Vitreomacular Interface Research Articles

Correlating optical coherence tomography biomarkers with visual acuity in nigerian retinitis pigmentosa patients.

Spectral Domain Optical Coherence Tomography (SD-OCT) has been used for imaging retinitis pigmentosa (RP) eyes and provides useful information on microstructural changes. To review SD-OCT findings and correlate the central foveal thickness (CFT), outer nuclear layer (ONL), external limiting membrane (ELM), and ellipsoid zone (EZ) with visual function in nonsyndromic RP eyes. A multicenter, retrospective review of records from consecutive eyes diagnosed to have RP. Biodata, systemic disease, visual acuity, lens status, intraocular pressure, and SD-OCT images were examined. The CFT was categorized into normal (250-299 microns), atrophic (0-249 microns), and edematous (≥300 microns). The ONL, ELM, and EZ within the subfoveal area was assessed and rated as normal, reduced (if less than normal), or absent (if missing). The status of these biomarkers was correlated with visual acuity and statistical analysis performed using Pearson Chi2, P < 0.05. In addition, the vitreomacular interface was examined for the presence of vitreomacular traction (VMT), vitreomacular adhesion (VMA), and epiretinal membrane (ERM). Fifty-two RP eyes of 27 patients had SD-OCT images that were used for study analysis. There were 17 males and 10 females; 52% of participants were between 31 and 50 years (age range: 22-77 years). An atrophic retina was the most common finding in 42 eyes (81%); the average CFT in the atrophic group was 175 microns (range: 111-245 microns). There were three eyes with cystoid macular edema, and seven eyes were normal. For the OCT biomarkers, a reduction in ONL and ELM occurred in 69% and 46% of eyes, respectively, while an absence was the most common EZ finding (in 50% of eyes). There was a significant correlation between the presence or absence of the three biomarkers and presenting vision: ONL, ELM, and EZ with P values of 0.000, 0.006, and 0.011, respectively. The CFT had no significant correlation with vision; P = 0.522. Other findings on OCT include ERM 17%, VMA 6%, and VMT 2%. This report supports the notion that OCT image reporting on physical retinal structure in RP eyes can be used to predict disease effects on vision. A prospective study to better quantify the degree of structural change and correlate with the degree of functional loss is required for RP gene types in Nigerians and black Africans.

Factors associated with diabetic macular edema in patients with proliferative diabetic retinopathy.

To identify factors associated with diabetic macular edema (DME) and to characterize the types of DME present in eyes with proliferative diabetic retinopathy (PDR). Observational, retrospective case series of PDR patients reviewed for demographic information, general medical history, ophthalmologic history, optical coherence tomography (OCT), and fluorescein angiogram image characteristics. DME and vitreomacular interface (VMI) status were determined using OCT images. DME was defined as center-involving DME (CI-DME) and noncenter-involving DME (NCI-DME). VMI was defined as vitreomacular adhesion (VMA), vitreomacular traction (VMT), or macular posterior vitreous detachment (PVD). A total of 293 eyes of 210 screened patients with PDR were included. Of the eyes, 194/293 (66.2%) had DME, and 99/293 (33.8%) had no DME; in univariable analysis, there were no significant differences in VMI status (p = 0.4) or epiretinal membrane (ERM, p = 0.1) between them. Of 194 eyes with DME, 90/194 (46.4%) had CI-DME, and 104/194 (53.6%) had NCI-DME. In univariable analysis, CI-DME eyes were significantly more likely than NCI-DME eyes to have a PVD (p = 0.029) and ERM (p < 0.001). In multivariable analysis, the presence of younger age (p = 0.028) and presence of ERM (p = 0.001) were significantly more likely to be observed in eyes with CI-DME. In this exploratory study focused on diabetic patients with PDR, we determined that VMI status did not have a significant association with DME in general, but VMI status, younger age, and presence of ERM may be associated with CI-DME.

