scholarly journals Lamellar Macular Holes; Pathophysiology, Classification, Clinic, Diagnosis, and Treatment

2018 ◽  
pp. 302-307
Keyword(s):  
Macular Hole ◽  
Posterior Vitreous Detachment ◽  
Prognostic Indicators ◽  
Optic Coherence Tomography ◽  
Retinal Layers ◽  
Macular Lesion ◽  
Macular Holes ◽  
Vitreous Cortex ◽  
Long Time ◽  
Vitreopapillary Adhesion

Lamellar macular hole (LMH), first described as a macular lesion developing after the opening of the central cyst in an eye with cystoid macular edema, has been used to define an aborted stage in full-thickness macular hole (MH) development. Abnormal posterior vitreous detachment associated with contraction of vitreous cortex plays a role in its pathophysiology. As a result of foveal traction of the attached and contracted macular vitreous cortex, splitting of the inner and outer retinal layers is observed. Contraction of the frequently accompanying epiretinal membrane also has an effect on the development of LMHs. Classified as tractional, degenerative, and mixed types, LMHs are seen as reddish, round, oval or lobulated lamellar defects at the fovea with the fundoscopic examination. In the differential diagnosis, it can be mistaken with MHs, and pseudoholes. Its diagnosis is best made with optic coherence tomography (OCT) examination. The diagnostic criteria with OCT are, defects in inner retinal layers with irregular foveal contour, thinning of the base of the fovea, partial-thickness MH with preservation of photoreceptors, and intraretinal splitting. Epiretinal proliferation is seen in most of the eyes. A thick, homogenous layer consisting of unusual material on the epiretinal surface has been defined as LMH-associated epiretinal proliferation by OCT. Persistent vitreopapillary adhesion is demonstrated in one-third of eyes. Patients with LMHs stay stable with minimal complaints about a long time, and surgery is not needed in most of them. When the patients have serious visual complaints, or a decrease in visual acuity (VA) is noted, surgery is indicated. The anatomical and functional success rate is high with pars plana vitrectomy, peeling of ERM, and ILM, air/gas endotamponade. Patient selection is important. Low preoperative VA, disruption at the junction of inner-outer photoreceptor layers, and foveal thinning are poor prognostic indicators. Further studies are warranted to determine which patients will benefit from surgery.

Prognostic relevance of anamnestic and diagnostic parameters in low-frequency hearing impairment

2006 ◽  
Vol 120 (8) ◽  
pp. 613-618 ◽  
Author(s):  
W Maier ◽  
J Schipper
Keyword(s):  
Prognostic Factor ◽  
Hearing Impairment ◽  
Hearing Threshold ◽  
Low Frequency ◽  
Prognostic Indicators ◽  
Infusion Therapy ◽  
Prognostic Relevance ◽  
Long Time ◽  
Dehydration Therapy

Low-frequency hearing impairment (LFHI) is mainly attributed to endolymphatic hydrops and has a great variety of possible outcomes. At present, no conservative therapeutic regimen has proven to be ‘gold-standard’, and information about the prognostic indicators of LFHI is scarce.In a retrospective investigation, we evaluated the records of 90 patients who had been treated with infusions improving blood perfusion. In patients lacking complete remission, dehydration infusion therapy was added. We also undertook audiometric follow up. We calculated the outcomes after infusion therapy, dehydration therapy and after long-time hearing follow up, and we determined the prognostic relevance of several parameters of anamnesis and clinical examination to outcomes, for both therapeutic interventions and long-time hearing.The prognosis of LFHI was significantly correlated to certain anamnestic and clinical parameters; a short duration of the disease, lack of vertigo and female gender implied a better outcome. The pretherapeutic hearing threshold was an important prognostic factor; the outcome was significantly worse in patients with distinct hearing impairment in low or high frequencies, compared with that in patients with little hearing loss. Whereas vertigo was a negative prognostic factor, the results of quantitative vestibular testing were irrelevant to the outcome. The glycerol test failed to predict the effectiveness of dehydration therapy and lacked any value in predicting prognosis.These results allow the clinician to focus the anamnesis and diagnostic examination on prognostically relevant parameters, thus enabling a better estimation of the long-term disease course and improved counselling of patients. Furthermore, these results help to distinguish valuable from irrelevant diagnostic procedures.

scholarly journals Optical Coherence Tomography Findings in Idiopathic Macular Holes

