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Comparison of anatomical and functional outcomes of different surgical techniques in myopic macular hole without retinal detachment

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International Journal of Ophthalmology(English edition) 2023年第10期16卷 1651-1656页

作者： Merve Ozbek Sehnaz Ozcaliskan Cengiz Alagoz Ozgur Artunay Department of Ophthalmology Beyoglu Eye Training and Research HospitalIstanbul 34421Türkiye

AIM:To define the anatomic and functional outcomes of pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling,inverted ILM flap and free ILM patch graft technique for the treatment of myopic macular hole(MH)without retinal ***:Sixty-four eyes of 64 patients who underwent PPV for myopic MH were *** 1 consists of patients underwent ILM peeling(n=26),and Groups 2 and 3 consists of patient underwent free ILM patch graft(n=20)and inverted ILM flap procedure(n=18)*** following surgery were MH closure and best corrected visual acuity(BCVA)in logMAR at ***:Closure of MH was obtained in 20 eyes(76.9%)of the Group 1,in 16 eyes(80%)of the Group 2 and in 16 eyes(88.9%)of the Group *** mean preoperative and postoperative BCVA was 1.60±0.53 logMAR and 1.27±0.58 logMAR,respectively(Pmyopic MH *** flap techniques offer higher closure rates compared to ILM peeling ***,in terms of visual outcomes,the study reveals no difference in three surgical techniques.

关键词： free internal limiting membrane patch graft inverted internal limiting membrane flap myopic macular hole internal limiting membrane peeling

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Long-Term Postoperative Perfusion Indices in Surgically Resolved myopic Traction Maculopathy

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Open Journal of Ophthalmology 2023年第1期13卷 143-171页

作者： Miguel A. Quiroz-Reyes Erick A. Quiroz-Gonzalez Miguel A. Quiroz-Gonzalez Virgilio Lima-Gomez Oftalmologia Integral ABC Retina Specialists Unit Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico Mexico City Mexico Institute of Ophthalmology Fundacion Conde de Valenciana Private Assistance Institution (Nonprofit Organization) Mexico City Mexico Juarez Hospital Public Assistance Institution (Nonprofit Organization) Mexico City Mexico

Background: Pathological myopia can be complicated by the presence of posterior staphyloma, macular atrophy, ruptures in Bruch’s membrane, pathologic choroidal neovascularization, and different degrees of myopic traction maculopathy. Purpose: To report the structural, functional and perfusional outcomes in patients underwent surgery for different stages of myopic traction maculopathy (MTM). Methods: A retrospective, consecutive, comparative, interventional, one-surgeon, case-control study was conducted in 46 eyes of 34 individuals between April 2015 and May 2021. Participants included normal emmetropic eyes (Control emmetropia, n = 25), healthy myopic eyes (Control high myopia, n = 20), and operated and structurally fully resolved myopic eyes with different stages of MTM (Surgically treated group, n = 46). Long-term postoperative functional and perfusional follow-up evaluations were performed with spectral domain-optical coherence tomography (SD-OCT) and OCT angiography. The primary outcome measure included long-term functional, structural and perfusion macular status across groups. Results: Forty-six eyes in 34 patients were included in the study group, with both eyes affected in 12 (26.3%) patients. The mean axial length was 29.89 ± 1.67 mm. The preoperative logMAR was 1.29 ± 0.54 and the postoperative logMAR was 0.60 ± 0.52 (P Conclusion: Compared to emmetropic and healthy myopic eyes, surgically-resolved MTM eyes generally have larger superficial foveal avascular zone area, lower vessel density, smaller choriocapillaris flow area, thinner central subfoveal thickness, and more macular defects. Eyes with stage III or IV MTM had larger deviation compared to eyes at earlier stages. Visual function change after surgery was associated with superficial foveal avascular zone area. Better functional, structural and perfusion index outcomes were observed when highly myopic eyes underwent early surgery.

关键词： Choriocapillaris Flow Area Deep Vascular Plexus Foveoretinal Detachment myopic Foveoschisis Foveal Avascular Zone myopic macular hole

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Resolving myopic Foveoretinal Detachment by Fovea-Saving Internal Limiting Membrane Peeling: A Case-Series Report

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Open Journal of Ophthalmology 2023年第1期13卷 106-121页

作者： Miguel Angel Quiroz-Reyes Erick Andres Quiroz-Gonzalez Miguel Angel Quiroz-Gonzalez Virgilio Lima-Gomez Oftalmologia Integral ABC Retina Department Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico Mexico City Mexico Juarez Hospital Public Assistance Institution (Nonprofit Organization) Mexico City Mexico

Background: In highly myopic eyes, myopic foveoschisis (MF), the earliest stage of myopic traction maculopathy (MTM), is present in up to 34% of patients with pathologic myopia and slowly progresses to form foveoretinal detachment (FRD) or macular hole (MH) with or without macular hole retinal detachment (MHRD) as a part of its natural history. Aim: To describe the microstructural and functional results in three highly myopic eyes that underwent macular surgery for early-stage MTM. The last postoperative structural findings were correlated with the final vision and macular automated microperimetry evaluation. Methods: We retrospectively reviewed three highly myopic eyes that underwent successful fovea-saving internal limiting membrane (FS-ILM) macular surgery for chronic FRD at Oftalmologia Integral ABC, Mexico City, Mexico. We performed postoperative multimodal microstructural and functional evaluations, including SD-OCT, SS-OCT, and microperimetric macular examinations. Results: There was a substantial difference between best-corrected visual acuity (BCVA) preoperatively and postoperatively in all three cases. Postoperative surgery was associated with significant improvement in visual acuity confirmed using a paired-sample permutation test. The mean presurgical BCVA value (LogMAR;mean ± SE) was ~0.83 ± 0.15, and the postsurgical value was ~0.43 ± 0.52 (P = 0.00065). The myopic foveoretinal detachment evaluation was ~7.3 ± 3.5 months, with a mean postoperative follow-up time of ~14 ± 4.08 months. Furthermore, postoperative multimodal imaging tests demonstrated an abnormal microstructural foveal SS-OCT pattern without evidence of macular hole (MH) development at the postoperative follow-up. macular microperimetry confirmed a subclinical reduced macula threshold sensitivity with an anomalous retinal sensitivity analysis map and a stable central foveal fixation site. Conclusions: Even with the successful microstructural disappearance of myopic macular detachment, the

关键词： Automated Microperimetry myopic Foveoretinal Detachment myopic Foveoschisis myopic macular hole myopic Traction Maculopathy Posterior Staphyloma

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