Vitreoretinal Conditions Research Articles

Comparing New Smartphone-Connected Handheld Ultrasound Device vs. Traditional Ultrasound in Vitreo-Retinal Disease Diagnosis.

(1) Background: Ocular emergencies account for 1.5-3% of emergency department (ED) visits and require urgent diagnosis to prevent serious complications. Ultrasonography is a crucial, non-invasive diagnostic tool for these conditions but traditionally lacks portability and integration with modern electronic smart devices. The purpose of this study was to assess the accuracy and performance of a new handheld ultrasound device in comparison to a conventional cart-based sonographic machine in patients attending to the ED for vitreo-retinal diseases. (2) Methods: three specialists in ophthalmology, with at least 4-year experience in vitreo-retinal diseases and eye ultrasound, evaluated images of 50 eyes with both portable and traditional ultrasound probes. Each specialist made the diagnosis based on the images captured with both probes and then rated their overall image quality and confidence of diagnosis with a five-point Likert scale. The concordance of diagnosis between the two probes was evaluated. (3) Results: The sample comprised 42 patients. Twenty (40%) healthy eyes and thirty eyes with the following vitreo-retinal interface conditions were examined: 12 retinal detachment (24%), 8 vitreous hemorrhage (16%), and 10 posterior vitreous detachment (20%). The overall accuracy of the two devices appeared to be comparable (70.7% vs. 69.3%). The Butterfly iQ+ probe showed similar sensitivity in retinal detachment diagnosis (91.7% vs. 94.4% of the Accutome B-scan Pro), while it showed poor performance in diagnosing posterior vitreous detachment (sensitivity = 27.2%); (4) Conclusions: The Butterfly iQ+ device demonstrated high sensitivity in the diagnosis of retinal detachment. Significant adjustments are still needed to improve the resolution of the vitreous body.

Vitreous substitutes and tamponades - A review of types, applications, and future directions.

Vitreous substitutes and tamponades occupy the vitreous cavity following vitrectomy in the management of various conditions such as retinal detachment, macular hole, and diabetic retinopathy. Such replacements can be for the short term (gases such as sulfur hexafluoride (SF6) and perfluoropropane (C3F8) or long term (such as silicone oils). Certain substitutes such as perfluorocarbon liquids are used only transiently during surgery as "a third hand" or rarely till a few days post surgery. Hydrogels and hyaluronan derivatives are among the newer vitreous substitutes that are showing promise for the future, albeit still under investigation. still being investigated for use as vitreous substitutes. These materials have properties similar to the natural vitreous and may offer advantages such as improved biocompatibility and biodegradability. Although vitreous substitutes are valuable tools in treating vitreoretinal conditions, they carry risks and potential complications such as cataract formation, glaucoma, and inflammation. The current communication extensively reviews the available literature on vitreous tamponades. It details the composition and properties of various vitreous substitutes and tamponades available for the clinician, highlighting the techniques of usage, indications, and limitations.

Interferons in vitreoretinal diseases; a review on their clinical application, and mechanism of action.

This review investigates the therapeutic benefits of interferons (IFNs) in vitreoretinal diseases, focusing on their regulatory roles in innate immunological reactions and angiogenesis. The study aims to categorize the clinical outcomes of IFN applications and proposes a molecular mechanism underlying their action. A systematic review was conducted using MEDLINE/PubMed, Web of Science, EMBASE, and Google Scholar databases to identify randomized clinical trials, case series, and case-control studies related to IFNs' impact on vitreoretinal diseases (1990-2022). The data synthesis involved an in-depth analysis of the anti-inflammatory and anti-angiogenesis effects of IFNs across various studies. Our findings indicate that IFNs exhibit efficacy in treating inflammation-associated vitreoretinal disorders. However, a lack of sufficient evidence exists regarding the suitability of IFNs in angiogenesis-associated vitreoretinal diseases like choroidal neovascularization and diabetic retinopathies. The synthesis of data suggests that IFNs may not be optimal for managing advanced stages of angiogenesis-associated disorders. While IFNs emerge as promising therapeutic candidates for inflammation-related vitreoretinal diseases, caution is warranted in their application for angiogenesis-associated disorders, especially in advanced stages. Further research is needed to elucidate the nuanced molecular pathways of IFN action, guiding their targeted use in specific vitreoretinal conditions.

