ABSTRACT
BACKGROUND: The aim of this prospective study was to analyze the specificity and sensitivity of HRT 3 compared with spectral optical coherence tomography (SOCT) in differentiating full-thickness macular holes, lamellar macular holes, and macular pseudoholes. MATERIAL AND METHODS: In 128 patients with a diagnosis made by SOCT of full-thickness macular hole, lamellar macular hole, or macular pseudohole, 161 eyes were examined with the HRT 3 Retina Module, and the results were compared. RESULTS: Using SOCT, full-thickness macular holes were diagnosed in 80 eyes, pseudoholes in 15 eyes, and lamellar macular holes in 66 eyes. Using HRT, full-thickness macular holes were diagnosed in 81 eyes, and pseudoholes and lamellar macular holes (non-full-thickness macular holes) were diagnosed in 80 eyes. In 160/161 cases, the diagnosis with HRT 3 was correct. Compared with SOCT, HRT 3 has a specificity of 98.7% and a sensitivity of 100% in differentiating full-thickness from non-full-thickness macular holes. CONCLUSION: The HRT 3 macular module enables diagnosis of macular holes. Full-thickness macular holes could be differentiated from non-full-thickness macular holes; however, lamellar macular holes could not be differentiated from macular pseudoholes.
Subject(s)
Image Enhancement/instrumentation , Image Processing, Computer-Assisted/instrumentation , Imaging, Three-Dimensional/instrumentation , Retinal Perforations/diagnosis , Tomography, Optical Coherence/instrumentation , Aged , Diagnosis, Differential , Equipment Design , Female , Humans , Macula Lutea/pathology , Male , Middle Aged , Prospective Studies , Sensitivity and SpecificityABSTRACT
BACKGROUND: This prospective study analyzed the usefulness of the HRT 2 retina module as a diagnostic tool for macular hole diagnosis. The influence of the preoperative status on postoperative anatomic and functional results is also discussed. Preoperative and postoperative retinal tomography maps (HRT 2) were compared with optical coherent tomography (OCT III) and spectral optical coherent tomography (SOCT). METHODS: Fifty eyes of 46 consecutive patients with stage III/IV macular hole underwent vitrectomy with internal limiting membrane peeling and fluid/air exchange. HRT 2, OCT III, and, in eight cases, SOCT images were analyzed. RESULTS: The mean best corrected visual acuity 1 week before surgery was 0.086+/-0.074 (0.01-0.35). The final best corrected visual acuity 12 months after surgery was 0.32+/-0.24 (0.01-1.0). Anatomic success was noted in 46/50 eyes 1 month after the first surgery and in all eyes after the second intervention. In 33/50 eyes (66%), visual acuity improved over two lines. In 13 eyes visual acuity remained stable, and in four eyes worse visual acuity was noted postoperatively. The mean macular hole diameter in HRT 2 was 497.2 microm and in OCT III was 490 microm. Different values were observed in cases of oval macular holes. The mean macular hole area was 0.193 mm(2). The macular hole radius in HRT 2 can be compared with the minimal diameter in OCT III. It influences the final visual acuity 12 months after surgery. CONCLUSIONS: The HRT 2 macular module enables diagnosis of macular hole and evaluation of its postoperative status. This technique has some advantages because it enables measurement of the macular hole's radius, area, and depth. In cases when the macular hole's radius as measured in HRT and OCT III differs, HRT seems to give more exact data because it shows the entire surface rather than just a cross-section of the retina. Macular hole radius and area as measured with HRT 2 can influence postoperative functional results.
Subject(s)
Image Enhancement/instrumentation , Image Processing, Computer-Assisted/instrumentation , Imaging, Three-Dimensional/instrumentation , Microscopy, Confocal/instrumentation , Ophthalmoscopes , Retinal Perforations/diagnosis , Tomography, Optical Coherence/instrumentation , Adolescent , Adult , Aged , Female , Fourier Analysis , Humans , Middle Aged , Postoperative Complications/diagnosis , Prospective Studies , Retina/pathology , Retinal Perforations/surgery , Software , Treatment Outcome , Visual Acuity/physiology , Vitrectomy/methodsABSTRACT
BACKGROUND: In our clinic we used trypan blue staining routinely for removal of internal limiting membranes (ILM) and epiretinal membranes (ERM) during vitreoretinal surgery for PVR retinal detachment. PATIENTS AND METHODS: We treated 27 eyes of 27 patients with severe PVR retinal detachment with vitreoretinal surgery. After complete vitrectomy and removal of epiretinal membranes we injected 0.15 % trypan blue solution and proceeded with further removal of the visualized remaining epiretinal membranes and ILM. We performed relaxing retinotomies in 14 eyes. Follow-up lasted six months. RESULTS: After the first surgery the retina was reattached in 24 of 27 eyes and after the second surgery in all eyes. The final visual acuity was: hand movements in 3 eyes, 1/50 or better in 24 eyes (eight of them had a visual acuity of 0.1 - 0.5). No case of macular pucker was observed during the follow-up. CONCLUSIONS: Trypan blue staining during vitreoretinal surgery in PVR retinal detachment therapy allows complete removal of ILM, ERM, and peripheral vitreous. It upgrades the quality of the surgery.
