Showing papers on "Vitreous Detachment published in 2020"
TL;DR: Fellow eyes of patients with FTMH with foveal crack sign are at a very high risk (77%) of F TMH development, as long as posterior vitreous adhesion is present.
Abstract: To investigate the prevalence and predictive value of the foveal crack sign (FCS) in fellow eyes of patients with full-thickness macular holes (FTMH) regarding future macular hole (MH) formation. In a retrospective observational case series, 113 fellow eyes of 113 patients with FTMH have been observed during a mean follow-up time of 21 months. According to baseline SD-OCT images, patients were divided into 4 separate groups: patients with FCS and vitreous adhesion, patients with FCS and vitreous detachment, patients without FCS with vitreous adhesion, patients without FCS with vitreous detachment. Progression rate to MH formation, predictive value of FCS and of vitreous interface status were calculated and compared across the four groups. FCS was observed in 19 of 113 fellow eyes (17%) of patients with FTMH, 10 of them with progression to MH during the mean follow up time of 21 months. 2 other eyes with progression to MH showed no FCS at baseline. Progression rate was shown to be 77% (10 of 13 eyes) in patients with FCS and vitreous adhesion, 0% (none of 6 eyes) in patients with FCS and vitreous detachment, 4% (2 of 48 eyes) in patients without FCS with vitreous adhesion, 0% (none of 46 eyes) in patients without FCS with vitreous detachment. FCS had sensitivity of 83.3% (95% CI 50.9-97.1%) and specificity of 91.1% (95% CI 83.3-95.6%) in predicting MH formation, positive predictive value of FCS was 52.6% (95% CI 29.5-74.8%) and negative predictive value 97.9% (95% CI 91.8-99.6%). Having simultaneously FCS and vitreous adhesion showed 83.3% (95% CI 50.9-97.1%) sensitivity and 97.1% (95% CI 91.1-99.2%) specificity in predicting macular hole formation; positive predictive value was 76.9% (95% CI 46.0-93.8%) and negative predictive value was 98.0% (95% CI 92.4-99.7%). Fellow eyes of patients with FTMH with foveal crack sign are at a very high risk (77%) of FTMH development, as long as posterior vitreous adhesion is present.
6 citations
TL;DR: In symptomatic PVDs, PVOs on OCT correlated with the presence of a retinal break, especially in the absence of a vitreous hemorrhage, as well as with Shaffer's sign.
Abstract: Background and objective Posterior vitreous detachment (PVD) is a separation of the posterior hyaloid from the retina that manifests as photopsias and floaters. Optical coherence tomography (OCT) has demonstrated posterior vitreous opacities (PVOs) that may correlate with Shaffer's sign, which may correlate with retinal breaks. Patients and methods Patients with symptomatic PVDs were retrospectively reviewed at a single institution by a single provider. Masked qualitative review of SD-OCTs by a single reviewer determined presence of PVOs. Results Among 78 patients, PVOs were found in 32 of the patients (41%), and 19 (59%) had retinal breaks. In those without PVOs, six (13%) had a break. Sensitivity and specificity were 76.0% and 75.5%, respectively. Removing patients with vitreous hemorrhages, sensitivity, and specificity of PVOs was 82.4% and 86.4%, respectively. Conclusion In symptomatic PVDs, PVOs on OCT correlated with the presence of a retinal break, especially in the absence of a vitreous hemorrhage. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:628-632.].
4 citations
TL;DR: Clinically relevant differences in the selection of toric intraocular lens power in normal eyes: preoperative measurement vs intraoperative aberrometry vs manual planning and surgery are identified.
Abstract: 1. Packer M. Effect of intraoperative aberrometry on the rate of postoperative enhancement: retrospective study. J Cataract Refract Surg 2010;36: 747–755 2. Woodcock MG, Lehmann R, Cionni RJ, Breen M, Scott MC. Intraoperative aberrometry versus standard preoperative biometry and a toric IOL calculator for bilateral toric IOL implantation with a femtosecond laser: one-month results. J Cataract Refract Surg 2016;42:817–825 3. Solomon KD, Sandoval HP, Potvin R. Correcting astigmatism at the time of cataract surgery: toric IOLs and corneal relaxing incisions planned with an image-guidance system and intraoperative aberrometer versus manual planning and surgery. J Cataract Refract Surg 2019;45: 569–575 4. Davison JA, Makari S, Potvin R. Clinically relevant differences in the selection of toric intraocular lens power in normal eyes: preoperative measurement vs intraoperative aberrometry. Clin Ophthalmol 2019;13:913–920 5. Holladay JT. Holladay IOL Consultant User’s and Reference Manual. Houston, TX, Holladay Lasik Institute, 1999
4 citations
TL;DR: New developments in surgical techniques and IOL design offer the ophthalmic surgeon a plethora of options, allowing safe and stable lens positioning in the absence of viable capsule remnants even in more complicated cases.