American Society of Retina Specialists Clinical Practice Guidelines on Multimodal Imaging for Retinal Disease.

Purpose: Advancements in retinal imaging have augmented our understanding of the pathology and structure-function relationships of retinal disease. No single diagnostic test is sufficient; rather, diagnostic and management strategies increasingly involve the synthesis of multiple imaging modalities. Methods: This literature review and editorial offer practical clinical guidelines for how the retina specialist can use multimodal imaging to manage retinal conditions. Results: Various imaging modalities offer information on different aspects of retinal structure and function. For example, optical coherence tomography (OCT) and B-scan ultrasonography can provide insights into the microstructural anatomy; fluorescein angiography (FA), indocyanine green angiography (ICGA), and OCT angiography (OCTA) can reveal vascular integrity and perfusion status; and near-infrared reflectance and fundus autofluorescence (FAF) can characterize molecular components within tissues. Managing retinal vascular diseases often includes fundus photography, OCT, OCTA, and FA to evaluate for macular edema, retinal ischemia, and the secondary complications of neovascularization (NV). OCT and FAF play a key role in diagnosing and treating maculopathies. FA, OCTA, and ICGA can help identify macular NV, posterior uveitis, and choroidal venous insufficiency, which guides treatment strategies. Finally, OCT and B-scan ultrasonography can help with preoperative planning and prognostication in vitreoretinal surgical conditions. Conclusions: Today, the retina specialist has access to numerous retinal imaging modalities that can augment the clinical examination to help diagnose and manage retinal conditions. Understanding the capabilities and limitations of each modality is critical to maximizing its clinical utility.

Evaluating referrals of flashing lights and floaters coming into secondary care from primary care

ABSTRACT Clinical Relevance Optometrists should look to take every opportunity to expand their knowledge, understanding and skills pertaining to vitreoretinal conditions. Background Despite the existence of acute eye care schemes and the up-skilling of optometrists, many units are still noticing large numbers of poor-quality referrals with high false positive rates. The authors pondered whether these schemes are effective. Methods At two different time points, a prospective analysis of patients took place, of all the flashing lights and floaters referrals coming into secondary care at the Royal Glamorgan Hospital, Wales, UK. The following data was captured: the exact source of the primary care referral, the diagnosis being queried, the secondary care diagnoses made and the secondary care management decisions. The accuracy of retinal break and Shafer’s sign detection were also directly compared between primary care and secondary care using Cohen’s Kappa Coefficient. Results For the 2018 period, n = 51 patients were included. For the 2022–23 period n = 100 patients were included. The majority of referrals during both periods were from optometrists (>80%) via the WECS pathway. The most common diagnoses being queried were retinal breaks (~50%), followed by retinal detachments (~20%). Interestingly up to 20% of patients seen in secondary care were diagnosed as normal examinations and ~ 20%. Over 1/3 of patients were discharged after their first visit to the EEC. Statistically significant differences were found between the accuracy of retinal tear and Shafer’s identification between the primary and secondary care settings. Conclusion A high number of false positive referrals are coming into secondary care from the WECS pathway and clear training and education needs have been identified.

Overview of biomarkers in vitreoretinal conditions

Biomarkers are measurable indicators that can be used to diagnose diseases or monitor their progression. In vitreoretinal conditions, biomarkers can be found in various structures of the eye, including the retina, vitreous, and choroid.One of the most commonly used biomarkers in vitreoretinal conditions is visual acuity, which is a measure of how well a person can see. Other biomarkers include imaging techniques, such as optical coherence tomography (OCT) and fundus photography, which can provide detailed images of the retina and vitreous.In addition to structural biomarkers, there are also functional biomarkers that can be used to evaluate visual function, such as contrast sensitivity and visual field testing. These measures are often used to monitor the progression of diseases such as macular degeneration and diabetic retinopathy.Recent advances in biomarker research have led to the discovery of new markers for vitreoretinal conditions, including genetic markers, inflammatory markers, and metabolic markers. These markers may provide new insights into the underlying mechanisms of disease and may help to identify new therapeutic targets.Overall, biomarkers are an important tool in vitreoretinal conditions for the diagnosis, monitoring, and management of a wide range of ocular diseases. They may also help to improve our understanding of these conditions and facilitate the development of new therapies.

