Macular Epiretinal Membrane Formation Research Articles

New retinal findings in NLRP3-associated autoinflammatory disease

PurposeTo determine whether the rare NLRP3-Associated Autoinflammatory Disease (NLRP3-AID) is associated with retinal changes and to assess the ocular involvement.MethodsA retrospective cohort study of 20 patients(40 eyes) diagnosed with rare NLRP3-AID at Peking Union Medical College Hospital, from April 2015 to August 2022. Patients underwent a comprehensive ophthalmological examination, including visual acuity, intraocular pressure examination, slit-lamp examination, fundus photography, optical coherence tomography(OCT), and fluorescence angiography (FA). Some patients also underwent optical coherence tomography angiography (OCTA).ResultsThis study analyzed 40 eyes of 20 patients (11 [55.0%] male; median age, 25.0 years [range, 12–52 years]) and 13 patients (26 eyes, 65%) demonstrated ocular involvement. The most common ophthalmologic manifestation was conjunctivitis (22 eyes, 84.6%), followed by papilledema (14 eyes, 53.8%), retinopathy (10 eyes, 38.5%), optic atrophy (6 eyes, 23.1%), uveitis (4 eyes, 15.4%), reduced pupil light reflex (3 eyes, 11.5%) and cataracts (2 eyes, 7.7%). Ocular involvement was bilateral in 11 patients (55.0%). Five kinds of retinal lesions were seen in 5 patients (10 eyes, 25%) with NLRP3-AID, including peripheral retinal vascular leakage, microaneurysms, macular ischemia, macular epiretinal membrane formation and drusen.ConclusionsPeripheral retinal vascular leakage, macular ischemia, microaneurysms and drusen are newly identified retinal findings in patients with NLRP3-AID, which suggests the importance of detailed retinal examination in these patients.

Outcomes of 25-gauge pars plana vitrectomy alone with air tamponade for the management of rhegmatogenous retinal detachment with inferior breaks

BackgroundThis study was investigated the surgical outcomes of primary rhegmatogenous retinal detachment (RRD) with inferior retinal breaks (IRBs) that were repaired by 25-gauge pars plana vitrectomy (PPV) with air tamponade.MethodsThis retrospective review included 81 consecutive patients who had RRD with IRBs and underwent PPV with air tamponade in our hospital from January 2017 to January 2020. The main outcomes were single surgery anatomical success (SSAS) rate, postoperative best-corrected visual acuity (BCVA), and complications.ResultsThe patient population consisted of 29 women and 52 men (mean age, 52.12 years); the mean follow-up interval was 8.88 months. The mean number of affected quadrants was 1.65 (range, 1–4 quadrants) and the mean number of breaks was 3.25. A single break was present in 20 cases (24.7%); two to 10 breaks were present in 61 (75.3%) cases. The SSAS rate was 91.36% (74/81) and the final anatomical success rate was 96.30% (78/81). More than half of the patients had BCVA < 0.3 logarithm of the minimum angle of resolution at the last follow-up. Axial length and patient age were candidate risk factors for redetachment (axial length, p = 0.03; age, p = 0.002). Postoperative complications included macular epiretinal membrane formation in one patient, lens opacity in three patients, and clinically significant macular edema in one patient.ConclusionsPPV with air tamponade may be effective for the treatment of primary RRD with IRBs. Extensive preoperative discussion may be necessary for young patients and patients with particularly long axial length.

SURGICAL OUTCOMES OF 25-GAUGE PARS PLANA VITRECTOMY USING AIR AS AN INTERNAL TAMPONADE FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT.

