To study the relation between preoperative macular changes and surgical outcomes in vitreomacular traction syndrome. Prospective study. We prospectively examined 14 eyes of 13 patients (aged 48 to 82 years; mean 66.1)...To study the relation between preoperative macular changes and surgical outcomes in vitreomacular traction syndrome. Prospective study. We prospectively examined 14 eyes of 13 patients (aged 48 to 82 years; mean 66.1) with vitreomacular traction syndrome using optical coherence tomography (OCT) before and after vitreous surgery. OCT demonstrated two types of partial posterior vitreous detachment: incomplete V-shaped detachment in 10 eyes (group 1) and partial detachment temporal to the fovea but attached nasally in 4 eyes (group 2). Preoperative OCT showed foveal retinal detachment in all eyes in group 1; the detached retina was intact in 2 eyes and edematous with (6 eyes) or without (2 eyes) cystic changes. After surgery, these 10 eyes had a normal foveal configuration accompanied by visual improvement. In group 2, 3 of the 4 eyes had prominent cystoid macular edema (CME) without foveal retinal detachment before surgery. After surgery, 2 eyes developed a full-thickness macular hole, 1 had persistent CME, and 1 developed macular atrophy. The visual acuity decreased in 2 eyes and remained the same in 2 eyes. Two types of vitreous traction develop in vitreomacular traction syndrome: an incomplete V-shaped posterior vitreous detachment that leads to foveal retinal detachment, the surgical outcome of which is favorable, and partial posterior vitreous detachment temporal to the fovea in which prominent CME developed, which may result in a macular hole or macular atrophy postoperatively.展开更多
Purpose: To evaluate vitreomacular traction syndrome with ocular coherence tom ography (OCT) retinal mapping before and after vitrectomy. Methods: A prospectiv e study of 11 eyes with vitreomacular traction syndrome w...Purpose: To evaluate vitreomacular traction syndrome with ocular coherence tom ography (OCT) retinal mapping before and after vitrectomy. Methods: A prospectiv e study of 11 eyes with vitreomacular traction syndrome was carried out. Ocular coherence tomography retinal mapping was performed before vitrectomy and 6 month s postoperatively. Visual acuity (VA) was measured with the ETDRS chart. Results : All patients showed a reduction in the thickness of the macular area postopera tively. The mean thickness in the central macular area was 609 μm preoperativel y and 243 μm 6 months postoperatively (P < 0.001). Ten patients had an increase in VA of at least two lines on the ETDRS chart and in one patient VA was unchan ged. The mean improvement in VA was 3.1 lines. Conclusion: Retinal mapping with OCT is a good method of evaluating the thickness of the macula before and after surgery in vitreomacular traction syndrome and vitrectomy improves VA in most cases.展开更多
Purpose: To define serous macular detachment in patients with diabetic cystoid macular oedema (CME). Methods: This study involved 78 eyes of 58 patients with diabetic CME. The patients underwent complete ophthalmic ex...Purpose: To define serous macular detachment in patients with diabetic cystoid macular oedema (CME). Methods: This study involved 78 eyes of 58 patients with diabetic CME. The patients underwent complete ophthalmic examination, fluorescei n angiography and optical coherence tomography (OCT). Eyes with epiretinal membr ane or vitreo-macular traction were not included in the study. Optical coherenc e tomography-3 was used in all patients and fundi were scanned on the horizonta l, vertical and four oblique planes through the centre of the fovea. Results: In all cases the increased thickness of the retina was related primarily to the hy poreflective intraretinal cavities. With OCT, 24 of 78 eyes (31%) had serous ma cular detachment as shown by retinal elevation over a non-reflective cavity wit h minimal shadowing of the underlying tissues. Fluorescein angiography did not s how serous macular detachment in any patient. Conclusions: Our data showed that the incidence of serous macular detachment in diabetic CME was much higher than previously reported. Optical coherence tomography-3 allows an in vivo cross-se ctional observation of very subtle serous macular detachment that is difficult t o diagnose at the slit-lamp or by fluorescein angiography in patients with diab etic CME.展开更多
Objective: To describe a standardized method for reporting quantitative change s in macular thickening using optical coherence tomography (OCT). Methods: The p roposed method consists of calculating the actual change ...Objective: To describe a standardized method for reporting quantitative change s in macular thickening using optical coherence tomography (OCT). Methods: The p roposed method consists of calculating the actual change in central foveal thick ening (the initial pretreatment thickness minus the posttreatment thickness) usi ng OCT and dividing that value by the potential change (the initial pretreatment thickness minus the normal thickness based on normative data) to provide the to tal improvement in macular edema as a percentage. We refer to this method as the standardized change in macular thickening (SCMT). To illustrate the effectivene ss of this method, we performed a retrospective review of 2 studies that evaluat ed different strategies for treating refractory macular edema. Results: Patients treated with intravitreal triamcinolone acetonide for refractory diabetic macul ar edema had an overall SCMT of approximately 75%, 78%, and 55%at the 1-, 3 -, and 6-month follow-up visits, respectively. More than half of the patients in the study cohort (9 of 16 patients) experienced greater than 80%SCMT at the last follow-up visit. Patients who underwent vitrectomy for a taut, thickened posterior hyaloid on OCT responded with an SCMT of approximately 78%at the 3-m onth follow-up visit and 87%at the final follow-up visit (mean, 19 months). P atients who underwent vitrectomy for diabetic macular edema unresponsive to lase r photocoagulation but with no evidence of vitreomacular traction experienced an SCMT of 37%at the 3-month follow-up visit and 20%at the final follow-up vi sit (mean, 17 months). Conclusion: The proposed method offers an objective and i ntuitive basis for evaluating and comparing the efficacy of different therapeuti c modalities.展开更多
