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The correlation between visual acuity outcomes and optical coherence tomography parameters following surgery for diabetic epiretinal membrane and taut posterior hyaloid
摘要： Purpose: To evaluate the relationship between visual outcomes and the determinants detected by spectral domain optical coherence tomography (OCT) in eyes with epiretinal membrane (ERM) and/or taut posterior hyaloid (TPH) that underwent pars plana vitrectomy (PPV). Materials and methods: A total of 30 participants with diabetic ERM and TPH were included in the study. All study participants underwent PPV. Preoperative and postoperative best corrected visual acuity (BCVA), peripapillary retinal nerve fiber layer (RNFL), macular RNFL, ganglion cell layer, inner plexiform layer, and ganglion cell complex thicknesses were measured in each participant. Linear regression analyses were performed to determine the association between the OCT parameters and the visual acuity measured at the time of the OCT measurement. Results: The postoperative BCVA logarithm of the minimum angle of resolution (logMAR) values were statistically higher than the preoperative values in the ERM group and TPH group (P=0.001 and P<0.001, respectively). The postoperative BCVA logMAR value was negatively correlated with average RNFL, inferior RNFL thicknesses, and image quality (P=0.002, P=0.004, and P=0.006, respectively). The preoperative and postoperative BCVA logMAR value difference was not correlated with age and all of the OCT parameters measured (P>0.05). Conclusion: This study shows that achievement of better peripapillary RNFL thickness results in better visual outcome after PPV and ERM/TPH removal.
关键词： retinal nerve fiber layer,ganglion cell complex,optical coherence tomography,taut posterior hyaloid,diabetic epiretinal membrane
更新于2025-09-23 15:22:29
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Spectral versus Time-Domain OCT in Detecting Preoperative Epiretinal Membranes that Accompany Macular Holes
摘要： Purpose: To compare the sensitivities of spectral-domain optical coherence tomography (SD-OCT) versus time-domain OCT (TD-OCT) in identifying epiretinal membranes (ERM) preoperatively in patients who underwent surgery for full-thickness macular holes (FTMH). Methods: This is an interventional retrospective case series of 59 eyes diagnosed with FTMHs who underwent 25-G pars plana vitrectomy with internal limiting membrane peeling between 2009 and 2015. Preoperative OCTs were obtained by SD-OCT (Spectralis, Heidelberg, Germany) or TD-OCT (Stratus, Carl Zeiss Meditec, Dublin, CA, USA). Volume scans were reviewed for ERM accompanying the FTMH. This was compared to indocyanine green-negative staining and intraoperative findings of ERM as the gold standard. Results: Baseline characteristics between the SD-OCT and TD-OCT groups were comparable. Mean duration of postoperative follow-up was 41.4 weeks (±49.0). Of 59 eyes, 33 (55.9%) exhibited an ERM intraoperatively. Four ERMs (SD-OCT group) compared to 12 (TD-OCT group) were not visualized on preoperative OCT (p = 0.003). Sensitivity and specificity of SD-OCT in ERM detection was 79% and 100% compared to 14% and 91% for TD-OCT. Visual acuity improved in both arms (0.5 and 0.3 logMAR units in SD-OCT and TD-OCT, respectively (p = 0.002, 0.0002). Conclusions: We found that SD-OCT was superior to TD-OCT in identifying the presence of ERM preoperatively in patients who underwent macular hole surgery. Since ERMs may decrease the chance of successful pharmacologic vitreolysis, we recommend using SD-OCT over TD-OCT in the evaluation of patients with FTMH to more accurately identify ERMs and allow more comprehensive treatment decisions (pharmacologic versus surgical).
关键词： Epiretinal membrane,Spectral-domain optical coherence tomography,Macular hole,Time-domain optical coherence tomography
更新于2025-09-23 15:22:29
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Axial length estimation error caused by hidden double-peak on partial coherence interferometry in an eye with epiretinal membrane: a case report
摘要： Here we report a patient in whom there was a myopic shift after combined cataract surgery and pars plana vitrectomy against the epiretinal membrane, related to axial measurement estimation error caused by a hidden double-peak appearance on partial coherence interferometry measurement. A 52-year-old female presented with epiretinal membrane and underwent combined cataract surgery and pars plana vitrectomy. Axial length was measured with partial coherence interferometry. Although the signal curve in the summary display showed a single peak, a 1.6 diopter myopic shift occurred. Viewed retrospectively, six of 20 individual signal curves showed a double peak. Most of them showed a higher anterior peak, with only one having a higher posterior peak. The other 14 curves showed a single peak at a similar distance to an anterior peak. The anterior peak appeared to be derived from the epiretinal membrane. The possibility of a double peak should always be considered in patients with epiretinal membrane even if the summary display of the partial coherence interferometry measurement shows a single peak. Checking all signal curves would reduce the risk of missing a hidden double peak.
