Supplemental Digital Content is Available in the Text.To report the structural and functional outcomes of autologous neurosensory retinal transplantation for closure of refractory double full-thickness macular hole in a patient diagnosed with Alport syndrome during one year of follow-up.
Glaucoma diagnosis in highly myopic subjects by optic nerve head (ONH) imaging is challenging as it is difficult to distinguish structural defects related to glaucoma from myopia-related defects in these subjects. Optical coherence tomography (OCT) has evolved to become a routine examination at present, providing key information in the assessment of glaucoma based on the study of the ONH. However, the correct segmentation and interpretation of the ONH data employing OCT is still a challenge in highly myopic patients. High-resolution OCT images can help qualitatively and quantitatively describe the structural characteristics and anatomical changes in highly myopic subjects with and without glaucoma. The ONH and peripapillary area can be analyzed to measure the myopic atrophic-related zone, the existence of intrachoroidal cavitation, staphyloma, and ONH pits by OCT. Similarly, the lamina cribosa observed in the OCT images may reveal anatomical changes that justify visual defects. Several quantitative parameters of the ONH obtained from OCT images were proposed to predict the progression of visual defects in glaucoma subjects. Additionally, OCT images help identify factors that may negatively influence the measurement of the retinal nerve fiber layer (RNFL) and provide better analysis using new parameters, such as Bruch’s Membrane Opening-Minimum Rim Width, which serves as an alternative to RNFL measurements in highly myopic subjects due to its superior diagnostic ability.
Background: To describe an effective combined surgical and pharmacological approach for the management of a sub-internal limiting membrane (sub-ILM) macular hemorrhage and exudation related to a retinal arterial macroaneurysm (RAM) decompensation.Methods: Pars plana vitrectomy (PPV) was performed, with an accurate forceps-assisted ILM removal, hemorrhage aspiration, and a dexamethasone intravitreal implant injection at the end of the surgery. Anatomical and functional outcomes were evaluated by fundus examination, spectral-domain optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCT-A) and best-corrected visual acuity (BCVA). Results: Postoperative outcome revealed that sub-ILM blood was successfully cleaned, and the RAM became progressively thrombosed with complete resolution of the exudation. Three months after surgery, BCVA improved from 20/400 to 20/80 with no signs of recurrence.Conclusion: This combined surgical and pharmacological approach could be an effective technique for the management of sub-ILM hemorrhage secondary to RAM decompensation, and favors anatomical macular restoration and significant recovery of the visual acuity.
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