Changes in Visual Acuity and Foveal Photoreceptor Integrity in Eyes With Chronic Cystoid Macular Edema Associated With Retinal Vein Occlusion

Kurashige, Yumiko; Tsujikawa, Akitaka; Murakami, Tomoaki; Miyamoto, Kazuaki; Ogino, Ken; Muraoka, Yuki; Yoshimura, Nagahisa

doi:10.1097/iae.0b013e3182278b98

Cited by 16 publications

(17 citation statements)

References 25 publications

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“…It is likely that long-standing macular striae and edema leads to foveal photoreceptor dysfunction in a similar fashion as described for chronic cystoid macular edema, which ultimately limits the potential for visual recovery. 48 A third study of 177 eyes that underwent bleb revision for 1 of 3 different indications (hypotony without leak, bleb leak, and bleb dysesthesia), by Radhakrishnan and associates, showed that revision surgery provided successful resolution of bleb-related complications, with most patients maintaining good IOP control thereafter. 49 However, the relationship between duration of hypotony and final visual outcome was not evaluated in their study.…”

Section: Discussionmentioning

confidence: 99%

Bleb Revision for Resolution of Hypotony Maculopathy Following Primary Trabeculectomy

Bitrian

Song

2014

American Journal of Ophthalmology

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PURPOSE To describe a surgical method of bleb revision for hypotony maculopathy, to evaluate its long-term efficacy, and to define the relationship between the duration of hypotony maculopathy and visual acuity (VA) outcomes. DESIGN Noncomparative retrospective case series. METHODS Medical records of 33 patients with hypotony maculopathy who underwent primary bleb revision between June 1999 and September 2012 by a single surgeon at an academic medical center were reviewed. Hypotony maculopathy was characterized by the presence of a decrease in VA, retinal striae, and macular edema in the setting of decreased intraocular pressure (IOP) after glaucoma filtering surgery. The main outcome measure was final logMAR VA after bleb revision at 6 and 12 months. RESULTS Thirty-three eyes of 33 patients were followed for 4.68 ± 3.56 years (range 0.55–12.69 years). Mean duration of hypotony maculopathy was 4.98 ± 8.93 months. LogMAR VA improved from 0.78 ± 0.40 at baseline to 0.34 ± 0.34 (P < .001) 6 months after bleb revision and to 0.45 ± 0.55 (P < .001) 12 months after bleb revision. Spearman rank coefficient (rs) correlating duration of hypotony and BCVA at both 6 and 12 months was significant (P = .015 and rs = 0.426, P = .028 and rs = 0.416, respectively). Mean IOP increased from 3.51 ± 2.27 mm Hg to 12.06 ± 4.06 mm Hg (P < .001) at 12 months. Fifty-two percent were on no antiglaucoma medications at last follow-up. Five eyes (15%) required a second bleb revision to correct persistent hypotony maculopathy. CONCLUSION Surgical repair for hypotony maculopathy provided a significant improvement in VA at 6 and 12 months. Surgical bleb revision is associated with good long-term control of IOP and improved VA in eyes with hypotony maculopathy after previous glaucoma filtering surgery.

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Section: Discussionmentioning

confidence: 99%

Bleb Revision for Resolution of Hypotony Maculopathy Following Primary Trabeculectomy

Bitrian

Song

2014

American Journal of Ophthalmology

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“…While in cystoid macular oedema, cysts seem not to have such a damaging effect on the photoreceptor layer, cystoid spaces in diabetic macular oedema have been suggested to be accompanied by photoreceptor damage and impaired IS ⁄ OS integrity (Kurashige et al 2012;Murakami et al 2012). Large cysts in the ONL of the retina in DME are suggested to occur in a rather late stage of DME and have a more severe negative impact on macular function by creating disorganization of photosensitive retinal tissue than smaller cysts or cystoid formation occurring in inner retinal layers.…”

Section: Discussionmentioning

confidence: 99%

Functional and morphological changes in diabetic macular edema over the course of anti-vascular endothelial growth factor treatment

et al. 2013

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ABSTRACT.Purpose: To evaluate macular morphology and function in diabetic macular edema (DME) over the course of intravitreal anti-vascular endothelial growth factor (VEGF) treatment with Ranibizumab.Methods: A consecutive series of 39 study eyes with centre-involving DME were included in this study. In all subjects, best-corrected visual acuity (BCVA) according ETDRS protocol, fluorescein angiography (FA), microperimetric macular sensitivity (MP) and Spectral Domain optical coherence tomography (SD-OCT) cross-sectional scans were obtained before treatment and after 3 monthly applied intravitreal Ranibizumab injections. Six different morphological qualities [IS ⁄ OS layer integrity, outer nuclear layer (ONL) cysts, ONL cyst size, inner nuclear layer (INL) cysts, blocking phenomenon and subretinal fluid] were graded of each cross-sectional OCT scan before and over the course of treatment by two experienced graders. Correlation analyses between functional and morphological parameters were obtained. Conclusions: ONL cysts and their size as morphological parameters correlate with retinal function measured with BCVA and microperimetry before and over the course of anti-VEGF therapy with Ranibizumab in patients with DME. Results:

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“…However, in the present study, the existence of ME showed no significant association with VA after anti-VEGF treatment. Kurashige et al [16] also suggested that total foveal retinal thickness had no significant association with VA, whereas the thickness of the foveal outer retina had a significant association with VA. On the other hand, strong associations between EZ disruption and VA have been reported [16-19]. Treatment for ME due to BRVO should aim to maintain the integrity of the outer retinal layer rather than to diminish ME itself.…”

Section: Discussionmentioning

confidence: 99%

Disorganization of the Retinal Inner Layers after Anti-VEGF Treatment for Macular Edema due to Branch Retinal Vein Occlusion

Nakano¹,

Ota²,

Jingami³

et al. 2018

Ophthalmologica

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Purpose: To evaluate the association between disorganization of the retinal inner layers (DRIL) and visual acuity (VA) after anti-VEGF treatment for macular edema (ME) due to branch retinal vein occlusion (BRVO). Methods: Sixty eyes of 60 patients were retrospectively investigated. Baseline characteristics and factors analyzed on optical coherence tomography (OCT) examination at the final visit were evaluated in association with VA at the final visit. Results: DRIL was detected in 39 eyes at the final visit. The central subfield thickness was significantly higher in the eyes with DRIL. While DRIL length at the final visit showed a significant association with final VA on univariable analysis, only age and ellipsoid zone disruption on OCT at the final visit were found to be significantly associated with VA on multivariable analysis. Conclusions: DRIL had only a minor role in determining VA after anti-VEGF treatment for ME due to BRVO.

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Changes in Visual Acuity and Foveal Photoreceptor Integrity in Eyes With Chronic Cystoid Macular Edema Associated With Retinal Vein Occlusion

Abstract: Even if a large cystoid space is located in the fovea, its effect on deterioration of the underlying foveal photoreceptor cells is not as strong as is generally thought.

Cited by 16 publications

References 25 publications

Bleb Revision for Resolution of Hypotony Maculopathy Following Primary Trabeculectomy

Bleb Revision for Resolution of Hypotony Maculopathy Following Primary Trabeculectomy

Functional and morphological changes in diabetic macular edema over the course of anti-vascular endothelial growth factor treatment

Disorganization of the Retinal Inner Layers after Anti-VEGF Treatment for Macular Edema due to Branch Retinal Vein Occlusion

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