»Brilliant Blue G« and »Membrane Blue Dual« assisted Vitrectomy for Macular Hole

The aim of this study is to evaluate vital dyes »Brilliant Blue G« (BBG) and »Membrane Blue Dual« (MBD) for intraoperative staining of the inner limiting membrane (ILM) during vitrectomy for macular hole (MH). Retrospective, comparative case series on 18 eyes with macular holes who underwent »23 and 25 gauge« pars plana vitrectomy. Main outcome measurements were staining intensity and characteristics, visual acuity, visual field, OCT measurements and complications over a period of 6 months. With the help of BBG and MBD succesfully was removed complete ILM in 14 eyes. Postoperative visual acuity was improved in 12 patients, unchanged in 2 patients and worse in 4 patients. Central retinal thickness showed significant postoperative reduction with closure of macular hole. OCT values range were from –10 to –250 mm. No visual field defects and no adverse effects were found. BBG and MBD sucesfully identificate internal limiting membrane during vitrectomy for MH. Good anatomical and functional results are achieved with the use of both vital dyes

Progression of Age Related Maculopathy in Phakic Versus Pseudophakic Eyes

Age-related maculopathy (ARM) is one of the leading causes of central visual acuity loss in older western population. Many factors are responsible for the fast development of ARM. One of this is significant increases of optical radiations through artificial lens after removal of the catarctous lens. The aim of this study was to compare progression of ARM in phakic and pseudophakic patients and to calculate the possibility of pseudophakia as a risk factor for faster progression of ARM. Medical records of 76 patients, older than 60 years (32 male and 44 female) with early forms of ARM were randomly evaluated. They had undergone cataract removal by phacoemulsification with intraocular lens implantation from January 2002 to December 2006 at the Department of Ophthalmology, Rijeka University Hospital, Croatia. Patients were examined two weeks after the surgery and followed up for two years. The control group consisted of 48 patients (21 males and 27 females) with also early forms of ARM, older than 60 years, examined at the Policlinic Department from January 2006 to December 2006 and followed up at least for two years without any cataract surgery. Comparing progression of ARM in these two groups, a total of 19 patients (25%) in pseudophakic group showed progression to late forms of ARM, but only 6 patients (12.5 %) in the control group developed these aggressive ARM forms. More aggressive forms of ARM in pseudophakic group indicate that pseudophakia should be considered as a risk factor for development of ARM

Focused High Risk – Population Screening for Carotid Stenosis and Retinal Microangiopathia after Radiotherapy for Laryngeal Carcinoma

Carotid artery stenosis (CAS) is one of the major complications of external irradiation (radiotherapy, RT) for laryngeal carcinoma. Considering amaurosis fugax is often one of the first signs of significant CAS our focus was to determine weather patients with post-irradiation CAS also develop ocular microangiopathy as a result of insufficient ophthalmic circulation. In our study Carotid Duplex ultrasound scans revealed that 33.33% of patients had significant radiation–induced CAS. The majority (over 85.71%) of radiation-induced CAS had more than one atherosclerotic plaque including any degree of stenosis in the RT group, and had significantly more than that of the control group. Microangiopathic changes were documented only with the patients that have had an increased cerebrovascular risk (diabetes mellitus and arterial hypertension)

Progression of Age Related Maculopathy in Phakic Versus Pseudophakic Eyes

Age-related maculopathy (ARM) is one of the leading causes of central visual acuity loss in older western population. Many factors are responsible for the fast development of ARM. One of this is significant increases of optical radiations through artificial lens after removal of the catarctous lens. The aim of this study was to compare progression of ARM in phakic and pseudophakic patients and to calculate the possibility of pseudophakia as a risk factor for faster progression of ARM. Medical records of 76 patients, older than 60 years (32 male and 44 female) with early forms of ARM were randomly evaluated. They had undergone cataract removal by phacoemulsification with intraocular lens implantation from January 2002 to December 2006 at the Department of Ophthalmology, Rijeka University Hospital, Croatia. Patients were examined two weeks after the surgery and followed up for two years. The control group consisted of 48 patients (21 males and 27 females) with also early forms of ARM, older than 60 years, examined at the Policlinic Department from January 2006 to December 2006 and followed up at least for two years without any cataract surgery. Comparing progression of ARM in these two groups, a total of 19 patients (25%) in pseudophakic group showed progression to late forms of ARM, but only 6 patients (12.5 %) in the control group developed these aggressive ARM forms. More aggressive forms of ARM in pseudophakic group indicate that pseudophakia should be considered as a risk factor for development of ARM

