A Case of Acute Angle-closure Glaucoma Secondary to Spontaneous Suprachoroidal Hemorrhage

PURPOSE: To report a case of acute angle-closure glaucoma secondary to spontaneous suprachoroidal hemorrhage in a hemodialysis patient. CASE SUMMARY: A 71-year-old man visited our clinic after 3 days of vision loss and ocular pain in the right eye. He had been treated with hemodialysis using heparin due to diabetic nephropathy. Visual acuity (VA) was hand motion in the right eye and 0.2 in the left eye. The intraocular pressure (IOP) was 58 mmHg in the right eye and 15 mmHg in the left eye. Gonioscopic examination revealed a closed angle in the right eye. Fundus examination of the right eye showed a massive hemorrhagic retinal detachment and ultrasound sonography revealed a dome-shaped retinal detachment with suprachoroidal hemorrhage in the right eye. The patient was treated with topical aqueous suppressants and cycloplegics. After two weeks of medical treatment, VA in the right eye was still hand motion and IOP was 8 mmHg. Gonioscopic examination showed a wide-open angle in the right eye. During the two-month observation period, VA in the right eye did not recover, however there was no sign of IOP elevation or symptoms of ocular pain. CONCLUSIONS: Spontaneous suprachoroidal hemorrhage can occur in patients who receive hemodialysis with heparin. This spontaneous suprachoroidal hemorrhage can be subsequently accompanied by acute angle-closure glaucoma. Spontaneous decrease of suprachoroidal hemorrhage, loss of angle-closure, and decline of IOP can be expected by treating with topical aqueous suppressants and cycloplegics.

Retinoic Acid Syndrome and Pseudotumor Cerebri in Patients with Acute Promyelocytic Leukemia

PURPOSE: To report cases of a retinal, preretinal and vitreous hemorrhage due to retinoic acid syndrome and a papilledema caused by increased intracranial pressure in patients with acute promyelocytic leukemia treated with all-trans retinoic acid (ATRA). CASE SUMMARY: (Case 1) A 48-year-old female visited our clinic with headache, dyspnea, and visual disturbance during ATRA medications for acute promyelocytic leukemia. Her visual acuity of both eyes was hand motion, and fundus examination revealed extensive retinal, preretinal, and vitreous hemorrhage. The laboratory test showed leukocytosis and computed tomography of brain and chest revealed subarachnoid hemorrhage and pulmonary alveolar hemorrhage. She was diagnosed with retinoic acid syndrome and was treated with vitrectomy in both eyes. (Case 2) A 17-year-old male, who had been treated with ATRA for acute promyelocytic leukemia, had headache and visual disturbance. His best-corrected visual acuity was 1.0 in both eyes, but the fundus examination showed papilledema and retinal hemorrhage in both eyes. Goldmann visual field examination revealed an enlarged blind spot in both eyes. He was diagnosed with papilledema caused by ATRA induced increased intracranial pressure, and was observed. CONCLUSIONS: Patients with acute promyelocytic leukemia treated with ATRA may have retinoic acid syndrome and increased intracranial pressure that could result in retinal hemorrhage, vitreous hemorrhage, and papilledema.

Short-term Analysis of the Residual Volume of an Eye Drop Following 23-Gauge Microincision Vitrectomy Surgery

PURPOSE: To evaluate the change of residual volume of eye drop after instillation in patients with 23-gauge microincision vitrectomy surgery (MIVS). METHODS: Patient who were treated 23-gauge MIVS from November 2014 to July 2015 were included. The residual volume was defined as the amount of remnant eye drop in patient's eyes after instillation, calculated as the difference between instillation volume and spilled volume of eye drop. Calculation of residual volume of eye drop was performed one day before surgery, and daily from postoperative day 1 to day 5. RESULTS: Forty consecutive patients were included. The residual volume of eye drop decreased from 30.3 ± 1.4 µL at baseline to 13.0 ± 1.5 µL at day 1, 18.3 ± 1.6 µL at day 2, 24.7 ± 1.5 µL at day 3, and 27.9 ± 1.4 µL in day 4, postoperatively (p < 0.001, respectively). The volume at postoperative day 5 was 29.4 ± 1.3 µL, but it was not different from the volume at baseline (p = 0.105). The change of residual volume was significantly correlated with postoperative chemosis (r = 0.672, p < 0.001) and effected by the number of quadrant with postoperative chemosis (p < 0.05). CONCLUSIONS: This study shows that postoperative residual volume of eye drop after instillation decreased until postoperative day 4, and postoperative chemosis affects the change of residual volume. Thus, checking proper use of eye drops and teaching about instillation technique by physician is necessary for patients with 23-gauge MIVS.

