RESULTS OF MACULAR HOLE SURGERY: Evaluation Based on the International Vitreomacular Traction Study Classification.

PURPOSE: To evaluate the differences in anatomical and visual function changes after macular hole (MH) surgery using the International Vitreomacular Traction Study classification. METHODS: Patients who underwent vitrectomy and blood-assisted internal limiting membrane peeling because of MHs were enrolled in the present study. The patients were divided into three groups according to the sizes of their MHs (small: ≤250 µm, medium: >250 µm and ≤400 µm, and large: >400 µm). The effect of vitreomacular traction on the outcome was also analyzed. All the patients were followed for at least 12 months. The changes in best-corrected visual acuity and the outer retina at the foveal area were monitored using spectral-domain optical coherence tomography. RESULTS: A total of 146 eyes of 146 patients were enrolled. The patients with small MHs showed significantly better mean final visual acuity (mean: 20/58) than patients with large MHs (20/178, P < 0.05). There was no significant difference between patients with small- and medium-sized MHs (20/69). Longitudinal analysis showed that the presence of vitreomacular traction was related to a better restoration of the outer retinal structure and visual acuity. CONCLUSION: Patients with smaller MHs and vitreomacular adhesion had superior final visual acuity and better restoration of the outer retinal structure after MH surgery.

Mycophenolate sodium in the treatment of corticosteroid-refractory non-infectious inflammatory uveitis (MySTRI study).

OBJECTIVES: To evaluate the therapeutic effect and safety profile of next generation mycophenolate sodium (MPS), which is different from mycophenolate mofetil with an enteric-coated formulation, in corticosteroid-refractory non-infectious inflammatory uveitis (CRU) patients. METHODS: Prospective, uncontrolled, open-label interventional case series. Forty consecutive patients at a tertiary uveitis referral centre received 6 months of oral MPS as the treatment regimen with follow-up 12 months. The main outcome measures were best-corrected visual acuity (BCVA), inflammatory index, steroid-sparing effect of tapering prednisone to ≤10 mg daily and side effects. RESULTS: Mean age of enroled patients was 49 (49 ± 13) years and 29 (72.5%) were female. Thirty-six (90.0%) had bilateral disease. There were 0 (0%) anterior uveitis, 2 (5.0%) intermediate uveitis, 22 (55.0%) posterior uveitis, and 16 (40.0%) panuveitis. Vogt-Koyanagi-Harada disease was the most common diagnosis (17/40, 42.5%), followed by idiopathic panuveitis (8/40, 20%) and idiopathic retinal vasculitis (5/40, 12.5%). LogMAR BCVA improved from 0.9 (SD = 0.09) to 0.31 (SD = 0.08) after 6 months of MPS with good steroid-sparing effect (p = 0.012). Further maintenance in LogMAR BCVA was evident after MPS discontinuation from 6th month to 12th month, from 0.31 (SD = 0.08) to 0.33 (SD = 0.07), respectively (p = 0.81). MPS was the only immunosuppressive drug needed to reach quiescent state in 29 patients (72.5%). The drug-related safety profile was satisfactory. CONCLUSION: MPS is an effective steroid-sparing drug for the treatment of CRU. The effect seen was not only during the 6 months of therapy, but also extended to 12 months to maintain BCVA and inflammation control. The side effects were acceptable.