logMAR 2.11±0.84 at baseline to logMAR 1.32±0.91, 0.94±0.66, 1.13±0.84, and 1.00±0.70 at postoperative month 1, 2, 3, and 6, respectively. A significant negative correlation was found between hemorrhage duration and postoperative VA at month 2 (p=0.005), month 3 (p=0.019), and month 6 (p=0.012). The mean preoperative SMH duration was significantly shorter in patients who achieved total resolution of the hemorrhage compared with the subtotal resolution group (p<0.001). The mean SMH area was smaller in the patients with continuous ellipsoid zone. Conclusion: Vitrectomy and submacular tPA and anti-VEGF injections with concurrent C3F8 tamponade appears to provide adequate displacement of the hemorrhage, resulting in significant VA improvement in patients with hemorrhagic neovascular AMD. Timing of the surgery appears to be the most important factor determining the final VA.


Asunto(s)
Activador de Tejido Plasminógeno , Degeneración Macular Húmeda , Anciano , Anciano de 80 o más Años , Inhibidores de la Angiogénesis , Bevacizumab , Endotaponamiento , Femenino , Fibrinolíticos/uso terapéutico , Angiografía con Fluoresceína , Humanos , Masculino , Estudios Retrospectivos , Factor A de Crecimiento Endotelial Vascular , Agudeza Visual , Degeneración Macular Húmeda/complicaciones , Degeneración Macular Húmeda/diagnóstico , Degeneración Macular Húmeda/tratamiento farmacológico
15.
Graefes Arch Clin Exp Ophthalmol ; 248(3): 369-74, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20084390

RESUMEN

BACKGROUND: Aortic distensibility (AD) and pulse wave velocity (PWV) reflect arterial stiffness, which is linked to increased cardiovascular morbidity and mortality in different diseases such as atherosclerosis, hypertension, and diabetes mellitus, all of which are also common risk factors in patients with branch retinal vein occlusion (BRVO). In the present study, we aimed to determine whether arterial stiffness in different segments of the arterial tree is increased in patients with BRVO. METHODS: The study group consisted of 35 patients with BRVO (20 female, 15 male, mean age: 55.9+/-6.8) and the age-matched control groups consisted of 19 patients with hypertension (9 female, 10 male, mean age: 55.2+/7.6) and 17 healthy subjects (9 female, 8 male, mean age: 53.4+/-9.6). Radial artery PWV was measured using a Pulse Wave Sensor HDI system, which measures non-invasively the radial pulse-wave recording with computer analysis of the diastolic decay, and provides separate assessment of the large arterial elasticity index (LAEI) and small artery elasticity index (SAEI). Aortic strain and AD was determined echocardiographically based on the relationship between changes in aortic diameter and pressure with each cardiac pulse. Patients with diabetes mellitus or inflammatory BRVO, and control patients with any occlusive vascular eye disease, were excluded. The results of the three groups were compared. RESULTS: Compared to the subjects of the healthy control group, those with BRVO had lower LAEI (p<0.05). Both AD and aortic strain were significantly lower in the BRVO group than in both control groups (p<0.05 for both) and in the hypertensive control group than the healthy controls (p<0.05). The AD, LAEI and SAEI were positively correlated (p=0.021, r=0.307 and p=0.041, r=0.269 respectively). CONCLUSIONS: The results of this study show that the arterial stiffness indices (large arterial elasticity index and aortic distensibility) are abnormal in patients with BRVO compared to the healthy and hypertensive controls. Arterial stiffness may play a role in the onset or progression of BRVO. Further studies are needed to determine the exact role of AS in the pathogenesis of BRVO, and to reveal its value in predicting systemic morbidity and mortality in patients with BRVO.


Asunto(s)
Aterosclerosis/fisiopatología , Flujo Pulsátil , Arteria Radial/fisiopatología , Oclusión de la Vena Retiniana/fisiopatología , Velocidad del Flujo Sanguíneo , Presión Sanguínea/fisiología , Ecocardiografía Tridimensional , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad
16.
J Ophthalmol ; 2020: 7651941, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32280534

RESUMEN

PURPOSE: To report the outcomes of combined surgery using femtosecond laser-assisted cataract surgery (FLACS) and sutureless 27-gauge pars plana vitrectomy with intravitreal tamponade. METHODS: This retrospective clinical study involved 23 eyes of 23 patients on whom combined vitreoretinal surgery was performed. Patients were initially given the femtosecond laser treatment that was performed after selection of capsulotomy and lens fragmentation patterns. The capsulotomy diameter was chosen as 4.9 mm in all patients. After the femtosecond laser, the sutureless phacovitrectomy procedure was performed. At the end of surgery, perfluoropropane or sterile air tamponade was applied. RESULTS: The mean age of patients was 66.43 ± 7.61 (range, 54-83) years. Fifteen patients were females (65.2%). The mean follow-up was 16.09 ± 4.71 (range, 9-25) months. The most common surgical indication was epiretinal membrane (65.3%). The mean preoperative best-corrected visual acuity (BCVA) was 0.71 ± 0.44 (range, 1.7-0.3) logMAR, and the mean postoperative BCVA at 6 months was 0.16 ± 0.14 (range, 0.4-0) logMAR (p < 0.001). The mean target sphere refractive error was -0.24 ± 0.16 (range, -0.50-0.11) D, and the mean postoperative spherical equivalent refractive error was -0.14 ± 0.39 (range, -1.00-0.50) D at 6 months (p=0.196). All intraocular lenses (IOLs) remained well centered in the capsular bag during surgery and follow-up. There was no iris capture, posterior synechiae, capsular opacification, or pseudophakic cystoid macular edema. The only complication related to femtosecond laser was two cases of subconjunctival haemorrhage related with suction. CONCLUSIONS: FLACS is a safe and effective technique providing the advantage of repeatable, precise capsulorhexis shape and size to achieve a well-centered and stable IOL postoperatively. These advantages can certainly improve the results of vitrectomy, especially in gas-filled eyes. FLACS and 27-gauge sutureless combined surgery may be a future trend in appropriate cases.

