Central Foveal Thickness Research Articles

Macular changes after cataract surgery.

This article aims to highlight if the central macular retina suffers changes after cataract surgery, and to evaluate the eventually discovered changes regarding persistence. This retrospective study, which lasted over three years (2021-2023), included patients who underwent cataract surgery performed by one surgeon. Spectral-domain optical coherence tomography (SD-OCT) imaging assessed macular changes and measured the central macular thickness. A total of 240 eyes with diagnosed senile cataract were included in this study. The mean age was 66 years ± 4 years. Preoperative central foveal thickness was 210 ± 27.3 µm, the postoperative thickness on day 1 was 234.3 ± 40.2 µm, at 6 months 230.5 ± 35.2 µm, and the 1-year follow-up 229.2 ± 30.3 µm. Macular changes after cataract surgery are easily confirmed by SD-OCT. The evaluation and monitoring of macular changes can be done by using central macular thickness assessment. The study provides data from a Romanian pool of patients. The values correlated well with those from similar studies of SD-OCT examinations, but differences were still observed, as there were different devices for performing SD-OCTs.

A Study of the Impact of ND: Yag Laser Posterior Capsulotomy on Foveal Thickness and Central Corneal Thickness by Using Spectral Domain Optical Coherence Tomography

A Study of the Impact of ND: Yag Laser Posterior Capsulotomy on Foveal Thickness and Central Corneal Thickness by Using Spectral Domain Optical Coherence Tomography

Subtyping stage 3 epiretinal membrane: a comprehensive study of ectopic inner foveal layers architecture and its clinical implications

AimsTo evaluate the visual function and foveal architecture in patients with stage 3 idiopathic epiretinal membrane (iERM).MethodsA cross-sectional observational study included 56 eyes of 52 patients with stage 3 iERM....

Comparison of Retinal Thickness betweenDiabetic Patients without Diabetic Retinopathy and Non-Diabetic Controls Using SD-OCT

Purpose: To determine retinal thickness in diabetic patients without diabetic retinopathy and non-diabetic controls using Spectral Domain Optical Coherence Tomography (SD-OCT). Study Design: Cross-sectional observational study. Place and Duration of Study: Diabetic Eye Clinic and General Eye OPD of Al-Ibrahim Eye Hospital, Karachi from July 2018 to August 2018. Methods: Patients with type 2 diabetes and non-diabetic healthy control eyes of either genderand age between 20 and 60 years were recruited. Patients with any other systemic and ocular disease affecting retinal thickness were excluded. After initial examination and informed written consent, patients were referred to ocular investigation department for detailed retinal examination and SD-OCT for measuring central retinal thickness. Data were analyzed for continuous and categorical variable using SPSS. Results: Average Central Retinal thickness was 297±21 and 315±13µmand Central Foveal Thickness was 246±16 and 249±19µmin diabetic and non-Diabetic patients respectively. Quadrant-wise evaluation revealed retinal thickness as follows; nasal 310 and 324µm), temporal (291and 304µm), superior (297and 316µm) and inferior (292and 314µm) in diabetics and non-diabetics respectively. Retinal thickness was greater at nasal and lesser at temporal regions. Conclusion: Diabetic patients without DR had thinner central retinal thickness compared to non-diabetic controls, as measured by Spectral Domain Optical Coherence Tomography (SD-OCT). Specifically, the average central retinal thickness and central foveal thickness were slightly reduced in diabetic patients. Quadrant-wise analysis revealed that the retinal thickness was consistently greater in the nasal region and lesser in the temporal region in both diabetic and non-diabetic patients.

Evaluation of the relationship between the real-time changes of macular structure and visual function in patients with rhegmatogenous retinal detachment after silicone oil tamponade

