Background: Pathological myopia can be complicated by the presence of posterior staphyloma, macular atrophy, ruptures in Bruch’s membrane, pathologic choroidal neovascularization, and different degrees of myopic trac...Background: Pathological myopia can be complicated by the presence of posterior staphyloma, macular atrophy, ruptures in Bruch’s membrane, pathologic choroidal neovascularization, and different degrees of myopic traction maculopathy. Purpose: To report the structural, functional and perfusional outcomes in patients underwent surgery for different stages of myopic traction maculopathy (MTM). Methods: A retrospective, consecutive, comparative, interventional, one-surgeon, case-control study was conducted in 46 eyes of 34 individuals between April 2015 and May 2021. Participants included normal emmetropic eyes (Control emmetropia, n = 25), healthy myopic eyes (Control high myopia, n = 20), and operated and structurally fully resolved myopic eyes with different stages of MTM (Surgically treated group, n = 46). Long-term postoperative functional and perfusional follow-up evaluations were performed with spectral domain-optical coherence tomography (SD-OCT) and OCT angiography. The primary outcome measure included long-term functional, structural and perfusion macular status across groups. Results: Forty-six eyes in 34 patients were included in the study group, with both eyes affected in 12 (26.3%) patients. The mean axial length was 29.89 ± 1.67 mm. The preoperative logMAR was 1.29 ± 0.54 and the postoperative logMAR was 0.60 ± 0.52 (P Conclusion: Compared to emmetropic and healthy myopic eyes, surgically-resolved MTM eyes generally have larger superficial foveal avascular zone area, lower vessel density, smaller choriocapillaris flow area, thinner central subfoveal thickness, and more macular defects. Eyes with stage III or IV MTM had larger deviation compared to eyes at earlier stages. Visual function change after surgery was associated with superficial foveal avascular zone area. Better functional, structural and perfusion index outcomes were observed when highly myopic eyes underwent early surgery.展开更多
Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treat...Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treating rhegmatogenous retinal detachment. Methods: A comprehensive literature search was performed using the Web of Science, MEDLINE, EMBASE, and Cochrane Library databases to retrieve comparative studies. The main objective was to assess the BCVA, while reattachment rates and ocular adverse events were considered secondary measures. Rev Manager software was used for statistical analysis. Results: The literature search identified 10 articles comprising 1518 eyes, with 682 eyes in the PPV group, 193 eyes in the lens-sparing versus phaco-procedure group, and 643 eyes in the combined PPV and SB surgery group. Quality assessment revealed a low risk of bias in most domains. The meta-analysis results revealed a significant difference in postoperative BCVA between the PPV and PPV combined with SB groups (WMD = −0.17, 95% CI [0.27, 0.07], p = 0.001). The primary reattachment rates were 82.80% for PPV alone and 87.52% for PPV combined with SB (p = 0.34). The final reattachment rates did not differ significantly between PPV and PPV combined with SB (99% vs. 99.8%;RR = 1.00, 95% CI [1.01, 0.99], p = 0.96). PPV alone demonstrated a significantly reduced risk of macular edema compared to PPV combined with scleral buckling (9.9% vs. 23%;p = 0.006). The incidences of macular hole development (p = 0.46), recurrent retinal detachment (p = 0.27), proliferative vitreoretinopathy development (p = 0.48), epiretinal membrane proliferation (p = 0.77), and limited choroidal hemorrhage (p = 0.69) were not significantly different between the two groups. Conclusions: These findings suggest that PPV alone may be a more effective treatment option in terms of visual acuity (VA) improvement, lower risk of macular edema and cataract development. However, there was no significant difference in VA improvement or complication rates between the lens-sparing and phaco-procedure groups. .展开更多
Background: Information on the long-term perfusion status of patients after successful surgery for giant retinal tear (GRT) macula-off rhegmatogenous retinal detachment (RRD) is limited. Purpose: To examine long-term ...Background: Information on the long-term perfusion status of patients after successful surgery for giant retinal tear (GRT) macula-off rhegmatogenous retinal detachment (RRD) is limited. Purpose: To examine long-term structural, functional, and perfusion outcomes in normal control eyes and eyes treated for different degrees of GRT-associated extensions of RRD. Methods: One emmetropic normal eye (control), one healthy highly myopic eye (control myopic), and three eyes surgically treated for GRT (surgical), were included in the study for a long-term comparison of study outcomes. The surgical eyes were classified based on the degree of GRT-associated RRD extension as follows: one eye with GRT-associated RRD extension ˚one eye with GRT-associated RRD extension between 180˚- 270˚and one eye with GRT-associated RRD extension > 270˚. Structural, functional, and perfusion outcomes were compared with those of the control eyes. Results: All three eyes were phakic and the condition was monocular. The mean age of the patients was 48.67 ± 8.50 years (range, 39 - 55 years). All three eyes had GRT macula-off RRD. The mean preoperative time for GRT surgery was 1.2 weeks. The mean pre- and postoperative best corrected visual acuities (BCVA) were 1.87 logMAR and 0.46 logMAR, respectively. The mean postoperative follow-up period was 19.67 ± 5.69 months. Proliferative vitreoretinopathy resulted in multiple surgeries in one eye (31.5%). Long-term postoperative optical coherence tomography (OCT) showed abnormal retinal thickness, ellipsoid zone disruption, and external limiting membrane line discontinuities in one eye. OCT angiography yielded abnormal perfusion indices in the surgically treated eyes. Conclusions: Our data showed multiple structural alterations in spectral-domain OCT biomarkers. One eye that developed secondary epiretinal membrane (ERM) proliferation showed a significantly improved BCVA after proliferation and internal limiting membrane were removed. Perfusion findings were correlated with the final BCVA. Despite a fully reattached retina without ERM proliferation, GRT-associated RRD has a guarded functional prognosis.展开更多