Combined cataract and vitreoretinal surgery

Combined cataract surgery and vitrectomy is a surgical technique used to address both cataract and vitreoretinal disorders. With the advances in surgical tools, simultaneous removal of cataract associated with vitreoretinal disorders is gaining popularity. This technique offers several advantages over separate surgeries, including reduced surgical time and anaesthesia exposure, as well as quicker visual rehabilitation. However, the optimal timing and approach for combined cataract surgery and vitrectomy remain controversial.Indications for combined cataract surgery and vitrectomy include various vitreoretinal conditions, such as retinal detachment, diabetic retinopathy, macular holes, and epiretinal membranes. The timing of surgery depends on the severity of the cataract and the vitreoretinal pathology, as well as the surgeon's preference. The most common surgical techniques include phacoemulsification with posterior chamber intraocular lens implantation, followed by pars plana vitrectomy. The filling of the vitreous cavity is possible with several types of tamponades, such as different gases, but in extreme cases even with silicone oil. After gas tamponade, proper positioning of the patient is of great importance.Complications associated with combined cataract surgery and vitrectomy include posterior capsule rupture, intraocular lens dislocation, postoperative inflammation, and intraocular pressure elevation. However, the overall complication rate is low, and the visual outcomes are generally favourable.In conclusion, combined cataract surgery and vitrectomy is a useful technique for managing various vitreoretinal conditions. Proper patient selection, careful surgical planning, and close postoperative monitoring are critical for achieving optimal outcomes.

Wound healing and postoperative management in paediatric patients following 27-Gauge Transconjunctival Sutureless Vitrectomy for vitreoretinal conditions.

The utilization of 27-G TSV, or 27-Gauge Transconjunctival Sutureless Vitrectomy, poses distinct difficulties in the context of paediatric patients, particularly those younger than 14 years old, on account of the dearth of exhaustive documentation concerning the efficacy and results of these operations. Therefore, this retrospective study was to evaluate the safety and efficacy of 27-G TSV in paediatric patients, with emphasis on management of intraoperative and postoperative complications and postoperative wound healing. A total of 54 eyes of 52 paediatric patients who underwent 27-G TSV at Sichuan Provincial People's Hospital were included in the study. The average duration of follow-up was 9.32 ± 3.35 months. The complication with the highest incidence rate was Rhegmatogenous Retinal Detachment (RRD), which was detected in 27.8% cases. Familial Exudative Vitreoretinopathy (FEVR) and Persistent Fetal Vasculature (PFV) each accounted for 16.7% of the cases. Retinopathy of Prematurity (ROP) and Vitreous Haemorrhage (VH) constituted 11.1% and 14.8%, respectively, of the reported cases. Lens injury (1.9%), cannula slippage (7.4%) and wound leakage (5.6%) were intraoperative complications. Iatrogenic retinal detachment occurred at 3.7%. Hypotony (10.8% of patients), vitreous haemorrhage (9.3%), cataract formation (9.3%), ocular hypertension (8.1%) and retinal detachment (5.6%) were postoperative complications. Effective management strategies were executed, such as performing in situ trocar puncture to address cannula slippage and promptly suturing to address wound leakage. 27-G TSV exhibited promise as the therapeutic alternative for range of vitreoretinal disorders in paediatric patients, accompanied by complications that were controllable during and after the procedure. Strict preoperative planning and precise surgical technique are indispensable in order to maximize patient outcomes and guarantee effective wound healing and recovery within this particular demographic.

Accuracy of Vitreoretinal Disease Information From an Artificial Intelligence Chatbot

This cross-sectional study compares 2 sets of responses by 1 chatbot to frequently asked questions about vitreoretinal conditions and procedures.

