Prognostic factor analysis of vitrectomy for myopic foveoschisis

Lim, Laurence Shen; Wong, Doric; Wong, Edmund; Yeo, Ian; Ang, C. H.; Kim, Leo A.; Vavvas, Demetrios G.; Lee, Shu Yen

doi:10.1136/bjophthalmol-2015-306885

Cited by 16 publications

(18 citation statements)

References 31 publications

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“…Intraoperative gas tamponade itself could contribute to a better prognosis, but compared with other factors, the effect on visual outcome was relatively small. Several articles estimating prognostic factors have recently been published [11,12,23]. Lim et al [12] demonstrated that preoperative ellipsoid disruption and thinner CFT were related to poor prognosis after PPV in MF patients.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative visual acuity [11] and various OCT findings, as well as operative techniques, have been identified as prognostic factors in this respect. For example, preoperative ellipsoid disruption and thinner central foveal thickness (CFT) are known to be useful OCT findings [12]. However, the usefulness of gas tamponade or ILM peeling remains controversial [13][14][15], and the role of additional factors remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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Surgical outcome and prognostic factors influencing visual acuity in myopic foveoschisis patients

Lee

Moon

Kang

et al. 2019

Eye

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Background To analyze the optical coherence tomography (OCT) characteristics and visual outcome of vitrectomy in myopic foveoschisis (MF) patients and identify prognostic factors. Methods This study is a retrospective clinical cohort study in tertiary care hospital. Thirty-two eyes of 32 patients who underwent MF-related vitrectomy in were investigated retrospectively. Best-corrected visual acuity (BCVA) measured at 1 year post surgery and changes in central foveal thickness (CFT) and co-existing macular pathologies, such as foveal detachment (FD), lamellar holes, and macular holes were the main outcome measures. Prognostic factors were identified using multivariate linear regression analysis. Results Average BCVA (in logarithm of the minimum angle of resolution) and mean CFT had improved from 0.46 ± 0.06 to 0.37 ± 0.07 (P = 0.089) and from 485.72 ± 164.69 to 341.71 ± 109.70 (P < 0.001), respectively. Univariate analysis identified baseline BCVA, epiretinal membrane, no coexisting OCT features other than MF, FD on OCT, and gas injection as significantly associated with visual outcome (P < 0.001, 0.014, 0.022, < 0.001, and 0.030). Better baseline BCVA and absence of FD on OCT remained significant (P < 0.001 and < 0.001, respectively) after multivariate analysis. Conclusion Good preoperative visual acuity and absence of FD pre-surgery are important predictors of good visual prognosis. Thus, timely surgical intervention, before development of macular complications, may improve visual outcome after surgical treatment of patients with MF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical outcome and prognostic factors influencing visual acuity in myopic foveoschisis patients

Lee

Moon

Kang

et al. 2019

Eye

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“…Lappen der Limitans-interna-Membran zur Behandlung von großen Makulalöchern: anatomische und funktionelle Kurzzeitergebnisse Background A macular hole (MH) is a full-thickness neuroretinal defect of the fovea causing a reduction in central vision. Although anatomical success following primary pars plana vitrectomy (PPV) and internal limiting membrane peel (ILM) with gas tamponade have improved to 60-100 %, closure rates are significantly lower in large MH (> 400 µm), atrophic MH and MH associated with high myopia [1,2]. In 2010, Michalewska et al described a technique for the primary repair of large MHs, where a remnant of an incompletely peeled ILM was used to cover the base of the hole [3].…”

Section: Internal Limiting Membrane Flap Techniques For the Repair Ofmentioning

confidence: 99%

Internal Limiting Membrane Flap Techniques for the Repair of Large Macular Holes: a Short-Term Follow-up of Anatomical and Functional Outcomes