Central Retinal Artery Occlusion by Left Atrial Myxoma

No abstract available.

Three Cases of Outer Retinal Tubulation in Bietti's Crystalline Dystrophy

PURPOSE: To report the prevalence and the characteristics of outer retinal tubulation (ORT) in Bietti's crystalline dystrophy in 6 eyes of 3 patients. CASE SUMMARY: Three patients with Bietti's crystalline dystrophy were examined using color fundus photography, fundus autofluorescence picture, spectral domain optical coherence tomography (SD-OCT), fluorescein angiography, electroretinogram and electrooculogram. ORT was detected in 3 of 3 (100%) Bietti's crystalline dystrophy patients. SD-OCT B-scan revealed hyperreflective material inside the hyporeflective internal space with hyperreflective border. ORT was observed under the fovea or outside the fovea and on the outer nuclear layer in the retina. ORTs were no greater than 70 x 140 microm in size when measured using SD-OCT B-scan image. CONCLUSIONS: ORT was observed frequently in patients with Bietti's crystalline dystrophy. These findings can potentially predict the extensive photoreceptor abnormalities in retinal pigment epithelial atrophy.

Surgical Outcomes of Taking a Reading Position after Air Tamponade in Idiopathic Macular Hole

PURPOSE: In this study we compared the postoperative hole closure rate and average vision between a group who assumed a face-down position for a week using gas and a group who assumed a reading position after fluid air exchage (FAX), both after receiving internal limiting membrane (ILM) peeling during vitrectomy in patients with idiopathic macular hole. METHODS: This study included 25 eyes of patients diagnosed with idiopathic macular hole that underwent vitrectomy. Group I assumed a face-down position for a week after intraocular gas tamponade after FAX during vitrectomy and Group II assumed a reading position for 3 days after only FAX. The hole closure rate and the best-corrected visual acuity (BCVA) were compared between the 2 groups 6 months postoperatively. RESULTS: The preoperative mean macular hole size was 456.2 +/- 164.1 microm in Group I and 411.2 +/- 105.7 microm in Group II and the differences between the 2 groups were not statistically significant (p = 0.647). At 6 months after surgery, the macular hole closure rate was 93% in Group I and 100% in Group II (p = 0.571) and the BCVA (log MAR) was 0.82 +/- 0.29 preoperatively and 0.92 +/- 0.35 postoperatively in Group I and 0.71 +/- 0.39 and 0.97 +/- 0.33 in Group II, respectively. The differences between the 2 groups (p = 0.09, p = 0.058) were not statistically significant (p = 0.809, p = 0.267). CONCLUSIONS: There was no significant differences in the macular hole closure rate and BCVA improvement after 6 months in patients with idiopathic macular hole who had FAX during vitrectomy and maintained only a reading position for 3 days compared with those with gas tamponade and who maintained a face-down position for a week. This surgical method is considered helpful for easing discomfort caused by a face-down position after the macular hole surgery.

Efficacy of Intravitreal Dexamethasone Implant for Macular Edema Due to Branch Retinal Vein Occlusion According to Symptom Duration

PURPOSE: To evaluate the efficacy of intravitreal dexamethasone implants for the treatment of macular edema (ME) due to branch retinal vein occlusion (BRVO) according to the duration of symptoms. METHODS: Thirty-one patients who received an intravitreal dexamethasone implant for ME due to BRVO were included in this retrospective study. The patients were divided into 2 groups. Group A included eyes with symptom duration less than 12 weeks and Group B included eyes with symptom duration of 12 weeks or longer. The main efficacy outcomes such as best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline and every 4 weeks over 24 weeks. Retreatment criteria included an increased CMT of 150 microm or reduction of logarithm of the minimal angle of resolution (log MAR) scores of at least 0.2. RESULTS: The CMT and BCVA improved significantly at each follow-up compared with the baseline (p 0.05). At 24 weeks, Group A showed less CMT and better BCVA compared with Group B (p = 0.043, p = 0.041, respectively). CONCLUSIONS: The intravitreal dexamethasone implant significantly reduced the CMT and improved BCVA in patients with ME due to BRVO. Patients with shorter symptom duration showed better anatomical and functional outcomes over 24 weeks. Early treatment with the intravitreal dexamethasone implant could produce better clinical results.

