Inverted internal limiting membrane flap technique for retinal detachment due to macular holes in high myopia with axial length ≥ 30 mm

Xu, Can; Chen, Feng; Han, Mengyao; He, Junyi; Zhang, Rui; Yan, Tao; Li, Xiangyun; Liu, Yong; Li, Yanzi; Wu, Jianhua

doi:10.1038/s41598-022-08277-y

Cited by 4 publications

(3 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean visual acuity was significantly better in the trained group only at month 3, and the final mean visual gain was not so different between the groups (Biofeedback, 0.57 logMAR; Control, 0.43 logMAR). The cataract extraction performed in all phakic eyes and the study population’s selection criteria, including the absence of retinal detachment and schisis with macular hole and an axial length ≥ 30 mm in only three cases, may justify the good visual acuity recovery as previously reported [ 40 , 41 , 42 ]. However, the visual acuity recovery did not reveal all functional changes related to the high myopic condition and surgical maneuvers.…”

Section: Discussionmentioning

confidence: 94%

Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole

Sborgia,

Niro,

Pastore

et al. 2023

JCM

View full text Add to dashboard Cite

Background: Microperimetric biofeedback training improved visual acuity and fixation stability in patients who previously underwent macular surgery. We aimed to compare the functional results of biofeedback training with the standard of care in patients who underwent successful inverted Internal Limiting Membrane (ILM)-flap technique for high myopic macular holes (hMMH). Methods: This was a retrospective, comparative, cohort study. Patients with hMMH after surgical hole closure underwent microperimetric biofeedback using structured light stimulus plus acoustic tone (n = 12; Biofeedback) or standard of care with scheduled visits (n = 11; Control). Best-corrected visual acuity, retinal sensitivity at central 12° (RS) and 4° (CRS) with a mean deviation at central 12° (MD), and fixation stability as bivariate contour ellipse area (BCEA 68%, 95%, and 99%) were assessed at baseline and month 1, 3, 6, and 12. The Mann–Whitney test was used to test the difference between the groups. Results: Baseline functional parameters were not significantly different among the groups. BCVA significantly improved in each group (Biofeedback, p = 0.002; Control, p ≤ 0.02) at all follow-up visits. CRS significantly improved at 6 (p = 0.03) and 12 (p = 0.01) months in the Biofeedback group and at month 12 (p = 0.01) in the Control group. RS (p = 0.001) and MD (p = 0.005) improved at the last follow-up only in the trained group. After training, BCEA 68% and 95% significantly improved (6 and 12 months, p < 0.05). The Biofeedback group had better results in RS (p ≤ 0.02), CRS (p ≤ 0.02), and BCEA 68%, 95%, and 99% (p ≤ 0.01) compared to the Control at all follow-ups. BCVA and MD were better in the Biofeedback group at month 3 (p = 0.01), and month 3 (p = 0.01) and 12 (p = 0.003), respectively. Conclusions: Microperimetric biofeedback can increase retinal sensitivity and stabilize fixation better than the standard care over months after a successful inverted ILM-flap for hMMH.

show abstract

Section: Discussionmentioning

confidence: 94%

Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole

Sborgia,

Niro,

Pastore

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…The ILM-flap inversion should allow photoreceptors to assume the correct position during the hole healing and improve visual acuity (22). However, the gliosis process, promoted by the inverted flap (32), could limit or delay the restoration of outer retinal layers (30,33) and related visual recovery (30,31). So, the analysis of functional changes after the closure of MH could be underestimated by BCVA, and microperimetry might better analyze those changes (23,34).…”

Section: Discussionmentioning

confidence: 99%

Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes

Sborgia,

Boscia,

Niro

et al. 2023

Front. Med.

