1,720,985 research outputs found
The long-term outcome of eyes with unexplained visual loss after gas tamponade for macula-on retinal detachment
Full text linkPurpose: To analyze the long-term outcome of eyes suffering from unexplained visual loss after gas tamponade for primary macula-sparing rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional analysis of all eyes with macula-on RRD experiencing an unexplained loss of vision after gas reabsorption that were treated and followed from 2010 to 2019. The investigational work-up included: best-corrected visual acuity (BCVA), clinical examination, spectral-domain optical coherence tomography (SD-OCT) and automated computerized perimetry. Results: The 9 eyes of the 9 patients were analyzed after 5.9±2.4 years. BCVA improved by 0.54±0.50 logMAR from baseline, achieving a final value of 1.17±0.52 logMAR (∼20/320; p=0.0115). The thicknesses of the macula, of the macular ganglion cells and of the retinal nerve fiber layers were unchanged compared to the baseline, as well as the rate of ellipsoid zone defects (22.2%). The proportion of eyes with microcystoid macular edema (MME) significantly decreased to 44.4% (p=0.0294). Perimetry mean deviation increased from a baseline value of -18.06±2.72 to -17.23±2.29 dB (p=0.0390), with an unchanged pattern standard deviation (p=0.1289). In general, a reduction of the scotomata relative depth from baseline was evident in all eyes. Conclusions: Eyes with macula-on RRD suffering from unexplained visual loss after gas reabsorption, despite disclosing an overall unchanged structural macular morphology, showed a moderate, but significant, visual and perimetric improvement in the long-term
Intraoperative efficacy and clinical outcomes of two commercial staining solutions used in idiopathic epiretinal membrane surgery
No full textPurpose To compare two commercially available staining solutions (MembraneBlue Dual (R) by D.O.R.C., Netherlands, and TWIN by AL.CHI.MI.A. S.R.L., Italy), in terms of intraoperative handling, staining efficacy and safety, in eyes undergoing surgery for idiopathic epiretinal membrane (ERM). Methods In this observational cross-sectional study, the performance of the dyes used during the procedure (cohesion, ERM and internal limiting membrane [ILM] staining efficacy) was scored by the surgeon using a customized questionnaire after 10 procedures with each of the two dyes. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), blue-light fundus autofluorescence (BAF), and microperimetry-determined retinal sensitivity were reviewed preoperatively and then at 1 and 3 months after surgery. Results ILM staining efficacy with TWIN was scored 2.89 +/- 0.33 by the surgeons, which turned out to be higher than with MembraneBlue Dual (R) (1.90 +/- 0.31, P = 0.0002). The cohesion score was 2.70 +/- 0.48 for TWIN and resulted significantly higher than with MembraneBlue Dual (R) (1.60 +/- 0.51, P = 0.0010). BCVA, CFT and retinal sensitivity were similar in the two groups, 1 and 3 months postoperatively (P nonsignificant for all). Conclusions Both TWIN and MembraneBlue Dual (R) dyes showed suitable staining properties and equivalent safety and efficacy profiles, both intra- and postoperatively. The TWIN dye might offer a solution for surgeons who prefer a more cohesive and stable dye
Comparative analysis of visual outcomes with 2 enhanced monofocal intraocular lenses
No full textPurpose: To compare the visual performance, spectacle independence and subjective visual quality of two enhanced monofocal intraocular lenses (IOL): Eyhance ICB00 and ZOE Primus-HD. Setting: Ophthalmology Department, San Raffaele Scientific Institute, Milan, Italy. Design: Prospective case series. Methods: We included patients without ocular comorbidities and corneal astigmatism <0.75 diopters (D) undergoing cataract surgery with bilateral implantation of enhanced monofocal Eyhance and ZOE. Six months postoperatively we analyzed the following parameters: subjective and objective refraction; monocular and binocular corrected distance (4 m) and uncorrected distance visual acuity (UDVA); corrected distance, intermediate (66 cm) and near (40 cm) visual acuity, as well as uncorrected intermediate (UIVA) and uncorrected near (UNVA) visual acuity; photopic contrast sensitivity, binocular defocus curve; halo and glare perception; spectacle independence. Results: We evaluated 100 eyes of 50 patients (25 patients per IOL group). The two IOLs showed superimposable visual performances, without significant differences in terms of refractive and visual outcomes, defocus curves, contrast sensitivity, scores of vision quality and spectacle independence. Of note, monocular and binocular UDVA was excellent in both groups. The 2 IOL models achieved satisfactory binocular UIVA, with more than 70% of patients reaching a binocular UIVA ≤0.1 logMAR. Up to 84% of patients eventually declared to feel comfortable frequently while staying at intermediate distance. Conclusions: The general visual outcome of the Eyhance ICB00 and the ZOE Primus-HD enhanced monofocal intraocular lenses are similar, with special reference to the satisfactory spectacle independence for intermediate distance
