Treatment of retinal detachment resulting from myopic macular hole with internal limiting membrane removal

Kadonosono, Kazuaki; Yazama, Futoshi; Itoh, Norihiko; Uchio, Eiichi; Nakamura, Satoshi; Akura, Junsuke; Sawada, Hajime; Ohno, Shigeaki

doi:10.1016/s0002-9394(00)00728-5

Cited by 149 publications

(93 citation statements)

References 15 publications

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“…However, the removal of ILMs is difficult to perform because of poor visibility of the ILMs [4,5,6]. Inappropriate removal of the ILMs poses the risk of damaging the retina [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Indocyanine Green Toxicity to Rat Retinas

et al. 2006

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Purpose: To investigate the toxicity of indocyanine green (ICG) on retinal cells using cultured retinal pigment epithelium (RPE) cells and the effects of intravitreous injection of ICG into rat eyes. Methods: Cultured RPE cells were exposed to various concentrations of ICG for 2 min, a viability assay was performed 1 day after exposure. For an in vivo study, 5 µl of ICG (5 or 25 mg/ml) were injected into the vitreous cavity of rat eyes, which were examined 1, 3 and 7 days after the injection by histological and glutamine synthetase (GS) immunohistological evaluation. Results: Viabilities of RPE cells were decreased dependent on the ICG dose. In the histological evaluation, we observed differences of effects of ICG between the central retinal area and the peripheral area. ICG injection caused degeneration of all retinal layers in the central retinal area. GS immunoreactivities decreased by ICG injection, which corresponded to an area of severe destruction. Conclusion: A high concentration of ICG may cause toxic effects on retinal cells. Mueller cell dysfunction may play some role in the retinal toxicity caused by ICG.

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“…However, the removal of ILMs is difficult to perform because of poor visibility of the ILMs [4,5,6]. Inappropriate removal of the ILMs poses the risk of damaging the retina [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Indocyanine Green Toxicity to Rat Retinas

et al. 2006

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“…Removal of the ILM reduces the risk of subsequent epiretinal membrane formation [14, 18]. ICG staining of the ILM has been used as an adjunctive treatment during vitrectomy for retinal detachment resulting from a myopic eye with a macular hole [4, 19]. In our series, electron microscopy of the excised specimens showed the presence of the ILM in the epiretinal tissue around the macular hole.…”

Section: Discussionmentioning

confidence: 71%

Triamcinolone Acetonide Facilitates Removal of the Epiretinal Membrane and Separation of the Residual Vitreous Cortex in Highly Myopic Eyes with Retinal Detachment due to a Macular Hole

Yamamoto

Ozaki

Murakami³

2004

Ophthalmologica

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Purpose: To study the usefulness of intravitreal triamcinolone acetonide injection during vitrectomy in highly myopic eyes with retinal detachment due to a macular hole. Methods: Pars plana vitrectomy was performed in 6 patients with retinal detachment resulting from a highly myopic eye with a macular hole. After separation of the posterior hyaloid and removal of any visible epiretinal membrane, triamcinolone acetonide was injected over the posterior pole. Excised specimens were evaluated by transmission electron microscopy. Results: Upon injection of triamcinolone acetonide, the entire epiretinal membrane and residual vitreous cortex could be visualized in all patients. The epiretinal membrane and residual posterior vitreous cortex were completely removed. Successful reattachment was performed without retinal damage in all cases. Electron microscopy revealed a cellular epiretinal membrane within a collagenous matrix lining the smooth internal surface of the internal limiting membrane. No complications related to the use of triamcinolone acetonide were encountered. Conclusion: Intraoperative visualization of the epiretinal membrane and residual posterior vitreous cortex with triamcinolone acetonide was found to be a useful adjunct to vitrectomy. Using triamcinolone acetonide during vitrectomy may facilitate both removal of the epiretinal membrane around the macular hole and separation of the residual vitreous cortex from the retina in highly myopic eyes with retinal detachment.

