To report a new method to perform intraoperative video fluorescein angiography (VFA) using an optical fiber-free intravitreal surgery system (OFFISS) and ret inal blood flow analysis during surgery. Observational case...To report a new method to perform intraoperative video fluorescein angiography (VFA) using an optical fiber-free intravitreal surgery system (OFFISS) and ret inal blood flow analysis during surgery. Observational case series. Four eyes of four patients with macular edema as a result of branch retinal vein occlusion u nderwent vitrectomy and intraoperative VFA with a bolus of 0.8 ml fluorescein dy e. The segmental blood flow was calculated using dye dilution technique. Intraoc ular pressure was maintained at 15 mm Hg. The VFA was clearly recorded with stab le excitation light and very little eye movement under retrobulbar anesthesia. T he segmental blood flow of the affected vessels (6.1 ±.1.2 pixel2/s) was signif icantly lower than that of the healthy vessels (17.9 ±.7.9 pixel2/s) (P < . 05) . The combination of VFAand OFFISS can facilitate intraoperative VFA, and may be useful for evaluating retinal blood flow during surgery.展开更多
Objectives: To determine the effect on the visual outcome after macular hole s urgery when staining the internal limiting membrane (ILM) with indocyanine green (ICG) dye and to study the mechanism of the adverse effec...Objectives: To determine the effect on the visual outcome after macular hole s urgery when staining the internal limiting membrane (ILM) with indocyanine green (ICG) dye and to study the mechanism of the adverse effects. Patients and Metho ds: We studied 40 eyes of 38 patients with an idiopathic macular hole (size,< 0. 5 disc diameter; duration,< 12 months). The concentration, exposure time, and am ount of the ICG solution that was minimally required to make the ILM visible wer e determined. The patients were randomly divided into group 1 (20 eyes of 19 pat ients) who underwent ILM peeling without ICG staining, and group 2 (20 eyes of 19 patients) who underwent ILM peeling with ICG staining. Routine examinations were conducted during the 12-month follow-u p period. Multifocal electroretinogram, optical coherence tomography, and fluore scein angiography were performed on 31 eyes of 30 patients. Results: The macular hole was closed in all patients. Visual acuity was improved in both groups, but it was significantly better in group 1 (median, 0.85) than in group 2 (median, 0.60; P=0.02) after 12 months. The improvement of visual acuity in group 1 (loga rithm of the minimum angle of resolution log-MAR units SD, 0.82 0.19)was significantly better than that in group 2 (logMAR units, 0.67 0.21; P=0.30). T he multifocal electroretinogram and optical coherence tomographic findings were not significantly different in the 2 groups. Fluorescein angiogram showed only w eak hyperfluorescence at the macula in some patients of both groups. Conclusions : The results suggest that ICG staining should not be used as long as the visibi lity of the retinal surface is good. However, ICG staining may be acceptable at a low concentration when a clear view of the retinal surface is unattainable. Th e results of the multifocal electroretinogram, optical coherence tomography, and fluorescein angiography suggest that the differences in visual recovery were ca used not only by pigment epithelial cell damage or retinal toxic effect but also probably by the effect of ICG staining on ganglion cells and their axons.展开更多
PURPOSE: To report a case of central retinal vein occlusion (CRVO) that had vitrectomy with radial optic neurotomy (RON), but the retinal blood flow(RBF) was still reduced 1 year later. DESIGN: Interventional case rep...PURPOSE: To report a case of central retinal vein occlusion (CRVO) that had vitrectomy with radial optic neurotomy (RON), but the retinal blood flow(RBF) was still reduced 1 year later. DESIGN: Interventional case report. METHODS: An 80-year-old woman had undergone vitrectomy and RON for a CRVO. She had a complete ophthalmic examination, including the RBF analysis using the dye dilutionmethod before and after RON. RESULTS: Seven months after RON, her visual acuity improved from 20/50 to 20/25, and her foveal thicknesswas decreased from 733 to 213 μm. Indocyanine green angiography demonstrated chorioretinal anastomoses. At 1 year postoperatively, the RBF was reduced from 23.2 to 18 0.1 pixel2/s, and the foveal thickness was increased to 767 μm. Her visual acuity decreased to 20/100. The chorioretinal anastomoses were still patent. CONCLUSIONS: These results demonstrate that a further reduction of RBF can occur after RON, and blood flow in the chorioretinal anastomoses may be insufficient to prevent the event.展开更多
文摘To report a new method to perform intraoperative video fluorescein angiography (VFA) using an optical fiber-free intravitreal surgery system (OFFISS) and ret inal blood flow analysis during surgery. Observational case series. Four eyes of four patients with macular edema as a result of branch retinal vein occlusion u nderwent vitrectomy and intraoperative VFA with a bolus of 0.8 ml fluorescein dy e. The segmental blood flow was calculated using dye dilution technique. Intraoc ular pressure was maintained at 15 mm Hg. The VFA was clearly recorded with stab le excitation light and very little eye movement under retrobulbar anesthesia. T he segmental blood flow of the affected vessels (6.1 ±.1.2 pixel2/s) was signif icantly lower than that of the healthy vessels (17.9 ±.7.9 pixel2/s) (P < . 05) . The combination of VFAand OFFISS can facilitate intraoperative VFA, and may be useful for evaluating retinal blood flow during surgery.