Antiplatelets and Anticoagulants in Vitreoretinal Surgery: A Systematic Review.

Background: Antiplatelets and anticoagulants have substantially influenced contemporary vitreoretinal surgical practices. The availability of new oral blood thinners has recently spurred a renewed interest in the clinical approach to vitreoretinal surgical conditions since it may be difficult for the surgeon to collect sufficient evidence-based data to decide whether to discontinue or continue such medications. Materials and Methods: We conducted a systematic review on the use of antiplatelets and/or anticoagulants in the perioperative setting in vitreoretinal surgery and their possible complications, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The level of evidence, according to the Oxford Centre for Evidence-Based Medicine (OCEM) 2011 guidelines, and the quality of evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, were assessed for all included articles. Results: In total, 2310 articles were initially extracted, out of which 1839 articles were obtained after duplicates were removed and their abstracts were screened. A total of 27 articles were included in the full-text review. Finally, a remaining 22 articles fulfilled the inclusion criteria. Conclusions: Even though there is just a small number of studies with solid results, the advantage of using antiplatelets and/or anticoagulants in vitreoretinal surgery seems to outweigh the disadvantages, which are mainly related to postoperative hemorrhagic complications.

Pars Plana Vitrectomy in Inherited Retinal Diseases: A Comprehensive Review of the Literature.

Inherited retinal diseases (IRDs) are a group of clinically and genetically heterogeneous disorders that may be complicated by several vitreoretinal conditions requiring a surgical approach. Pars plana vitrectomy (PPV) stands as a valuable treatment option in these cases, but its application in eyes with such severely impaired chorioretinal architectures remains controversial. Furthermore, the spreading of gene therapy and the increasing use of retinal prostheses will end up in a marked increase in demand for PPV surgery for IRD patients. The retinal degeneration that typically affects patients with hereditary retinal disorders may influence the execution of the surgery and the expected results. Considering the importance of PPV application in IRD-related complications, it is fundamental to try to understand from the literature what is adequate and safe in posterior eye segment surgery. Use of dyes, light toxicity, and risk of wounding scar development have always been themes that discourage the execution of vitreoretinal surgery in already impaired eyes. Therefore, this review aims to comprehensively summarize all PPV applications in different IRDs, highlighting the favorable results as well as the potential precautions to consider when performing vitreoretinal surgery in these eyes.

Change in refraction, corneal power and axial length of the eye secondary to silicone oil tamponade injection after pars plana vitrectomy

Background: Refractive and ocular biometric changes after silicone oil tamponade (SOT) in phakic eyes have been studied thoroughly; however, similar studies amongst Sudanese patients with vitreoretinal conditions were not carried out.Aim: This study aimed to assess post-operative changes in refraction, corneal power and axial length after pars plana vitrectomy (PPV) with SOT in phakic patients.Setting: The study was conducted at Sudan Eye Center, Khartoum, Sudan.Methods: A cross-sectional retrospective hospital-based study was performed at Sudan Eye Center. The study included all phakic patients who underwent PPV with SOT for a variety of vitreoretinal conditions from October 2018 to January 2019. Clinical investigations included uncorrected visual acuity (VA), best-corrected VA, refraction, corneal power and axial length pre- and post-surgery. Differences in these parameters were assessed using a paired sample t-test with a significance level of 0.05.Results: Medical records of 59 consecutive patients (59 eyes, 41 men and 18 women) with ages ranging from 22 years to 75 years were studied. The findings revealed a statistically significant hypermetropic change (pre: –0.17 ± 2.44 dioptre [D] and post: +4.43 ± 2.04 D) with a p-value of 0.001. In terms of axial length, there was a significant increase (pre: 23.61 ± 1.17 mm and post: 23.82 ± 1.27 mm; p 0.001). However, no significant change was found in corneal power (pre: –43.60 ± 1.96 D and post: 43.63 ± 2.03 D; p = 0.45).Conclusion: A hypermetropic shift in refraction, longer axial length and non-considerable increase in corneal power were observed amongst Sudanese phakic patients after PPV with instillation of silicone oil.

