Macular Hole Surgery in Dome-Shaped Maculopathy

Lee, Sol; Gallemore, Ron P.

doi:10.2147/imcrj.s282118

Cited by 2 publications

(3 citation statements)

References 19 publications

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“… 66 Nevertheless, the treatment of complicated cases of FTMH, such as postoperative MH or MH associated with high myopia and macular schisis remains challenging. 67 , 68 …”

Section: Discussionmentioning

confidence: 99%

Internal Limiting Membrane Peeling and Gas Tamponade For Full-Thickness Macular Holes of Different Etiology – Is It Still Relevant?

Ruban¹,

Petrovski²,

Petrovski³

et al. 2022

OPTH

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Background Despite the abundance of novel surgical approaches proposed for full thickness macular hole (FTMH) treatment, the choice of the optimal technique remains debatable Vitrectomy with «classic» internal limiting membrane peeling and gas tamponade remains the standard of FTMH surgery in many cases, but there are still very limited recent publications on the outcomes of such surgery. Purpose To investigate the anatomical and functional result and to analyze the significance of outcome-related risk factors of the classic 25-gauge pars plana vitrectomy (PPV) with ILM peeling and gas tamponade (GT) for treatment of FTMH of different etiology. Patients and methods Thirty-eight eyes of thirty-seven patients with FTMH who underwent 25-gauge PPV, ILM peeling and GT were recruited for this retrospective, consecutive, interventional study. Four eyes with persistent holes underwent a re-operation. Outcome-related factors were discussed. Results The primary closure rate was 89.5% (34/38). All eyes that underwent the repeated surgery (4 cases) obtained final closure. A hole size of >500 μm has a statistically significant effect on the primary macular hole closure (F = 0.048; φ = 0.38; p ˂ 0.05). In the general group (N = 38), the duration of symptoms directly correlated with age ( ρ = 0.34; p = 0.04), size of the hole ( ρ = 0.66; p ˂ 0.001) and BCVA before surgery ( ρ = 0.59; p ˂ 0.001), after 1 month ( ρ = 0.36; p = 0.03), and after 3 months ( ρ = 0.35; p = 0.03). Preoperative BCVA was better in initially closed cases (Group 1) (U = 26.0; p = 0.05). In the Group 2 with primary unclosed holes, 75% of the eyes (3/4) had an axial length (AL) >26 mm, while in Group 1 such eyes were 12.5 times less (2/34) 5.9% (F = 0.004; φ = 0.63; р ˂ 0.01). The ELM recovery rate at 3 months was 92% (35/38 eyes) and the restoration of EZ at 3 months was 47% (18/38 eyes). Best-corrected visual acuity of all individuals improved significantly from 0.72 ± 0.35 (logMAR) (Me = 0.7; IQR: 0.5–0.8) to 0.25±0.14 (logMAR) (Me = 0.2; IQR: 0.2 – 0.3) at 1 month and 0.17 ± 0.13 (logMAR) (Me = 0.2; IQR: 0.1 – 0.2) at 3 months after surgery (P = 0.0001). Conclusion 25G PPV with ILM and GT for FTMH of different etiology provide satisfactory morphologic and functional outcomes. Elongated AL, large diameter of MH and long duration of symptoms are the risk factors for initial closure. Proper second surgery can obtain satisfactory outcomes for persistent holes.

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“… 66 Nevertheless, the treatment of complicated cases of FTMH, such as postoperative MH or MH associated with high myopia and macular schisis remains challenging. 67 , 68 …”

Section: Discussionmentioning

confidence: 99%

Internal Limiting Membrane Peeling and Gas Tamponade For Full-Thickness Macular Holes of Different Etiology – Is It Still Relevant?

Ruban¹,

Petrovski²,

Petrovski³

et al. 2022

OPTH

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“…Most published studies have focused on acetazolamide and dorzolamide, with nearly all studies reporting therapeutic responses. Tables 1 [8][9][10][11][12][13][14][15][16][17][18][19][20] and 2 [10,11,15,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] summarize studies on the efficacy of systemic and topical CAIs in ME, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…In the case of dome-shaped maculopathy and macular hole, which were surgically repaired, acetazolamide was administered postoperatively for 2 months to facilitate fluid resorption. However, subretinal fluid persisted despite CAI administration and was resolved by adding combined oral spironolactone and topical NSAIDs [ 8 ]. Acetazolamide resulted in anatomical and visual improvements in refractory pseudophakic and uveitis-related CME [ 10 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Carbonic anhydrase inhibitors in the management of macular edema: A review of the literature

Shahsuvaryan¹

2022

Med Hypothesis Discov Innov Ophthalmol

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Background: Macular edema (ME) is a vision-threatening condition that commonly develops as a consequence of ocular diseases, including age-related macular degeneration, retinal vaso-occlusion of the central retinal vein and its branches, diabetic retinopathy, central serous chorioretinopathy, uveitis, retinitis pigmentosa, pseudophakia, ocular trauma, and drug toxicity. The treatment of ME remains challenging, although steroids and vascular endothelial growth factor inhibitors are available. Cost-effective therapy using a noninvasive administration route is required. This study aimed at reviewing the role of carbonic anhydrase inhibitors (CAIs) in the management of ME. Methods: A literature search was conducted using PubMed/MEDLINE and Google Scholar for studies from January 2000 to March 2022. The following keywords were used in various combinations: “macular edema”, “carbonic anhydrase”, “carbonic anhydrase inhibitors”, “acetazolamide”, “dorzolamide”, and “brinzolamide”. Results: Articles with high or medium clinical relevance were selected for this review. We found that multiple studies have demonstrated the relevance and efficacy rates of CAIs in the management of ME. Most published studies focused on acetazolamide and dorzolamide, with nearly all studies reporting therapeutic responses. Conclusions: ME is the leading cause of vision loss and requires noninvasive and cost-effective pharmacotherapy. With progress in the understanding of ME, particularly the role of carbonic anhydrase as a key driver, CAIs are the focus of research. Further optimization of the choice of CAIs and retinal bioavailability, potentially with nanoparticle formulations, is required to enable the effective management of ME. Further research is warranted to address the therapeutic effects of CAIs in different formulations.

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Macular Hole Surgery in Dome-Shaped Maculopathy

Cited by 2 publications

References 19 publications

Internal Limiting Membrane Peeling and Gas Tamponade For Full-Thickness Macular Holes of Different Etiology – Is It Still Relevant?

Internal Limiting Membrane Peeling and Gas Tamponade For Full-Thickness Macular Holes of Different Etiology – Is It Still Relevant?

Carbonic anhydrase inhibitors in the management of macular edema: A review of the literature

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