scholarly journals Serous Retinal Detachment Associated with Dome-Shaped Macula and Staphyloma Edge in Myopic Patients before and after Treatment with Spironolactone

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Álvaro Fernández-Vega Sanz ◽  
Carlos Mario Rangel ◽  
Eva Villota Deleu ◽  
Beatriz Fernández-Vega Sanz ◽  
Ronald Mauricio Sánchez-Ávila
Keyword(s):  
Retinal Detachment ◽  
Functional Outcomes ◽  
Retinal Thickness ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Corrected Visual Acuity ◽  
Novel Treatment ◽  
Mineralocorticoid Antagonist ◽  
Before And After

Objective. Serous retinal detachment (SRD) is a common anatomical complication associated with dome-shaped macula (DSM) and staphyloma margin in myopic patients. Here we described the anatomical and functional outcomes obtained with the use of oral spironolactone, a mineralocorticoid antagonist, in the management of myopic patients with SRD associated with DSM and staphyloma margin.Methods. We evaluated both eyes of twelve myopic patients with long-standing SRD associated with DSM or staphyloma margin. The patients were treated daily for six months with oral spironolactone 50 mg. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT), determined by optical coherence tomography, were evaluated on the first day and on monthly follow-up visits.Results. Pretreatment BCVA (mean ± standard deviation) was 0.406 ± 0.324 LogMAR, and posttreatment BCVA was 0.421 ± 0.354 LogMAR (P=0.489). Pretreatment CRT was 323.9 ± 78.6 μm, and after six months of treatment it was significantly lower, 291.2 ± 74.5 μm (P=0.010). There were no treatment-related complications.Conclusions.We evaluated a novel treatment for SRD associated with DSM and staphyloma margin in myopic patients. After six months of treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced; however, there was no improvement in BCVA.

Success of Intravitreal Ranibizumab for Myopic Choroidal Neovascularization After 2 Years of Treatment

2017 ◽  
Vol 1 (2) ◽  
pp. 122-125 ◽  
Author(s):  
Beatriz Abadia ◽  
Pilar Calvo ◽  
Antonio Ferreras ◽  
Gloria Lopez ◽  
Jesús Leciñena ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Medical Records ◽  
Functional Outcomes ◽  
Retinal Thickness ◽  
Pathological Myopia ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Pro Re Nata

Purpose: To analyze the anatomical and functional outcomes in patients with choroidal neovascularization (CNV) secondary to pathological myopia (PM). Methods: Retrospective review of the medical records of 40 patients with CNV secondary to PM treated exclusively with intravitreal ranibizumab 0.5 mg and at least 24 months of follow-up. The initial dose comprised 1 or 3 monthly injections followed by a pro re nata regimen. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) measured with spectral domain optical coherence tomography (OCT), and ocular and systemic adverse event were recorded. Results: Mean patient age was 62.5 ± 12.5 years. The mean spherical equivalent refractive error was −12.3 ± 6.9 diopters, and a single intravitreal injection was initially performed in 72.5% of cases. Mean baseline BCVA was 0.33 ± 0.20 logMAR (Snellen equivalent, 20/60), and mean CRT by OCT was 340.65 ± 80 µm. Both BCVA and OCT revealed significant improvement compared to baseline at all established cutoff points ( P < .001). Final BCVA was 0.50 ± 0.3 logMAR (Snellen, 20/40), and final CRT was 255.69 ± 47.7 µm ( P < .001). The mean number of ranibizumab injections was 2.75 ± 1.97. No cases of endophthalmitis or retinal detachments were reported, and no serious adverse systemic events were identified. Conclusion: Excellent anatomical and functional outcomes were obtained after treatment with intravitreal ranibizumab for CNV secondary to PM.

scholarly journals Spontaneous Closure of the Macular Hole in a Patient with Acquired Vitelliform Lesion

2020 ◽  
Vol 11 (1) ◽  
pp. 16-21
Author(s):  
Masanori Fukumoto ◽  
Shou Oosuka ◽  
Takaki Sato ◽  
Teruyo Kida ◽  
Tsunehiko Ikeda
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Rare Case ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Spontaneous Closure ◽  
Retinal Reattachment

In this paper, we report an extremely rare case of spontaneous closure of a macular hole (MH) that developed in a patient in whom acquired vitelliform lesion (AVL) occurred after vitrectomy for atopic retinal detachment (ARD). A 32-year-old male developed ARD in both eyes, and retinal reattachment was achieved after vitrectomy. Five years after surgery, optical coherence tomography showed localized serous retinal detachment (SRD) and a granular lesion with a higher brightness in the subretinal fluid, thus leading to the diagnosis of AVL. One month later, an MH developed, and a follow-up examination performed 6 weeks later revealed that the MH had spontaneously closed and the SRD decreased. In the fovea, fluorescein angiography revealed a window defect due to atrophy of the retinal pigment epithelium (RPE). These findings in this present case suggest the possibility that RPE dysfunction was involved in the development of AVL and MH.

