The role of ultra-widefield imaging with navigated central and peripheral cross-sectional and three-dimensional swept source optical coherence tomography in ophthalmology: Clinical applications.

PURPOSE: To assess central and peripheral retinal and choroidal diseases using ultra-widefield (UWF) fundus imaging in combination with navigated central and peripheral cross-sectional and three-dimensional (3D) swept source optical coherence tomography (SS-OCT) scans. METHODS: Retrospective study involving 332 consecutive patients, with a nearly equal distribution of males and females. The mean age of patients was 52 years (range 18-92 years). Average refractive error was -3.80 D (range +7.75 to -20.75 D). RESULTS: The observations in this study demonstrate the efficacy of peripheral navigated SS-OCT in assessing various ocular conditions. The technology provides high-quality images of the peripheral vitreous, vitreoretinal interface, retina, and choroid, enabling visualization of vitreous floaters and opacities, retinal holes and tears, pigmented lesions, and peripheral retinal degenerations. 3D OCT scans enhance the visualization of these abnormalities and improve diagnostic and therapeutic decisions. CONCLUSION: Navigated central and peripheral cross-sectional and 3D SS-OCT scans offer significant complementary benefits in the assessment and management of retinal diseases. Their addition to UWF imaging provides a comprehensive view of central and peripheral ocular structures, aiding in early detection, precise anatomical measurements, and objective monitoring of disease progression. In addition, this technology serves as a valuable tool for patient education, a teaching tool for trainees, and documentation for medico-legal purposes.

Application progress of human amniotic membrane in vitreoretinopathy: a literature review.

Recently, the application of the amniotic membrane (AM) in ophthalmology is gradually expanding from the anterior to the posterior segment of the eye. Its characteristics of anti-inflammation, anti-bacterial, anti-vascularization, immune regulation, anti-fibrosis, pro-epithelialization, and so forth have made it a hot topic in ophthalmic research. AM has been confirmed to repair photoreceptors, restore normal retinal structures, and close the abnormal structures in the optic disc. Currently, the application areas mainly include retinal hole, retinal detachment, optic disc pit, retinal degenerative diseases, and choroidal hole. This article reviews the current literature applying AM transplantation in the treatment of various posterior segment diseases while comparing the clinical outcomes with other techniques.

Preoperative estimation of retinal hole location using ultra-wide-field imaging.

BACKGROUND/OBJECTIVE: Accurate localization of retinal holes is essential for successful scleral buckling (SB) surgery. We aimed to verify the feasibility of using ultra-wide-field (UWF) imaging for preoperative estimation of retinal hole location. PATIENTS AND METHODS: We observed 21 eyes from 21 patients with rhegmatogenous retinal detachment (RRD) who underwent successful SB. They were treated at the Department of Ophthalmology of the Second Hospital of Hebei Medical University between November 2020 and November 2021. UWF fundus photography using an Optos device was performed at different steering positions 1 day before, 1 day after, and 1 month after SB. Using the preoperative fundus images, we measured the transverse diameter of the optic disc (D1) and the distance from the centre of the retinal holes to the ora serrata (D2). The accurate transverse diameter of the optic disc (Dd) was measured preoperatively using optical coherence tomography. The same surgeon measured the scleral chord lengths intraoperatively from the limbus to the located retinal hole marked on the sclera using an ophthalmic calliper. Statistical software was used to analyze the consistency of scleral chord length between the retinal hole and the limbus, which was estimated by preoperative UWF imaging and was measured using an ophthalmic calliper intraoperatively. RESULTS: There was no statistically significant difference in the scleral chord length between the retinal holes and the limbus, which was estimated by preoperative UWF fundus photography and was measured by the calliper during surgery. CONCLUSION: It is feasible to locate retinal holes using UWF fundus photography before SB, which is helpful for quick localization, thereby reducing the learning curve of SB surgery.

Preoperative ultra-wide-field imaging can provide abundant information about retinal holes and is helpful for assessing their location before surgery.In this prospective cohort study of 21 patients, 25 retinal holes in four quadrants were observed.Axial length and the position of the holes have little impact on preoperative ultra-wide field imaging assessment.

Simultaneous presentation of idiopathic macular and posterior full-thickness retinal holes successfully treated with inverted internal limiting membrane flap technique.