文摘Objectives: To determine the effect on the visual outcome after macular hole s urgery when staining the internal limiting membrane (ILM) with indocyanine green (ICG) dye and to study the mechanism of the adverse effects. Patients and Metho ds: We studied 40 eyes of 38 patients with an idiopathic macular hole (size,< 0. 5 disc diameter; duration,< 12 months). The concentration, exposure time, and am ount of the ICG solution that was minimally required to make the ILM visible wer e determined. The patients were randomly divided into group 1 (20 eyes of 19 pat ients) who underwent ILM peeling without ICG staining, and group 2 (20 eyes of 19 patients) who underwent ILM peeling with ICG staining. Routine examinations were conducted during the 12-month follow-u p period. Multifocal electroretinogram, optical coherence tomography, and fluore scein angiography were performed on 31 eyes of 30 patients. Results: The macular hole was closed in all patients. Visual acuity was improved in both groups, but it was significantly better in group 1 (median, 0.85) than in group 2 (median, 0.60; P=0.02) after 12 months. The improvement of visual acuity in group 1 (loga rithm of the minimum angle of resolution log-MAR units SD, 0.82 0.19)was significantly better than that in group 2 (logMAR units, 0.67 0.21; P=0.30). T he multifocal electroretinogram and optical coherence tomographic findings were not significantly different in the 2 groups. Fluorescein angiogram showed only w eak hyperfluorescence at the macula in some patients of both groups. Conclusions : The results suggest that ICG staining should not be used as long as the visibi lity of the retinal surface is good. However, ICG staining may be acceptable at a low concentration when a clear view of the retinal surface is unattainable. Th e results of the multifocal electroretinogram, optical coherence tomography, and fluorescein angiography suggest that the differences in visual recovery were ca used not only by pigment epithelial cell damage or retinal toxic effect but also probably by the effect of ICG staining on ganglion cells and their axons.
文摘PURPOSE: To report a case of central retinal vein occlusion (CRVO) that had vitrectomy with radial optic neurotomy (RON), but the retinal blood flow(RBF) was still reduced 1 year later. DESIGN: Interventional case report. METHODS: An 80-year-old woman had undergone vitrectomy and RON for a CRVO. She had a complete ophthalmic examination, including the RBF analysis using the dye dilutionmethod before and after RON. RESULTS: Seven months after RON, her visual acuity improved from 20/50 to 20/25, and her foveal thicknesswas decreased from 733 to 213 μm. Indocyanine green angiography demonstrated chorioretinal anastomoses. At 1 year postoperatively, the RBF was reduced from 23.2 to 18 0.1 pixel2/s, and the foveal thickness was increased to 767 μm. Her visual acuity decreased to 20/100. The chorioretinal anastomoses were still patent. CONCLUSIONS: These results demonstrate that a further reduction of RBF can occur after RON, and blood flow in the chorioretinal anastomoses may be insufficient to prevent the event.