Evaluation of the Clinical Application of Multi-Color Optical Coherence Tomography as a Diagnostic Tool for Different Retinal Pathologies

Objective: To assess clinical application of multi-color OCT (Optical Coherence Tomography) with the utilization of the CSLO (Confocal Scanning Laser-Ophthalmoscopy) in various pathologies of retina. Methodology: This study was conducted at in Benazir Bhutto Shaheed Teaching Hospital Abbottabad and the duration of this study was from April 2021 to June 2021. There were thirty-six patients in this research study who were suffering from various retinal pathologies as disorders of vitreomacular interface, diabetic retinopathy and macular degeneration related with age with the utilization of multi-color OCT as a tool of screening. Results: This study discovered that ophthalmologist were able to get high resolution images of CSLO reflectance because of the automatic tracking system of this particular tool (new version). Confocal optics may be used to avoid the scattering of light. Some of the differences were presence of hemorrhages and presences of pigment changes when comparison with the conventional CFP was performed. Approximately 20.0% patients with AMD, 37.50% patients with diabetes and 100% patients suffering from disorders of vitreomacular interface could have been missed easily with the utilization of CFP. Conclusions: The findings conclude that multi-color OCT is able to deliver information &amp; figures far more confident was compared to conventional method of CFP, because it is much influenced by the media opacities. For the best interpretation of the Multi-color OCT, more watchfulness of the ophthalmologists is necessary with high level of comprehensiveness. Keywords: Retinal Pathologies, Multi-Color, Diabetic Retinopathy, Optical Coherence Tomography.

Changes in higher-order aberrations after vitrectomy for vitreomacular interface diseases.

To evaluate ocular wavefront aberrations after vitrectomy in patients with vitreomacular interface diseases. Thirty eyes of 30 patients with vitreomacular interface diseases were included in this prospective study. A Sirius topographer (SCHWIND eye-tech-solutions, Germany) was used to measure corneal aberrations and a Hartmann Shack aberrometer (IRX-3; Imagine Eyes, Orsay, France) to measure ocular aberrations. Data were recorded at baseline and 3months after vitrectomy. Eight patients were excluded due to the formation of cataract during the post-operation follow-up period. Data of 22 eyes (13 eyes with epiretinal membrane, two eyes with epiretinal membrane with vitreomacular traction, one eye with vitreomacular traction, and six eyes with macular hole) were analyzed for the study. The corneal aberrations such as coma, trefoil, spherical aberration, and root mean square of total higher-order aberrations did not significantly change after vitrectomy. The preoperative ocular aberrations such as coma 0.33 (0.14-0.47) µm, trefoil 0.28 (0.15-0.44) µm, root mean square of higher-order aberrations 0.51 (0.45-0.68) µm, root mean square of total aberrations 1.38 (1.16-2.60) µm were significantly reduced to 0.21 (0.14-0.29) µm, 0.20 (0.14-0.30) µm, 0.36 (0.21-0.52) µm, 0.15 (1.13-1.41) µm, respectively, after vitrectomy. The ocular higher-order aberrations were significantly reduced after vitreomacular surgery for vitreomacular interface diseases.

Vitreomacular Interface Abnormalities in Myopic Foveoschisis: Correlation With Morphological Features and Outcome of Vitrectomy.