PURPOSE: To report an unusual non-iatrogenic case of central macular and posterior full-thickness retinal holes (FTRHs). OBSERVATIONS: A 60-year-old man presented with a progressive visual loss in the right eye. A complete ophthalmological evaluation including best corrected visual acuity (BCVA) measurement, fundus examination and spectral - domain optical coherence tomography (SD-OCT) was performed.Fundus examination and SD-OCT confirmed the presence of simultaneous macular and posterior FTRHs. A 25-gauge vitrectomy was performed and the internal limiting membrane (ILM) was grasped and peeled off around the two holes. A fragment of the peeled-off ILM anchored on the FTRHs edges was left and inserted into the gaps.Closure of both retinal holes was achieved at 1-month, and BCVA improved from 20/630 at baseline to 20/63 at month 3. No intraoperative or postoperative complications were recorded. CONCLUSIONS AND IMPORTANCE: Inverted ILM flap technique represents a good treatment option in this rare non-iatrogenic condition, allowing a good anatomical and functional recovery.

Human amniotic membrane patch and platelet-rich plasma to promote retinal hole repair in a recurrent retinal detachment.

PURPOSE: To present a modified surgical technique, based on a combination of human amniotic membrane (hAM) patch and autologous Platelet-rich plasma (PRP) in a case of recurrent retinal detachment (RRD) due to a perivascular retinal hole over an area of staphyloma in an eye with pathologic myopia. METHODS: Presenting the surgical technique with the disposal of surgical video. After performing 23-gauge pars plana vitrectomy (PPV) the hAM patch was inserted under the neuroretina through the perivascular hole and PRP was injected on top to speed up the closure of the hole. To complete the surgical procedure High Viscosity Silicon oil (5000cst) was used as tamponade. The patient was prescribed to maintain a face-down position for the first 3 days after the operation. Follow-up was evaluated through Optical coherence tomography (OCT) scans. RESULTS: The 3 days postoperative OCT showed a flat retina with the filling of the myopic staphyloma. The hAM patch was well positioned and the retinal hole could not be identified. At 6 weeks from intervention, the site of the retinal hole at OCT scan was covered by new tissue. Silicone oil was removed 3 months later with no recurrence. CONCLUSION: hAM transplantation is a novel technique in case of retinal detachment recurrences to seal retinal holes over high myopic chorioretinal atrophy. The adjunctive use of PRP and high viscosity silicon oil allows to reducing the standard face-down positioning timing, representing a valid solution for elderly patients who have difficulties maintaining the position for long periods.

Comparison of various surgical techniques for optic disc pit maculopathy: vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap 'plug' versus autologous scleral 'plug'.

AIM: To compare the anatomical and visual outcomes of vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap to plug the pit versus autologous scleral plug for the treatment of optic disc pit maculopathy (ODP-M). METHODS: This retrospective study included 23 patients (23 eyes) who underwent 25G pars plana vitrectomy, ILM peeling and gas tamponade. While the pit was not plugged in group 1 (n=8), inverted ILM flap and autologous scleral flap were used to plug the pit in group 2 (n=7) and group 3 (n=8), respectively. Complete anatomical success was defined as total resolution of subretinal fluid (SRF) and macular schisis on optical coherence tomography while visual success was defined as a gain of at least 2 Snellen lines 1 year after surgery. RESULTS: Baseline characteristics were similar in all three groups. Mean central foveal thickness and SRF decreased in all three groups (p<0.05). Complete anatomical success was achieved in 25.0%, 85.7% and 87.5% eyes while visual success was achieved in 12.5%, 28.6% and 12.5% eyes in groups 1, 2 and 3, respectively. One eye (4.3%) in group 2 developed full-thickness macular hole at 1 month post-surgery. After complete resolution, there was no recurrence of fluid. CONCLUSION: OPD-M has a better surgical outcome if the pit is plugged. Both inverted ILM flap and autologous scleral plug are equally efficacious adjuncts to plug the pit.

Phototoxic maculopathy due to extreme usage of infrared illuminator-assembled night-vision handheld scope.

Night-vision handheld scopes are of wide use in military operations at dark conditions. In some cases in the battlefield, as in our case report, if there is no light coming from any source (neither from Moon nor from Stars), infrared light-emitting diode illumination can be coupled with night-vision goggles. Reflected illumination from the target is mostly blue filtered through the night-vision goggles objective lens. Retinal damage induced by unfiltered blue light and visible light has been previously reported. We described a phototoxic maculopathy induced by night-vision handheld scope assembled with infrared light-emitting diode illuminator in two soldiers who are on duty at nights for nearly two-thirds of the last year. The phototoxic maculopathy can represent with typical optical coherence tomography findings such as intraretinal hyperreflective accumulation particularly located on the surface of outer retinal segments defect or presumably in the vicinity of the light passageway. Here, we presented a unique factor causing phototoxic maculopathy.