To report surgical outcomes of 25-gauge pars plana vitrectomy using air as an internal tamponade for patients with primary rhegmatogenous retinal detachment (RRD). A retrospective clinical study of 59 eyes of 59 consecutive patients presented with primary RRD at the Beijing Tongren Eye Center in China. From August 2016 to May 2018, medical records of the patients who underwent 25-gauge pars plana vitrectomy with air tamponade for RRD were reviewed. The main outcome measures were primary and final anatomical success (retinal re-attachment) rates, and postoperative complications. Of the 59 patients, aged 54.47 ± 11.81 years, 31 (52.5%) were men. Vitrectomy was performed 3 to 40 (averaged 16.98 ± 10.17) days after the onset of symptoms, and the mean follow-up period was 12.90 ± 5.92 months (ranging 6.07-26.10 months). Forty-two eyes (71.2%) had RRD with retinal breaks in the superior half of the retina, and the mean number of retinal breaks was 1.75 ± 0.94. Three eyes (5.1%) had RRD with giant retinal tears. Of the 59 eyes, 35 (59.3%) had RRD with inferior quadrants involved. Proliferative vitreoretinopathy (PVR) gradings were C1 in 2 (3.4%) eyes and B or below in 57 (96.6%) eyes. The primary and final anatomical success rates were 94.9% (56/59) and 98.3% (58/59), respectively. Of the three eyes which developed re-detachment of the retina, one eye had postoperative progression of PVR and two eyes were RRD associated with macular hole in high myopia. Postoperative complications included 5 eyes (8.5%) with serous choroidal detachment within 3 days after surgery and 4 eyes (6.8%) with macular epiretinal membrane formation 1 to 8 months after surgery. Secondary cataract surgery was performed in 13 of the 53 phakic eyes (24.5%) during follow-up. Small-gauge pars plana vitrectomy with air tamponade may be effective in treating selected cases of relatively simple primary RRD. Additional studies are needed to verify the efficacy of this surgical approach for more complicated cases such as those with giant retinal tears.

Therapy for macular epiretinal membrane formation in the early stage after retinal detachment surgery

目的 探讨尿激酶联合地塞米松结膜下注射治疗视网膜复位术后早期并发黄斑前膜的效果.方法6例6眼原发性(裂孔源性)视网膜脱离复位术后早期黄斑前膜形成,黄斑前膜薄如玻璃纸样,视网膜表面波纹,中心凹旁血管扭曲,视物变形、视力下降.药物治疗行尿激酶联合地塞米松结膜下注射,共2～3次.随访观察治疗前后视力改变、视物变形改善、眼底病变进展情况及视觉电生理变化.随访时间为6月至3年.结果4例治疗后视物变形改善,视力提高.2例无变化.5例的眼底病变无进一步发展,1例视物变形,视力下降,眼底黄斑前膜发展,网膜皱摺,血管走向变形.结论视网膜复位术后黄斑前膜形成早期,尿激酶联合地塞米松结膜下注射可部分控制病变进一步发展.严重的黄斑前膜需通过玻璃体手术加以剥除,恢复黄斑区的解剖形态,以提高视力,改善视物变形。

Macular Epiretinal Membrane Formation and Treated Retinal Breaks

We sought to determine the incidence of macular epiretinal membrane formation in eyes treated for retinal breaks after three different modalities of treatment: laser photocoagulation, cryotherapy, or both. We reviewed the charts of 262 consecutive patients with a diagnosis of retinal tears and included 205 patients who had more than six months of follow-up. One hundred ninety-five patients were treated. One hundred seventy of these patients had retinal breaks in one eye and 25 patients had breaks in both eyes, for a total of 220 treated eyes. Cryopexy was applied in 125 eyes, laser retinopexy in 73 eyes, and both modalities in 22 eyes. Macular epiretinal membranes developed in a total of 26 eyes: 12 in the cryopexy group, ten in the laser-treated group, and four in the dual modality group. No statistically significant difference, at a level of P < or = .01, was seen in the rate of epiretinal membrane formation between the different treatment modalities. No statistically significant difference, at a level of P < or = .01, was seen in the rate of epiretinal membrane formation in the presence or absence of vitreous hemorrhage or in the type of precedent retinal break. After treatment of retinal breaks with laser photocoagulation and cryotherapy, no statistically significant difference in the incidence of macular epiretinal membrane formation was demonstrated.