PurposeTo evaluate the relationship between the real-time changes of macular structure and visual function in rhegmatogenous retinal detachment (RRD) patients. MethodsForty-six patients were enrolled in this retrospective study. The best corrected visual acuity (BCVA) and macular structural changes were analyzed within 3 months after silicone oil tamponade. ResultsThe mean final BCVA was significantly better than the preoperative BCVA (P = 0.002). The parafoveal thickness became thinner, the proportion of subretinal fluid (SRF) decreased, and the proportion of intact external limiting membrane (ELM) increased within 3 months postoperatively. The recovery stage and the integrity of ELM in the SRF (-) group were significantly faster than that in the SRF (+) group (all P < 0.05). The central foveal thickness (CFT), the inferior and temporal thickness of the parafovea, and the integrity of the ELM were significantly correlated with BCVA at each time point (all P < 0.05). Long duration of preoperative RRD, thinner CFT at 1 month postoperatively, and without integrity of ELM at 3 months postoperatively were associated with poor final BCVA recovery (R2 = 0.462). ConclusionsThe macular microstructural tended to restore integrity within 3 months. The presence of SRF in macula delayed the recovery of RRD patients but did not affect the visual function.

Retinal thickness and macular microvascular changes seen on optical coherence tomography angiography (OCTA) in patients with sickle cell retinopathy in a tertiary care eye hospital

PurposeTo report retinal thickness values and macular vascular flow characteristics identified by optical coherence tomography angiography (OCT-A) in patients with various sickle cell genotypes in a population from sub-Saharan Africa. DesignRetrospective, observational study. MethodsThis is a single-institution case series of adult patients with various sickle cell genotypes who presented to the Eye Foundation Hospital Lagos between January 2022 and December 2023. Case files of patients were reviewed, and macular OCT and OCT-A images analyzed quantitatively for macular thickness, areas of flow loss, size of foveal avascular area, parafoveal flow, as well as vascular density in both the superficial and deep vascular plexi. The findings were compared by sickle cell genotype and comparisons made with age matched normal patients. ResultsA total of 38 eyes of 19 patients’ records were reviewed, and 35 eyes met the inclusion criteria; 16 eyes of 9 age and gender matched controls were included. The mean central foveal thickness (CFT) was 242.4 μm ± 33.3 μm among patients’ eyes, while a mean CFT of 236.1 μm ± 10.1 μm was measured among controls (p = 0.312). A smaller mean FAZ area of 0.270 mm2 ± 0.116 mm2 was seen among the control eyes compared to a mean of 0.314 mm2 ± 0.206 mm2 among patients’ eyes (p = 0.439). The mean flow area was larger among control eyes with 0.849 mm2 ± 0.647 mm2 compared to a mean flow of 0.822 mm2 ± 0.471 mm2 among patients’ eyes (0.868). The mean superficial foveal vessel density was greater among control eyes (19.30 ± 4.58) compared to patient eyes (18.77 ± 7.78) (p = 0.765). The mean deep foveal vessel density was greater among controls (35.30 ± 8.36) than among patients (34.06 ± 9.30) (p = 0.650). The difference between eyes of SC (53.37 ± 5.13) patients and SS (47.94 ± 8.44) patients in the deep temporal perifoveal VD was statistically significant (p = 0.035). ConclusionThe retina in eyes with sickle retinopathy and that of controls tends to be thickest in the nasal quadrant, then the superior, then inferior, and then thinnest in the temporal quadrant. Macular vessel density in both the superficial and deep capillary plexi was thicker among controls compared to eyes with sickle cell retinopathy. Among patients’ eyes, the deep capillary vessel density in the temporal perifoveal quadrant was greater among SC patients compared to SS (p = 0.035).

Use of a Fundus Image-Based Titration Strategy for Selective Retina Therapy for Central Serous Chorioretinopathy.

Background/Objectives: This study evaluated the clinical outcomes of selective retina therapy (SRT) for treating central serous chorioretinopathy. A fundus image-based titration method was used for laser irradiation. Methods: This retrospective cohort study included 29 eyes (29 patients) that underwent SRT for CSC. Both the pulse energy and number of micropulses were adjusted according to the fundus image. Mean best-corrected visual acuity (BCVA), central foveal thickness (CFT), and subretinal fluid (SRF) height were measured 1, 2, 3, 4, and 6 months after SRT. Mean deviation (MD) was measured using microperimetry at 3 and 6 months post-treatment. Results: At 6 months after SRT treatment, SRF was completely resolved in 89.7% of cases (26/29 eyes). The mean Snellen BCVA significantly improved from 0.34 ± 0.31 logMAR (logarithm of the minimum angle of resolution) (20/40) at baseline to 0.24 ± 0.24 logMAR (20/32) at 6 months (p = 0.009). The 0.1 improvement in mean BCVA is equivalent to a 5-letter gain on the ETDRS chart. The mean CFT decreased significantly from 309.31 ± 81.6 μm at baseline to 211.07 ± 50.21 μm at 6 months (p < 0.001). The mean SRF height also decreased significantly from 138.36 ± 56.78 μm at baseline to 23.75 ± 61.19 μm at 6 months (p < 0.001). The mean MD was improved from -1.56 ± 1.47 dB at baseline to -1.03 ± 2.43 dB at 6 months (p = 0.07) after treatment. Conclusions: SRT using fundus image-based titration can yield favorable functional and anatomical outcomes in the treatment of CSC.