Purpose: To compare the morphologic characteristics and response to surgery of myopic foveoschisis (MF) with different patterns of vitreomacular interface abnormalities (VMIAs).Methods: In this observational case series, 158 eyes of 121 MF patients with epiretinal membrane (ERM) or vitreomacular traction (VMT) based on optical coherence tomography (OCT) were enrolled. All the eyes were divided into two groups by the pattern of VMIAs: ERM and VMT group. Sixty-one eyes underwent pars plana vitrectomy (PPV) and were followed up for at least 6 months. The morphologic characteristics based on OCT and the surgical outcome were evaluated.Outcome: ERM and VMT were found in 47.47 and 52.53% of the cases, respectively. A higher rate of foveal detachment (61.4 vs. 26.7%; p < 0.001) and a higher rate of outer lamellar macular hole (45.8 vs. 21.3%; p = 0.001) were detected in the eyes with VMT compared with those with ERM. In contrast, a lower rate of inner lamellar macular hole (28.9 vs. 60.0%; p = 0.001) was detected in the eyes with VMT compared with those with ERM. The disruption of the external limiting membrane (ELM) was more common in the eyes with VMT than in those with ERM (45.8 vs. 21.3%; p = 0.001). PPV was performed in 61 eyes with a mean follow-up time of 23.55 ± 19.92 months. After surgery, anatomical resolution was achieved in 51 eyes (83.6%). At the final visit, the mean central foveal thickness (CFT) decreased significantly from 547.83 to 118.74 μm, and the mean LogMAR BCVA improved significantly from 0.92 to 0.57. The VMT group was associated with a higher proportion of eyes with visual acuity improvement postoperatively (p = 0.02) and had more a decrease of CFT (P = 0.007) compared with the ERM group.Conclusion: In the eyes with MF, outer retinal lesions occurred more frequently in the eyes with VMT, whereas inner retinal lesions occurred more frequently in the eyes with ERM. Tangential force generated by ERM may act as a causative factor for the inner retinal lesions in MF, and inward-directed force resulting from VMT may act as a causative factor for outer retinal lesions in MF.

ASSESSMENT OF VITREORETINAL INTERFACE ALTERATIONS IN DIABETIC MACULAR EDEMA TREATED WITH INTRAVITREALANTIVEGF INJECTIONS

Background : The introduction of anti-VEGF therapy has had a greater effect on the world of retina than any other advance in the past few decades. This study was conducted to see whether anti-VEGF agents have any kind of brotic effect for the development of vitreomacular interface abnormalities, in diabetic eyes without pre-existing brotic membranes. Materials and Methods: This study was a Hospital based retrospective observational study, conducted in the Department of Ophthalmology, SKIMS Medical College Hospital, Srinagar.100 eyes were included in the study. Patients with DME followed at least 9 months were reviewed. Patients were divided into two groups: 50 eyes in anti-VEGF group that had DME and received intravitreal injections and 50 eyes in control group without signicant central DME. The groups were comparable in terms of diabetes duration and HbA1c. Results: Atotal of 100 eyes were taken in the study that met the inclusion criteria. Vitreomacular interface abnormalities (VMIA) (ERM, VMT and Macular hole) developed in 11 (22%) of the eyes during a follow up period of 36 weeks as compared to 2 eyes (4%) of the control group. This difference is statistically signicant (p = 0.015). Poor baseline vision was found to be a risk factor for VMIAdevelopment. Conclusion: Our study revealed that patients with clinically signicant DME who underwent intravitreal injections had a rate of vitro macular interface abnormalities formation in 22% of eyes during a follow up period of 9 months as compared to 4% eyes of the control group. This difference was statistically signicant. VMIA changes in the eyes was associated with initial poor vision. Improvement of BCVA and Central Macular Thickness at the nal visit compared with baseline in eyes treated with intravitreal anti-VEGFs was statistically signicant.

Influence of vitreomacular interface score on treatment outcomes of anti-VEGF therapy for neovascular age-related macular degeneration

BackgroundTo quantitatively evaluate the vitreomacular interface of eyes with neovascular age-related macular degeneration (AMD) and to investigate its association with the 1-year treatment outcome following intravitreal injections of aflibercept (IVA).MethodsThis prospective observational case series included 59 eyes of 59 consecutive patients with treatment-naïve neovascular AMD who were treated with three monthly IVA and subsequent four bi-monthly IVA and were followed up for 1 year. We estimated posterior vitreous detachment at 1, 9, and 25 macular points within an area of 6 × 6 mm2 at the center of the fovea using the built-in enhanced vitreous visualization mode of swept-source optical coherence tomography. One year after the initial IVA, we classified the eyes into either wet or dry groups.ResultsThe wet and dry groups included 12 and 47 eyes, respectively. The resistance rate against IVA was 20.3%. The 25-point interface score was higher in the wet group than in the dry group (23.0 ± 4.3 vs. 18.6 ± 9.8, P = 0.03), whereas there were no significant between-group differences in the 9-point and 1-point scores (P = 0.21, and 0.47, respectively) or in the other studied parameters. Multivariable analysis revealed that the 25-point vitreomacular interface score was strongly correlated with subfoveal choroidal thickness (P = 0.02, β = − 0.31).ConclusionsOur findings suggest that wide-ranged separation of the posterior vitreous membrane from the retina induces poor response to IVA.

