Aims: To report the clinical features and outcomes of polypoidal choroidal vasculopathy (PCV) in Chinese patients with or without laser treatment. Methods: A consecutive series of 204 indocyanine green angiographies (ICGA) performed for patients with a provisional diagnosis of age related macular degeneration were reviewed retrospectively. Inclusion criteria were ICGA with angiographic features of PCV and patients of Chinese ethnic origin. Medical records were then reviewed and patients were recalled for further assessments. Results: 22 eyes of 19 patients (9.3%) were included. The mean follow up period was 27.4 months (range 4-60 months). The mean age of patients at presentation was 65.1 years (range 51-77 years). The commonest clinical feature at presentation was subretinal haemorrhage (63.6%), followed by retinal exudation (59.1%) and haemorrhagic pigment epithelial detachment (59.1%). There was a predominance of males (68.4%), unilaterality (84.2%), and macular location of polyps (63.6%). Nine eyes received laser photocoagulation. The median initial visual acuity for both the laser and non-laser groups was 6/18. Stable or improved vision was attained in 56% and 31% of laser and non-laser groups, respectively (Fisher's exact test, p=0.38). Mean loss of Snellen lines was 3.1 and 1.1 for the two groups, respectively (two sample t test, p=0.31). At the last follow up, 15 (68.2%) eyes had poor visual acuity of 6/60 or worse, mostly attributed to disciform scar or exudative maculopathy. Conclusions: There is a predominance of males, unilaterality, and macular location of polyps in Chinese patients with PCV. The overall visual prognosis is guarded regardless of treatment. There is a large amount of variation in the natural course of PCV among different ethnic groups.

Internal limiting membrane removal during macular ERM surgery may minimize the recurrence of ERM, without adverse visual outcome. Further controlled prospective studies are needed to determine the role of ILM peeling in ERM surgery.

No abstract

No abstract

No abstract

No abstract

Aims: To determine surgical outcome in primary idiopathic stage 3 or 4 macular holes with indocyanine green (ICG) assisted retinal internal limiting membrane (ILM) peeling. Methods: A prospective, consecutive, interventional case series with 41 eyes of 40 patients was included. No patient defaulted follow up. Besides a standard macular hole surgery, all eyes received ICG assisted ILM removal of 3-4 disc diameters around macular holes. At the end of the surgery, 12% perfluoropropane gas was used. A face down posture for 2 weeks was required postoperatively. Results: The mean follow up period was 15.1 months (range 6-24 months). Twenty (48.8%) eyes had stage 3 macular holes and 21 (51.2%) had stage 4 macular holes. The overall median duration of holes was 11 months. 19 (46.3%) were chronic macular holes of more than 12 months' duration. The anatomical success rates after one surgery was 87.8% (36 eyes), while that of chronic and non-chronic ones was 78.9% and 95.5%, respectively. The median preoperative and postoperative visual acuity was 20/200 (range 20/60 to counting fingers) and 20/100 (range 20/20 to 20/400), respectively. 24 (58.5%) eyes had improvement of two or more Snellen lines. The mean was 3.2 lines (range two to nine lines), with 3.6 lines and 2.7 lines for non-chronic and chronic holes, respectively. For all the 41 eyes, 16 (39%) eyes had a final visual acuity of 20/50 or better. Conclusion: ICG assisted retinal ILM removal, in idiopathic primary chronic and non-chronic stage 3 or 4 macular hole surgery, appears to give a promising anatomical closure rate without compromising the visual result. Since Kelly and Wendel first demonstrated the successful closure of macular hole with pars plana vitrectomy and fluid-gas exchange a decade ago, this surgery has been widely practised as the treatment of stage 2, 3, and 4 macular holes.1-3 Various adjuncts have also been studied in order to promote a glial scar formation that improved the closure rate of macular hole surgery. These adjuncts included intraoperative applications of transforming growth factor-β2, autologous serum, autologous platelet concentrates, and laser photocoagulation to the retinal pigment epithelium in the bed of the macular hole. 4-11The internal limiting membrane (ILM) forms the innermost layer of the retina and the outer boundary of the vitreous. It contains collagen fibrils, proteoglycans, basement membrane and the plasma membrane of Müller cells, and possibly other glial cells of the retina.12 Histologically, ILM around macular holes also contains myofibrocytes, and contraction of these myofibrocytes has been suggested to cause enlargement of the macular hole and prevent its closure.13 Therefore, the removal of the ILM may be a surgical adjunct that can promote gliosis and the closure of macular hole.14-17 However, the visualisation of the thin and transparent ILM intraoperatively is often difficult and may preclude its complete removal without damaging other parts of the retina. Excessive unsuccessful attempts to remove the ILM duri...

No abstract