Visual prognostic factors following surgery for stage 3 idiopathic epiretinal membrane by Govetto classification.

To investigate the visual prognosis of metamorphopsia in patients undergoing surgery for stage 3 idiopathic epiretinal membrane (ERM) by Govetto classification using preoperative optical coherence tomography (OCT) parameters. Retrospective clinical study. This study included 45 eyes of 45 patients with a minimum follow-up period of 3 months. The best-corrected visual acuity (BCVA) and metamorphopsia score using the M-CHARTS were recorded. Central foveal thickness (CFT), inner nuclear layer thickness (INL), ectopic inner retinal layer thickness (EIFL), outer retinal layer thickness, disruption of the ellipsoid zone, cotton ball sign, and intraretinal cystoid changes were measured based on spectral domain OCT. Preoperative and postoperative values and conditions were compared, and correlations between the preoperative values or conditions and postoperative metamorphopsia scores or BCVA were analyzed. After surgery, the horizontal, vertical, and mean metamorphopsia scores, as well as BCVA, CFT, INL, and EIFL significantly improved (p < 0.001). Using multivariate analysis, only preoperative CFT was a significant explanatory parameter for both the postoperative horizontal metamorphopsia scores and mean values of the postoperative horizontal and vertical metamorphopsia scores (p = 0.019 and p = 0.011, respectively). Age (p = 0.011) and preoperative CFT (p = 0.026) were significant explanatory parameters of postoperative BCVA. Preoperative CFT significantly correlated with postoperative metamorphopsia in patients undergoing surgery for stage 3 idiopathic ERM. This finding might help surgeons predict postoperative visual outcomes and make timely surgical decisions.

SPECTRAL-DOMAIN OCT INSIGHTS INTO IDIOPATHIC EPIRETINAL MEMBRANE SURGERY OUTCOMES.

This study aims to assess the prognostic value of a classification system that includes the presence of ectopic inner foveal layers (EIFL) and other anatomical variables identified in spectral-domain optical coherence tomography (SD-OCT) for idiopathic epiretinal membrane (ERM) surgery. A descriptive-analytic, longitudinal, retrospective study was conducted on patients with idiopathic ERMs treated with pars plana vitrectomy (PPV) from January 2017 to December 2021. Clinical data and SD-OCT images were reviewed pre-surgery and 12 months post-surgery. The primary outcome measured was best corrected visual acuity (BCVA) before and after surgery, analyzing the impact of anatomical factors on BCVA in patients undergoing ERM surgery. The study included 342 eyes from 323 patients. Post-surgical evaluations showed significant reductions in central foveal thickness (CFT) across all ERM stages, with most stage 4 ERMs regressing to stage 3. The mean improvement in BCVA was significant for all stages, with earlier stages showing better results. Presence of macular edema (ME) and ellipsoid zone (EZ) disruption were significant predictors of post-surgical BCVA, while disorganization of the retinal inner layer (DRIL) showed association with visual recovery but was not conclusively predictive. The study highlights the importance of SD-OCT in assessing retinal changes in idiopathic ERMs, demonstrating the prognostic value of EIFL stage scheme and other anatomical variables like EZ disruption and ME presence on BCVA. These findings offer insights for surgical prognostication and the potential for personalized treatment strategies.

Real-life results after the administration of a single 0.19 mg fluocinolone acetonide (ILUVIEN®) implant in patients with refractory diabetic macular edema.

