Inner Retinal Optic Neuropathy: Vitreomacular Surgery-Associated Disruption of the Inner Retina

Pan, Billy X.; Yee, Kenneth M.P.; Ross‐Cisneros, Fred N.; Sadun, Alfredo A.; Sebag, J.

doi:10.1167/iovs.14-15235

Cited by 11 publications

(7 citation statements)

References 52 publications

(58 reference statements)

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“…The authors found that the eyes with severe DRIL had limited gain in BCVA at postoperative follow-up. Pan et al [39] investigated the association between central scotoma and vitreoretinal surgery (including ERM and macular hole). In this study, 4 of 11 eyes had postoperative central scotoma and reduced BCVA.…”

Section: Discussionmentioning

confidence: 99%

“…The immunostained tissue samples from these patients showed diffuse neurofilaments on the membrane. Hence, the authors proposed that iatrogenic retinal nerve fiber layer damage during vitreoretinal surgery could cause postoperative central scotoma and worse BCVA [39]. Furthermore, several studies reported that eyes with ectopic inner foveal layers (EIFL) negatively correlated with preoperative and postoperative BCVA improvements [40][41][42].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Combined Vitrectomy with Intravitreal Corticosteroid Injection for Idiopathic Epiretinal Membrane Removal on Anatomical and Functional Outcomes: A Meta-Analysis

2022

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Background: Macular edema can be a cause of visual loss in eyes undergoing vitrectomy with epiretinal membrane(ERM) peeling. Objective: To evaluate the efficacy of combined vitrectomy with intravitreal corticosteroid injection for ERM. Methods: We conducted a systematic literature review by searching PubMed, Embase, and Medline up to December 2020 for studies that evaluated the effect of intravitreal corticosteroid injection during vitrectomy for ERM. Follow-up data on postoperative best-corrected visual acuity (BCVA) and central macular thickness (CMT) were collected and pooled using the standard mean deviation (SMD) with the corresponding 95% confidence interval (CI). Heterogeneity was statistically quantified using I2 statistics, and a meta-analysis was performed using a random-effects model. Results: Eight studies provided data on a total sample of 443 eyes. The meta-analysis revealed that concomitant intravitreal corticosteroid administration during vitrectomy contributed to a significant reduction in CMT than vitrectomy alone at 3 months after operation (pooled SMD = −0.353; 95% CI, −0.594 to −0.111; p = 0.004). However, between the two groups, no significant difference was found in CMT reduction at 1 and 6 months after operation and in postoperative BCVA improvement at 1, 3, and 6 months after operation. Conclusion: Combined treatment with vitrectomy and intravitreal corticosteroid injection may accelerate CMT reduction 3 months after ERM surgery. However, it did not result in a significant change in CMT and BCVA compared with vitrectomy alone at the end of follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of Combined Vitrectomy with Intravitreal Corticosteroid Injection for Idiopathic Epiretinal Membrane Removal on Anatomical and Functional Outcomes: A Meta-Analysis

2022

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“…12, 14 Given the findings in this study, the retinal alterations appear to be more consistent to broad-based peeling tractional forces rather than direct tissue-instrument interaction. One recent study by Pan et al 22 described how intraoperative trauma to the retinal nerve fiber layer led to postoperative central scotoma and reduced visual acuity in several patients who underwent membrane peeling for macular hole. Another possible explanation is that membrane peeling may induce damage to the Müller cell footplates which are attached to the ILM.…”

Section: Discussionmentioning

confidence: 99%

“…While several studies have described the lack of association between DONFL and mean retinal sensitivity, other studies have reported findings including decreased retinal sensitivity and paracentral scotoma after ILM peeling. 22, 28 A second possible explanation is that microperimetry alone is not sufficient to fully evaluate retinal sensitivity after membrane peeling. A recent study by Nguyen et al 29 evaluated visual function after macular pucker surgery using Freiburg acuity contrast testing, and found that while gross visual acuity was not affected, contrast sensitivity was altered.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Development of Dissociated Optic Nerve Fiber Layer Appearance in the Pioneer Intraoperative Optical Coherence Tomography Study

Runkle

Srivastava

Yuan

et al. 2018

Retina

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Acute postpeel increase in inner retinal thickness and macular hole repair were associated with development of DONFL appearance. However, it is unclear whether the surgical indication (e.g., macular hole) or the surgical manipulations performed (e.g., internal limiting membrane peeling) is the major factor that has an impact on DONFL appearance. Overall, these findings suggest that one mechanism in the development of DONFL appearance may be intraoperative trauma to the inner retina, potentially during internal limiting membrane peeling (e.g., macular hole repair).

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“…The commercial availability of human antibodies to these proteins enabled IHC evaluation in embryonic human eyes as previously described by our group. [31][32][33] Five formalin-fixed, paraffin-embedded whole human eyes from embryos aged 10 (n ¼ 2), 14 (n ¼ 2), and 18 WG were used for histologic examination of the hyaloid vasculature. Immunohistochemistry experiments were performed in duplicate in the same eye and, when tissue was available, in multiple eyes of the same gestational age.…”

Section: Immunohistochemistry (Ihc)mentioning

confidence: 99%

Proteomic Analysis of Embryonic and Young Human Vitreous

Yee

Feener

Madigan

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The proteomic profile of vitreous from second-trimester human embryos and young adults was characterized using mass spectrometry and analyzed for changes in protein levels that may relate to structural changes occurring during this time. This vitreous proteome was compared to previous reports to confirm proteins already identified and reveal novel ones. METHODS.Vitreous from 17 human embryos aged 14 to 20 weeks gestation (WG) and from a 12-, a 14-, a 15-, and a 28-year-old was individually analyzed using tandem mass spectrometry-based proteomics. Peptide spectral count associations with embryonic age were assessed using a general linear model of fold changes and Spearman's rank correlation. Differences between embryonic and young adult vitreous proteomes were also compared. Immunohistochemistry was used to evaluate three proteins in five additional fetal (10-18 WG) human eyes.RESULTS. There were 1217 proteins identified in fetal and young adult human vitreous, 206 after quantile normalization and variance filtering. In embryos, the peptide counts of 37 proteins changed significantly from 14 to 20 WG: 75.7% increased, 24.3% decreased. Immunohistochemistry confirmed the absence of clusterin and cadherin in 10 and 14 WG eyes and their presence at 18 WG. Comparing embryonic to young adult vitreous, 47 proteins were significantly higher or lower. A total of 768 proteins not previously identified in the literature are presented. CONCLUSIONS.Proteins previously unreported in the human vitreous were identified. The human vitreous proteome undergoes significant changes during embryogenesis and young adulthood. A number of protein levels change considerably during the second trimester, with the majority decreasing.

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Inner Retinal Optic Neuropathy: Vitreomacular Surgery-Associated Disruption of the Inner Retina

Cited by 11 publications

References 52 publications

Efficacy of Combined Vitrectomy with Intravitreal Corticosteroid Injection for Idiopathic Epiretinal Membrane Removal on Anatomical and Functional Outcomes: A Meta-Analysis

Efficacy of Combined Vitrectomy with Intravitreal Corticosteroid Injection for Idiopathic Epiretinal Membrane Removal on Anatomical and Functional Outcomes: A Meta-Analysis

Factors Associated With Development of Dissociated Optic Nerve Fiber Layer Appearance in the Pioneer Intraoperative Optical Coherence Tomography Study

Proteomic Analysis of Embryonic and Young Human Vitreous

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