View full text Add to dashboard Cite

IntroductionInverted Internal Limiting Membrane (ILM)-flap technique demonstrated its effectiveness, in terms of anatomical closure rate and visual acuity recovery for high myopic macular holes. We evaluated macular function after a successful inverted ILM-flap for macular holes in high myopic eyes (hMMH) using microperimetry to predict visual prognosis.MethodsA retrospective study on 23 eyes of 23 patients after surgical closure of hMMH, was performed. All patients underwent inverted ILM-flap and gas tamponade. Cataract surgery was performed in phakic eyes. Study outcomes including best-corrected visual acuity (BCVA), retinal sensitivity (RS) at central 12°, central retinal sensitivity (CRS) at central 4° and mean deviation (MD), and fixation behavior as bivariate contour ellipse area (BCEA, degrees2) measured by microperimetry, were evaluated over 6 months. A mixed-effects model was used to evaluate and compare the repeated measurements of outcomes between phakic and pseudophakic eyes. A regression model was performed to assess the relationship between BCVA at 6 months and independent variables.ResultsOverall mean BCVA improved from 0.98 ± 0.21 logMAR at baseline to 0.47 ± 0.31 logMAR at the last follow-up (p < 0.001). Over 6 months, overall sensitivity measurements improved (RS, p = 0.001; CRS, p < 0.0001; MD, p = 0.03), and the BCEA decreased in dimension, although not significantly (p ≥ 0.05). The mixed model revealed a significantly better effect of inverted ILM-flap combined with cataract surgery on BCVA and CRS in phakic eyes than inverted ILM-flap alone in pseudophakic ones. The regression model revealed a relationship of 6-month BCVA with pre-operative BCVA (β = 0.60, p = 0.02) and RS (β = −0.03, p = 0.01).ConclusionThe inverted ILM-flap technique significantly improved visual acuity and retinal sensitivity after the hMMH closure, particularly when combined with cataract extraction. Pre-operative visual acuity and retinal sensitivity at central 12° may predict post-surgical visual acuity.

show abstract

“…Ocular axial length (AL) is an eye dimension that refers to the distance (in millimeters) from the apex of the anterior corneal (front of the eye) to the retina. AL elongation is a feature of myopia, which is the most common form of refractive error, and several other eye diseases such as retinal tear, retinal detachment, inherited retinal diseases, glaucoma, and myopic macular degeneration ( Adams, 1987 ; Grosvenor, 1988 ; Arias et al, 2015 ; Tideman et al, 2016 ; Tideman et al, 2018 ; Streho et al, 2019 ; Rezapour et al, 2021 ; Fonteh et al, 2022 ; Foo et al, 2022 ; Omodaka et al, 2022 ; Williams et al, 2022 ; Xu et al, 2022 ). Moreover, the measurement of AL is generally more precise and reproducible than assessments of refractive/myopia status ( Mu et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

A multiethnic genome-wide analysis of 19,420 individuals identifies novel loci associated with axial length and shared genetic influences with refractive error and myopia

Jiang¹,

Melles²,

Yin³

et al. 2023

Front. Genet.

View full text Add to dashboard Cite

Introduction: Long axial length (AL) is a risk factor for myopia. Although family studies indicate that AL has an important genetic component with heritability estimates up to 0.94, there have been few reports of AL-associated loci.Methods: Here, we conducted a multiethnic genome-wide association study (GWAS) of AL in 19,420 adults of European, Latino, Asian, and African ancestry from the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort, with replication in a subset of the Consortium for Refractive Error and Myopia (CREAM) cohorts of European or Asian ancestry. We further examined the effect of the identified loci on the mean spherical equivalent (MSE) within the GERA cohort. We also performed genome-wide genetic correlation analyses to quantify the genetic overlap between AL and MSE or myopia risk in the GERA European ancestry sample.Results: Our multiethnic GWA analysis of AL identified a total of 16 genomic loci, of which 5 are novel. We found that all AL-associated loci were significantly associated with MSE after Bonferroni correction. We also found that AL was genetically correlated with MSE (rg = −0.83; SE, 0.04; p = 1.95 × 10−89) and myopia (rg = 0.80; SE, 0.05; p = 2.84 × 10−55). Finally, we estimated the array heritability for AL in the GERA European ancestry sample using LD score regression, and found an overall heritability estimate of 0.37 (s.e. = 0.04).Discussion: In this large and multiethnic study, we identified novel loci, associated with AL at a genome-wide significance level, increasing substantially our understanding of the etiology of AL variation. Our results also demonstrate an association between AL-associated loci and MSE and a shared genetic basis between AL and myopia risk.

show abstract

Inverted internal limiting membrane flap technique for retinal detachment due to macular holes in high myopia with axial length ≥ 30 mm

Cited by 4 publications

References 40 publications

Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole

Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole

Microperimetric evaluation and predictive factors of visual recovery after successful inverted internal limiting membrane-flap technique for macular hole in high myopic eyes

A multiethnic genome-wide analysis of 19,420 individuals identifies novel loci associated with axial length and shared genetic influences with refractive error and myopia

Contact Info

Product

Resources

About