文摘Background: Pathological myopia can be complicated by the presence of posterior staphyloma, macular atrophy, ruptures in Bruch’s membrane, pathologic choroidal neovascularization, and different degrees of myopic traction maculopathy. Purpose: To report the structural, functional and perfusional outcomes in patients underwent surgery for different stages of myopic traction maculopathy (MTM). Methods: A retrospective, consecutive, comparative, interventional, one-surgeon, case-control study was conducted in 46 eyes of 34 individuals between April 2015 and May 2021. Participants included normal emmetropic eyes (Control emmetropia, n = 25), healthy myopic eyes (Control high myopia, n = 20), and operated and structurally fully resolved myopic eyes with different stages of MTM (Surgically treated group, n = 46). Long-term postoperative functional and perfusional follow-up evaluations were performed with spectral domain-optical coherence tomography (SD-OCT) and OCT angiography. The primary outcome measure included long-term functional, structural and perfusion macular status across groups. Results: Forty-six eyes in 34 patients were included in the study group, with both eyes affected in 12 (26.3%) patients. The mean axial length was 29.89 ± 1.67 mm. The preoperative logMAR was 1.29 ± 0.54 and the postoperative logMAR was 0.60 ± 0.52 (P Conclusion: Compared to emmetropic and healthy myopic eyes, surgically-resolved MTM eyes generally have larger superficial foveal avascular zone area, lower vessel density, smaller choriocapillaris flow area, thinner central subfoveal thickness, and more macular defects. Eyes with stage III or IV MTM had larger deviation compared to eyes at earlier stages. Visual function change after surgery was associated with superficial foveal avascular zone area. Better functional, structural and perfusion index outcomes were observed when highly myopic eyes underwent early surgery.
文摘Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treating rhegmatogenous retinal detachment. Methods: A comprehensive literature search was performed using the Web of Science, MEDLINE, EMBASE, and Cochrane Library databases to retrieve comparative studies. The main objective was to assess the BCVA, while reattachment rates and ocular adverse events were considered secondary measures. Rev Manager software was used for statistical analysis. Results: The literature search identified 10 articles comprising 1518 eyes, with 682 eyes in the PPV group, 193 eyes in the lens-sparing versus phaco-procedure group, and 643 eyes in the combined PPV and SB surgery group. Quality assessment revealed a low risk of bias in most domains. The meta-analysis results revealed a significant difference in postoperative BCVA between the PPV and PPV combined with SB groups (WMD = −0.17, 95% CI [0.27, 0.07], p = 0.001). The primary reattachment rates were 82.80% for PPV alone and 87.52% for PPV combined with SB (p = 0.34). The final reattachment rates did not differ significantly between PPV and PPV combined with SB (99% vs. 99.8%;RR = 1.00, 95% CI [1.01, 0.99], p = 0.96). PPV alone demonstrated a significantly reduced risk of macular edema compared to PPV combined with scleral buckling (9.9% vs. 23%;p = 0.006). The incidences of macular hole development (p = 0.46), recurrent retinal detachment (p = 0.27), proliferative vitreoretinopathy development (p = 0.48), epiretinal membrane proliferation (p = 0.77), and limited choroidal hemorrhage (p = 0.69) were not significantly different between the two groups. Conclusions: These findings suggest that PPV alone may be a more effective treatment option in terms of visual acuity (VA) improvement, lower risk of macular edema and cataract development. However, there was no significant difference in VA improvement or complication rates between the lens-sparing and phaco-procedure groups. .
文摘Background: Information on the long-term perfusion status of patients after successful surgery for giant retinal tear (GRT) macula-off rhegmatogenous retinal detachment (RRD) is limited. Purpose: To examine long-term structural, functional, and perfusion outcomes in normal control eyes and eyes treated for different degrees of GRT-associated extensions of RRD. Methods: One emmetropic normal eye (control), one healthy highly myopic eye (control myopic), and three eyes surgically treated for GRT (surgical), were included in the study for a long-term comparison of study outcomes. The surgical eyes were classified based on the degree of GRT-associated RRD extension as follows: one eye with GRT-associated RRD extension ˚one eye with GRT-associated RRD extension between 180˚- 270˚and one eye with GRT-associated RRD extension > 270˚. Structural, functional, and perfusion outcomes were compared with those of the control eyes. Results: All three eyes were phakic and the condition was monocular. The mean age of the patients was 48.67 ± 8.50 years (range, 39 - 55 years). All three eyes had GRT macula-off RRD. The mean preoperative time for GRT surgery was 1.2 weeks. The mean pre- and postoperative best corrected visual acuities (BCVA) were 1.87 logMAR and 0.46 logMAR, respectively. The mean postoperative follow-up period was 19.67 ± 5.69 months. Proliferative vitreoretinopathy resulted in multiple surgeries in one eye (31.5%). Long-term postoperative optical coherence tomography (OCT) showed abnormal retinal thickness, ellipsoid zone disruption, and external limiting membrane line discontinuities in one eye. OCT angiography yielded abnormal perfusion indices in the surgically treated eyes. Conclusions: Our data showed multiple structural alterations in spectral-domain OCT biomarkers. One eye that developed secondary epiretinal membrane (ERM) proliferation showed a significantly improved BCVA after proliferation and internal limiting membrane were removed. Perfusion findings were correlated with the final BCVA. Despite a fully reattached retina without ERM proliferation, GRT-associated RRD has a guarded functional prognosis.
