A novel surgical technique of internal limiting membrane peeling for high myopic foveoschisis:a wide range of whole piece consecutive peeling without preservation of epi-fovea

AIM:To demonstrate an improved surgical technique of whole piece consecutive internal limiting membrane(ILM) peeling without preservation of the epi-fovea to treat high myopic foveoschisis(MF).METHODS:A 23-gauge 3-port pars plana vitrectomy was performed on 16 patients with high MF.A parallel arc line along the vascular arcades was scraped out with a curved membrane scraper DSP.Next,an ILM forceps was used to catch hold of the incisal edge of the ILM flap,and the action of releasing and separating was subsequently taken toward the direction of the macular fovea.Next,the ILM forceps was used to grasp the released area,and the whole area coherent ILM peeling covering the macular fovea was implemented thereafter.Finally,the ILM was folded backwards and peeled off in the arc direction.RESULTS:At the final visit,the average central macular thickness decreased remarkably from 423.76±177.67 to 178.24±66.21 μm.The mean logarithm of the minimum angle of resolution best-corrected visual acuity of 1.37±0.59 was significantly alleviated to 0.74±0.59.CONCLUSION:The wide range of whole piece consecutive ILM peeling without preservation of the epifovea is proven to be effective and significantly reduced the occurrence of retinal tear and macular hole.

2例日光性视网膜病变患者的多焦视网膜电图和光学相干断层扫描表现

Purpose: Clinical investigation of central retinal dysfunction in two cases of solar retinopathy. Methods: Two patients were examined for best corrected visua l acuity (VA), fundus inspection, visual fields, multifocal electroretinography (mfERG) with a stimulus pattern of 241 hexagons and, at follow-up, also with op tical coherence tomography (OCT). Results: At the initial examination, mfERG rev ealed central retinal dysfunction, which had improved by the time of follow-up. In Case 1, a foveal oedema regressed over time, although VA remained slightly r educed. In Case 2, OCT showed spots of increased reflectivity corresponding to t he patient’s symptoms. Conclusion: Central retinal dysfunction due to solar ret inopathy may improve over time. However, structural and functional changes may p ersist. This report illustrates that mfERG and OCT are useful tools for objectiv e documentation of the pathology in solar retinopathy.

2型糖尿病性视网膜病变的定量分析:筛选可预测继发于糖尿病黄斑病变的视力损害进展参数

Purpose: To describe whether quantitative assessment of early changes in the m orphology of retinopathy lesions can predict development of vision-threatening diabetic maculopathy. Methods: We used a nested case-control study, and we stud ied 11 type 2 diabetes patients who had developed visual loss secondary to diabe tic maculopathy. For each diabetes patient, we also studied three matched contro l patients who had been followed for a comparable period of time without develop ing visual loss. Fundus photographs describing the early development of retinopa thy were digitized and subjected to a full manual quantitative grading on a comp uter monitor. Differences in the early development of retinal morphology were co mpared between the two groups. The outcome parameters were changes in the number and area of haemorrhages and exudates in different regions of the fundus, and t he weighted distance of these lesions from the fovea and the optic disc. Results : In patients who developed visual loss secondary to diabetic maculopathy there was significant early progression in the total area and number of haemorrhages a nd exudates. The haemorrhages had progressed in all retinal areas except the area around th e optic disc and the temporal vascular arcades. The exudates had progressed temp orally from the fovea and in the retinal periphery. Conclusions: The results sug gest that a quantitative description of the regional development of early diabet ic retinopathy may help in identifying patients who will later develop vision-t hreatening maculopathy.