Outer Retinal Tubulation in Chronic Central Serous Chorioretinopathy

PURPOSE: To evaluate outer retinal tubulation (ORT) found in chronic central serous chorioretinopathy (CSC) using color fundus photography and spectral domain optical coherence tomography (SD-OCT). METHODS: ORT identified in patients with chronic CSC was examined using color fundus photography, fundus autofluorescence image, fluorescein angiography, indocyanin green angiography, and SD-OCT. The images were analyzed for morphological features, location, and size of ORT in the retinal layers. RESULTS: ORT was detected in 3 of 342 (0.88%) chronic CSC patients. Color fundus photography revealed circular or ovoid shape with hollow lumen and deep yellowish border mainly appearing at the affected retinal pigment epithelium layer in the macular area. SD-OCT B-scan revealed hyperreflective material observed inside the hyporeflective internal space with hyperreflective border. ORT had circular or ovoid shape on the SD-OCT C-scan. ORT was primarily located on the outer nuclear layer in the retina, emanating to the inner nuclear layer and was not greater than 170 x 170 microm in size when measured with SD-OCT B-scan image. CONCLUSIONS: ORT was identified in patients with chronic CSC which was observed using color fundus photography and circular or ovoid structure was observed using a SD-OCT C-scan.

Analysis of Factors Associated with Retinal Vascular Caliber in Normal Korean Subjects

PURPOSE: To measure the diameter of the retinal arterial and venous caliber of normal Korean subjects and evaluate the factors affecting these diameters. METHODS: Fundus photography was performed on 152 normal Korean subjects. Central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were measured with a computer-based program (IVAN), and were used to investigate the relationship between the diameter and factors including age, gender, hypertension, diabetes, and smoking. RESULTS: Among the study subjects, the CRVE was 209.33 +/- 12.40 microm and the CRAE was 149.70 +/- 9.01 microm. The CRVE and CRAE decreased with increasing age in all study subjects (both p 0.05). CONCLUSIONS: In our study group, retinal vascular caliber of normal Korean subjects decreased with aging. Retinal vascular caliber was affected by gender and hypertension, but not by smoking and diabetes.

Two Cases of Long-Term Changes in the Retinal Nerve Fiber Layer Thickness after Intravitreal Bevacizumab for Diabetic Papillopathy

PURPOSE: To report long-term changes in the average retinal nerve fiber layer (RNFL) thickness in 2 patients who had intravitreal bevacizumab (IVB) injection for diabetic papillopathy. CASE SUMMARY: A 36-year-old patient with diabetes complained of decreased visual acuity (20/200) in the right eye. The fundus examination showed optic disc swelling in both eyes. The average RNFL thickness based on optical coherence tomography (OCT) increased to 278 microm and Goldmann perimetry showed nasal visual field defect in the right eye. The IVB was injected into the right eye. Three weeks after the IVB injection, RNFL thickness decreased to 135 microm and visual acuity improved to 20/25 in the right eye. However, RNFL thickness increased from 126 to 207 microm and visual acuity decreased to 20/32 in the left eye. Thus, IVB was injected into the left eye. In week 3, RNFL thickness decreased to 147 microm and visual acuity improved to 20/20 in the left eye. At 12 months after IVB injection, RNFL thickness was 87 microm in the right eye and 109 microm in the left eye. A 57-year-old patient with diabetes complained of decreased visual acuity (20/200) and showed optic disc swelling in the right eye. The average RNFL thickness increased to 252 microm and Goldmann perimetry showed an enlarged blind spot in the right eye. IVB was injected into the right eye. After 3 weeks, RNFL thickness decreased to 136 microm and visual acuity improved to 20/70 in the right eye. Six months after IVB injection, RNFL thickness was 83 microm in the right eye. CONCLUSIONS: Visual acuity progressively improved within 3 weeks and RNFL thickness measured by spectral domain OCT showed progressive thickness reduction in 2 cases of diabetic papillopathy patients who had IVB injections.