17.
Ophthalmic Surg Lasers Imaging Retina ; 50(3): e77-e80, 2019 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-30893461

RESUMEN

Intraocular corticosteroids are used in ophthalmologic conditions such as macular edema secondary to vascular occlusions, diabetes, and uveitis. Infectious ocular diseases must be ruled out before intravitreal corticosteroid implantation. Here, the authors report a case that has been referred to their clinic for surgical treatment due to dense vitreous hemorrhage in the right eye after bilateral intravitreal dexamethasone implantation. As an intraoperative finding, diffuse changes in the color-like paleness of the retina as well as intraretinal white-colored deposits were observed. Serology tests were performed, and syphilis serology was positive. Intravenous penicillin provides resolution of inflammation. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e77-e80.].


Asunto(s)
Dexametasona/efectos adversos , Infecciones Bacterianas del Ojo/diagnóstico , Glucocorticoides/efectos adversos , Sífilis/diagnóstico , Hemorragia Vítrea/inducido químicamente , Implantes de Medicamentos , Femenino , Humanos , Edema Macular/tratamiento farmacológico , Persona de Mediana Edad
19.
J Ophthalmol ; 2018: 1757494, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29850199

RESUMEN

PURPOSE: To compare the effectiveness of sustained-release dexamethasone (DEX) intravitreal implant in nonvitrectomized eyes and vitrectomized eyes with diabetic macular edema (DME). METHODS: A retrospective review of the medical records of 40 eyes of 30 consecutive patients with diabetic macular edema who underwent intravitreal DEX implant injection. Patients were divided into 2 subgroups: 31 eyes that were nonvitrectomized (group 1) and 9 eyes that had previously undergone standard pars plana vitrectomy (group 2). The main outcome measures were BCVA and foveal thickness (FT). RESULTS: A significant improvement was seen in BCVA in both group 1 and group 2 at the 1st, 2nd, and 6th months after treatment with DEX implant (p < 0.05). In group 1, a significant reduction in FT was observed at the 1st, 2nd, and 6th months (p < 0.05). In group 2, a significant reduction in FT was seen at the 1st and 2nd months (p < 0.05), but the reduction rate at the 6th month after the injection was not statistically significant (p = 0.06). CONCLUSION: DEX implant is effective for the treatment of diabetic macular edema, and the effectiveness of the drug is similar in vitrectomized and nonvitrectomized eyes.

20.
Invest Ophthalmol Vis Sci ; 48(4): 1773-81, 2007 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-17389511

RESUMEN

PURPOSE: To evaluate the preclinical safety of intravitreal bevacizumab, which is a full-length humanized monoclonal antibody against the vascular endothelial growth factor (VEGF), in rabbit eyes over a short-term period. METHODS: Twenty-four rabbits were divided into two groups, each with two subgroups. The first group (groups 1 and 2) received 1.25 mg (0.05 mL) intravitreal bevacizumab, and the second group (groups 3 and 4) received 3.00 mg (0.12 mL) intravitreal bevacizumab. The right eyes were designated as the study eyes, and the left eyes served as a control and received the same volume of saline intravitreally. Groups 1 and 3 were labeled as early groups and scheduled to be terminated at 14 days. Groups 2 and 4, labeled as late groups, were scheduled to be terminated at 28 days. Besides electroretinography (ERG) and visually evoked potentials (VEP), central corneal thickness, intraocular pressure, fundus photography, and anterior segment imaging were performed at baseline and scheduled time points. Enucleated eyes were preserved for light and electron microscopic investigation. RESULTS: No anterior segment inflammation was observed, except in one eye in group 1 which showed a uveitic reaction. No evidence of retinal toxicity was seen with intravitreal bevacizumab at doses of 1.25 and 3.00 mg, by either ERG or light microscopy. Electron microscopic assessment revealed mitochondrial damage in the inner segments of photoreceptors. Immunohistochemical staining with bax and caspase-3 and -9 showed intensive apoptotic protein expression in all study sections and minimal expression in the control eyes. CONCLUSIONS: Although electrophysiologic investigation and light microscopy showed normal retinal function and structure, mitochondrial disruption in the inner segments of photoreceptors was detected by electron microscopy, and apoptotic expression was detected after the injection of intravitreal bevacizumab.


Asunto(s)
Inhibidores de la Angiogénesis/administración & dosificación , Anticuerpos Monoclonales/administración & dosificación , Retina/efectos de los fármacos , Factor A de Crecimiento Endotelial Vascular/inmunología , Inhibidores de la Angiogénesis/toxicidad , Animales , Segmento Anterior del Ojo/efectos de los fármacos , Segmento Anterior del Ojo/patología , Anticuerpos Monoclonales/toxicidad , Anticuerpos Monoclonales Humanizados , Bevacizumab , Caspasa 3/metabolismo , Caspasa 9/metabolismo , Evaluación Preclínica de Medicamentos , Electrorretinografía/efectos de los fármacos , Potenciales Evocados Visuales/efectos de los fármacos , Inyecciones , Presión Intraocular/efectos de los fármacos , Masculino , Mitocondrias/efectos de los fármacos , Mitocondrias/metabolismo , Mitocondrias/ultraestructura , Conejos , Retina/metabolismo , Retina/patología , Cuerpo Vítreo , Proteína X Asociada a bcl-2/metabolismo
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