Real-life data on the functional and anatomical outcome of intravitreal fluocinolone acetonide (FAc) in patients with refractory diabetic macular edema (DME). Retrospective study on 44 eyes with chronic DME that received intravitreal FAc implant and were previously treated with intravitreal Dexamethasone, triamcinolone or anti-VEGF. We assessed best-corrected visual acuity (BCVA), central maximum thickness (CMT) and foveal thickness (FT) as measured by spectral-domain optical coherence tomography (Spectralis OCT; Heidelberg Engineering). Secondary outcomes were intraocular pressure (IOP), adverse events, time to additional treatments. The FAc implant significantly reduced the CMT (baseline 541.23 ± 155.29 µm, p &lt; .001) and FT (baseline 460.34 ± 139.28 µm, p &lt; .001) for up to 36 months. Despite postoperative visual improvement over time, BCVA did not significantly shift from baseline (0.55 ± 0.38 logMAR, p = .568). The FAc implant effect diminished after 21.34 ± 12.74 months. IOP increased in 9% of eyes (n = 4) but was well controlled under topical (n = 1) or surgical therapy (n = 3). Even though patients' visual recovery does not benefit significantly, the FAc implant addresses the important pillars of chronic DME therapy regarding reduced injection frequency and reduced DME.

Efficacy of pars plana vitrectomy combined with internal limiting membrane peeling and gas tamponade for treating myopic foveoschisis: a meta-analysis

ObjectiveThis study aimed to evaluate and explore the efficacy of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) peeling and gas tamponade in treating myopic foveoschisis (MF) through a meta-analysis.MethodsSystematic searches were conducted on the PubMed, Web of Science and National Library of Medicine (NLM) English-language databases and the China National Knowledge Infrastructure (CNKI) and Wanfang Chinese-language databases. The primary outcome measures were postoperative best-corrected visual acuity (BCVA) and central foveal thickness (CFT), with the secondary outcome being the postoperative complication rate. Data analysis was performed using RevMan5.3 software.ResultsA total of 10 studies involving 234 eyes were included. The meta-analysis results showed the following: (1) The average postoperative BCVA improved compared with preoperative levels, with an average improvement in the logarithm of the minimum angle of resolution of 0.40, a statistically significant difference (95% CI: −0.44, − 0.20, p < 0.001); (2) the rate of postoperative BCVA improvement was 77% (95% CI: 65%, 90%, p < 0.001); (3) the postoperative CFT significantly decreased by an average of 385.92 μm, a statistically significant difference (95% CI: −437.85, − 333.98, p < 0.001); (4) the postoperative macular retinal complete reattachment rate was 90% (95% CI: 83%, 97%, p < 0.001); (5) the most common postoperative complication was a cataract, with an incidence of 55.9%.ConclusionUsing PPV combined with ILM peeling and gas tamponade to treat MF is reliable.

Analyzing foveal slope and retinal thickness in diabetics and healthy individuals with and without diabetic family history in South India for early neuronal damage prediction

Purpose: The purpose of this study was to investigate whether the clinically “healthy subjects,” identified as being at “risk” of developing diabetes, show significant changes in retinal thickness using optical coherence tomography(OCT) and foveal slope patterns. Methods: A cross-sectional, comparative study was conducted among the subjects who attended the hospital from December 2022 to April 2023. Subjects were included after obtaining written informed consent and were divided into three groups: Type 2 DM, healthy subjects with a family history (high-risk group), and those without a family history of diabetes. Foveal, parafoveal, and perifoveal thicknesses were measured using OCT. The fovea slope pattern was calculated using Image J software. Descriptive statistics, Pearson correlation, and ANOVA were performed for statistical analysis. Results: The study group had a mean age of 45.7 years, 95% of whom were female. The mean central foveal thickness (CFT) for the three groups was (CFTDM: 270 ± 33 μm; CFT FHD+: 254±19.6 μm; CFTFHD−: 255.4 ±19.2 μm; P = 0.118). The mean AUC (ILM-RPE) for (DM: 94577 ± 118905) pixel2 was significantly different from healthy control (FHD−:183705 ±156139 pixel2; P = 0.030) but was insignificant (P = 1.000) from subjects with family history (FHD+: 112749 ± 130451 pixel2). Males with diabetes had a greater foveal thickness than females (male: 277.8 ± 39.5 μm vs. female: 242.0 ± 41.7 μm, P = 0.05); however, no significant gender disparity was reported in the foveal slope. Conclusion: Decreased ILM-RPE thickness and foveal configuration were identified in subjects with family histories who do not meet the clinical criteria of diabetes but showed trends similar to diabetics.