Subretinal lavage during diagnostic vitrectomy: an adjunctive technique for cell sampling in suspected vitreoretinal lymphoma
No full textPurpose: Current diagnostic methods for vitreoretinal lymphoma (VRL) with predominant subretinal involvement exhibit limited sensitivity. We introduce a novel subretinal lavage technique intended to enhance diagnostic yields during vitrectomy procedures. Methods: During diagnostic vitrectomy, 0.1-0.3 ml of balanced saline solution (BSS) is injected into the subretinal space, creating a localized retinal detachment. Immediately thereafter, the diluted cellular suspension is gently aspirated manually using a 41-gauge extendable soft needle. Results: The technique was successfully performed in three patients without complications, consistently yielding approximately 0.3 ml of lymphoma cell-enriched fluid. Cytological analysis confirmed the presence of CD20-positive B lymphocytes and the MYD88 L265P mutation in all cases. Vitreous cytology was concurrently positive in two out of the three patients. Conclusions: Subretinal lavage is a safe, straightforward, and effective adjunct to standard vitreous biopsy, significantly improving diagnostic accuracy in VRL cases characterized by predominant subretinal infiltration. Implementation of this technique may lead to improved clinical decision-making and patient outcomes
Optical Coherence Tomography Angiography in the Evaluation of Geographic Atrophy Area Extension
No full textA Review of Current and Future Management of Geographic Atrophy
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Choroidal neovascular area and vessel density comparison between two swept-source optical coherence tomography angiography devices
No full textPURPOSE: To compare choroidal neovascularization (CNV) area and vessel density (VD) measurements between two different swept-source optical coherence tomography angiography (SS-OCTA) devices. METHODS: En face optical coherence tomography angiography (OCTA) images of patients affected by neovascular age-related macular degeneration were collected prospectively from two devices: Zeiss PLEX Elite 9000 (Carl Zeiss Meditec, Dublin, CA) and Topcon DRI OCT Triton SS-OCTA (Topcon, Tokyo, Japan). Choroidal neovascularization area and VD of images were measured and analyzed with ImageJ software by two readers to evaluate the agreement between two devices, with respect to different image size (3 × 3 and 6 × 6 mm) and different image segmentation (automatic vs. manual), and a Topcon equivalent Zeiss segmentation as control (i.e., the equivalent anatomical slab given by Topcon device on the Zeiss device). RESULTS: A total of 30 eyes (30 patients) were analyzed. There was an excellent agreement between the two readers in CNV area measurements intraclass correlation coefficient >0.9 in all analyses. We found excellent agreement in CNV area measurements (manual and automatic segmentations) when comparing 3 × 3-mm or 6 × 6-mm images both for each single device and between the two devices (overall intraclass correlation coefficient > 0.9). Vessel density measurements between manual to automatic segmentation within the same device and same image size had a high intraclass correlation coefficient value, but there was a poor agreement in VD between different image sizes (3 × 3 mm vs. 6 × 6 mm) in the same device and also comparing the two devices (3 × 3 Topcon vs. 3 × 3 Zeiss; 6 × 6 Topcon vs. 6 × 6 Zeiss). There was a poor agreement between the Topcon equivalent Zeiss segmentation and all other segmentations. CONCLUSION: There was an excellent agreement in CNV area measurements for both swept-source optical coherence tomography angiography devices in automatic and manual segmentations. However, the Topcon equivalent Zeiss segmentation was not comparable with any of the preset segmentations of Topcon and Zeiss devices. There was a poor agreement in CNV VD between different image size and different devices. For these reasons, it seems that, for accurate longitudinal analysis of VD, it is better to use the same device for each individual, even if both devices can be used interchangeably for CNV area measurements using automatic or manual segmentations
Optical coherence tomography angiography in geographic atrophy
No full textTo analyze choriocapillaris (CC) vessel density (VD) around geographic atrophy (GA) secondary to non-neovascular dry age-related macular degeneration using optical coherence tomography angiography
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