Long-Term Safety and Efficacy of Siluron2000 with Pars Plana Vitrectomy in the Treatment of Patients with Severe Vitreoretinopathy and Chronic Macular Holes.

PurposeSilicone oil intraocular retinal tamponade is a useful adjunct to pars plana vitrectomy (PPV) in the treatment of complex vitreoretinal conditions. Siluron2000, a modified silicone oil product containing an additional small, high molecular weight and low viscosity, very-long-chain silicone molecule, was developed to reduce post-operative silicone oil emulsification, a non-infrequent complication that occurs with low molecular weight silicone oil. This study was designed to assess the safety and efficacy of long-term Siluron2000.Patients and MethodsThis was a single-center, retrospective, observational study. All consecutive patients undergoing PPV with intravitreal Siluron2000 injection between January 2017 and September 2019 with at least 6-month follow-up were identified based on billing codes.ResultsA total of 57 eyes of 57 consecutive patients comprising 51 cases of proliferative vitreoretinopathy and 6 cases of recurrent full thickness macular hole were included. Median follow-up was 18 months. Emulsification occurred in 9 patients (15%). Retinal re-attachment was achieved in 47 patients (82%). The median time without silicone oil emulsification was 17 months. Of the cases with residual retinal detachment (RD) despite intravitreal Siluron2000, 4 (7%) were total RDs and 6 (10%) were inferior RDs with attached macula. The most common complications were glaucoma 12 (21%), cataract 11 (19%), and epiretinal membrane 2 (3.5%). There was no association between the duration of Siluron2000 and visual outcomes.ConclusionSiluron2000 is an effective long-term tamponade agent in the treatment of complex vitreoretinopathy. Visual and anatomical outcomes are similar to those reported with higher mw silicone oil tamponade agents but with a lower emulsification rate.

Outcomes of Primary 27-Gauge Vitrectomy for 73 Consecutive Cases With Uveitis-Associated Vitreoretinal Disorders.

Background: Since the advent of 27-gauge microincision vitrectomy system a decade ago, evidence regarding the feasibility, safety, and effectiveness of 27-gauge pars plana vitrectomy (PPV) has increased.Aim: To assess the effectiveness and safety profile of 27-gauge PPV for various vitreoretinal conditions associated with uveitis.Methods: We retrospectively investigated 73 consecutive cases that underwent primary 27-gauge PPV for uveitis-related ocular disorders between October 2014 and April 2021. The primary outcome measures were mean change in logMAR best-corrected decimal visual acuity (BCVA) pre-operatively to 3 months post-operatively, the proportion of BCVA improvement category defined as the degree of logMAR BCVA difference (“improved” [≤−0.3], “unchanged” [−0.3 to 0.3], and “worsened” [≥0.3]) pre-operatively to 3 months post-operatively, the mean change in intraocular inflammation scores pre-operatively to 3 months post-operatively; and intraoperative and post-operative complications.Results: The mean logMAR BCVA significantly improved from 0.69 pre-operatively to 0.42 at 3 months post-operatively (P = 0.017). The percentages of eyes with “improved,” “unchanged,” and “worsened” BCVA at 3 months post-operatively were 37, 50, and 13%, respectively. The mean anterior chamber cell score was 0.6 pre-operatively and 0.2 at 3 months post-operatively (P = 0.001), the mean anterior chamber flare score was 0.4 pre-operatively and 0.1 at 3 months post-operatively (P = 0.004), and the mean vitreous haze score was 1.9 pre-operatively and 0.1 at 3 months post-operatively (P < 0.001). Surgery-related complications occurred in 35 (48%) eyes, 68% of which were related to intraocular pressure and transient.Conclusions: Given its risk–benefit profile, 27-gauge PPV is a promising option for the treatment of vitreoretinal disorders in uveitis.

Surgical Treatment of Epiretinal Membrane.

