ABSTRACT
<p><b>BACKGROUND</b>Managements of optic neuritis (ON) included high-dose corticosteroids or combined with systemic immunomodulatory agents. It was important to make a correct diagnosis of ON before initiation of treatment. The purpose of the study was to report and analyze the clinical features of retinal diseases in patients who were misdiagnosed as having retrobulbar ON.</p><p><b>METHODS</b>Retrospective review of 26 patients (38 eyes) initially diagnosed with retrobulbar ON but were ultimately diagnosed with retinal or macular diseases. Data obtained from fundus examination, fluorescence fundus angiography (FFA), automated static perimetry, full-field electroretinogram (ffERG), multifocal electroretinogram (mfERG), and optical coherence tomography (OCT) were evaluated.</p><p><b>RESULTS</b>Thirty-eight eyes of 26 patients were found to have misdiagnosis of retrobulbar ON, based on normal or slight abnormal fundus findings and abnormal visual evoked potentials (VEP). The mean age of the patients was 34 years and the correct diagnosis of the patients included acute zonal occult outer retinopathy (AZOOR, 15 eyes, 14 patients), occult macular dystrophy (OMD, 8 eyes, 4 patients), cone or cone-rod dystrophy (10 eyes, 5 patients), acute macular neuroretinopathy (AMNR, 3 eyes, 2 patients), and cancer-associated retinopathy (CAR, 2 eyes, 1 patient).</p><p><b>CONCLUSION</b>When attempting to diagnose retrobulbar ON in clinical practice, it is crucial to carry out necessary examinations of the retinal function and morphology to decrease misdiagnosis.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Electroretinography , Optic Neuritis , Diagnosis , Retinal Diseases , Diagnosis , Retrospective Studies , Tomography, Optical CoherenceABSTRACT
AIM: To compare the anatomical and visual outcome in primary idiopathic macular hole surgery with or without indocyanine green (ICG) stained internal limiting membrane (ILM) peeling.METHODS: The medical records of the last 40 consecurive eyes receiving primary idiopathic macular hole surgery with gas as internal tamponade performed by a single surgeon were retrospectively reviewed and ahalyzed. All eyes had a follow-up of at least 6 months. In the initial 22 consecutive eyes, no ILM peeling was performed (non-ILM peeling group). The subsequent 18eyes underwent surgery with ICG stained ILM peeling (ILM peeling group).RESULTS: The primary anatomical closure rates were 88.9% and 59.1% in the ILM peeling group and non-ILM peeling group, respectively. The difference was statistically significant (Fisher′s exact test, P=0.038). Improvement in visual acuity was more marked in the ILM peeling group than in the non-ILM peeling group, with a mean improvement of 3.6 and 1.3 lines respectively (two-tailed t-test, P=0.036). There were significantly more cases with improvement of two or more lines of visual acuity after surgery, with 66.7% in the ILM peeling group and 31.8% non-ILM peeling group (Chi-square test P =0.028). However, there was no significant difference in the final postoperative logMAR BCVA between the two groups(two-tailed t-test, P=0.073).CONCLUSION: Based on this study, ICG stained ILM peeling seems to improve the anatomical and visual outcome in primary idiopathic macular hole surgery. Further studies in this aspect are warranted.