Vitreomacular interface: A case series of adhesion and traction

The vitreomacular interface has historically been difficult to clinically evaluate. However, with the advent of optical coherence tomography (OCT), pathology at this interface is becoming easier to diagnose and monitor. Vitreomacular interface attachment can range from adhesions without foveal architectural changes such as in a vitreomacular adhesion (VMA) to tractions leading to architectural changes such as in vitreomacular traction (VMT). Many of these cases can be observed and managed by optometry without consult to a retina specialist. The following is a presentation of three cases of vitreomacular pathology, with a review of grading system, presentations that have shown to present a higher incidence of spontaneous release, and treatment options.

Real-life outcomes of intravitreal ranibizumab, aflibercept, and dexamethasone implant administrations in patients with treatment-naïve diabetic macular edema.

PURPOSE:To investigate optical coherence tomography (OCT) biomarker data on visual recovery in treatment-naïve diabetic macular edema (DME) and follow the results of intravitreal ranibizumab (RNB), aflibercept (AFL), and dexamethasone (DEX) implant administration within the 1st year of the pro re nata treatment regimen.METHODS:One hundred and twenty eyes of 102 patients were enrolled in the study. The patients medical records were analyzed retrospectively. Best-corrected visual acuity (BCVA), central macular thickness (CMT), type of DME, presence of subretinal fluid, number and localization of hyperreflective dots, vitreomacular interface disorders, disorganization of the retinal inner layer (DRIL), inner segment/outer segment (IS/OS) junction-external limiting membrane (ELM) status, intraretinal cyst diameter and localization, and subfoveal choroidal thickness were examined in all patients.RESULTS:A statistically significant increase in BCVA and a decrease in CMT were detected in all treatment groups. When cases were evaluated in terms of BCVA before and after treatment, statistically significant differences were observed in the RNB and AFL groups at 1 and 4 months and in the DEX group during the 1st year. In terms of OCT biomarkers, visual recovery was obtained in cases of intact IS/OS-ELM and non-DRIL patients. In the serous macular detachment group, more visual gain was achieved with the RNB (1 and 4 months) and AFL (1, 4, and 6 months) agents compared to the DEX implant. On the other hand, in the group with cystoid macular edema, more visual gain was achieved with RNB compared to the DEX implant in all months, but more visual gain was achieved only in the 1st month with AFL administration.CONCLUSION:Significant improvement was achieved for both BCVA and CMT in all treatment groups. We expect that OCT-based prognostic factors will become more important in the treatment of DME and will be determining factors in the choice of treatment.

Cell composition at the vitreomacular interface in traumatic macular holes

PurposeTo describe characteristics of the vitreomacular interface (VMI) in traumatic macular holes (TMH) compared to idiopathic macular holes (IMH) using immunofluorescence and electron microscopy, and to correlate with clinical data.MethodsFor immunocytochemical and ultrastructural analyses, premacular tissue with internal limiting membrane (ILM) and epiretinal membrane (ERM) was harvested during vitrectomy from 5 eyes with TMH and 5 eyes with IMH. All specimens were processed as flat mounts for phase-contrast microscopy, interference and fluorescence microscopy, and transmission electron microscopy (TEM). Primary antibodies were used against microglial and macroglial cells. Clinical data was retrospectively evaluated.ResultsSurgically excised premacular tissue of eyes with TMH showed a less pronounced positive immunoreactivity for anti-glutamine synthetase, anti-vimentin and anti-IBA1 compared to eyes with IMH. Cell nuclei staining of the flat-mounted specimens as well as TEM presented a lower cell count in eyes with TMH compared to IMH. All detected cells were found on the vitreal side of the ILM. No collagen fibrils were seen in specimens of TMH. According to patients’ age, intraoperative data as well as spectral-domain optical coherence tomography (SD-OCT) analysis revealed an attached posterior vitreous in the majority of TMH cases (60%), whereas all eyes with IMH presented posterior vitreous detachment.ConclusionThe vitreomacular interface in TMH and IMH shows significant differences. In TMH, glial cells are a rare finding on the vitreal side of the ILM.