Efficacy of anti-VEGF intravitreal injection in traumatic submacular hemorrhage: a retrospective study.

In this study we investigated the efficacy of short-term intravitreal injections of anti-vascular endothelial growth factors (anti-VEGF) in treating traumatic submacular hemorrhage. A total of 115 patients were diagnosed with submacular hemorrhage between 2018 and 2022 at Shenzhen Eye Hospital. In a retrospective analysis, we examined 13 of these patients who presented with submacular hemorrhage and choroidal rupture due to ocular trauma. Eight patients were treated with intravitreal anti-VEGF injection and 5 with oral drugs. We systematically analyzed changes in their ocular conditions pre and post-treatment. The evaluations encompassed best-corrected visual acuity (BCVA), optical coherence tomography, fundus fluorescein angiography, and retinal imaging. The 13 patients diagnosed with submacular hemorrhage comprised of 10 males and 3 female, with their age ranging between 27 and 64years, with an average age of 38.1years (standard deviation [SD]: 11.27). A statistically significant reduction in central foveal thickness (CFT) was observed following intravitreal injections of anti-VEGF drugs (P = 0.03). In control group, the CFT was reduced without statistical significance (P = 0.10). The BCVA of the patients in treatment group improved significantly from 1.15 (SD: 0.62. Range: 0.4-2) to 0.63 (SD: 0.59. Range: 0.1-1.6), indicating an average increase of 4.13 lines (SD: 3.36. Range: 0-9) as measured by the visual acuity test using an eye chart (P = 0.01). The difference between baseline visual acuity and final visual acuity was not statistically significant in control group (P = 0.51). Short-term administration of anti-VEGF drugs exhibited significant efficacy in reducing submacular hemorrhage following ocular trauma and enhancing visual acuity.

Evaluation of combined epiretinal membrane removal with intravitreal triamcinolone injection utilizing ectopic inner foveal layer staging scheme.

To investigate the macular morphological and visual outcomes of combined idiopathic epiretinal membrane (iERM) removal with triamcinolone acetonide (TA) injection based on consideration of the ectopic inner foveal layer (EIFL) staging scheme. Retrospective case-control study. The clinical data of 84 eyes of 84 patients who underwent vitrectomy for iERM between 2018 and 2022 were reviewed. The enrolled subjects were divided into the TA and non-TA groups. Fifty-one eyes received intravitreal TA injection following vitrectomy and ERM peeling (TA group), and 33 were only treated by standard vitrectomy and ERM peeling (non-TA group). Preoperative and postoperative EIFL stages, central foveal thickness (CFT), and best-corrected visual acuity (BCVA) were compared between both groups. After a mean follow-up of 7.69 ± 3.68months, both groups exhibited significant improvement in EIFL stages (P < 0.01), with no discernible advantage observed in the TA group. The TA and non-TA groups demonstrated improvement in the EIFL stages in 56.86 and 63.64% of eyes, respectively (P = 0.43). The CFT and BCVA significantly improved in both groups at the final visit (P < 0.01). However, CFT in the non-TA group displayed a more significant reduction during the follow-up (P < 0.03). Subgroup analysis revealed no significant differences in postoperative CFT and BCVA between the two groups in cases with or without continuous EIFL (P > 0.10). Our findings indicate that combined intravitreal TA injection following ERM removal conferred no significant benefits in alleviating macular thickening or improving visual acuity in iERM.

Internal limiting membrane peeling combined with silicone oil or air tamponade for highly myopic foveoschisis.

