The use of internal limiting membrane maculorrhexis in treatment of idiopathic macular holes. (1/292)

The purpose of this study was to assess surgical results of internal limiting membrane (ILM) maculorrhexis in macular hole surgery. This study is a part of continuing prospective clinical trial of our team of researchers. Thirteen eyes of 13 patients with idiopathic macular hole underwent vitrectomy with the removal of posterior cortical vitreous, peeling of the macular ILM, and intraocular gas tamponade, followed by postoperative face-down positioning. The excised specimens were evaluated with transmission electron microscopy. Complete closure of the hole was observed in all 13 eyes (100% anatomic success rate). Visual improvement of 2 or more lines on ETDRS visual acuity chart was achieved in 11 (85%) of the 13 eyes. Six (54.5%) eyes attained visual acuity of 20/50 or better. Electron microscopy showed ILM in the removed specimens. ILM maculorrhexis is a promising new surgical approach to close idiopathic macular holes but requires further investigation and long-term evaluation.  (+info)

Estimation of the retinal nerve fibre layer thickness in the papillomacular area of long standing stage IV macular holes. (2/292)

AIM: To compare the thickness of the retinal nerve fibre layer (RNFL) in the papillomacular area of patients with long standing stage IV macular holes with age matched controls, using a scanning laser polarimeter. METHODS: The nerve fibre analyser (NFA) was used to measure the mean thickness of the RNFL around the optic nerve head, the thickness values of temporal and nasal 45 degrees sectors and the integral values in 10 patients with macular holes and in 10 age matched controls. RESULTS: The mean RNFL thickness around the optic nerve head was 79.71 (SD 15.06) microm in the macular hole group and 75.1 (10.8) microm in the control group (p = 0.44). The mean thickness in the temporal sector was 63.69 (12.08) microm in the macular hole group and 58.65 (8.9) microm in the control group (p = 0.3). The mean ratio between the temporal and nasal sector thickness values was 0.8441 in the macular hole group and 0.7819 in the controls (p = 0.42). CONCLUSIONS: There was no significant difference in the thickness of the RNFL in the papillomacular area in the two groups. This suggests that there may be no changes in the thickness of the RNFL in patients with long standing macular holes.  (+info)

Diagnosis and management of idiopathic macular holes. (3/292)

Modern vitreoretinal surgery is now one of the most effective tools for treating posterior segment diseases. Recent advances in the pathogenesis and classification and better indicators of visual outcome for idiopathic macular holes have led to a renewed interest in this clinical entity. Refinements in the techniques and instrumentation have led to improvement in surgical results. This article reviews the diagnosis and management of idiopathic macular holes.  (+info)

Psychophysical observations concerned with a foveal lesion (macular hole). (4/292)

A not uncommon occurrence in elderly people is the development of a 'macular hole' but very few psychophysical observations have been made in such cases. I describe here some distortions of image experienced when I view objects with my right eye which has a macular hole. Objects are distorted by being shrunk towards the fovea. Thus, a disc retains its shape but becomes smaller whereas lines are broken or bent. By analogy with animal experiments it is suggested that the perceptual changes are due to physiological changes in the visual cortex.  (+info)

Prophylactic scleral buckle for prevention of retinal detachment following vitrectomy for macular hole. (5/292)