scholarly journals Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jay Chhablani ◽  
Gagan Kalra ◽  
Lubna Alkwatli ◽  
Bernd Fassbender ◽  
Francesca Amoroso ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Subretinal Fluid ◽  
Central Retinal Thickness ◽  
Duration Of Symptoms ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Background Subthreshold microsecond pulsing laser is an increasingly common treatment approach for central serous chorioretinopathy. However, there is no literature available on the safety of microsecond laser using different fluence settings in this disease. While many publications can be obtained from conventional microsecond pulsing lasers, few parameter sets are published with the navigated microsecond pulsing laser. Therefore, this study aims to investigate the safety of different parameter sets in subthreshold microsecond pulsing laser treatments. Methods In this retrospective chart review, consecutive patients with central serous chorioretinopathy (> 3 months duration of symptoms) treated with navigated subthreshold microsecond pulsing laser and a follow up of at least five months after microsecond laser application were included. For each patient, the treatment parameters, plan layout, and adverse events related to laser were evaluated. Secondary outcomes included best-corrected visual acuity and anatomical improvements (central retinal thickness). Results One hundred and one eyes were included in the observation and followed for a mean of 10 months (range 5–36). Although a larger range of parameter sets and fluence settings have been used, no patient demonstrated adverse events from navigated microsecond pulsing laser. While 88% of the cases demonstrated stability, 13 cases lost five or more letters due to the persistence of the subretinal fluid. In mean, a best-corrected visual acuity improvement of 0.07logMar (± 0.2) was seen (p = 0.02). In 51% of the patients, a statistically significant improvement of the central retinal thickness was noted at the last follow-up with a mean thickness reduction of 70 µm (± 143) (p < 0.01). Conclusion In conclusion, none of the used parameter sets lead to tissue damage (when using a cautious titration) and, in summary, lead to an improvement in subretinal fluid and improvement in visual acuity. However, further prospective studies are needed to correctly identify the dependency of the treatment strategy on the outcome criteria.

Long-term natural history of highly myopic eyes with a dome-shaped macula with or without untreated serous retinal detachment: a 4-year follow-up study

2020 ◽  
pp. bjophthalmol-2020-316629
Author(s):  
Francesco Viola ◽  
Gaia Leone ◽  
Elena Garoli ◽  
Claudia Mainetti ◽  
Davide Galli ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Morphological Changes ◽  
Serous Retinal Detachment ◽  
Single Centre ◽  
Follow Up Study ◽  
Corrected Visual Acuity ◽  
Single Centre Study ◽  
History Of

PurposeTo evaluate the long-term functional and morphological changes occurring in myopic eyes with a dome-shaped macula (DSM), with or without untreated serous retinal detachment (SRD).MethodsThis prospective, single-centre study enrolled consecutive cases of highly myopic patients with DSM with or without a SRD. Patients underwent complete ophthalmological examinations, optical coherence tomography, axial length measurements and autofluorescence. Follow-up visits were performed with a maximum interval of 6 months for 4 years. Eyes with choroidal neovascularisation were excluded.ResultsTwenty-six eyes from 18 patients (mean age 61.2) were included. At baseline, 13 eyes had SRD and 13 did not. The DSMs were either horizontal (69%) or round (31%). There were no significant differences in best-corrected visual acuity (BCVA) between eyes with and without SRD during the 48-month follow-up period. Multivariate analysis showed that baseline BCVA was the only parameter among those analysed (age and SRD height) to have a significant effect on the final BCVA (p<0.0001). SRD fluctuated overtime and SRD height was significantly influenced by choroidal thickness (p=0.002). The scleral bulge thickness had no effect on SRD thickness.ConclusionsBCVA remained clinically stable over 4 years without treatment despite the fluctuations and persistence of the SRDs.

scholarly journals Effect of COVID-19 Lockdown in Spain on Structural and Functional Outcomes of Neovascular AMD Patients

2021 ◽  
Vol 10 (16) ◽  
pp. 3551
Author(s):  
Alicia Valverde-Megías ◽  
Daniela Rego-Lorca ◽  
José Ignacio Fernández-Vigo ◽  
Antonio Murciano-Cespedosa ◽  
Alicia Megías-Fresno ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Visual Loss ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Single Center Study ◽  
Center Study