Solar maculopathy: prognosis over one year follow up.

BACKGROUND: To document the visual acuity, spectral domain optical coherence tomography (SD-OCT) findings and prognosis in10 eyes of 6 patients with foveal damage from solar retinopathy in 1 year. METHODS: This was a prospective, observational case series of patients presented by solar maculopathy at Ophthalmology department, Sohag University. All patients underwent visual acuity (VA) testing, refraction, dilated fundus examination fluorescein angiography (FA) and SD-OCT (spectral Domain ocular coherence Tomography) imaging and follow up for 1 year. RESULTS: The mean age was 16.5 years (range 9-27 years, both eyes are affected in 4 patients. The mean spherical equivalent (SE) was - 0.25 ± 0.50 D. The visual acuity of the affected eyes ranged from 0.4 to 0.9 on presentation. At presentation Significant foveal pathology was identified on SD-OCT in 10 eyes, All eyes showed disruption of the photoreceptor ellipsoid zone and the interdigitation zone on SD-OCT, Follow up of the cases continued for 1 year.100% of cases showed improvement in VA: 20% eyes regained 1, 50% eyes with VA of 0.9; two eyes 20% 0.8 and one eyes (10%) with 0.4. The improvement began after 1 week and reached its maximum and became stationary after the 6th month of follow up, the outer retinal hole persist in OCT in 80% of cases. CONCLUSION: Solar maculopathy has a good prognosis yet shows no improvement after 6 months. Young age might pose as a risk factor.

Coexistence of Peripheral Retinal Diseases with Macular Hole

Objectives: To investigate the frequency of retinal tear, retinal hole, and lattice degeneration in peripheral retinal examination of patients with macular hole. Materials and Methods: The files of patients who underwent pars plana vitrectomy surgery with a diagnosis of macular hole at Eskisehir Osmangazi University Department of Ophthalmology between 2008 and 2018 were retrospectively analyzed. A total of 106 patients with primary macular hole who underwent peripheral retinal examination were included in the study. The frequency of retinal tears, holes, and lattice degeneration associated with macular hole was investigated. Results: Peripheral retinal examination of 106 patients who underwent macular hole surgery revealed retinal tear in 3 patients (2.8%), retinal hole in 4 patients (3.8%), and lattice degeneration in 10 patients (9.4%). Retinal hole and lattice degeneration were observed concomitantly in 1 patient. Conclusion: This study showed that patients with macular hole have concomitant retinal tears and holes, which are also thought to arise due to vitreoretinal traction, at a frequency similar to that in the general population. This result suggests that both the anterior and posterior vitreous may have different pathologies at the same time related to these diseases.

Extramacular Retinal Hole Following Intravitreal Dexamethasone Implant: Case Report

The intravitreal dexamethasone implant Ozurdex is indicated for the treatment of macular edema due to diabetes and branch retinal vein occlusion. While the most common ocular side effects are elevated intraocular pressure and cataract formation, rare complications related to the injection have been reported. We present a case with extramacular retinal hole after Ozurdex injection.

Autologous Internal Limiting Membrane Transplants Successfully Close a Large Parafoveal Retinal Hole.

　Parafoveal retinal holes (PRHs) are one of the complications that can occur after internal limiting membrane (ILM) peeling during macular surgery. Here we describe a patient in whom an exceptionally large PRH (1,069-µm dia.) was successfully closed by repeated autologous ILM transplantation.

Maculopathy due to drug inhalation.

CASE REPORT: A case of maculopathy due to "poppers" is described. DISCUSSION: Poppers is a drug composed of various forms of alkyl nitrite. A 39 year-old man, who had been using poppers for years, was seen in the clinic with phosphenes, reduced visual acuity and central scotoma. The SD-OCT in the right eye showed disruption at the level of the IS/OS junction line. The SD-OCT scan in the left eye showed an outer rectangular retinal hole and an outer retinal cyst.

Effects of Chinese medicine combined with laser therapy for peripheral retinal hole with shallow detachment / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the clinical effect of traditional Chinese medicine plus laser photocoagulation on eyes which have peripheral retinal hole with shallow detachment. METHODS: The 227 cases ( 246 eyes ) of retinal hole with shallow detachment were randomly divided into an integrated Chinese and western medicine group and a western medicine group. The former underwent laser photocoagulation combined with oral Chinese medicine;while the latter was treated with laser photocoagulation alone. Analyses of the effect were performed two months after treatment. RESULTS:The total cure rate of integrated Chinese and western medicine group was 87. 7%, while that of western medicine group was 71. 6%, significant difference was considered between the two groups (P CONCLUSION: Chinese medicine combined with laser photocoagulation plays an exact role in eyes which have peripheral retinal hole with shallow detachment, especially when the detached range is greater than 1PD, and it is significantly better than western laser therapy.