Удаление внутренней пограничной мембраны при патологии витреомакулярного интерфейса: за и против

Purpose. To provide data on efficacy and safety of internal limiting membrane (ILM) removal in various pathologies of the vitreomacular interface. Material and methods. To perform the review, literature sources were searched through the PubMed and Scopus databases up to year 2021 using the keywords "internal limiting membrane peeling", "macular hole", "epiretinal membrane". A total of 38 articles relevant to the topic of the review were selected. Results. Numerous studies have confirmed the efficacy of internal limiting peeling in improving anatomical and functional outcomes of treatment of various pathologies. However, even a flawlessly performed peeling can cause both anatomical and functional effects on the retina. Various studies have demonstrated that the anatomical complications of ILM peeling did not correlate with the functional outcomes of surgery. Conclusion. Available evidence supports ILM peeling as an intervention that improves anatomical and functional results of treatment and reduces rate of reoperation. However, in order to evaluate the safety of this procedure, further studies with an assessment of the visual function with a long follow-up period are required. Key words: internal limiting membrane, peeling, macular hole, epiretinal membrane

Latent Diabetic Macular Edema in Chinese Diabetic Retinopathy Patients.

Purpose: To compare the detection rates of optical coherence tomography (OCT) and fluorescein angiography (FA) in a diabetic macular edema (DME) and the severity of diabetic retinopathy in both color fundus images (CFI) and FA, and to investigate the predictive factors in macular leakages in FA.Methods: This was a retrospective study, and a total of 132 eyes of 77 patients with diabetic retinopathy were enrolled. Macular OCT, FA, and CFI were reviewed and measured. Central foveal thickness was also measured.Results: The severity of diabetic retinopathy in FA was significantly higher than that in CFI (p < 0.001). OCT detected 26 eyes with DMEs, which included the following: 13 eyes with cystoid macular edemas; 13 eyes with serous retinal detachments; 11 eyes with diffuse retinal thickening; 4 eyes with vitreomacular interface abnormalities. In contrast, 72 out of 132 eyes (54.5%) showed macular leakages in FA, which was significantly higher than that detected by OCT (p < 0.001). Compared with FA, the sensitivity and the specificity of OCT in detecting DMEs were 30.6 and 93.3%, respectively. However, central foveal thickness was not significantly different between the patients with non-clinically significant macular edema (CSME, 253.1 ± 26.95 μm) and slight CSME (270.9 ± 37.11 μm, p = 0.204). The mean central foveal thickness in diabetic macular edema (FA) eyes was 271.8 ± 66.02 μm, which was significantly higher than that (253. ± 25.21 μm) in non-DME (FA) eyes (p = 0.039). The central foveal thickness in DME (FA) eyes was significantly lower than that in eyes with DME (OCT) (p = 0.014). After adjusting for age and sex, a logistic regression analysis showed that the classification of diabetic retinopathy in FA was positively associated with macular leakage in FA (p < 0.001).Conclusions: The severity of diabetic retinopathy is underestimated in CFI compared with that in FA. FA can detect latent DMEs, which appeared normal on OCT. The central foveal thickness is not a sensitive parameter for detecting latent DMEs.

Intraocular lens power calculation formulas accuracy in combined phacovitrectomy: an 8-formulas comparison study