This is a retrospective single-center study of patients with neovascular age-related macular degeneration whose follow-up was delayed due to COVID-19 pandemic with at least three months between visits in Madrid, Spain. The purpose of the study was to evaluate best corrected visual acuity (BCVA) changes and try to identify features in optical coherence tomography (OCT) that could be related to more profound visual loss. It included 270 eyes. The two last visits before lockdown were used for comparison with the visit after lockdown. BCVA changed from 60.2 ± 18.2 to 55.9 ± 20.5 ETDRS letters. 29% of the eyes lost more than 5 letters. OCT was active in 67% of eyes before lockdown and in 80.4% after lockdown. Multiple lineal analysis showed that patients whose OCT before lockdown presented with a combination of intra and subretinal fluid were more likely to suffer a greater visual loss (p = 0.002). These patients should be encouraged to not miss any visits in case a new lockdown is imposed.

scholarly journals Changes of macular vessel density and thickness in gas and silicone oil tamponades after vitrectomy for macula-on rhegmatogenous retinal detachment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Liu ◽  
Boya Lei ◽  
Rui Jiang ◽  
Xin Huang ◽  
Min Zhou ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Retinal Thickness ◽  
Vessel Density ◽  
Gas Tamponade ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose To investigate the macular vessel density and thickness in macular-on rhegmatogenous retinal detachment (RRD) after vitrectomy with gas and silicone oil (SO) tamponade. Methods Patients with macular-on RRD eyes, treated with a single successful vitrectomy with gas or SO tamponade and a minimum 30 months follow-up, were reviewed. Best-corrected visual acuity (BCVA), macular vessel density and retinal thickness by using optical coherence tomography angiography, were compared to the contralateral eyes. Results Sixteen eyes with gas tamponade and 17 eyes with SO tamponade were included in the study. LogMAR best-corrected visual acuity (BCVA) slightly improved from 0.25 ± 0.18 (Snellen 20/36) to 0.17 ± 0.23 (Snellen 20/30) in eyes with gas tamponade, and decreased from 0.30 ± 0.22 (Snellen 20/40) to 0.49 ± 0.28 (Snellen 20/62) in eyes with SO tamponade. The parafoveal vessel densities in superficial vascular complex (SVC) and the corresponding inner retinal thickness (IRT) were similar between the affected eyes and the contralateral eyes in gas tamponade group (P = 0.578, P = 0.943), while significantly reduced in the affected eyes, compared to the contralateral eyes in SO tamponade group (P < 0.001, P < 0.001). Conclusion Eyes in SO tamponade group had worse BCVA, lower SVC vessel densities and thinner corresponding IRT after vitrectomy for macular-on RRD, than those in gas tamponade group.

scholarly journals One-year results of half-dose versus one-third-dose photodynamic therapy in chronic or recurrent central serous chorioretinopathy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jirarattanasopa Pichai ◽  
Banchasakjaroen Vanchalerm ◽  
Ratanasukon Mansing
Keyword(s):  
Photodynamic Therapy ◽  
Recurrence Rate ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Corrected Visual Acuity ◽  
Half Dose ◽  
One Year ◽  
The One ◽  
Different Doses

Abstract Background Central serous chorioretinopathy (CSC) is characterized by an accumulation of subretinal fluid (SRF) in the macula. It is usually treated by laser photocoagulation or photodynamic therapy (PDT) with consisting of different doses and power. This study aimed to compare the efficacy of half-dose PDT and one-third-dose PDT in chronic or recurrent CSC. Methods A retrospective review of patients with chronic or recurrent CSC who were treated with either a half-dose or one-third-dose PDT, and had follow up 12 months afterwards. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of subretinal fluid (SRF) at baseline as well as 1, 3, 6 and 12 months post-PDT were assessed. Results Forty-six eyes and 20 eyes received half-dose and one-third-dose PDT, respectively. The study showed efficacy of the one-third-dose PDT compared with half-dose PDT in BCVA improvement (0.10±0.04 logMAR for one-third-dose versus 0.17±0.04, for half-dose, P=0.148) and CRT improvement (125.6±24.6 μm for one-third-dose versus 139.1±16.54, for half-dose, P=0.933) at 12 months. The SRF recurrence rate was significantly higher in the one-third-dose PDT group compared with the half-dose PDT group (40.0% versus 15.2%, P=0.027) at 12-months. Conclusion At 12 months, the one-third-dose PDT was effective in terms of BCVA and CRT improvement, when compared with half-dose PDT. However, this study showed that one-third-dose PDT had a higher recurrence rate of SRF.

scholarly journals Morphological Changes in Lamellar Macular Holes According to SD-OCT Examination over a Long Observation Period

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1145
Author(s):  
Magdalena Kal ◽  
Izabela Chojnowska-Ćwiąkała ◽  
Mateusz Winiarczyk ◽  
Monika Jasielska ◽  
Jerzy Mackiewicz
Keyword(s):  
Retinal Thickness ◽  
Morphological Changes ◽  
Outer Diameter ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Kolmogorov Smirnov ◽  
Inner Diameter ◽  
Observation Period ◽  
Sd Oct