Epiretinal membrane (ERM) is a common retinal disease characterized by cellular proliferation and metaplasia that lead to the formation of a pathological fibrocellular membrane immediately superjacent to the inner retinal surface. The vast majority of ERMs are considered idiopathic. However, ERM formation can result from various primary intraocular diseases, including retinal breaks and detachment, retinal vascular diseases, and vitreoretinal inflammatory conditions. Although ERMs are generally asymptomatic or cause mild metamorphopsia and/or a modest decrease in visual acuity, some can cause severe macular distortion and macular edema, resulting in significantly impaired function. Surgical removal of ERM is the only treatment, and improvements in vitrectomy systems have enabled less invasive treatment. However, there are currently no standardized criteria for ERM surgery, and the indications for surgery are determined from the patient's subjective symptoms. Another problem with ERM surgery is that not all patients show satisfactory postoperative recovery of visual function. Thus, further research is needed to determine the criteria for ERM surgery and methods to improve the postoperative prognosis.

Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA).

The advent of optical coherence tomography (OCT) revolutionized both clinical assessment and research of vitreoretinal conditions. Since then, extraordinary advances have been made in this imaging technology, including the relatively recent development of swept-source OCT (SS-OCT). SS-OCT enables a fast scan rate and utilizes a tunable swept laser, thus enabling the incorporation of longer wavelengths than conventional spectral-domain devices. These features enable imaging of larger areas with reduced motion artifact, and a better visualization of the choroidal vasculature, respectively. Building on the principles of OCT, swept-source OCT has also been applied to OCT angiography (SS-OCTA), thus enabling a non-invasive in depth-resolved imaging of the retinal and choroidal microvasculature. Despite their advantages, the widespread use of SS-OCT and SS-OCTA remains relatively limited. In this review, we summarize the technical details, advantages and limitations of SS-OCT and SS-OCTA, with a particular emphasis on their relevance for the study of retinal conditions. Additionally, we comprehensively review relevant studies performed to date to the study of retinal health and disease, and highlight current gaps in knowledge and opportunities to take advantage of swept source technology to improve our current understanding of many medical and surgical chorioretinal conditions. We anticipate that SS-OCT and SS-OCTA will continue to evolve rapidly, contributing to a paradigm shift to more widespread adoption of new imaging technology to clinical practice.

Macular optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment.

The primary aim of this study was to summarize and illustrate the main structural cross-sectional optical coherence tomography findings encountered after vitreoretinal surgery for rhegmatogenous retinal detachment. This was a non-systematic review of literature on structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment. Adequate illustrations of the main findings described were found after a retrospective analysis of imaging and charts of patients operated at the department where this study was performed. The main structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment included persistent subretinal fluid, subretinal blebs, retinal folds, subretinal perfluorocarbon liquids, macular alterations related to silicone oil, epiretinal membranes, proliferative vitreoretinopathy, cystoid macular edema, macular holes, and recurrent retinal detachment. In conclusion, optical coherence tomography was a useful tool after vitreoretinal surgery for rhegmatogenous retinal detachment. Some optical coherence tomography findings may not be evident on fundus examination, and optical coherence tomography can reveal essential details for the clinical management and the visual prognosis. Other findings, despite being visible on funduscopic examination, may be better assessed with the aid of optical coherence tomography. All these elements contribute to support the importance of tomographic assessment in the follow-up of eyes treated for vitreoretinal conditions.

PMU1 A SYSTEMATIC LITERATURE REVIEW OF THE EFFICACY AND SAFETY OF MICROINCISION VITRECTOMY SURGERY TOOLS IN VITREORETINAL DISEASES

