Purpose:To evaluate the autologous translocation of peripheral choroid and retinal pigment epithelium(RPE)in 45 eyes of 43 patients with age-related macular degeneration(AMD).Design:Prospective nonrandomized study.Met...Purpose:To evaluate the autologous translocation of peripheral choroid and retinal pigment epithelium(RPE)in 45 eyes of 43 patients with age-related macular degeneration(AMD).Design:Prospective nonrandomized study.Methods:All patients had visual loss due to AMD(n=5 classic membranes,n=14 occult,n=2 mixed,n=16 pigment epithelial detachment(PED),n=5 subretinal hemorrhage,n=3 geographic atrophy).After extraction of the neovascular complex,an autologous peripheral full-thickness explant of RPE,Bruch membrane,and choroid was translocated from the midperiphery to themacula.Results:Preoperative distant visual acuity ranged from 20/800 to 20/40.Reading vision ranged from 1.4 logarithm of reading acuity determination(logRAD)to 0.5 logRAD(0.04 to 0.32 Snellen equivalent).Revision surgery was required in 22 eyes as a result of proliferative vitreoretinopathy(PVR),retinal detachment,macular pucker,or vitreous hemorrhage.In eight patients,the patch was renewed.At six months,distant visual acuity ranged from light perception to 20/50(increase of 15 letters in four eyes).Reading vision ranged from 1.4 to 0.4 logRAD.Visual outcome was unrelated to the type of AMD.Vascularization of the transplant was visible on indocyanine green(ICG)angiography in 40 of 42 eyes.In most patients,autofluorescence of the pigment epithelium was coincident with revascularization of the graft.Fixation on the patch was positively related to visual acuity.Conclusions:Autologous translocation of a full thickness transplant of choroid and RPE usually results in a vascularized and functioning graft.Vascularization was even achieved in patients with geographic atrophy.Fixation stability and microperimetry before the patch translocation may be helpful in selecting patients who will profit from surgery.展开更多
PURPOSE: To demonstrate the plane of premacular hemorrhage in Valsalva retinopathy with optical coherence tomography.DESIGN: Observational case report METHODS: Two young men with Valsalva stress-related premacular hem...PURPOSE: To demonstrate the plane of premacular hemorrhage in Valsalva retinopathy with optical coherence tomography.DESIGN: Observational case report METHODS: Two young men with Valsalva stress-related premacular hemorrhage were evaluated by OCT scans, taken just above the level of sedimented blood. RESULTS: In both cases, OCT demonstrated two distinct membranes: a highly reflective band immediately above the premacular hemorrhage, corresponding to the internal limiting membrane, and an overlying patchy membrane with low optical reflectivity consistent with posterior hyaloid. CONCLUSION: OCT supported the clinical impression that the plane of premacular hemorrhage in Valsalva retinopathy is probably under ILM. Larger case studies are required to confirm this finding.展开更多
Purpose To describe a patient with resolved hypotony maculopathy with a persis tent retinal fold (despite normalization of intraocular pressure [IOP]) who un de rwent successful surgical intervention by vitrectomy, in...Purpose To describe a patient with resolved hypotony maculopathy with a persis tent retinal fold (despite normalization of intraocular pressure [IOP]) who un de rwent successful surgical intervention by vitrectomy, internal limiting membrane peel, and gas tamponade. Design Interventional case report. Methods A 55 year old man with a hypotony induced macular retinal fold that did not improve fol lowing normalization of IOP underwent vitrectomy, internal limiting membrane pee ling, and gas injection. Optical coherence tomography scans were performed both before and after surgery. Results Best corrected visual acuity (BCVA) improved from 6/60 preoperatively to 6/9, with improvement in distortion. On repeat optic al coherence tomography examination, the macular retinal fold had resolved. Conc lusion Vitrectomy, internal limiting membrane peeling and gas tamponade may be u seful for cases of resolved hypotonymaculopathy complicated by a persistentmacul ar fold after normalization of IOP.展开更多
文摘Purpose:To evaluate the autologous translocation of peripheral choroid and retinal pigment epithelium(RPE)in 45 eyes of 43 patients with age-related macular degeneration(AMD).Design:Prospective nonrandomized study.Methods:All patients had visual loss due to AMD(n=5 classic membranes,n=14 occult,n=2 mixed,n=16 pigment epithelial detachment(PED),n=5 subretinal hemorrhage,n=3 geographic atrophy).After extraction of the neovascular complex,an autologous peripheral full-thickness explant of RPE,Bruch membrane,and choroid was translocated from the midperiphery to themacula.Results:Preoperative distant visual acuity ranged from 20/800 to 20/40.Reading vision ranged from 1.4 logarithm of reading acuity determination(logRAD)to 0.5 logRAD(0.04 to 0.32 Snellen equivalent).Revision surgery was required in 22 eyes as a result of proliferative vitreoretinopathy(PVR),retinal detachment,macular pucker,or vitreous hemorrhage.In eight patients,the patch was renewed.At six months,distant visual acuity ranged from light perception to 20/50(increase of 15 letters in four eyes).Reading vision ranged from 1.4 to 0.4 logRAD.Visual outcome was unrelated to the type of AMD.Vascularization of the transplant was visible on indocyanine green(ICG)angiography in 40 of 42 eyes.In most patients,autofluorescence of the pigment epithelium was coincident with revascularization of the graft.Fixation on the patch was positively related to visual acuity.Conclusions:Autologous translocation of a full thickness transplant of choroid and RPE usually results in a vascularized and functioning graft.Vascularization was even achieved in patients with geographic atrophy.Fixation stability and microperimetry before the patch translocation may be helpful in selecting patients who will profit from surgery.
文摘PURPOSE: To demonstrate the plane of premacular hemorrhage in Valsalva retinopathy with optical coherence tomography.DESIGN: Observational case report METHODS: Two young men with Valsalva stress-related premacular hemorrhage were evaluated by OCT scans, taken just above the level of sedimented blood. RESULTS: In both cases, OCT demonstrated two distinct membranes: a highly reflective band immediately above the premacular hemorrhage, corresponding to the internal limiting membrane, and an overlying patchy membrane with low optical reflectivity consistent with posterior hyaloid. CONCLUSION: OCT supported the clinical impression that the plane of premacular hemorrhage in Valsalva retinopathy is probably under ILM. Larger case studies are required to confirm this finding.
文摘Purpose To describe a patient with resolved hypotony maculopathy with a persis tent retinal fold (despite normalization of intraocular pressure [IOP]) who un de rwent successful surgical intervention by vitrectomy, internal limiting membrane peel, and gas tamponade. Design Interventional case report. Methods A 55 year old man with a hypotony induced macular retinal fold that did not improve fol lowing normalization of IOP underwent vitrectomy, internal limiting membrane pee ling, and gas injection. Optical coherence tomography scans were performed both before and after surgery. Results Best corrected visual acuity (BCVA) improved from 6/60 preoperatively to 6/9, with improvement in distortion. On repeat optic al coherence tomography examination, the macular retinal fold had resolved. Conc lusion Vitrectomy, internal limiting membrane peeling and gas tamponade may be u seful for cases of resolved hypotonymaculopathy complicated by a persistentmacul ar fold after normalization of IOP.