BackgroundOur study aimed to assess and compare the accuracy of 8 intraocular lens (IOL) power calculation formulas (Barrett Universal II, EVO 2.0, Haigis, Hoffer Q, Holladay 1, Kane and PEARL-DGS) in patients submitted to combined phacovitrectomy for vitreomacular (VM) interface disorders.MethodsRetrospective chart review study including axial-length matched patients submitted to phacoemulsification alone (Group 1) and combined phacovitrectomy (Group 2). Using optimized constants in both groups, refraction prediction error of each formula was calculated for each eye. The optimised constants from Group 1 were also applied to patients of Group 2 – Group 3. Outcome measures included the mean prediction error (ME) and its standard deviation (SD), mean (MAE) and median (MedAE) absolute errors, in diopters (D), and the percentage of eyes within ± 0.25D, ± 0.50D and ± 1.00D.ResultsA total of 220 eyes were included (Group 1: 100; Group 2: 120). In Group 1, the difference in formulas absolute error was significative (p = 0.005). The Kane Formula had the lowest MAE (0.306) and MedAE (0.264). In Group 2, Kane had the overall best performance, followed by PEARL-DGS, EVO 2.0 and Barrett Universal II. The ME of all formulas in both Groups 1 and 2 were 0.000 (p = 0.934; p = 0.971, respectively). In Group 3, a statistically significant myopic shift was observed for each formula (p < 0.001).ConclusionSurgeons must be careful regarding IOL power selection in phacovitrectomy considering the systematic myopic shift evidenced—constant optimization may help eliminating such error. Moreover, newly introduced formulas and calculation methods may help us achieving increasingly better refractive outcomes both in cataract surgery alone and phacovitrectomy.

Profil des trous maculaires à Cotonou

To establish the epidemiological and tomographic profile of macular holes in the Beninese subject. This cross-sectional study included consecutive patients seen for macular testing during the period from January 2016 to August 2017 at the St. Anthony of Padua Retinal Testing Center in Cotonou (Benin). All patients who had a macular hole and macular OCT were included. To define macular hole types, we used the 2013 DUKER New Classification and analyzed for each case: age sex, history, involved eye, fellow eye, visual acuity, hole type, hole diameter, status of the vitreous cortex, edge edema, mean macular thickness, presence of vitreomacular traction, epimacular membrane, and retrofoveal choroidal thickness. Patients with a pseudo-macular hole or lamellar hole were excluded. During this study period, 401 patients underwent a macular OCT procedure at the Retinal Testing Center, with 22 patients having a macular hole, of which 15 women and 07 men for a sex ratio of 2.14 women to men. The mean age of the patients was 61±10 years, with a median age of 63 years. The mean diameter of the holes was 705μm±232μm. No small holes were found. The mean central macular thickness was 272μm±39μm. In 52.4% of cases, the condition of the felloweye indicated the presence of vitreomacular traction. The etiological profile of the macular hole found in 72.7% a primary origin, and a secondary origin (diabetic and traumatic) in 13.6% and 9.09% respectively. The majority of the macular holes observed were large macular holes, which could be explained by the progressive course of these macular holes as well as late detection. Over half of the fellow eyes showed vitreomacular traction, reflecting the potential risk of bilateralization. Macular hole is a pathology of the vitreomacular interface, tending to be large in our geographic context. On OCT, the data found remain comparable those reported in the literature.

К вопросу о создании современной единой классификации хирургической патологии витреомакулярного интерфейса

The progress of modern methods the vitreomacular interface (VMI) visualization, clinical and histopathological studies are constantly expanding our understanding of the course of the macular pathological process. At the same time, the diagnostic and classification schemes we use may lose their relevance without reflecting the pathogenesis of the disease, complicating the choice of treatment tactics, and also complicating professional communication when we using various classification approaches. Aim. To offer our views on the possibility of creating a unified clinical classification of primary surgical pathology of VMI. Material and methods. Research papers related to the surgical pathology of VMI were analyzed. Results. The main role in the development of VMI pathology belongs to the vitreous body and the changes that occur in it, leading to posterior vitreous detachment (PVD). Pathological PVD is a variant of vitreomacular adhesion: vitreoschisis or separation of the entire thickness of the posterior cortex with the presence of local vitreoretinal fixation. In the first case, an epiretinal membrane (ERM) develops, which can progress to an ERM with macular pseudohole or to an ERM with foveoschisis. In the second case, pathological PVD is realized in vitreomacular traction (VMT). Depending on various factors, VMT can resolve both asymptomatically and with the formation of a defect in the retinal tissue, leading to outer lamellar macular hole (outer LMH) and the subsequent formation of a full-thickness macular hole (FTMH). If the traction does not cause strong changes, then it, disrupting the architectonics of the retina, triggers the processes leading to the LMH (which was previously called degenerative LMH), and it, in turn, in rare cases, can also become FTMH. Conclusions. We proposed the combined clinical classification scheme of VMI primary surgical pathology, which more fully reflects modern ideas about pathogenesis and allows, based on OCT data, to more clearly differentiate macular changes requiring a various surgical approach. Key words: PPV, vitreomacular interface, classification, VMT, epiretinal membrane, ERM, pseudohole, macular hole.