AIM: To review the rate of retinal detachment after macular hole surgery in patients who received vitrectomy and scleral buckle versus those who had vitrectomy alone. METHODS: All patient charts and hospital records were examined for patients who underwent vitrectomy surgery for macular hole between September 1993 and June 1997. A total of 326 patients were identified and all were followed for a minimum of 6 months. Clinical records were examined for details of the surgical procedure, visual acuity, hole closure status, adjuvant therapies used, and postoperative retinal attachment status. Relative risks (the ratio of the incidence rate in the exposed to that in the unexposed) with 95% confidence intervals and chi(2) tests were calculated to determine which variables were associated with retinal detachment. The primary outcome measure in this review was retinal attachment status. RESULTS: Of 326 eyes which underwent surgery for macular hole during the study period, scleral buckles were utilised in 152 (46.6%) patients. Analysis revealed a detachment rate of 13.2% in patients who did not receive a scleral buckle compared with 5.9% detachment rate in those who did. Analysis of these results indicated a 2.42 times greater risk of developing a retinal detachment in patients without a scleral buckle. Complications related to the use of scleral buckles occurred in two of 152 cases (1.3%) CONCLUSIONS: A reduction in the rate of retinal detachment was noted in patients receiving prophylactic scleral buckles. Those finding suggest a possible beneficial effect of this adjunctive procedure in preventing postoperative retinal detachments. The authors are currently preparing a multicentred, prospective, clinical trial to further study this hypothesis  (+info)

Assessment of macular function by multifocal electroretinogram before and after macular hole surgery. (6/292)

AIM: To evaluate macular function before and after successful surgical closure of idiopathic macular holes using multifocal electroretinogram (ERG). METHODS: 40 patients (40 eyes) with idiopathic macular holes were examined using multifocal ERG both before and after vitreous surgery. The postoperative period was from 1 to 12 months. RESULTS: Preoperatively, the electrical retinal response densities in the foveal and the perifoveal area were apparently decreased. After a mean postoperative period of 3-6 months, the foveal and perifoveal area electrical retinal response densities improved to two to four times the preoperative level and the improvement continued to 1 year after surgery. CONCLUSION: In macular holes, the decrease in retinal electrophysiological response was not limited to the fovea but involved an area of the perifovea of 1.6 disc diameters. The electrical retinal response density of these areas gradually improved after macular hole closure.  (+info)

Juvenile retinoschisis: imaging findings. (7/292)

We present the CT and B-scan sonographic findings in an infant with juvenile retinoschisis, a rare hereditary eye disease, which usually follows an X-linked recessive inheritance pattern.  (+info)

Treatment of retinal tears and lattice degenerations in fellow eyes in high risk patients suffering retinal detachment: a prospective study. (8/292)

BACKGROUND/AIMS: Fellow eye prophylaxis for retinal detachment (RD) is still a controversial issue since opinions are not unanimous regarding the kind of lesions to be treated or the method of treatment. This prospective clinical study aimed to follow the course of vitreoretinal conditions in 150 high risk fellow eyes. METHODS: 150 consecutive patients with unilateral rhegmatogenous RD were included in this study. Inclusion criteria were good explorability of fellow eye retinal periphery and one of the following conditions in the fellow eye-aphakia, pseudophakia with capsulotomy, high myopia (>-6D), contralateral eye to a giant retinal tear. Prophylactic treatment (photocoagulation or scleral buckling) was performed in the presence of retinal tears and lattice degenerations. The state of the vitreous body was determined at the beginning of the study and at the end, when RD occurred. RESULTS: Follow up ranged from 36 to 132 months. 95 fellow eyes were subjected to laser treatment; five eyes underwent prophylactic surgical treatment. Initially, in the treated group posterior vitreous detachment (PVD) was present in 100 eyes (100% of cases), but as a complete PVD only in 42 of them (42%). 10 eyes in the treated group developed RD during the follow up period. In five of these cases the partial PVD had progressed and a retinal tear in a previously healthy area was the cause of the retinal detachment. In the other five eyes RD apparently developed from previously treated lesions. Progression of PVD was evident in four out of these five eyes. The untreated eyes had no visible degenerative lesions. During follow up eight eyes developed RD. These eyes had no PVD at the beginning of the study, but showed a partial PVD at the time of the diagnosis of RD. CONCLUSION: Fellow eyes with pre-existing retinal tears and PVDs can go on to retinal detachment in spite of laser prophylactic treatment. When PVD is not detectable or a partial PVD is present, the progression of posterior vitreous separation can account for retinal tears and RDs arising in formerly healthy areas.  (+info)