Rapidly Progressing Foveal Atrophy with Tuberculous Serpiginous-Like Choroiditis Despite Combined Anti-Tuberculosis and Steroid Treatment

PURPOSE: To report a case of rapidly progressing foveal atrophy with tuberculous serpiginous-like choroiditis. CASE SUMMARY: A 54-year-old female patient had decreased vision of hand motions (os) for 3 days. Fundus examination showed optic disc swelling and yellowish chorioretinal lesions in the posterior pole (os). Optical coherence tomography (OCT) showed intraretinal edema and subretinal fluid in the left macula. Routine laboratory tests, serologic tests, and magnetic resonance imaging results were normal except for erythrocyte sedimentation rate (28 mm/hr). Fluorescein angiography showed the chorioretinal lesions appeared to be early hypofluorescence followed by late hyperfluorescence. Indocyanine green angiography showed hypofluorescence during early and late phases and the result of interferon-gamma release assay was positive. Under diagnosis of tuberculous serpiginous-like choroiditis, anti-tuberculous therapy combined with systemic corticosteroid was started. Despite decreased optic disc swelling, OCT showed a rapid progression of foveal atrophy within 2 weeks. Twelve weeks later, visual acuity was finger count at 10 cm. Six months later, best-corrected visual acuity and foveal atrophy were no interval change. CONCLUSIONS: Tuberculous serpiginous-like choroiditis with foveal involvement can show rapidly progressive foveal atrophy and poor visual prognosis.

Bilateral Candida albicans Endophthalmitis after Robot-Assisted Laparoscopic Radical Prostatectomy in a Patient with Prostate Adenocarcinoma

PURPOSE: To report a case of bilateral Candida albicans endophthalmitis after robot-assisted laparoscopic radical prostatectomy (RALP) in a patient with prostate adenocarcinoma. CASE SUMMARY: A 61-year-old male patient had RALP for prostate adenocarcinoma. Four days after the surgery, the patient had a fever and pancytopenia. Two weeks after the surgery, the patient complained of decreased visual acuity in both eyes. Best-corrected visual acuity (BCVA) was counting fingers at 60 cm in the right eye and 20/63 in the left eye. The fundus examination showed vitreous opacity and yellow circumscribed chorioretinal lesions in both eyes. The blood and urine cultures were negative. An intravitreal voriconazole injection (100 microg/0.1 ml) was given in both eyes. However, the vitritis worsened, and BCVA decreased to counting fingers at 30 cm in the right eye and 60 cm in the left eye. Thus, combined phacoemulsification and 23-gauge microincisional vitrectomy surgery with a silicone oil injection was performed in both eyes at 1-week intervals. The vitrectomy sample culture was positive for Candida albicans in both eyes. Four months after the vitrectomy, BCVA was 20/100 in both eyes without subretinal lesions. CONCLUSIONS: Clinicians should be aware that bilateral Candida albicans endophthalmitis could be complicated by RALP in a patient with prostate adenocarcinoma or with other risk factors.

Clinical Characteristics of Polypoidal Choroidal Vasculopathy Associated with Chronic Central Serous Chorioretionopathy

PURPOSE: To investigate the clinical characteristics of polypoidal choroidal vasculopathy (PCV) associated with chronic central serous chorioretinopathy (CSC). METHODS: We retrospectively reviewed the medical records of 246 PCV patients (283 eyes) between July 2004 and August 2009 and investigated the clinical characteristics of the PCV patients who had specific fundus findings of chronic CSC. RESULTS: Among PCV patients, 13 eyes (4.6%) of 13 PCV patients (5.3%) had fundus findings of chronic CSC. All of the PCV lesions had a solitary polyp located outside the atrophic retina, predominantly in the macular area (84.6%), most showed an exudative pattern (69.2%) and there were a few that showed a hemorrhagic pattern (30.8%). All of the lesions were smaller than 1 disc diameter. Most of the PCV lesions (76.9%) were cured with less than two treatments in a short period of 6.4 +/- 1.9 months; however, visual acuity deteriorated (61.5%) or was not changed (30.8%) in most of the cases. CONCLUSIONS: The PCV associated with chronic CSC had several clinical features such as a small exudative retinal lesion with a solitary polyp and frequent involvement of the macular area. Even though there was poor visual outcome due to the atrophic change, all of the PCV lesions were easily resolved in a short period with a simple treatment course and no recurrence.