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“…[3][4][5][6][7][8] Oshima et al 3 reported that the initial success rate was 90.9%, and the recurrence rate was 9.1% in 11 eyes with complete ERM removal using a diamond-dust silicone cannula. On the other hand, the success rate was 6.7% and the recurrence rate was 83.3% in six eyes with incomplete ERM removal.…”

Section: Discussionmentioning

confidence: 99%

“…A tangential traction of the macular area is believed to be a major factor although the mechanism causing the MH-RD in highly myopic eyes is still not been conclusively determined. [1][2][3][4][5][6][7] Pars planar vitrectomy (PPV) with the removal of a macular epiretinal membrane (ERM) and gas tamponade is a common and effective method to treat the RD caused by an MH in highly myopic eyes. The complete removal of the ERM has been shown to lead to a high success rate of 84-100%, and to reduce the incidence of a reopening of the MH and resultant RD.…”

Section: Introductionmentioning

confidence: 99%

“…These procedures have led to a success rate of 93.2-100%. [6][7][8] Peyman et al 9 were the first to report that an intravitreal injection of triamicinolone acedonide (TA) during vitrectomy made the ERM more visible and facilitated the complete removal of not only the ERM but also residual posterior hyaloid during the surgery. Since then, Yamamoto et al 10 and Sakaguchi et al 11 have described the usefulness of TA during vitrectomy for treatment of RD due to an MH in small series of highly myopic eyes and reported a 100% successful rate after the first surgery.…”

Section: Introductionmentioning

confidence: 99%

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Anatomical and visual outcome after vitrectomy with triamcinolone acedonide-assisted epiretinal membrane removal in highly myopic eyes with retinal detachment due to macular hole

Fang

Zheng

Weng

et al. 2008

Eye

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Purpose To determine the effectiveness of staining an epiretinal membrane (ERM) with triamicinolone acedonide (TA) during vitrectomy for a retinal detachment (RD) due to a macular hole (MH) in highly myopic eyes. Patients and methods Thirty-four highly myopic eyes (4À6.0 dioptres) of 34 patients with an RD caused by an MH underwent vitrectomy with TA-assisted ERM removal. The excised ERMs from five eyes were examined by transmission electron microscopy (TEM). The main outcome measures were the retinal status and best-corrected visual acuity (BCVA). The anatomic status of the MH was determined by optic coherence tomography (OCT) in 24 successfully retinal-reattached eyes. The follow-up periods ranged from 5 to 20 months. Results The granules of TA adhered to the ERM and the residual posterior hyaloid, which made them more visible and facilitated their removal. Tissues resembling the internal limiting membrane were not detected in any of the five excised tissues. The retinal reattachment rate was 88% after the first surgery. The mean log MAR BCVA significantly improved from 1.83 ± 0.50 (mean±SD) before surgery to 1.22±0.35 at the final follow-up (Po0.001, Wilcoxon signed rank test). OCT showed a normal concave appearance in 11 of 24 eyes (46%), but a central neural epithelial defect was present in 13 of 24 eyes (54%). Conclusions TA facilitates the complete removal of both the ERM and residual posterior hyaloid, thus ensuring high anatomical and visual success rates in highly myopic eyes with an RD due to MH.

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Treatment of retinal detachment resulting from myopic macular hole with internal limiting membrane removal

Cited by 149 publications

References 15 publications

Evaluation of Indocyanine Green Toxicity to Rat Retinas

Evaluation of Indocyanine Green Toxicity to Rat Retinas

Triamcinolone Acetonide Facilitates Removal of the Epiretinal Membrane and Separation of the Residual Vitreous Cortex in Highly Myopic Eyes with Retinal Detachment due to a Macular Hole

Anatomical and visual outcome after vitrectomy with triamcinolone acedonide-assisted epiretinal membrane removal in highly myopic eyes with retinal detachment due to macular hole

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