Microsurgical treatment of macular holes

Ruptura žute pjege poremećaj je koji zahvaća najdelikatnije strukture centralne mrežnice. Neliječena uglavnom dovodi do značajnog gubitka centralne vidne oštrine. Mikrokirurško liječenje rupture žute pjege prvi put se spominje 1991. godine u radovima Kelly i Wendela. Od tih relativno jednostavnih početaka uz upotrebu klasičnih vitrektoma velikog promjera i upotrebe zraka kao tamponade na kraju operacije do razvoja bešavnih mikroincizijskih tehnologija prošlo je više od 20 godina. Uvođenjem ljuštenja membrane limitans interne uz pomoć posebnih vitalnih boja i novih vrsta tamponada poboljšao se anatomski i funkcionalni uspjeh ovih operacija. Upotrebom optičke koherentne tomografije omogućena je bolja analiza vitreoretinalnih promjena, kao i praćenje postoperativnih promjena u području žute pjege. Nove metode u liječenju kompliciranih ruptura žute pjege kao što su formiranje inverznog poklopca od tkiva membrane limitans interne, farmakološka vitreoliza, transplantacija retine te novi oblici konzervativnog liječenja kod početnih ruptura žute pjege daju nadu da sve mogućnosti liječenja ove bolesti nisu iscrpljene.A macular hole is a disorder of the most delicate structures in the central retina. Left untreated it usually leads to severe loss of visual acquity. Microsurgical treatment of macular holes is first mentioned in 1991 by Kelly and Wendell. It has been more than 20 years since those rather simple beginnings using classical vitrectomes with bigger radius and air tamponade to the suture-free microincision technologies we use today. Internal limiting membrane peeling in combination with special vital dyes and new types of tamponade upgraded the anatomical and functional success of these surgeries. Usage of optic coherence tomography enables better analysis of vitreoretinal disorders and monitoring postoperative changes in the macular area. New methods in treatment of complicated macular holes such as inverted internal limiting membrane flap, pharmacologic vitreolysis, retinal transplantation and new options of conservative treatment in initial stages of macular holes give confidence that there is still room for improvement in treatment of macular holes

Microsurgical treatment of macular holes

Ruptura žute pjege poremećaj je koji zahvaća najdelikatnije strukture centralne mrežnice. Neliječena uglavnom dovodi do značajnog gubitka centralne vidne oštrine. Mikrokirurško liječenje rupture žute pjege prvi put se spominje 1991. godine u radovima Kelly i Wendela. Od tih relativno jednostavnih početaka uz upotrebu klasičnih vitrektoma velikog promjera i upotrebe zraka kao tamponade na kraju operacije do razvoja bešavnih mikroincizijskih tehnologija prošlo je više od 20 godina. Uvođenjem ljuštenja membrane limitans interne uz pomoć posebnih vitalnih boja i novih vrsta tamponada poboljšao se anatomski i funkcionalni uspjeh ovih operacija. Upotrebom optičke koherentne tomografije omogućena je bolja analiza vitreoretinalnih promjena, kao i praćenje postoperativnih promjena u području žute pjege. Nove metode u liječenju kompliciranih ruptura žute pjege kao što su formiranje inverznog poklopca od tkiva membrane limitans interne, farmakološka vitreoliza, transplantacija retine te novi oblici konzervativnog liječenja kod početnih ruptura žute pjege daju nadu da sve mogućnosti liječenja ove bolesti nisu iscrpljene.A macular hole is a disorder of the most delicate structures in the central retina. Left untreated it usually leads to severe loss of visual acquity. Microsurgical treatment of macular holes is first mentioned in 1991 by Kelly and Wendell. It has been more than 20 years since those rather simple beginnings using classical vitrectomes with bigger radius and air tamponade to the suture-free microincision technologies we use today. Internal limiting membrane peeling in combination with special vital dyes and new types of tamponade upgraded the anatomical and functional success of these surgeries. Usage of optic coherence tomography enables better analysis of vitreoretinal disorders and monitoring postoperative changes in the macular area. New methods in treatment of complicated macular holes such as inverted internal limiting membrane flap, pharmacologic vitreolysis, retinal transplantation and new options of conservative treatment in initial stages of macular holes give confidence that there is still room for improvement in treatment of macular holes

Microsurgical treatment of macular holes

Ruptura žute pjege poremećaj je koji zahvaća najdelikatnije strukture centralne mrežnice. Neliječena uglavnom dovodi do značajnog gubitka centralne vidne oštrine. Mikrokirurško liječenje rupture žute pjege prvi put se spominje 1991. godine u radovima Kelly i Wendela. Od tih relativno jednostavnih početaka uz upotrebu klasičnih vitrektoma velikog promjera i upotrebe zraka kao tamponade na kraju operacije do razvoja bešavnih mikroincizijskih tehnologija prošlo je više od 20 godina. Uvođenjem ljuštenja membrane limitans interne uz pomoć posebnih vitalnih boja i novih vrsta tamponada poboljšao se anatomski i funkcionalni uspjeh ovih operacija. Upotrebom optičke koherentne tomografije omogućena je bolja analiza vitreoretinalnih promjena, kao i praćenje postoperativnih promjena u području žute pjege. Nove metode u liječenju kompliciranih ruptura žute pjege kao što su formiranje inverznog poklopca od tkiva membrane limitans interne, farmakološka vitreoliza, transplantacija retine te novi oblici konzervativnog liječenja kod početnih ruptura žute pjege daju nadu da sve mogućnosti liječenja ove bolesti nisu iscrpljene.A macular hole is a disorder of the most delicate structures in the central retina. Left untreated it usually leads to severe loss of visual acquity. Microsurgical treatment of macular holes is first mentioned in 1991 by Kelly and Wendell. It has been more than 20 years since those rather simple beginnings using classical vitrectomes with bigger radius and air tamponade to the suture-free microincision technologies we use today. Internal limiting membrane peeling in combination with special vital dyes and new types of tamponade upgraded the anatomical and functional success of these surgeries. Usage of optic coherence tomography enables better analysis of vitreoretinal disorders and monitoring postoperative changes in the macular area. New methods in treatment of complicated macular holes such as inverted internal limiting membrane flap, pharmacologic vitreolysis, retinal transplantation and new options of conservative treatment in initial stages of macular holes give confidence that there is still room for improvement in treatment of macular holes