Function of Shoulder and Quality of Life between Operation of Thyroid Cancer / 고신대학교의과대학학술지

OBJECTIVES: To determine which factors are changed in the thyroid cancer postoperative care and how quality of life compared between patients who had undergone modified radical neck dissection and selective neck dissection. METHODS: Prospectively, total 151 patients who diagnosed as thyroid cancer and underwent 16 modified radical neck dissection (mRND) or 135 selective neck dissection (SND) were evaluated for shoulder function, neck mobility, and quality of life and degree of depression at baseline, 2 days and 1 week postoperatively. All patients performed neck and shoulder stretching exercise three times a day beginning the morning following surgery. Shoulder function was assessed with the Constant's shoulder scale. Quality of life was assessed with the SF36v2 questionnaire. And depression was assessed with Beck depression inventory (BDI). RESULTS: The disability scores of patients were significantly worse for neck range of motion (ROM), shoulder pain, ADL, shoulder ROM, shoulder abduction power, total score of Constant's shoulder scale, physical function domain in SF-36v2 and BDI score & grade 2 days after the surgeries. SF36v2 domain score was no significantly difference between two groups. CONCLUSION: The mRND and SND are risk factors for neck ROM limitation, shoulder dysfunction, and onset of depression. In comparison between mRND and SND, more deterioration in ADL, shoulder abduction power, total score of Constant's shoulder scale are associated with modified radical neck dissection. More study is needed about usefulness of the stretching exercise in shoulder pain onset through comparison with control group.

Leisure Time Physical Activity of People with Spinal Cord Injury: Mainly with Clubs of Spinal Cord Injury Patients in Busan-Kyeongnam, Korea

OBJECTIVE: To estimate hours of leisure time physical activity (LTPA) performed by people with chronic spinal cord injury (SCI) and to identify the demographic and injury-related characteristics associated with LTPA of people with chronic SCI. METHOD: Seventy nine persons with SCI living in Busan and Gyongsangnam-do were recruited. They completed a self-administered questionnaire, which consisted of items about personal characteristics, type of LTPA, hours of LTPA, LTPA intensity, and LTPA satisfaction. RESULTS: Most participants (92.4%) did not work. The respondents reported a daily mean of 3.13 hours (+/-1.47) of LTPA; however, 3.8% reported no LTPA whatsoever. Years post-injury, income sources, and type of medical payment emerged as a predictors of LTPA. Years post-injury were positively correlated with amount of leisure activity. In the case of self income, LTPA was longer than for groups with different income sources (e.g.partner, parents). For patients receiving workers' compensation insurance, LTPA was longer than for patients receiving non-WC insurance. Most LTPA was done at a moderate intensity. The three most frequently reported types of LTPA were wheeling (26%), sports (19%), and stretching exercise (15%). There was overall dissatisfaction with LTPA. CONCLUSION: Daily LTPA hours were longer than previously reported, but wheeling accounted for a large part of the activity. Intensity of activity was generally moderate. The employment rate was very low. Clearly, participating in regular LTPA for health purposes is very important to people with chronic SCI, but it is also important for them to have jobs.

Effect of Mitomycin C and 5-Fluorouracil on Cultured Human Nasal Mucosa Fibroblasts

PURPOSE: To investigate the effects of two antimetabolites, mitomycin C (MMC) and 5-fluorouracil (5-FU), on proliferation of cultured human nasal mucosa fibroblasts. METHODS: Human nasal mucosa fibroblasts were primarily cultured, and exposed to various concentrations of MMC and 5-FU for 5 minutes. Control fibroblasts were exposed to only DMEM media without the drugs. Effect of drugs on cell morphology was observed by phase-contrast microscopy. Cell viability and apoptosis were measured using MTT [3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyl-tetrazolium bromide] assay and Acridine orange/Hoechst (AO/HO) staining, respectively. RESULTS: In both experimental groups exposed to MMC and 5-FU, fibroblasts maintained standard spindle shape. The MTT assay showed that both MMC and 5-FU inhibited fibroblast proliferation in a dose dependent manner. AO/HO staining showed apoptotic cells in both experimental groups. CONCLUSIONS: Both MMC and 5-FU have an antiproliferative effect on fibroblasts in vitro at least through induction of apoptosis. Therefore, adjuvant use of either MMC or 5-FU during endonasal dacryocystorhinostomy may improve the clinical outcome by inhibiting proliferation of the nasal mucosa.

A Case of Accidental Macular Injury by Nd: YAG Laser and Subsequent 6 Year Follow-Up

Here, we report the case of a patient who sustained Nd: YAG laser macular injury with subsequent 6 year follow-up evaluation. A 23-year-old female was accidentally exposed to a Q-switched Nd: YAG laser without protective goggles. Upon initial evaluation, the best-corrected visual acuity of her affected eye was 20/100 OD. Fundoscopic examination revealed a macular laser burn and vitreous hemorrhage. Corticosteroids, in the form of 60 mg prednisolone, were administered orally with a 10 mg per week taper. Nineteen days following exposure, fundoscopic examination revealed a distinct epiretinal membrane which resolved within six months. The best-corrected visual acuity of the affected eye remained 20/100 OD. This clinical course is similar to those of previously reported cases including vitreous hemorrhage and subsequent epiretinal membrane formation. However, visual acuity did not recover despite spontaneous regression of the epiretinal membrane and at 6 year follow-up, there was neither choroidal neovascularization nor macular hole formation.