关键词： master,intraocular lens,epiretinal membrane,double peak
更新于2025-09-19 17:15:36
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Combined Femtosecond Laser-Assisted Cataract Surgery and 27-Gauge Transconjunctival Sutureless Vitrectomy
摘要： 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.
关键词： phacovitrectomy,epiretinal membrane,intravitreal tamponade,femtosecond laser-assisted cataract surgery,27-gauge transconjunctival sutureless vitrectomy
更新于2025-09-19 17:13:59
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MORE EFFECTIVE SCREENING FOR EPIRETINAL MEMBRANES WITH MULTICOLOR SCANNING LASER OPHTHALMOSCOPE THAN WITH COLOR FUNDUS PHOTOGRAPHS
摘要： Purpose: To assess the ability of the multicolor scanning laser ophthalmoscope (MC-SLO) to screen for epiretinal membranes (ERMs). Methods: A retrospective cross-sectional study of 35 eyes of 32 patients with an ERM detected by optical coherence tomography and 46 eyes of 23 healthy volunteers. The detection of the ERM was graded into three visibility scores—1, not visible, 2, barely visible, and 3, clearly visible—by retina specialists or by ophthalmology residents. The sensitivity and speci?city of the detection with the merged image of the MC-SLO or color fundus photographs (CFPs) were calculated. Results: The sensitivity for ERM detection in the MC-SLO and CFP were 91.4% and 65.7% by specialists and 97.1% and 60.0% by residents. The speci?city for both devices was 100% by specialists and residents. The visibility score for the MC-SLO images were signi?cantly higher than that for the CFP by both specialists and residents. In addition, the visibility score for the MC-SLO determined by residents was signi?cantly higher than that for the CFP by specialists. Conclusion: The detection of an ERM is better with the MC-SLO images than with CFP. Furthermore, the ERM detection in the MC-SLO images by residents was comparable to that by specialists.
关键词： epiretinal membrane,multicolor scanning laser ophthalmoscope
更新于2025-09-12 10:27:22
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EFFECT OF LASER PHOTOCOAGULATION ON MACULAR EDEMA ASSOCIATED WITH MACULAR HOLES
摘要： To report the outcomes of laser therapy to barricade eccentric full-thickness macular hole with associated cystoid macular edema. We report two patients who developed an eccentric full-thickness macular hole with persistent cystoid macular edema after pars plan vitrectomy with and without internal limiting membrane peel for epiretinal membrane and the results of argon laser therapy. Barricade argon laser therapy was applied concentric to the full-thickness macular hole. Associated cystoid macular edema was noted to resolve within 1 to 3 months of therapy in both cases. Barricade laser therapy surrounding a macular hole can lead to resolution of associated cystoid macular edema. Pathogenic mechanisms to explain this favorable outcome are discussed.
关键词： cystoid macular edema,argon laser,epiretinal membrane,PPV/ILM,laser retinopexy,laser barricade,eccentric macular hole,macular hole
更新于2025-09-12 10:27:22
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Macular microvasculature features before and after vitrectomy in idiopathic macular epiretinal membrane: an OCT angiography analysis
摘要： Purpose To evaluate pre-operative and post-operative morphologic characteristics in idiopathic macular epiretinal membrane (ERM) by optical coherence tomography angiography (OCTA). Methods Thirty-three subjects with unilateral idiopathic ERM were enrolled and the contralateral eyes served as controls. Vascular parameters including super?cial capillary plexus (SCP), deep capillary plexus (DCP), outer capillary plexus (OCP), and choroidal capillary plexus (CCP) were evaluated by OCTA. Results The super?cial foveal avascular zone (FAZ) was signi?cantly smaller in eyes with ERM (P < 0.0001). The vessel densities (VDs) were signi?cantly increased in the fovea but dramatically decreased in the parafovea in SCP and DCP of ERM eyes (all P < 0.0001), in contrast to those in OCP and CCP. The blood ?ow was augmented in OCP but declined in choroid compared with the controls. In CCP, the mean foveal VD in ERM was signi?cantly smaller (P = 0.023), whereas parafoveal VD did not signi?cantly change (P = 0.66). At 6 months after surgery, ?ow area was decreased in OCP (P = 0.0007), and foveal and parafoveal VDs were signi?cantly altered in all layers except the foveal VD in OCP and the choroid (all P < 0.05). The total and inner retinal thickness of the fovea and parafovea were correlated with pre-operative and post-operative visual outcomes, respectively. Smaller FAZ and greater interocular differences between post-operative and fellow eyes in FAZ were associated with worse post-operative visual outcomes. Conclusions OCTA provides a better display of the vascular network of the retina and choroid to evaluate the severity and surgical prognosis of ERM patients.
