The Management of Lamellar Macular Holes: A Review

Since its introduction in 1959, artificial intelligence technology has evolved rapidly and helped benefit research, industries and medicine. Deep learning, as a process of artificial intelligence (AI) is used in ophthalmology for data analysis, segmentation, automated diagnosis and possible outcome predictions. The association of deep learning and optical coherence tomography (OCT) technologies has proven reliable for the detection of retinal diseases and improving the diagnostic performance of the eye's posterior segment diseases. This review explored the possibility of implementing and using AI in establishing the diagnosis of retinal disorders. The benefits and limitations of AI in the field of retinal disease medical management were investigated by analyzing the most recent literature data. Furthermore, the future trends of AI involvement in ophthalmology were analyzed, as AI will be part of the decision-making regarding the scientific investigation, diagnosis and therapeutic management.

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“…They obtained an AUROC curve of 0.75. Drusen regression has been shown to precede the progression of non-exudative AMD (49)(50)(51)(52).…”

Section: Deep Learning and Age-related Macular Degenerationmentioning

confidence: 99%

Artificial intelligence and deep learning in ophthalmology - present and future (Review)

Moraru

Costin

Moraru³

et al. 2020

Exp Ther Med

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“…Thus, an earlier intervention that can stabilize the foveal configuration may be advantageous in certain cases. Nevertheless, most of the available studies have only shown a stabilization or possible moderate gain in visual acuity after vitrectomy with ILM peeling in progressive LMHs [10]. Recent publications report similar results with the so-called LHEP embedding technique, in which LHEP becomes embedded in the foveal defect during vitrectomy [13].…”

Section: Discussionmentioning

confidence: 94%

Highly Concentrated Autologous Platelet-Rich Plasma Restores Foveal Anatomy in Lamellar Macular Hole Surgery

Hagenau

Nobl

Vogt

et al. 2021

Klin Monbl Augenheilkd

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Background Lamellar macular holes (LMHs) are an entity of a progressive disease in which the efficacy of the therapy of choice, vitrectomy, seems to be reduced. It is unknown whether highly concentrated autologous platelet-rich plasma (PRP) is of value in the therapy of LMHs. The purpose of this study was to gauge the potential of highly concentrated PRP to restore foveal anatomy in LMH surgery. Patients and Methods In this interventional case series, eight eyes of eight patients with progressive LMH were included. All patients underwent a 23-gauge pars plana vitrectomy with induction of a posterior vitreous detachment and peeling of tractive epiretinal membranes whenever present. Under air tamponade, 0.1 mL of highly concentrated autologous PRP was applied. Subsequently, a gas or air tamponade was performed. All patients were instructed to rest in the supine position for the first 1 to 2 postoperative hours. Best-corrected visual acuity (BCVA) testing, microperimetry, spectral-domain optical coherence tomography (SD-OCT) and fundus photography were performed prior to and 3 months after surgery. Results SD-OCT showed closure of the macular defect with restoration of a normal foveal configuration in all (8 of 8) patients 3 months postoperatively. BCVA improved significantly, from 0.28 ± 0.08 to 0.12 ± 0.14 logMAR (Wilcoxon: p = 0.03). Microperimetry remained unchanged (24.13 ± 1.96 vs. 23.7 ± 1.54 dB; p = 0.46). No clinically significant intra- or postoperative complications were observed. Conclusion The use of highly concentrated PRP enables excellent anatomical and functional outcomes in the surgical therapy of LMH. Further prospective comparative trials are warranted to compare this promising technique with existing surgical strategies.

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“…Such an acute event probably determined the patients to confront their apprehension about coming to a hospital during a lockdown period. Postoperative complications of cataract surgery are also suscepti-ble to be rapidly diagnosed and emergency therapy is of utmost importance (13,14,15,16,17,18). Special interdisciplinary procedures helped reduce the length of hospital stay (18).…”

Section: Discussionmentioning

confidence: 99%

Ophthalmic pathology treated during Covid-19 at the Ophthalmology Clinic of “Sf. Spiridon” County Clinical Emergency Hospital in Iaşi, Romania

Bogdănici

2021

MSJ

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Within the current epidemiological context and due to the increased risk of infectivity, this article focuses on the practical activity of "Sf. Spiridon" Ophthalmology Clinic in Iaşi, during the emergency period (March 16 th -May 16 th , 2020), the evaluated ocular pathology and the approached strategy from the point of view of med ical and surgical vision. Material and methods: As an Emergency Hospital and Tertiary Center of Moldova, Romania "Sf. Spiridon" Hospital in Iaşi was the only hospital in the region that dealt with all the urgent ophthalmological pathology during COVID-19. The clinic worked due to the established protocol, the patient's circuit was changed, with the buffer zone for the suspicious COVID-19 patient, where the patient was hospitalized until the negative PCR result. All patients having a negative PCR test benefited from both medical and / or surgical treatment depending on the type of ocular pathology. Results: 619 patients were examined in the emergency room, of which 61 patients were hospitalized in Clinic I Ophthalmology, "Sf. Spiridon" Hospital in Iaşi, between March 16 and May 16, 2020. Most patients (59%) came from the neighboring counties (Suceava, Vaslui, Piatra Neamţ, Bacău) the rest being from Iaşi (41%). The age varied from 2 to 87 years, the average age being 51.72 ± 22.16. Most frequently, patients were hospitalized with retinal detachment (29.5%), trauma (24.6%) and corneal sclerosis (13.1%), most cases being surgical. The average length of stay was 6.3 days. The average time of surgery stages was 45 minutes. The condition at discharge was in 60% of cases improved and 30% cured. All patients tested negative for COVID-19 PCR. Visual acuity and IOP showed slightly higher / lower changes at discharge than a t the time of admission. Depending on the diagnosis, the average stay for the patients with retinal detachment was about 4 days, while for patients with glaucoma (13 days) or ulcer corneal (12 days), the long-term hospitalization exceeded 12 days. The multivariate analysis showed that about 10% of the number of days spent in hospital (dependent variable) can be e xplained by the diagnosis of hospitalization and the type of intervention. Correlated with the status of discharge, the number of days spent in hospital did not differ significantly. Conclusions: Most of the ophthalmological activity during the pandemic was surgical, due to the large number of trauma cases from neighboring counties, being the only non-COVID-19 hospital in the North-eastern region of Romania. Complying with the protocol suggested by

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The Management of Lamellar Macular Holes: A Review

Cited by 12 publications

References 52 publications

Artificial intelligence and deep learning in ophthalmology - present and future (Review)

Artificial intelligence and deep learning in ophthalmology - present and future (Review)

Highly Concentrated Autologous Platelet-Rich Plasma Restores Foveal Anatomy in Lamellar Macular Hole Surgery

Ophthalmic pathology treated during Covid-19 at the Ophthalmology Clinic of “Sf. Spiridon” County Clinical Emergency Hospital in Iaşi, Romania

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