Evaluation of Microincision Vitrectomy Surgery Using Wide-Viewing System for Complications With Ocular Sarcoidosis

Takayama, Kei; Tanaka, Atsushi; Shibata, Masanori; Muraoka, Tadashi; Ishikawa, Sho; Harimoto, Kouzo; Takeuchi, Masaru

doi:10.1097/md.0000000000000559

Cited by 11 publications

(11 citation statements)

References 29 publications

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“…The diagnostic vitrectomy used in this study was useful to rule out various etiologies causing VO and consequently allows choices of appropriate therapeutic options. [ 13 , 15 , 18 ]…”

Section: Discussionmentioning

confidence: 99%

Assessment of diagnostic and therapeutic vitrectomy for vitreous opacity associated with uveitis with various etiologies

et al. 2018

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Vitreous opacity (VO) is a common feature of intermediate uveitis, posterior uveitis, and panuveitis. Fundus observation is critical for determining the etiology of uveitis, however, is often interfered with VO. In these clinical settings, vitrectomy contributes to a correct diagnosis and guides alternative management strategies. The purpose of this study was to evaluate the diagnostic yield and surgical outcome of vitrectomy in uveitic patients with VO and compare the visual outcome between infectious and noninfectious uveitis. Forty-five eyes with uveitis-associated VO underwent diagnostic and therapeutic vitrectomy, and etiological diagnosis of uveitis was confirmed in 34 of 45 eyes (75.6%). The diagnoses were infectious uveitis in 13 eyes (28.9%), noninfectious uveitis in 21 eyes (46.7%), and unidentified uveitis in 11 eyes (24.4%). Visual acuity (VA) improvement rates at 6 months after surgery were 69.2%, 76.2%, and 90.9% in the infectious, noninfectious, and unidentified uveitis groups, with no significant difference among 3 groups. Significant decrease in inflammation score after vitrectomy was observed only in the infectious uveitis group. This study demonstrated that diagnostic vitrectomy for inflammatory eyes with VO of unknown etiology was effective in infectious and noninfectious uveitis, and the therapeutic effect of VA improvement was observed in both types of uveitis.

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“…The diagnostic vitrectomy used in this study was useful to rule out various etiologies causing VO and consequently allows choices of appropriate therapeutic options. [ 13 , 15 , 18 ]…”

Section: Discussionmentioning

confidence: 99%

Assessment of diagnostic and therapeutic vitrectomy for vitreous opacity associated with uveitis with various etiologies

et al. 2018

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“…Best-corrected visual acuity (BCVA) was measured at the initiation using a standard Japanese visual acuity chart. The decimal BCVA was converted to the logarithm of the minimum angle of resolution (logMAR) for statistical analysis, as previously described [ 10 ]. IOP was measured by Goldmann applanation tonometry and indirect ophthalmoscopy at the initiation and each subsequent visit.…”

Section: Methodsmentioning

confidence: 99%

Comparison of intraocular pressure-lowering effects of ripasudil hydrochloride hydrate for inflammatory and corticosteroid-induced ocular hypertension

et al. 2017

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Ocular hypertension (OHT) caused by inflammation or corticosteroid treatment is a common complication of uveitis. Ripasudil hydrochloride hydrate (K-115) is reportedly efficacious for lowering intraocular pressure (IOP). We retrospectively compared the IOP-lowering effect of K-115 for inflammatory and corticosteroid-induced OHT associated with uveitis. Thirty-six consecutive eyes of 27 patients with uveitis-associated OHT (20 and 16 eyes with inflammation- and corticosteroid-induced OHT, respectively) were treated with K-115 with or without other anti-glaucoma agents. In the inflammation-induced OHT, mean IOP and aqueous flare significantly decreased (P < 0.001 and P = 0.035, respectively), changing from 26.4 ± 7.5 mmHg and 28.1 ± 15.0 photon counts per millisecond (pc/ms) at the initial assessment to 17.9 ± 5.4 mmHg and 17.1 ± 10.7 pc/ms at the last visit, respectively. In the corticosteroid-induced OHT, mean IOP significantly decreased (P = 0.0005), changing from 26.7 ± 7.8 mmHg and 18.7 ± 11.2 pc/ms to 18.6 ± 8.8 mmHg and 22.6 ± 15.3 pc/ms, respectively; conversely, aqueous flare remained unchanged. In the inflammation-induced OHT, K-115 was more efficacious in the eyes with higher IOP. Neither remarkable adverse effects nor exacerbation of uveitis were observed in the eyes of either group during the observation period. K-115 decreased IOP in both inflammation- and corticosteroid-induced OHT associated with uveitis and played a synergistic role in reducing ocular inflammation in uveitis treatment.

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“…In fact, employment of a small-gauge, cannulated vitrectomy system might also diminish secondary intraocular inflammation induced by the vitrectomy itself. Recent reports have suggested that microincision vitreous surgery can be a safe and efficacious approach for patients with uveitis [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Inflammatory Control and Surgical Outcome of Vitrectomy in Intermediate Uveitis

Shin

Joong

et al. 2017

Journal of Ophthalmology

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Purpose. To demonstrate the long-term effectiveness of vitrectomy for intermediate uveitis (IU) and to determine whether complete control of inflammation before vitrectomy is necessary. Methods. This retrospective study included 66 eyes of 66 patients with IU who underwent vitrectomy for vitreoretinal complications. Eyes were followed for at least 12 months after vitrectomy. The degree of inflammation control and visual acuity were compared before and after vitrectomy. These parameters were compared according to the presence of complete inflammation control before surgery. Results. The indications of vitrectomy included epiretinal membrane (26 eyes), vitreous opacity (21 eyes), and tractional retinal detachment (12 eyes), among others. Uveitic attacks did not occur in 44 of the 66 patients after vitrectomy. The numbers of uveitis attacks, local steroid injections, and systemic medications significantly decreased, and vision meaningfully improved after vitrectomy. These parameters did not differ significantly, regardless of the presence of preoperative inflammation. Conclusions. This study showed that vitrectomy is a good modality to manage vitreoretinal complications associated with IU, even if complete control of intraocular inflammation is not achieved before vitrectomy.

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Evaluation of Microincision Vitrectomy Surgery Using Wide-Viewing System for Complications With Ocular Sarcoidosis

Cited by 11 publications

References 29 publications

Assessment of diagnostic and therapeutic vitrectomy for vitreous opacity associated with uveitis with various etiologies

Assessment of diagnostic and therapeutic vitrectomy for vitreous opacity associated with uveitis with various etiologies

Comparison of intraocular pressure-lowering effects of ripasudil hydrochloride hydrate for inflammatory and corticosteroid-induced ocular hypertension

Preoperative Inflammatory Control and Surgical Outcome of Vitrectomy in Intermediate Uveitis

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