Posterior vitreous detachment and retinal detachment after implantation of the Visian phakic implantable collamer lens.

INTRODUCTION: To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses (ICL) implantation. MATERIALS AND METHODS: This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana'a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), slit-lamp biomicroscopy, intraocular pressure and dilated retinal examination. Investigations included corneal topography, central corneal thickness, anterior chamber depth and white to white diameter. Retinal diseases and complications were recorded and analyzed preoperatively and postoperatively. RESULTS: Preoperatively, 61 (9.9%) eyes had posterior segment pathology requiring prophylactic laser photocoagulation. One eye developed spontaneous rhegmatogenous retinal detachment (RRD), one eye developed traumatic retinal detachment and two eyes required laser treatment postoperatively. The overall retinal detachment rate post-ICL was 0.32%. CONCLUSIONS: Posterior segment complications are rare after ICL implantation but dilated vitreoretinal assessment is important before and after the procedure. Patients with suspicious retinal lesions need a comprehensive vitreoretinal evaluation by a retinal specialist. If a patient develops floaters or blurry vision he/she requires further assessment by a vitreoretinal specialist.

Surgical management of optic disc pit maculopathy with outer retinal hole.

OBJECTIVE: To report the successful outcome of a rare optic pit-associated maculopathy with an outer retinal hole following 23 G vitrectomy, internal limiting membrane (ILM) peeling and fluid-gas exchange without additional endolaser. METHOD: Interventional case report. RESULTS: This case report documents a 56-year-old male patient with complaints of progressive diminution of vision in the right eye more than in the left eye due to an optic disc pit with an outer retinal hole and a cataract. Optical coherence tomography confirmed the presence of an outer retinal hole. The case report shows the successful outcome of a rare optic pit-associated maculopathy with an outer retinal hole and a cataract following phacoemulsification with 23 G vitrectomy, ILM peeling and fluid-gas exchange without additional endolaser.

Histological Changes of the Vitreous and Retina in Retinal Lattice Degeneration

PURPOSE: To investigate of the histological characteristics of the lattice degeneration of the human peripheral retina. METHODS: The histological characteristics of the lattice degeneration of the retina was checked by flat preparation and serial section of the lattice lesion in three eyes was investigated by transmission electron microscopy. RESULTS: Flat preparation showed lattice lesion with a hole at the lateral margin with overlying sclerotic vessel and pigment clumping within the lesion. The ultrastructural initial findings showed that the collagen filament in the vitreous cavity was continuous with Muller fiber of the retina with the defect of the inner retina. The full-thikness defect of the sensory retina leaded to the retinal hole. The vascular wall was replaced and occluded by fine fibrillar collagen. The glial cell proliferated into the neural tissue of the sensory retina. These glial cells may secrete long spacing collagen (LSC) and curvilinear material shown at the area of the sensory retinal defect and near the vitreoretinal interface. CONCLUSIONS: These results suggest that the thinning of the retina occurs from the inner retina leading to retinal hole as the lattice degeneration progresses. LSC and curvilinear material are suggestive of derivatives derived from the extracellular material secreted from the glial cell.

Analysis of changes of visual acuity, multifocal electroretinogram and optical coherence tomogram before and after successful idiopathic macular hole surgery / 中华眼底病杂志

Objective To observe the changes of visual acuity?multifocal electroretinogram (mfERG) and optical coherence tomogram(OCT) before and after successful idiopathic macular hole (IMH) surgery, and evaluate the efficiency of the IMH surgery. Methods A total of 28 eyes of 28 patients with IMH who underwent vitrectomy during February 2001 and May 2002 in our hospital were collected. visual acuity, mfERG, and OCT were examined preoperatively and 1, 3, 6, and 12 months postoperatively, respectively. The results were analyzed statistically compared with 33 eyes in control group. Results (1) OCT showed that 27 eyes (96.43%) had anatomic closure of the macular hole 1 month after the surgery without recurrence in 12 months. Just 1 eye (3.57%) failed in the closure within 1 year. (2) The visual acuity was much higher in the eyes 1 year after surgery, especially within 6 months postoperatively, than that before the vitrectomy(P