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Lynn L. Huang ◽  
David H. Levinson ◽  
Jonathan P. Levine ◽  
Umar Mian ◽  
Irena Tsui
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Clinical Assessment ◽  
Chart Review ◽  
Subretinal Fluid ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Intraretinal Cysts

Purpose. To describe the characteristics of idiopathic macular holes (MH) on optical coherence tomography (OCT) and correlate OCT with clinical assessment.Design. Cross-sectional chart review and OCT assessment.Participants. Sixty-seven eyes with a clinically diagnosed idiopathic MH with available OCT data.Methods. A retrospective chart review and OCT assessment.Results. Based on OCT grading, 40 eyes had a full-thickness macular hole (FTMH) and 21 eyes had a lamellar macular hole (LMH). Clinical exam and OCT assessment agreed in 53 (87%) eyes when assessing the extent of MH. Six eyes (14.6%) in the FTMH group, and 3 eyes in the LMH group (14.3%) had persistent vitreomacular traction. Thirty-seven eyes (92.5%) in the FTMH group and 11 eyes (52.4%) in the LMH group had associated intraretinal cysts. Two eyes (5.0%) in the FTMH group and zero eyes in the LMH group had subretinal fluid. Intraretinal cysts were found to be more frequently associated with FTMH than with LMH (P<0.001).Conclusion. This paper described OCT findings in a group of patients with clinically diagnosed MH. A high level of correlation between clinical assessment and OCT findings of LMH and FTMH was observed, and intraretinal cysts were often present in FTMH.

scholarly journals Autologous Lens Capsule Flap Transplantation for Persistent Macular Holes

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sławomir Cisiecki ◽  
Karolina Bonińska ◽  
Maciej Bednarski
Keyword(s):  
Macular Hole ◽  
Functional Outcomes ◽  
Lens Capsule ◽  
Operative Techniques ◽  
Basal Diameter ◽  
Macular Holes ◽  
Capsular Flap ◽  
Potential Alternative ◽  
The Mean ◽  
Hole Closure

Purpose. To analyze the anatomical and functional outcomes after autologous lens capsule transplantation in patients with persistent macular hole. Methods. This is a retrospective observational study of five eyes of five patients treated with vitrectomy and autologous lens capsular flap transplantation. Complete ophthalmic examination was performed preoperatively and seven days and 1, 3, 6, 12, and 18 months after surgery. Results. Successful macular hole closure was achieved in all patients. The mean minimum macular hole diameter before the surgery was 666.8 µm, and the mean basal diameter was 1086.4 µm. The mean visual acuity before lens capsular flap transplantation was 20/200, while after surgery, it was 20/125. Conclusions. Autologous lens capsular flap transplantation is a potential alternative treatment for patients with large persistent macular holes after other operative techniques have failed.

scholarly journals Cytomic analysis: a modern universal tool for biomedical and ecological and hygienic research (literature review). Part 1

2021 ◽  
Vol 100 (10) ◽  
pp. 1151-1156
Author(s):  
Elena K. Krivtsova ◽  
Faina I. Ingel ◽  
Lyudmila V. Akhaltseva
Keyword(s):  
Medical Research ◽  
Genetic Instability ◽  
Cell Transformation ◽  
Molecular Genetic ◽  
Genetic Material ◽  
Peripheral Blood Lymphocytes ◽  
Molecular Genetic Analysis ◽  
Research Literature ◽  
Prognostic Indicators ◽  
Long Time

The understanding of the connection between malignant cell transformation and genetic instability has existed for a long time. Such markers of genetic instability as micronuclei (MN) and nuclear abnormalities - nucleoplasmic bridges (NPM) and nuclear buds are signs of malignant growth. However, they were seen only as a by-product of genetic instability, a convenient tool for its study for a long time. Only the studies of recent decades that used the latest methods of molecular genetic analysis (genome sequencing of an individual cell, long-term intravital microscopy and individual chromosomes labelling, hybridization in situ, etc.) have made it possible to establish that the rearrangements of the genetic material in cancer cells are much deeper and more massive than it thought to be. In addition, MN turned out to play an active role in maintaining the state of chromosomal instability in the cell population. This review outlines the current understanding of the processes leading to the emergence of unstable genomes - the phenomenon of «genomic chaos» and its particular case, chromothripsis. The molecular biological features of MN and their role in cellular life and the life of the whole organism are also considered. The significance of MN as diagnostic and prognostic indicators in oncological, neurodegenerative and many other diseases has been analyzed. Much attention is paid to the use of cytome analysis of peripheral blood lymphocytes and human epithelial cells in medical research. It has been suggested that, when used in medical research, cytome analysis can serve as a tool to identify individuals with higher cancer risk. We used the PubMed, Web of Science, ResearchGate, Scopus, eLibrary databases as the sources of literature.

