Comparison of anatomical and functional outcomes of different surgical techniques in myopic macular hole without retinal detachment

AIM: To define the anatomic and functional outcomes of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, inverted ILM flap and free ILM patch graft technique for the treatment of myopic macular hole (MH) without retinal detachment. METHODS: Sixty-four eyes of 64 patients who underwent PPV for myopic MH were included. Group 1 consists of patients underwent ILM peeling (n=26), and Groups 2 and 3 consists of patient underwent free ILM patch graft (n=20) and inverted ILM flap procedure (n=18) respectively. Outcomes following surgery were MH closure and best corrected visual acuity (BCVA) in logMAR at 6mo. RESULTS: Closure of MH was obtained in 20 eyes (76.9%) of the Group 1, in 16 eyes (80%) of the Group 2 and in 16 eyes (88.9%) of the Group 3. The mean preoperative and postoperative BCVA was 1.60±0.53 logMAR and 1.27±0.58 logMAR, respectively (P<0.05). There was no significant difference in the postoperative BCVA and anatomical closure rates in the three groups. Although the anatomical closure rate did not differ significantly in the groups, closure of MH tended to be better in the inverted ILM flap technique group at 6mo. CONCLUSION: Different surgical techniques may provide favorable visual and anatomical results for myopic MH surgery. ILM flap techniques offer higher closure rates compared to ILM peeling technique. However, in terms of visual outcomes, the study reveals no difference in three surgical techniques

Interleukin-8 and tumor necrosis factor-α levels in vitreous samples from patients with diabetic retinopathy

AIM: To measure the interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)levels in vitreous samples obtained the patients undergoing pars plana vitrectomy(PPV)due to diabetic retinopathy(DR), then to compare these results with those of the control group and to state their impact on DR pathogenesis.<p>METHODS: From Istanbul Bilim University Ophthalmology Department, 57 eyes of 57 diabetes mellitus(DM)patients who had been diagnosed with proliferative diabetic retinopathy and 22 cases of macular hole, with no proliferative vitreoretinopathy were included in the study as the study and the control groups respectively. All of the 79 patients underwent a 3-port, 20 gauge PPV. Vitreous samples of 0.5mL were aspirated with vitrector at the beginning of the PPV operation before the intraocular infusion and being diluted. Samples were transferred to the freezer to be stored at -70℃. Results of IL-8 and TNF-α were calculated as pg/mL with ELISA method.<p>RESULTS: IL-8 levels 〖82.7891±74.08700(0.08- 307.09)pg/mL〗 in which vitreous samples obtained DR patients during vitrectomy were significantly elevated when compared to IL-8 levels 〖2.9805±3.77546(0.08-18.53)pg/mL〗 of control patients(<i>P</i><0.001). Similarly, TNF-α level 〖18.0007±13.90015(2.32-51.11)pg/mL〗 was also significantly elevated in DR patients when compared to control patients' TNF-α level 〖1.7005±1.26949(0.1- 5.17)pg/mL〗(<i>P</i><0.001). <p>CONCLUSION: The levels of TNF- α, which plays a role in retinal neovascularization, and, IL-8, which acts as an inflammatory and angiogenic mediator were found to be high in DR patients

Real-World Outcomes of Anti-VEGF Treatment for Neovascular Age-Related Macular Degeneration in Turkey: A Multicenter Retrospective Study, Bosphorus Retina Study Group Report No: 1

Objectives: To evaluate the real-world outcomes of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in neovascular age-related macular degeneration (nAMD) patients. Materials and Methods: Multicenter, retrospective, interventional, non-comparative study. The records of nAMD patients treated with an anti-VEGF agent on a pro re nata treatment regimen basis between January 2013 and December 2015 were reviewed. The patients who completed a follow-up period of 12 months were included. Primary outcome measures of this study were the visit and injection numbers during the first year. Results: Eight hundred eighty eyes of 783 patients met the inclusion criteria for the study. Mean number of visits at month 12 was 6.9±2.5 (range: 1-15). Mean number of injections at month 12 was 4.1±1.9 (range: 1-11). Mean visual acuity at baseline and months 3, 6, and 12 was 0.90±0.63 LogMAR (range: 0.0-3.0), 0.79±0.57 LogMAR (range: 0.0-3.0), 0.76±0.57 LogMAR (range: 0.0-3.0), and 0.79±0.59 LogMAR (range: 0.0-3.0), respectively. Mean central retinal thickness at baseline and months 6 and 12 was 395±153 μm (range: 91-1582), 330±115 μm (range: 99-975), and 332±114 μm (range: 106-1191), respectively. Conclusion: The numbers of visits and injections were much lower than ideal and were insufficient with the pro re nata treatment regimen

Intravitreal Ranibizumab Therapy for Choroidal Neovascularization Secondary to Pathological Myopia: 3-Year Outcomes