Abstract: is simpler and might result in less intraoperative complications with a better stability of the IOL–capsular bag complex. Recently, we have adopted the newly released Carlevale IOL (FIL-SSF) in most cases of scleral fixation with or without capsular bag instability. This specific foldable IOL can be inserted through a 2.2 mm corneal tunnel and is easily fixated to the sclera with excellent centration. The Carlevale IOL is a hydrophilic acrylic IOL with 4 points of scleral sulcus counterpressure and T-shaped harpoons protruding off the closed haptics to allow self-anchoring on the sclera without the need for sutures. This IOL is 13.2mm long, and the optic plate is 6.5mmwide. Our surgical series with Carlevale IOL consists of 18 patients. Indications for surgery were IOL dislocation (12 cases [67%]), IOL exchange due to IOL opacification (5 cases [28%]), and secondary implant due to complicated cataract surgery (1 case [5%]). The mean ± SD age of patients was 81.3 ± 4.1 years. The mean preoperative corrected distance visual acuity was 0.69 ± 0.51 logarithm of the minimum angle of resolution (logMAR). After a mean follow-up of 9.3 ± 6.9 months, the mean corrected distance visual acuity improved by 2.6 Early Treatment Diabetic Retinopathy Study lines to 0.43 ± 0.48 logMAR (P = .001). We recorded 1 case (5.5%) of transient intraoperative bleeding in the anterior chamber. An optimal centration and stability of the IOL were observed in all cases. No cases of scleral or conjunctival erosion were observed. One case (5.5%) of transient intraocular pressure increase developed postoperatively. We believe that new developments in surgical techniques and IOL design offer the ophthalmic surgeon a plethora of options, allowing safe and stable lens positioning in the absence of viable capsule remnants even in more complicated cases.—Daniele Veritti, MD, Lisa Grego, MD, Francesco Samassa, MD, Valentina Sarao, MD, Paolo Lanzetta, MD
1 citations
TL;DR: In the authors' DME patients, vitreous adherence to the posterior pole was highly prevalent, with a total agreement between US and SD-OCT 55 × 35° video display mode.
Abstract: Background and objectives To assess the percentage of vitreous adherence to the posterior pole in patients with diabetic macular edema (DME) with ocular ultrasonography (US) and establish a comparison with spectral-domain optical coherence tomography (SD-OCT). Patients and methods Cross-sectional consecutive analysis of patients followed in a diabetic retinopathy consultation. Vitrectomized eyes and patients with epiretinal membranes were excluded. A comparison between macular SD-OCT 20 × 20°, SD-OCT 55 × 35°, and ocular US for the vitreous status was performed. A subanalysis of the percentage of eyes with thickened posterior hyaloid and focal vitreous macular adhesion (VMA) was determined with SD-OCT 20 × 20° and SD-OCT 55 × 35°. Results From 78 eyes of 39 patients, 55 eyes were included. All patients had type 2 diabetes mellitus with a median duration of 20 years (range: 3 to 40 years); 60% were phakic, and 61.8% were male. Previous treatments included intravitreal injections in 54.5% eyes, macular laser in 67.3%, and panretinal photocoagulation in 56.4%. All eyes had a non-posterior vitreous detachment (PVD) status on US. The 55 × 35° SD-OCT detected a non-PVD status in 96.4% (100% in video display mode) and a VMA in 87.3%. The 20 × 20° SD-OCT only detected a VMA in 43.6% of cases, with a thickened posterior hyaloid in 40% and a focal VMA in 18.2%. Conclusions In the authors' DME patients, vitreous adherence to the posterior pole was highly prevalent, with a total agreement between US and SD-OCT 55 × 35° video display mode. SD-OCT 20 × 20° is not an accurate method to diagnose VMA compared to SD-OCT 55 × 35°. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:S50-S53.].
1 citations
26 Jun 2020
TL;DR: Though it is a rare entity, iris retraction with normal intraocular pressure may mask a serious disorder such as retinal detachment, and examination including funduscopy should be given priority in these patients.
Abstract: Objective: To report the clinical case of a patient presenting at the Ophthalmology emergency department of “Hospital Universitario Fundacion Jimenez Diaz” of Madrid with retinal detachment associated with iris retraction.Clinical case: Sixty-year-old female with a history of vitreous detachment of the right eye presenting at the emergency department due to redness and pain in the same eye. Ophthalmologic examination revealed the presence of rhegmatogenous retinal detachment associated with iris retractionConclusion: Though it is a rare entity, iris retraction with normal intraocular pressure may mask a serious disorder such as retinal detachment. This is why it is very important to identify this detachment, and examination including funduscopy should be given priority in these patients.