Background: The aim of this study was to evaluate the quantitative morphological changes in lamellar macular holes (LMHs) based on SD-OCT examinations and to assess the correlations among minimal retinal thickness (MRT), reading vision (RV), and best corrected visual acuity (BCVA) over a 36-month follow-up period. Methods: A group of 40 patients (44 eyes) with LMH was evaluated, with an average age of 69.87 (SD = 10.14). The quantitative parameters monitored in the follow-up period (at 0, 3, 6, 12, 18, 24, 30, and 36 months) were tested for normality of distribution by Shapiro–Wilk and Kolmogorov–Smirnov tests. Results: The RV and BCVA values were stable, and no significant changes were found at any of the check-ups during the 36-month follow-up period (BCVA p = 0.435 and RV p = 0.0999). The analysis of individual quantitative LMH parameters during the 36-month follow-up period did not demonstrate statistically significant differences: MRT (p = 0.461), Max RT temporal (p = 0.051), Max RT nasal (p = 0.364), inner diameter (ID) (p = 0.089), and outer diameter (OD) (p = 0.985). Conclusions: The observations at 0, 6, 12, 18, 24, 30, and 36 months revealed moderate and significant correlations between RV and MRT. No significant correlation between BCVA and MRT was observed.

Sub-Threshold Micro Pulse Laser (810NM): Treatment for Chronic Central Serous Retinopathy

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Mariam Shamim Kashif ◽  
Najia Uzair ◽  
Lubna Feroz ◽  
Asaad Mehmood
Keyword(s):  
Retinal Thickness ◽  
Case Series ◽  
Central Retinal Thickness ◽  
Central Serous Retinopathy ◽  
Invasive Treatment ◽  
Micropulse Laser ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Sd Oct

Purpose:  To find the effectiveness of sub-threshold (810nm) micropulse diode laser treatment (SMT) in chronic central serous retinopathy (CSR). Study Design:  Interventional case series. Place and Duration of Study:  Layton Rahmatulla benevolent trust eye hospital, from April 2019 to July 2020. Methods:  The patients of chronic CSR (≥ 6 months) participated in the study. We used Spectral Domain Optical coherence tomography (SD-OCT) to record baseline central retinal thickness (CT). Best corrected visual acuity (BCVA) was recorded with Snellen’s chart and converted to Log MAR for statistical analysis. All patients underwent treatment with sub-threshold laser (810nm) in micropulse mode with 5% duty cycle (DC). Results:  Twenty five eyes with chronic CSR were enrolled in the study. The patients were treated with laser and final assessment was made at 6 months. Mean BCVA at presentation was 0.46 Log MAR ± 0.12 and a mean baseline CT of 362.2 μm ± 32.6µm. At final follow-up there was a mean decrease in CT of 97.2 μm ± 21.8 from the baseline. After treatment mean BCVA was 0.33 Log MAR ± 0.12 and mean CT was 266 μm ± 20.9. Nineteen out of twenty-five eyes (76%) achieved a gain of vision between 1 to 3 lines and gain of 3 lines was achieved in 8% of cases. At the final follow-up there was incomplete resolution of sub retinal fluid in 4 eyes (16%) with no improvement in BCVA. Conclusion:  SMT (810 nm) is an effective and minimally invasive treatment modality for chronic CSR. Key Words:  Sub-Threshold micropulse laser, Central serous retinopathy, Central retinal thickness, sub retinal fluid.

Scleral Buckling with a Noncontact Wide-Angle viewing System in the Management of Rhegmatogenous Retinal Detachment

2016 ◽  
Vol 27 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Hua Yan
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Proliferative Retinopathy ◽  
Wide Angle ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Additional Approach ◽  
Sclerotomy Site

Purpose To introduce a modified scleral buckling surgery using noncontact wide-angle viewing system and intraocular illumination in the treatment of rhegmatogenous retinal detachment (RRD) without proliferative retinopathy. Methods A modified scleral buckling surgery using noncontact wide-angle viewing system with a 25-G optic fiber through sclerotomy site was performed in 22 eyes of 22 patients with RRD. Twelve women and 10 men were included. The mean age was 49.23 ± 15.19 years. The mean refraction of myopia was -4 D (range -3 to -7 D). The mean duration of RRD was 6.64 ± 3.14 days. The preoperative best-corrected visual acuity (BCVA) ranged from 0.02 to 0.8. Mean follow-up was 9.59 ± 2.24 months. Proliferative retinopathy was grade A in 8 eyes and grade B in 14 eyes. Results This surgery was performed successfully and retinal attachment was achieved in all eyes at the final follow-up. The postoperative BCVA increased in all eyes. No complication was encountered related to this technique. Conclusions This modified scleral buckling surgery brings a panoramic and upright view and easy surgical maneuvers. It may be an additional approach for the management of RRD.

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