Objectives: The purpose of this study was to report the functional and anatomical results of intravitreal ranibizumab (IVR) injections administered for myopic choroidal neovascularization (mCNV) secondary to pathological myopia.Methods: In this retrospective study, 32 eyes of 32 mCNV patients were evaluated. After a first IVR injection, patients were followed up and treated with an as-needed monthly regime. Best-corrected visual acuity and optic coherence tomography (OCT) findings were evaluated at baseline and then monthly. The reinjection criteria were a reduction in visual acuity and/or an increase in central macular thickness measured with OCT.Results: The mean age of the patients was 57.7±14.6 years, and the mean axial length was 27.8±1.3 mm. The mean visual acuity improved significantly from 46.4±9.7 letters at baseline to 54.1±9.5 letters at the last follow-up visit (p0.05). The mean number of injections was 3.5±1.1, 2.3±0.9, and 1.7±0.8, at 12, 24, and 36 months, respectively.Conclusion: The results of this study indicated that IVR injections provided a significant long-term visual and anatomical benefit in cases of mCNV with few injectionsObjectives: The purpose of this study was to report the functional and anatomical results of intravitreal ranibizumab (IVR) injections administered for myopic choroidal neovascularization (mCNV) secondary to pathological myopia.Methods: In this retrospective study, 32 eyes of 32 mCNV patients were evaluated. After a first IVR injection, patients were followed up and treated with an as-needed monthly regime. Best-corrected visual acuity and optic coherence tomography (OCT) findings were evaluated at baseline and then monthly. The reinjection criteria were a reduction in visual acuity and/or an increase in central macular thickness measured with OCT.Results: The mean age of the patients was 57.7±14.6 years, and the mean axial length was 27.8±1.3 mm. The mean visual acuity improved significantly from 46.4±9.7 letters at baseline to 54.1±9.5 letters at the last follow-up visit (p0.05). The mean number of injections was 3.5±1.1, 2.3±0.9, and 1.7±0.8, at 12, 24, and 36 months, respectively.Conclusion: The results of this study indicated that IVR injections provided a significant long-term visual and anatomical benefit in cases of mCNV with few injection

Bietti crystalline dystrophy complicated by choroidal neovascularization treated with a single dose of aflibercept

Bietti crystalline dystrophy is a rare hereditary autosomal recessive disease that causes photoreceptor loss secondary to degeneration of retinal pigment epithelium due to intracellular retinal pigment epithelial crystalline deposits and abnormal lipid metabolism. We aimed to present a case of choroidal neovascular membrane secondary to Bietti crystalline dystrophy diagnosed with multimodal imaging and treated with an intravitreal injection of aflibercept. A single dose of aflibercept injection might be effective due to its higher affinity for vascular endothelial growth factor (VEGF) in comparison with other anti-VEGFs. It might be a treatment alternative that can be considered in the choroidal neovascular membrane due to uncommon etiologies

Efficacy of pneumatic retinopexy in young adults with rhegmatogenous retinal detachment

Background: In young adults with rhegmatogenous retinal detachment, pneumatic retinopexy can be a cost-effective and minimally invasive highly effective method in suitable cases. Objectives: To evaluate the role of pneumatic retinopexy in the treatment of young adults with rhegmatogenous retinal detachment (RRD) and the factors that may affect the success of pneumatic retinopexy. Design: Retrospective study. Methods: The study included 67 eyes of 67 patients aged between 21 and 40 who underwent pneumatic retinopexy (PR) between January 2015 and June 2021 for primary RRD. We retrospectively analyzed the prognostic factors that may affect the success of PR, such as preoperative age, best corrected visual acuity, tear site, lens condition, and axial length. Results: PR was successful in 61.2% of the patients, whereas 38.8% required secondary surgery. Between the group that had a single surgery (Group 1) and the group that required secondary surgery (Group 2) the tear location, axial length, and volumes of gases used were statistically different ( p  = 0.04, p   0.05), and glaucoma was not observed in the postoperative period. Conclusion: Since it is a minimally invasive and cost-effective method that provides rapid visual rehabilitation, it can be considered as first-line therapy in young adults who are suitable for PR

Intravitreal bevacizumab injection in patients with choroidal neovascularization due to choroid rupture after blunt-head trauma

PubMed ID: 18825317Purpose: To describe and report the effect of intravitreal bevacizumab (Avastin) as primary treatment for secondary choroidal neovascularization (CNV) after choroidal rupture due to blunt-head trauma. Design: Interventional case report. Methods: The study was ofthe left eye of a patient who presented with choroidal neovascularization secondary to choroidal rupture due to blunt-head trauma. The patient received single intravitreal injection of 1.25 mg (0.05 ml) bevacizumab as treatment for CNV after informed consent was signed. The patient underwent fundus fluorescein angiography (FA) and optic coherence tomography (OCT) before the bevacizumab injection and then again three months after. Visual acuity was also measured before and after treatment. The patient was re-examined on the first day, and monthly thereafter. After intravitreal injection of bevacizumab the visual and anatomic responses were observed. Results: The patient showed regression of the neovascularization three months after injection of bevacizumab. There was no loss of vision in the immediate postoperative period and at the 3rd month vision improved from 20/60 to 20/20. Central retinal thickness decreased. No cataract progression, endophthalmitis, or injection-related complications were observed. Conclusions: Our study shows that intravitreal 1.25 mg bevacizumab can be an effective alternative treatment for choroidal neovascularization (CNV) due to choroidal rupture. © Springer Science+Business Media B.V. 2008