To compare the efficacy of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) and silicone oil or sterile air tamponade for the treatment of myopic foveoschisis (MF) in highly myopic eyes. This retrospective study included 48 myopic eyes of 40 patients with MF and axial lengths (ALs) ranging from 26-32 mm treated between January 2020 and January 2022. All patients were underwent PPV combined with ILM peeling followed by sterile air or silicone oil tamponade and followed up at least 12mo. Based on the features on spectral-domain optical coherence tomography (SD-OCT), the eyes were divided into the MF-only group (Group A, n=15 eyes), MF with central foveal detachment group (Group B, n=20 eyes), and MF with lamellar macular hole group (Group C, n=13 eyes). According to AL, eyes were further divided into three groups: Group D (26.01-28.00 mm, n=12 eyes), Group E (28.01-30.00 mm, n=26 eyes), and Group F (30.01-32.00 mm, n=10 eyes). The best-corrected visual acuity (BCVA), central foveal thickness (CFT), and complications were recorded. The patients included 16 males and 24 females with the mean age of 56±9.82y. The BCVA and CFT improved in all groups after surgery (P<0.01), while there was no significant difference of the CFT in Group A, B, and C postoperatively (P>0.05). The intergroup differences of BCVA and CFT postoperatively were statistically significant in Group D, E, and F. Twenty eyes were injected with sterile air, and 28 eyes were injected with silicone oil for tamponade based on the AL. However, there was no statistically significant difference among Groups D, E, and F in terms of the results of sterile air or silicone oil tamponade. The mean recovery time was 5.9mo for MF patients subjected to silicone oil tamponade and 7.7mo for patients subjected to sterile air tamponade, and the difference was not statistically significant. PPV and ILM peeling combined with silicone oil or sterile air tamponade can achieve good results for MF in highly myopic eyes with ALs≤32 mm.

S-cone contribution to oscillatory potentials in patients with blue cone monochromacy

PurposeThe aim of this exploratory study is to investigate the role of S-cones in oscillatory potentials (OPs) generation by individuals with blue-cone monochromacy (BCM), retaining S-cones, and achromatopsia (ACHM), lacking cone functions.MethodsThis retrospective study analyzed data from 39 ACHM patients, 20 BCM patients, and 26 controls. Central foveal thickness was obtained using spectral-domain optical coherence tomography, while amplitude and implicit time (IT) of a- and b-waves were extracted from the ISCEV Standard dark-adapted 3 cd.s.m−2 full-field ERG (ffERG). Time–frequency analysis of the same measurement enabled the extraction of OPs, providing insights into the dynamic characteristics of the recorded signal.ResultsBoth ACHM and BCM groups showed a significant reduction (p < .00001) of a- and b-wave amplitudes and ITs as well as the power of the OPs compared to the control groups. The comparison between ACHM and BCM didn’t show any statistically significant differences in the electrophysiological parameters. The analysis of covariance revealed significantly reduced central foveal thickness in the BCM group compared to ACHM and controls (p < .00001), and in ACHM compared to controls (p < .00001), after age correction and Tukey post-hoc analysis.ConclusionsS-cones do not significantly influence OPs, and the decline in OPs' power is not solely due to a reduced a-wave. This suggests a complex non-linear network influenced by photoreceptor inputs. Morphological changes don’t correlate directly with functional alterations, prompting further exploration of OPs’ function and physiological role.

Sex-Specific Differences in the Relationship Between Prematurity and Ocular Geometry.

To explore differences in the relationship between gestational age (GA) and birth weight (BW) percentile and ocular geometry between males and females. The Gutenberg Prematurity Eye Study involved a prospective ophthalmic examination of adults, aged 18 to 52 years, who were born preterm or at term, in Germany. The associations between GA and BW percentile on the main outcome measures were evaluated by uni- and multivariable linear regression analyses. The main outcome measures were central corneal thickness, corneal radius, anterior chamber depth, lens thickness, posterior segment length, and central foveal thickness. Potential sex-specific differences and an effect modification by sex were analyzed. This study involved 438 participants (245 females, 193 males) with an average age of 28.6 ± 8.7 years. In female participants, central foveal thickness was negatively associated with a higher GA (B = -2.99; P < 0.001). Similarly, male participants also demonstrated a negative association between central foveal thickness and GA (B = -4.27; P < 0.001). The multivariable model with effect modification revealed that the central foveal thickness was thicker with lower GA. There was an association between the effect modification of GA with sex and central foveal thickness, demonstrating a more pronounced effect of GA on central foveal thickness in male participants (B = 1.29; P = 0.04). This study identified a sex-specific correlation between lower GA and thicker central foveal thickness, suggesting differences in the developmental trajectory of this biometric parameter concerning GA. A thicker central foveal thickness might affect the visual acuity of individuals born preterm in adulthood, with a more pronounced impact in males and a potential predisposition to age-related diseases later in life. Sex did not influence the association of GA or BW percentile to other ocular geometric parameters.

