PurposeTo evaluate the various patterns of subretinal fluid (SRF) in eyes with age-related macular degeneration (AMD) in the absence of macular neovascularisation (MNV) and to assess the long-term outcomes in these eyes.MethodsThis retrospective study included only eyes with non-neovascular AMD and associated SRF. Eyes with evidence of MNV were excluded. Spectral-domain optical coherence tomography (SD-OCT) was obtained at baseline and at follow-up, and qualitative and quantitative SD-OCT analysis of macular drusen including drusenoid pigment epithelial detachment (PED) and associated SRF was performed to determine anatomic outcomes.ResultsForty-five eyes (45 patients) were included in this analysis. Mean duration of follow-up was 49.7±36.7 months. SRF exhibited three different morphologies: crest of fluid over the apex of the drusenoid PED, pocket of fluid at the angle of a large druse or in the crypt of confluent drusen or drape of low-lying fluid over confluent drusen. Twenty-seven (60%) of the 45 eyes with fluid displayed collapse of the associated druse or drusenoid PED and 24 (53%) of the 45 eyes developed evidence of complete or incomplete retinal pigment epithelial and outer retinal atrophy.ConclusionNon-neovascular AMD with SRF is an important clinical entity to recognise to avoid unnecessary anti-vascular endothelial growth factor therapy. Clinicians should be aware that SRF can be associated with drusen or drusenoid PED in the absence of MNV and may be the result of retinal pigment epithelial (RPE) decompensation and RPE pump failure.
Résumé Objectif: Étudier les effets de la pandémie de COVID-19 sur l'évolution du traitement des patients atteints de la forme néovasculaire de la dégénérescence maculaire liée à l'âge (DMLA) ayant reçu un traitement par injection anti-VEGF avec des données réelles. Méthodes: Cette étude rétrospective a été effectuée sur 116 yeux de 106 patients. Examen ophtalmique, évaluation de la meilleure acuité visuelle corrigée (MAVC), les résultats de la tomographie en cohérence optique (OCT) et les données des deux dernières visites avant les restrictions (V-2 et V-1) et de la première visite (V0) après l’annonce de la fin du confinement et des visites ultérieures (V1 et Vlast) ont été enregistrés. La période du confinement a été déterminée entre le 11 mars et le 1er juin 2020. Résultats: L'intervalle d'injection avant V-1 était significativement plus longue que l'intervalle après V0 (2,56 ± 0,9 vs 2,14 ± 0,8 mois, p = 0,02). Alors que l'épaisseur maculaire centrale médiane (EMC) avait significativement augmentée à V0 par rapport à V-1 [274 (132-711) contre 238 (136-628), p <0,001], la EMC médiane était significativement plus faible à V1 par rapport à V0 [256 (136-591) contre 274 (132-711), p = 0,003]. La MAVC médiane était de 0,67 (0,1-1,1) logMAR à V-1 et s'est significativement aggravée à 0,78 (0,1-1,2) logMAR à V0 (p = 0,003). Bien que la MAVC médiane se soit améliorée à 0,69 logMAR (0,1-1,2) à Vlast, la différence n'a pas atteint une signification statistique par rapport à V0 (p = 0,08). Conclusion: Le retard de traitement dû à la pandémie de COVID-19 entraîne une progression de la DMLA et une déficience visuelle. Planifier des traitements et des visites anti-VEGF plus fréquents peut être une approche appropriée jusqu'à ce que la maladie se stabilise. Cependant, il convient de garder à l'esprit que malgré l'amélioration des résultats des OCT, le succès souhaité en matière d'AV n'a pas pu être atteint à court terme.
Drugs used in IVF treatment increase estrogen levels, which may affect corneal biomechanics and induce progression of keratoconus. Corneal cross-linking treatment could be offered to minimize the risk of keratoconus progression before IVF treatment.
PurposeTo describe the long-term anatomical and functional results of surgery for retinal detachment (RD) associated with stage 4 retinopathy of prematurity (ROP) and patient and surgery-related factors affecting postoperative success.DesignRetrospective case series at a single tertiary referral paediatric vitreoretinal practice.MethodsOne hundred and twenty-one eyes of 82 infants (40 female/42 male) who underwent lens-sparing vitrectomy (LSV) or lensectomy with vitrectomy surgery for stage 4A and 4B ROP at Gazi University Department of Ophthalmology between 2011 and 2016 were enrolled in this study. Patient characteristics including gestational age, birth weight, gender, stage of ROP at presentation, preoperative treatment (laser, anti-vascular endothelial growth factor (VEGF) or combined), anatomical and functional outcome and complications were recorded. The effect of birth weight, gestational age, presence of plus disease, preoperative treatment status, surgically induced posterior hyaloid detachment, postoperative vitreous haemorrhage and iatrogenic retinal tear formation on anatomical and functional results was evaluated.Results61.2% of the eyes were stage 4A and 38.8% were stage 4B ROP. The mean follow-up was 24.5 months. 18.2% of the eyes had no preoperative treatment. Anatomical success was 86.5% for stage 4A and 68.1% for stage 4B at the first year, 91.7% for stage 4A and 69.4% for stage 4B at the second year, and 95.8% for stage 4A and 57.9% for stage 4B at the third year. Functional success was 85.1% for stage 4A and 65.9% for stage 4B at the first year, 89.6% for stage 4A and 61.1% for stage 4B at the second year, and 87.5% for stage 4A and 57.8% for stage 4B at the third year. The mean visual acuity was 1.12±0.34 logarithm of the minimum angle of resolution (logMAR) for stage 4A and 1.34±0.32 logMAR at the 3-year follow-up duration (p>0.05). There was preoperative plus disease in 59.5% of the eyes. Subsequent retinal surgeries were required in 17.4% of the eyes. Presence of plus disease and absence of preoperative treatment, iatrogenic retinal tear formation and postoperative vitreous haemorrhage were found to have significant negative effects, while surgical induction of posterior hyaloid detachment and sparing the lens intraoperatively affected the anatomical and functional results positively.ConclusionsSurgery for stage 4 ROP-associated RD resulted in encouraging anatomical and functional outcomes and the results are even better in eyes with preoperative (laser/anti-VEGF) treatment, LSV and surgically induced posterior hyaloid detachment.
Purpose: To report anatomical and functional results of vitreoretinal surgery in our case series of late cicatricial retinopathy of prematurity (ROP) patients with subtotal retinal detachment. Methods: This is a retrospective, consecutive case series. Eleven eyes of 10 patients presented with partial tractional retinal detachment secondary to late cicatricial ROP (cicatricial stage 4B) who underwent vitreoretinal surgery were retrospectively reviewed. Anatomical and functional outcomes were evaluated. Results: The mean gestational age at birth was 28.6 (26–32) weeks. The mean age at surgery was 79 (4–213) months. Patients were followed up for 21.7 (6–40) months. Six eyes (55%) had lens-sparing vitrectomy and five eyes (45%) had lensectomy + vitrectomy. Anatomical success was achieved in 10 eyes (91%). Improvement in visual acuity was noted in nine eyes (82%). Conclusion: Eye grows but fibrotic tissue does not grow with age, and during this period retinal traction may get worse. Relieving these tractions may lead to good anatomical and visual outcomes in selected late cicatricial ROP cases.
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