Роль макулярного интерфейса в диагностике ретинопатии недоношенных и диабетической ангиоретинопатии

Vitreomacular interface is an important part of the diagnosis from retinopathy of prematurity (ROP) to retinal diseases in adults. It is required to develop a method for macula localization to determine 3 stable points for photographic measurements of a 3D eye model. Purpose. To minimize the risk of mistakes in the diagnosis and choice of treatment for ROP and diabetic angioretinopathy (DARP) by improving the quality and analysis of modeled wide-field images on the Key to Diagnosis I and II platforms. Material and methods. 1278 RetCam and fundus images of 402 patients. 3 clinical groups: 1 – ROP 272 (544 eyes): 1A – I stage 152(304 eyes), 1B – II stage 45 (90 eyes), 1C – III stage 8 (12 eyes), 1D – posterior aggressive ROP 7 (14 eyes), 1E-retinal immaturity 60 (120 eyes); 2 – DARP 120 (240 eyes): 2A – non-proliferative 13 (17 eyes), 2B – preproliferative 47 (55 eyes), 2C – proliferative 27 (33 eyes), 2D – terminal 33 (37 eyes), 3 – control 10 (20 eyes). A standard clinical examination, analysis of modeled wide-field images, localization of the macula and traction index of the macular region (Tm) were performed. Results. Platform modules have been developed for automatic wide-field images modeling and macular localization, which is a reference point for assessing the extent of pathological changes. In ROP there was significant negative correlation of the Tm value with a stage: 1А – 0,8±0,03, 1B – 0,75±0,04, 1C – 0,74±0,13, 1D – 0,99±0,01, 1E – 0,91±0,09. For groups 2A – 2B, there was no correlation between Tm and the DARP severity. Conclusion. Tm reflects the severity of traction processes at the periphery of the retina and can be used as a marker in case of diagnostic defects in ROP. The localization of the macula determines the stable points for automatic morphometry. Key words: retinopathy of prematurity, pediatric retinal camera RetCam-Shuttle, telemedicine, diabetic angioretinopathy, vitreomacular interface.

Сравнительная оценка анатомического и функционального результата при применении технологии PRPв хирургии макулярного отверстия разного диаметра

Purpose. Compare the anatomical and functional results of using PRP technology in the surgery of macular holes of various diameters. Materials and methods. We observed 15 patients (15 eyes). After the vitrectomy, the internal border membrane was peeled. Platelet-rich autoplasm was injected intravitreally. The observation period was 1 month. Results. As a result of surgical treatment, we managed to close the opening in all cases, restore the anatomy of the fovea, and improve visual acuity in all patients. Conclusions. According to the assessment of the results obtained in the ongoing study, the use of this technology is an effective and promising method of treatment based on the stimulation of the tissues' own regenerative potential. Key words: мacular foramen, platelet-rich plasma, vitreomacular interface, macular pathology, vitrectomy, internal border membrane, posterior hyaloid membrane, retina, vitreoretinal surgery, foveolar fossa.