Comparison of facedown and non-facedown positions after vitrectomy with fovea-sparing internal limiting membrane peeling and air tamponade for treating myopic foveoschisis with foveal detachment: A prospective, randomized interventional study

PurposeTo compare the anatomical and visual outcomes after vitrectomy with facedown (FD) or non-FD positions for treating myopic foveoschisis (MF) with foveal detachment. DesignProspective, randomized interventional study. Methods55 eyes with MF and foveal detachment that underwent vitrectomy with fovea-sparing internal limiting membrane (ILM) peeling and air tamponade were randomized to either the postoperative FD (26 eyes) or non-FD (29 eyes) positions. Best-corrected visual acuity (BCVA) and optical coherence tomography were assessed at baseline, 2 weeks, 3 months, and 6 months after vitrectomy with fovea-sparing ILM peeling and air tamponade with the FD or non-FD positions. Logistic and linear regression analyses were performed to study correlations between clinical factors and foveoschisis resolution and postoperative BCVA. ResultsAll patients completed ≥6 months of follow-up. MF and foveal detachment were completely resolved in 22 eyes (92 %) in the FD group and 22 eyes (76 %) in the non-FD group (P = 0.160). Macular hole-associated retinal detachment occurred in one eye in the FD (4 %) and non-FD (3 %) groups. The postoperative best-corrected visual acuity (BCVA) at 6 months did not differ significantly between the two groups (P = 0.495). The BCVA improved by ≥0.3 logMAR in 14 eyes (58 %) in the FD group versus 17 eyes (59 %) in the non-FD group (P = 0.983). Central foveal thickness (CFT) and height of foveal detachment were significantly associated with foveoschisis resolution (P = 0.045 and 0.039, respectively). Better preoperative BCVA and foveoschisis resolution were significantly associated with better postoperative BCVA (P = 0.031 and 0.003, respectively). ConclusionsThe non-FD position appeared to be as effective as the FD position after vitrectomy with fovea-sparing ILM peeling and air tamponade for treating MF with foveal detachment.

Retinal and Vitreous Changes Associated with Spontaneous Improvement in Myopic Macular Schisis

PurposeTo describe the retinal and vitreous changes in eyes showing myopic macular schisis (MMS) improvement when vitrectomy was not performed and identify triggering factors. DesignRetrospective observational study. SubjectsPatients with non-operated myopic macular schisis MethodsThe records of patients with MMS who were followed without performing surgery for more than 6 months were retrospectively reviewed, and the eyes showing an anatomical improvement were included. MMS evolution was analyzed quantitatively (central foveal thickness [CFT], parafoveal thickness, maximum height) and qualitatively (presence/absence of foveal detachment, lamellar hole, epiretinal membrane, choroidal neovascularization, inner and outer retinoschisis, vitreous status) at baseline and at the final visit. An anatomical improvement was defined as a decrease in CFT by at least 50 μm. Main outcome measureThe rate anatomical improvement of MMS without performing vitrectomy and the morphological changes observed in these cases. ResultsIn a cohort of 74 non-operated eyes with MMS, MMS improved in 14 eyes (19%) after a mean follow-up of 55 ± 38 months (range: 8-138). In these improved cases, the mean decrease in CFT was 153 ± 166 μm (range: 24-635, p=0.005) and a complete resolution of MMS was observed in 9 eyes (64%). In 9 eyes (64%), the improvement was associated with visible vitreous changes in the macular area on the OCT scans. The mean visual acuity, which was already good at baseline (20/50, 0.4 ± 0.2 LogMAR), increased at the last visit (20/40, 0.3 ± 0.3 LogMAR) but without reaching significance. ConclusionThis long-term follow-up analysis showed that almost 20% of MMS in eyes without indication for surgery could improve over time. In most cases, the improvement was associated with an apparent resolution of vitreous tensions.

Foveal atrophy in patients with active central serous chorioretinopathy at first presentation: characteristics and treatment outcomes

Background/aimsThis study aimed to investigate the clinical characteristics and treatment outcomes of patients with active central serous chorioretinopathy (CSC) and foveal atrophy.MethodsPatients diagnosed with active idiopathic CSC using multimodal imaging...