Microincision vitrectomy surgery (MIVS) and small-gauge instrumentation have improved vitrectomy procedures and increased their application in a range of vitreoretinal conditions. The objective of this systematic literature review was to identify publications reporting the efficacy and safety of MIVS tools in vitreoretinal diseases in clinical and real-world settings. Search strategies using key terms were conducted in Embase®, PubMed®, and Cochrane databases, supplemented with grey literature searches. Citations were reviewed by two independent researchers. Comparative clinical trials and observational studies were included. Outcomes of interest included visual acuity, surgical success, and complications. Overall, 1,323 publications were retrieved and systematically screened for eligibility. Twenty comparative publications were eligible for analysis. The majority (n=13) of included publications were observational studies. Comparative evidence in included publications was related to probe gauge and cannulas (n=12), surgical platform (n=6), and method (n=2). Post-operative IOP was reported in 14 studies, with four publications reporting significant improvement in IOP compared to baseline, regardless of probe gauge, and two publications reporting significant differences related to the surgical platform. Procedure time was reported in 13 publications, for various procedures, ranging from 6 to 57 minutes comparing 20-, 23-, 25-, and 27-gauge instruments. Post-operative BCVA ranged from -0.1 to 1.8 logMAR, with significant improvement from baseline reported in five publications, regardless of gauge. Most commonly reported post-operative complications included hypotony (n=9), ocular hypertension (n=8), vitreous haemorrhage (n=8), and retinal detachment (n=7). There are numerous studies evaluating the use of various MIVS tools in vitreoretinal surgery, however, there is also a high degree of heterogeneity in study design, populations, time of assessment, and surgical tools across studies. The differences in population, vitreoretinal pathology, and time of assessment results in difficulties comparing outcomes across trials. Consistency in the measuring and reporting of outcomes is required to reliably make comparisons across studies.

Increased Levels of DKK1 in Vitreous Fluid of Patients with Pathological Myopia and the Correlation between DKK1 Levels and Axial Length

ABSTRACT Purpose Dickkopf 1 (DKK1) functions as a natural antagonist of the canonical Wnt/β-catenin pathway. The purpose of this study was to examine the expression of DKK1 in vitreous samples of patients with pathological myopia, in order to search for possible correlations between DKK1 and axial length. Materials and Methods The expression of DKK1 and other cytokines in vitreous samples of 44 non-myopic eyes, 42 eyes with low-to-moderate myopia, and 51 eyes with pathological myopia were examined using multiplex cytokine detection technology. Ophthalmologic characteristics, including axial length and subfoveal choroidal thickness, were clinically measured for further analysis. Results The intravitreous levels of DKK1 (P < .0001) were markedly higher in the pathological myopia group than in the control group. There were no differences of DKK1 levels in different vitreoretinal conditions. Additionally, we found that the DKK1 levels were positively correlated with HGF (β = 0.268, P = .032), and TIMP-3 (β = 0.209, P = .047) levels, as well as with axial length (β = 0.714, P < .0001) in the pathological myopia group. Conclusions Elevated levels of DKK1 were found in the eyes with elongated axial length.

Optical biometry features in silicon oil filled eyes

Background. The article presents results of axial length (AL) measurement in eyes filled with silicone oil and in those without silicone oil with IOLMaster and Lenstar LS 900 optical biometry methods.&#x0D; Materials and methods. The anteroposterior axis was measured in 27 eyes of 27 patients with silicone oil tamponade after surgical treatment of several vitreoretinal conditions. Using IOLMaster, the AL of eyes without silicone oil tamponade varied from 21.99 mm to 29.38 mm, Lenstar LS 900 biometry gave results from 21.96 mm to 29.41 mm.&#x0D; Results. According to data obtained and to their distribution, all cases were divided into 2 groups: I group eyes with AL less than 23.63 mm, and II group eyes with AL more than 23.63 mm. In the group II, the disparity of consecutive measurements was reliable and amounted to 0.28 0.46 mm (р = 0.024) for IOLMaster and 0.23 0.44 mm (р = 0.029) for Lenstar LS 900.&#x0D; Conclusion. So AL values at IOLMaster and Lenstar LS 900 biometry of silicone oil filled eyes may significantly overestimate the real ones when exceeding 23.63 mm. In case of simultaneous phacoemulsification with IOL implantation, this could lead to hypermetropic shift of postoperative refraction. Lenstar LS 900 measurement error in silicon oil filled eyes is less than that of IOLMaster, thus making the first biometry method preferable. In eyes with AL shorter than 23.63 mm, the measurement difference was not reliable, thus the biometry accuracy in silicone oil filled short eyes becomes higher.