Guber

Lang

Valmaggia

2017

Klin Monatsbl Augenheilkd

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To evaluate the technique of inverted internal limiting membrane (ILM) flaps for the management of large macular holes and autologous ILM free flaps for non-closing macular holes. All macular holes were treated with pars plana vitrectomy and dual blue assisted ILM flap technique. The inverted ILM flap was created as a primary procedure for large macular holes (diameter> 400 µm). On the other hand, the free ILM flap technique was used as a secondary procedure for non-closing macular holes after failed initial standard procedure. SD-OCT images were taken to assess the anatomical outcome of surgery, while best corrected visual acuity (BCVA) was used to evaluate the functional outcome during a 2-month follow-up. All patients underwent successful planned manipulation of the ILM flap. In seven patients/eyes, an inverted ILM flap was created, in three patients/eyes a free ILM flap translocation was performed. All patients achieved complete anatomical closure. Partial microstructural reconstruction, demonstrated on SD-OCT as restoration of the external limiting membrane and the ellipsoid zone, was observed in some cases as early as one month after surgery. Functionally, in comparison to baseline, most of the patients showed improvements in BCVA of 1 to 2 lines at the first postoperative follow-up visit. Inverted ILM flaps for large macular holes and free flaps for non-closing macular holes appear to be a safe and effective approach, with favourable short-term anatomical and functional results.

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“…Einführung Das Makulaloch (ML) ist ein Netzhautdefekt der Fovea, welcher das zentrale Sehen beeinträchtigt. Obwohl in 60-100 % der Fälle ein anatomischer Verschluss nach primärer Pars-plana-Vitrektomie (PPV) mit Membrana-limitans-interna-Peeling (ILM-Peeling) und Gasendotamponade erzielt wird, sind die Verschlussraten bei größeren ML (> 400 µm), atrophen ML sowie ML bei hoher Myopie tendenziell geringer [1,2]. Im Jahr 2010 haben Michalewska et al eine neue Technik für die Erstbehandlung von großen ML vorgestellt.…”

Section: Long-term Outcome After Autologous Free Internal Limiting Meunclassified

Langzeitergebnis nach autologer Membrana-limitans-interna-Lappenplastik bei nicht verschlossenem Makulaloch

Guber

Vieregge

Scholl

et al. 2018

Klin Monatsbl Augenheilkd

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Zusammenfassung Ziel Das Ziel dieser Studie ist es, die Operationstechnik sowie die Langzeitergebnisse nach freiem autologem Membrana-limitans-interna-Lappen (ILM-Lappen) für nicht verschlossene Makulalöcher zu evaluieren. Methoden Die freie ILM-Lappentechnik wurde als sekundäres Verfahren für nicht schließende Makulalöcher nach fehlgeschlagenem initialem Standardverfahren verwendet. Um das anatomische Ergebnis der Operation zu beurteilen, wurden optische Kohärenztomografie-Aufnahmen (SD-OCT-Aufnahmen) postoperativ durchgeführt, während die bestkorrigierte Sehschärfe (BCVA) verwendet wurde, um das funktionelle Ergebnis zu beurteilen. Alle Patienten wurden über einen Zeitraum von 1 Jahr nachkontrolliert. Ergebnisse Insgesamt wurden 5 Augen eingeschlossen. Bei allen Patienten konnte das Makulaloch mittels ILM-Lappen erfolgreich verschlossen werden. Eine partielle retinale Regeneration, die als Wiederherstellung der äußeren Grenzmembran und der Ellipsoidzone im SD-OCT dargestellt werden konnte, wurde in allen Fällen beobachtet. Funktionell zeigten die meisten Patienten Verbesserungen der BCVA von 1 – 2 Linien. Fazit Die autologe ILM-Lappentechnik bei persistierenden Makulalöchern scheint ein sicherer und effektiver Ansatz zu sein. Insgesamt zeigen sich gute anatomische und funktionelle Langzeitergebnisse.

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Prognostic factor analysis of vitrectomy for myopic foveoschisis

Abstract: Eyes with myopic foveoschisis with preoperative ellipsoid disruption and thinner central foveal thickness tend to have poorer visual outcomes. While current surgical manoeuvres are effective in reattaching the fovea, they may also cause iatrogenic injury to the photoreceptors.

Cited by 16 publications

References 31 publications

Surgical outcome and prognostic factors influencing visual acuity in myopic foveoschisis patients

Surgical outcome and prognostic factors influencing visual acuity in myopic foveoschisis patients

Internal Limiting Membrane Flap Techniques for the Repair of Large Macular Holes: a Short-Term Follow-up of Anatomical and Functional Outcomes

Langzeitergebnis nach autologer Membrana-limitans-interna-Lappenplastik bei nicht verschlossenem Makulaloch

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