Microcystic macular degeneration in autosomal hereditary optic neuropathies: A cross-sectional retrospective study

Patients with autosomal optic neuropathies (AON) may develop microcystic macular degeneration (MMD), observed on retinal optical coherence tomography (OCT) examination. This study aimed to report the prevalence of MMD in AON patients and to assess the consequences of MMD on retinal architecture. Retrospective single-center study conducted between 2001 and 2018. Patients affected by AON secondary to OPA1 or WFS1 gene mutations were included. The following data were collected: visual acuity, macular volume, vitreomacular interface and presence or absence of MMD. Forty-two subjects (34 OPA1, 8 WFS1) were included. MMD was found in 12 (29%) patients, i.e. 6 of the 8 WFS1 patients (75%) and 6 of the 34 OPA1 patients (17%). In cases with MMD, total retinal volume was greater (P=0.02) in accordance with thickening of the inner nuclear layer (P<0.001). WFS1 subjects had the highest total retinal volume (P=0.01), in relation to a thickening of the inner plexiform layer (P=0.02), inner nuclear layer (P<0.001) and outer plexiform layer (P=0.002). MMD was significantly associated with the WFS1 mutation (P<0.001). No significant association was found between the presence of vitreomacular adhesion and MMD. MMD was found in 29% of patients affected by AON and was more frequent in cases with a WFS1 gene mutation. MMD appears to be related to primary ganglion cell degeneration and Müller cell dysfunction. The vitreomacular interface does not appear to play a role in the occurrence of MMD.

Sensitivity of spectral domain optical coherence tomography in the diagnosis of posterior vitreous detachment in vitreomacular interface disorders: A prospective cohort study.

To evaluate the sensitivity of Spectral Domain Optical Coherence Tomography (SD-OCT) regarding the diagnosis of posterior vitreous detachment (PVD) in vitreomacular interface disorders (VID). A total of 48 eyes of 48 patients were included in this prospective cohort study. PVD in eyes with VID was investigated. We determined the status of posterior vitreous cortex using slit lamp (SL) biomicroscopy and SD-OCT preoperatively, during vitrectomy and on the intraoperative video recording. Sensitivity and specificity of the examining methods were analysed. Four masked independent examiners participated in this study. PVD was diagnosed in 16 eyes (33.3%) on SD-OCT, 20 eyes (41.7%) on SL examination and 28 eyes (58.3%) during vitrectomy. Sensitivity and specificity for diagnosis of PVD was 37.5% and 31.3% using SD-OCT, 90% and 64.3% on the SL examination, 92.9% and 90% on the video recording respectively, compared to the intraoperative PVD diagnosis. SD-OCT shows a relatively low detection sensitivity of PVD in VID. Thorough OCT investigation is necessary to establish an appropriate diagnosis of PVD and treatment in VID.

Vitreomacular interface after anti-VEGF injections in diabetic macular edema

BackgroundThe purpose of this study was to evaluate the incidence of vitreomacular adhesion (VMA) release after anti-VEGF therapy for the treatment of diabetic macular edema (DME) and to evaluate further changes in outcome.Methods This was a retrospective study that enrolled 66 eyes of 66 patients with DME who presented with VMA diagnosed by spectral-domain optical coherence tomography (OCT) at baseline. VMA was classified as focal (attachment: ≤ 1500 μm) or broad (attachment: > 1500 μm). All patients received at least three monthly intravitreal injections of an anti-VEGF agent. Follow-up visits were performed 1 month after each injection to evaluate the incidence of VMA release.ResultsThe mean patient age was 61.4 years (range: 29 to 78 years), and 72.7 % were male. The mean best-corrected visual acuity was 0.62 logMAR, and the mean central retinal thickness (CRT) was 473 μm at baseline. The mean length of follow-up was 18.5 months, and the mean number of injections was 5.8. The intravitreal drugs used were aflibercept (40.9 %), ranibizumab (37.9 %) and bevacizumab (21.2 %). Forty-seven eyes had broad VMA, and 19 had focal VMA. Twenty-two eyes (33.3 %) developed VMA release following a mean of 5.7 injections (range: 3–13). Sixteen eyes (72.7 %) with focal VMA and 6 eyes (27.3 %) with broad VMA at baseline developed VMA release. Twenty-one eyes that developed VMA release showed an improvement in CRT following VMA release (mean: -106 μm; range: 22 to 289 μm).ConclusionsVMA release occurs in approximately 1/3 of patients with DME following anti-VEGF therapy. Most of them show a short-term decrease in CRT.