Evaluation of inner retinal layers with optic coherence tomography in vigabatrin-exposed patients

2017 ◽  
Vol 38 (8) ◽  
pp. 1423-1427 ◽  
Author(s):  
Betül Tuğcu ◽  
Mesrure Köseoğlu Bitnel ◽  
Fatma Selin Kaya ◽  
Betül Tekin Güveli ◽  
Dilek Ataklı
Keyword(s):  
Optic Coherence Tomography ◽  
Retinal Layers

Tomographic Structural Changes of Retinal Layers after Internal Limiting Membrane Peeling for Macular Hole Surgery

2017 ◽  
Vol 59 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Mun Yueh Faria ◽  
Nuno P. Ferreira ◽  
Diana M. Cristóvao ◽  
Sofia Mano ◽  
David Cordeiro Sousa ◽  
...  
Keyword(s):  
Macular Hole ◽  
Structural Changes ◽  
Internal Limiting Membrane ◽  
Macular Hole Surgery ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Retinal Layers

Morphofunctional analysis of the retina in the surgical treatment of idiopathic macular holes

2021 ◽  
pp. 48-52
Author(s):  
A.S. Zotov ◽  
◽  
A.S. Balalin ◽  
S.V. Balalin ◽  
S.M. Purshak ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Treatment ◽  
Macular Hole ◽  
Practical Importance ◽  
Functional Results ◽  
Hole Diameter ◽  
Optical Coherence ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Morphofunctional Analysis

Purpose. To evaluate the role of microperimetry and optical coherence tomography (OCT) in the morphofunctional analysis of the retina after surgical treatment of idiopathic macular holes (IMH). Materials and methods. A retrospective study of 33 patient's treatment results (33 eyes) with IMH was carried out. All patients underwent minimally invasive with 25G or 27G vitrectomy. Best corrected visual acuity (BCVA), macular photosensitivity, fixation stability, macular neuroepithelial (NE) volume and minimal macular hole diameter were analyzed. Follow-up period: 6 months. Results. A complete closure of the macular hole was achieved in all cases post-op. The patients had reliable improvement of BCVA, retinal photosensitivity and decrease of macular NE volume. Based on a multifactor correlation analysis with the purpose to predict the results of surgical treatment, the dependence of post-op BCVA on the pre-op photosensitivity of the retina and the minimal diameter of the macular hole was revealed. Conclusions. Microperimetry and OCT are modern non-invasive research methods allowing to estimate anatomical and functional results of surgical IMH treatment. The study of retinal photosensitivity in the macula and minimal macular hole diameter pre-op allows to predict post-op BCVA, which has a practical importance. Keywords: idiopathic macular hole, vitrectomy, microperimetry, optical coherence tomography.

Dome-Shaped Detachment of Premacular Vitreous Cortex in Macular Hole Development

2000 ◽  
Vol 31 (3) ◽  
pp. 203-209
Author(s):  
Keisuke Mori ◽  
Tomoatsu Abe ◽  
Shin Yoneya
Keyword(s):  
Macular Hole ◽  
Vitreous Cortex

scholarly journals A Female Case of X-Linked Retinoschisis with Macular Hole Bilaterally

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
A. Altun
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Surgical Experience ◽  
Flap Technique ◽  
Macular Holes ◽  
Female Case ◽  
Pars Plana

Purpose. We aimed at reminding that X-linked retinoschisis may also be seen in female patients and share our vitreoretinal surgical experience. Methods. The patient underwent pars plana vitrectomy including the closure of the macular holes with inverted ILM flap technique bilaterally. Lens extractions were performed by phacoemulsification during the removal of silicone oil endotamponade. Patient. An 18-year-old girl with X-linked retinoschisis and large macular holes in both eyes presented to the clinic of ophthalmology. It was confirmed that the patient had RS1 mutation Results. Nine-month-follow-up was uneventful for retinal findings. Significant improvement in visual acuity was achieved, and macular holes were remained closed. Conclusion. In cases with large macular holes due to XLR, an inverted ILM flap technique might be safe and effective. Four-month-silicone-endotamponade might be sufficient.

Sign in / Sign up

Export Citation Format

Share Document