文摘To study the relation between preoperative macular changes and surgical outcomes in vitreomacular traction syndrome. Prospective study. We prospectively examined 14 eyes of 13 patients (aged 48 to 82 years; mean 66.1) with vitreomacular traction syndrome using optical coherence tomography (OCT) before and after vitreous surgery. OCT demonstrated two types of partial posterior vitreous detachment: incomplete V-shaped detachment in 10 eyes (group 1) and partial detachment temporal to the fovea but attached nasally in 4 eyes (group 2). Preoperative OCT showed foveal retinal detachment in all eyes in group 1; the detached retina was intact in 2 eyes and edematous with (6 eyes) or without (2 eyes) cystic changes. After surgery, these 10 eyes had a normal foveal configuration accompanied by visual improvement. In group 2, 3 of the 4 eyes had prominent cystoid macular edema (CME) without foveal retinal detachment before surgery. After surgery, 2 eyes developed a full-thickness macular hole, 1 had persistent CME, and 1 developed macular atrophy. The visual acuity decreased in 2 eyes and remained the same in 2 eyes. Two types of vitreous traction develop in vitreomacular traction syndrome: an incomplete V-shaped posterior vitreous detachment that leads to foveal retinal detachment, the surgical outcome of which is favorable, and partial posterior vitreous detachment temporal to the fovea in which prominent CME developed, which may result in a macular hole or macular atrophy postoperatively.
文摘Purpose: To evaluate vitreomacular traction syndrome with ocular coherence tom ography (OCT) retinal mapping before and after vitrectomy. Methods: A prospectiv e study of 11 eyes with vitreomacular traction syndrome was carried out. Ocular coherence tomography retinal mapping was performed before vitrectomy and 6 month s postoperatively. Visual acuity (VA) was measured with the ETDRS chart. Results : All patients showed a reduction in the thickness of the macular area postopera tively. The mean thickness in the central macular area was 609 μm preoperativel y and 243 μm 6 months postoperatively (P < 0.001). Ten patients had an increase in VA of at least two lines on the ETDRS chart and in one patient VA was unchan ged. The mean improvement in VA was 3.1 lines. Conclusion: Retinal mapping with OCT is a good method of evaluating the thickness of the macula before and after surgery in vitreomacular traction syndrome and vitrectomy improves VA in most cases.
文摘Purpose: To define serous macular detachment in patients with diabetic cystoid macular oedema (CME). Methods: This study involved 78 eyes of 58 patients with diabetic CME. The patients underwent complete ophthalmic examination, fluorescei n angiography and optical coherence tomography (OCT). Eyes with epiretinal membr ane or vitreo-macular traction were not included in the study. Optical coherenc e tomography-3 was used in all patients and fundi were scanned on the horizonta l, vertical and four oblique planes through the centre of the fovea. Results: In all cases the increased thickness of the retina was related primarily to the hy poreflective intraretinal cavities. With OCT, 24 of 78 eyes (31%) had serous ma cular detachment as shown by retinal elevation over a non-reflective cavity wit h minimal shadowing of the underlying tissues. Fluorescein angiography did not s how serous macular detachment in any patient. Conclusions: Our data showed that the incidence of serous macular detachment in diabetic CME was much higher than previously reported. Optical coherence tomography-3 allows an in vivo cross-se ctional observation of very subtle serous macular detachment that is difficult t o diagnose at the slit-lamp or by fluorescein angiography in patients with diab etic CME.
文摘Objective: To describe a standardized method for reporting quantitative change s in macular thickening using optical coherence tomography (OCT). Methods: The p roposed method consists of calculating the actual change in central foveal thick ening (the initial pretreatment thickness minus the posttreatment thickness) usi ng OCT and dividing that value by the potential change (the initial pretreatment thickness minus the normal thickness based on normative data) to provide the to tal improvement in macular edema as a percentage. We refer to this method as the standardized change in macular thickening (SCMT). To illustrate the effectivene ss of this method, we performed a retrospective review of 2 studies that evaluat ed different strategies for treating refractory macular edema. Results: Patients treated with intravitreal triamcinolone acetonide for refractory diabetic macul ar edema had an overall SCMT of approximately 75%, 78%, and 55%at the 1-, 3 -, and 6-month follow-up visits, respectively. More than half of the patients in the study cohort (9 of 16 patients) experienced greater than 80%SCMT at the last follow-up visit. Patients who underwent vitrectomy for a taut, thickened posterior hyaloid on OCT responded with an SCMT of approximately 78%at the 3-m onth follow-up visit and 87%at the final follow-up visit (mean, 19 months). P atients who underwent vitrectomy for diabetic macular edema unresponsive to lase r photocoagulation but with no evidence of vitreomacular traction experienced an SCMT of 37%at the 3-month follow-up visit and 20%at the final follow-up vi sit (mean, 17 months). Conclusion: The proposed method offers an objective and i ntuitive basis for evaluating and comparing the efficacy of different therapeuti c modalities.