关键词： Microvasculature,Vitrectomy,Epiretinal membrane,Optical coherence tomography angiography
更新于2025-09-10 09:29:36
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Spectral-Domain Optical Coherence Tomography Findings in Neurofibromatosis Type 2
摘要： Neurofibromatosis type 2 (NF2) is an autosomal-dominant disease, characterized by bilateral vestibular schwannomas, multiple central nervous system (CNS) tumors, skin tumors, and juvenile cataract. The present study assessed retinal abnormalities using spectral-domain optical coherence tomography (SD-OCT) in a case series of NF2 patients. METHODS. Nine NF2 patients from the neurofibromatosis outpatient reference center of the Federal University of Minas Gerais, in Brazil, were submitted to a complete anamnesis and a detailed ophthalmic evaluation, including SD-OCT, to detect retinal lesions. RESULTS. Of the nine NF2 patients evaluated, five had an early onset (<20 years) of NF2, and four patients had a late onset (>20 years) of symptoms. SD-OCT scans revealed retinal abnormalities in every patient with early onset (EOS) and in two patients with late onset (LOS) of the disease. In the EOS group, SD-OCT scans revealed flame-shaped epiretinal membranes (ERM) with peculiar characteristics in four eyes of three patients. Two patients had fine undulations of the inner retinal surface with a subtle ERM. Retinal hamartomas were present in four eyes of three patients with EOS; in two eyes, they were subclinical and were detected only by SD-OCT scans. In two patients with LOS and one patient with EOS, SD-OCT scans revealed retinal tufts of a nerve fiber layer. CONCLUSIONS. SD-OCT revealed ERM in most patients with NF2, therefore it may be a valuable exam for evaluating NF2 patients. Epiretinal membranes in NF2 has unique features, distinguishing it from idiopathic ERM or membranes associated with other diseases. We suggest that flame-shaped ERM seems to be specific for NF2 and that ERM can be considered as an important diagnostic sign of NF2.
关键词： epiretinal membrane,neurofibromatosis type 2,vestibular schwannoma,optical coherence tomography,retina
更新于2025-09-10 09:29:36
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Evaluation of Each Retinal Layer Thickness According to Preoperative OCT Patterns after Idiopathic ERM Removal
摘要： ??: ??? ???????? ? ? ????????? ???? ??? ?? ?? ?? ???? ????? ??? ??? ????, ?????? ????? ????? ???. ??? ??: ??? ?????? ??? ?? 6?? ?? ????? ???? ?? 63? 63?? ???? ????? ?????. ? ? ???????? ?? ????? ??? ???, ???, ????? ???? ?? ?? ???? ????? ??? ??? ????, ?????? ????? ??? ???. ??: ? ? ??? ???, ???, ??? ????, ?????? ??? ????? ???. ???? ?? ? ? ? ??????+????, ????, ?????? ???, ???, ??? ??? ??? ????? ???, ? ? ??????+????? ?????? ???, ???, ??? ??? ????? ??? ??? ???. ? ? ??? ???? ??? ? ? ???? ???, ????? ????? ? ? ??????+????? ?????, ?????? ????? ????? ?? ??? ????. ??: ??? ???????? ????????? ???? ??? ?? ? ? ???? ??? ??? ???. ?? ???? ??? ?? ? ? ??? ???? ?? ? ????? ???? ??? ????? ??? ???? ??? ? ???.
关键词： Epiretinal membrane,Retinal layer thickness,Optical coherence tomography
更新于2025-09-04 15:30:14
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Cross-Sectional Imaging Analysis of Epiretinal Membrane Involvement in Unilateral Open-Angle Glaucoma Severity
摘要： PURPOSE. To determine the relevance of epiretinal membranes (ERMs) in primary open-angle glaucoma (POAG) and potential risk for glaucoma severity. METHODS. Sixty eyes of 30 patients with POAG who had a unilateral ERM were analyzed; 60 nonglaucomatous eyes of 30 patients with a unilateral ERM also were recruited in this institutional cross-sectional study. Patients underwent swept-source (SS) optical coherence tomography (OCT) imaging and visual ?eld testing. Intraindividual differences in the SS-OCT retinal nerve ?ber layer (RNFL) disc cupping area measurements and visual ?eld outcomes were analyzed in the two groups. RESULTS. In patients with POAG, the mean circumpapillary RNFL thickness in the eyes with an ERM was 75.6 6 16.5 lm superiorly and 71.8 6 26.0 inferiorly compared with the fellow eyes without an ERM (87.2 6 23.6 lm, P ? 0.0061 and 81.3 6 27.7 lm, P ? 0.034, respectively). The areas of disc cupping and cup-to-disc ratio seen on OCT horizontal and vertical B-scans were larger in eyes with an ERM than in the fellow eyes without ERM (P ? 0.0004 and P ? 0.0011, respectively). The average mean deviations were (cid:2)11.6 6 7.5 dB in the ERM group and (cid:2)8.19 6 6.4 dB in the group with no ERM (P ? 0.029). Eyes with an ERM received more antiglaucoma eye drops (P ? 0.018). Those differences were not seen between eyes with an ERM or fellow eyes in patients without glaucoma. CONCLUSIONS. The presence of an ERM can be a potential risk factor for unilateral severity in eyes with POAG.
关键词： epiretinal membrane,glaucoma,inner retina
更新于2025-09-04 15:30:14