Magnetic Resonance Arthrographic Findings of the Painful Hemiplegic Shoulder

OBJECTIVE: To identify the etiology of hemiplegic shoulder pain by magnetic resonance (MR) arthrography. METHOD: The study included seventy-four hemiplegic patients with shoulder pain. After several physical examinations, all patients had fluoroscopically guided injection by a physiatrist with a maximum of 12~15 ml of contrast agent. Then T1-weighted, T2-weighted and fat-suppressed T1-weighted images were taken at the oblique coronal plane. In addition, fat-suppressed T1-weighted images were obtained at the oblique sagittal and oblique coronal plane. RESULTS: Except for the 9 patients who did not finish the study, the mean age of the participants was 61.5+/-8.9 years and mean duration of the cerebrovascular accident (CVA) was 15.7+/-9.7 weeks. The findings were as follows: 40% supraspinatus tendinitis, 30.8% superior labrum anterior to posterior (SLAP) lesion, 29.2% adhesive capsulitis, 24.6% supraspinatus partial tear, 23.1% biceps tendinitis, 13.8% supraspinatus full thickness tear, 7.7% infraspinatus partial tear. The SLAP lesion had significant statistic relationship with biceps tendinitis (p<0.05) but not with rotator cuff lesion. CONCLUSION: We found that causes of hemiplegic shoulder pain were various. The prevalence of the SLAP lesion was high (30.8%). We recommend the MR arthrography when the hemiplegic shoulder pain does not improve by conventional therapy or the cause of the pain is uncertain.

Clinical Results After Application of Bevacizumab in Recurrent Pterygium

PURPOSE: To clinically establish the effectiveness and safety of bevacizumab on recurrent pterygium. METHODS: Twenty patients with recurrent pterygium were given a subconjunctival injection of 0.3 cc bevacizumab, and were evaluated for periodic clinical results at 1 week, 2 weeks, 4 weeks, and every month thereafter. The patients were also evaluated for clinical results and complications. RESULTS: Of recurrent pterygium patients with bevacizumab injection, the conjunctival injection decreased maximally after 1 to 2 weeks, but significantly increased at 4 weeks (above the lowest level measured at 1 to 2 weeks), and no patient presented conjunctival injection above the pre-injection level at 3 months, except in 2 cases. Two weeks after the injection, ICG anterior segment angiography revealed a significant decrease (30.14+17.69%) in vessel thickness of the pterygium 2 weeks after the bevacizumab injection compared to before the injection. There had been no cases of progression of pterygium, and no ocular or systemic complications due to bevacizumab. CONCLUSIONS: As shown above in the results, subconjunctival injection of 0.3 cc bevacizumab decreased the conjunctival injection and effectively suppressed any further progression of pterygium. Thus, bevacizumab subconjunctival injection appears to be effective in recurrent pterygium treatment instead of surgical methods.

The Effect of Internal Limiting Membrane Peeling on Retinal Vein Occlusion Induced Macular Edema

PURPOSE: To evaluate the effect of pars plana vitrectomy with indocyanine green-assisted peeling of the internal limiting membrane (ILM) on visual acuity in macular edema in RVO patients. METHODS: Twenty-three eyes of 23 patients were treated consecutively (male: female=7:16). Thirteen patients were BRVO, and ten patients were CRVO. Vitrectomy that involved peeling the ILM with the assistance of indocyanine dye was performed in all 23 eyes. A visual acuity change of 2 lines or more was regarded as significant. We compared preoperative BCVA and postoperative BCVA. RESULTS: Improvement of visual acuity was observed in 13 eyes (8 eyes in BRVO, 5 eyes in CRVO) of 23 total eyes (56.5%). No change in visual acuity was observed in 5 eyes (3 eyes in BRVO, 2 eyes in CRVO). Worsening of visual acuity was observed in 5 eyes (2 eyes in BRVO, 3 eyes in CRVO). CONCLUSIONS: Pars plana vitrectomy with ILM peeling in patients with macular edema induced by RVO showed visual improvement in 56.5% of the cases in our study (61.5% in BRVO, 50% in CRVO). PPV with ILM peeling may be an effective procedure in reducing macular edema due to RVO.