International Journal of Retina and Vitreous最新文献

{"title":"Blue light reflectance imaging in non-perfusion areas detection: insights from multimodal analysis.","authors":"Ricardo Leitão Guerra, Gabriel Castilho Sandoval Barbosa, Cezar Leitão Guerra, Emmerson Badaro, Luiz Roisman, Luiz Filipe Lucatto, Eduardo Novais","doi":"10.1186/s40942-024-00602-z","DOIUrl":"10.1186/s40942-024-00602-z","url":null,"abstract":"<p><strong>Design: </strong>A retrospective, cross-sectional image analysis using a convenience sample.</p><p><strong>Subjects: </strong>Five cases selected based on the availability of comprehensive imaging data.</p><p><strong>Methods: </strong>This study involved a retrospective review of images from five cases, focusing on the use of retinal monochromatic blue light reflectance (BLR) imaging to detect non-perfusion areas. Two cases of sickle-cell retinopathy demonstrated peripheral retinal non-perfusion identified through widefield fluorescein angiography. Three other cases-one with branch retinal vein occlusion, one with branch retinal artery occlusion, and one presenting paracentral acute middle maculopathy showed focal macular non-perfusion detected by structural OCT and OCTA. The areas of nonperfused retinal tissue, confirmed by fluorescein angiography, OCT, and OCTA, were then correlated with findings from the BLR image. This correlation aimed to identify any potential associations between these imaging modalities.</p><p><strong>Main outcome measures: </strong>Enhance understanding of the utilization of retinal monochromatic BLR images as a non-perfusion biomarker.</p><p><strong>Results: </strong>The perfusion defects identified through fluorescein angiography were qualitatively correlated with hypo-reflective regions observed in the BLR images. A notable correlation was also observed between the OCTA deep capillary plexus findings and the BLR images. Additionally, areas of retinal thinning identified on structural OCT thickness maps corresponded with the hypo-reflective regions in the BLR images. This indicates the potential of BLR in identifying non-perfused retinal areas.</p><p><strong>Conclusions: </strong>This study reinforces the evidence, through OCT, OCTA, and angiographic correlation, that the BLR can effectively identify areas of retinal non-perfusion in a non-invasive manner. Further research is warranted to assess the method's sensitivity, specificity, and limitations. While the interaction of blue light with the retina, leading to specular reflections and scattering, is established, this research represents a pioneering effort in suggesting which specific retinal structures may be implicated in this phenomenon. This novel insight opens avenues for deeper exploration into the underlying mechanisms and potential clinical applications of utilizing the BLR imaging technique for assessing retinal vascular abnormalities.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic macular edema (DME): dissecting pathogenesis, prognostication, diagnostic modalities along with current and futuristic therapeutic insights.","authors":"Ahmed Sermed Al Sakini, Abdulrahman Khaldoon Hamid, Zainab A Alkhuzaie, Sandra Thair Al-Aish, Shahad Al-Zubaidi, Abduljaber A'Ed Tayem, Mohammed Ayad Alobi, Anne Sermed Al Sakini, Rami Thair Al-Aish, Khayry Al-Shami, Hamdah Hanifa, Sara S Khunda","doi":"10.1186/s40942-024-00603-y","DOIUrl":"10.1186/s40942-024-00603-y","url":null,"abstract":"<p><p>One of the most common health concerns disturbing people within working years globally is diabetes mellitus (DM). One well-known consequence of DM is vascular damage, which can manifest as macro- and microangiopathy affecting the ocular retina. Therefore, Diabetic macular edema (DME) is a major sight-threatening complication of diabetic retinopathy (DR) worldwide. It is the most prevalent cause of significant vision impairment in diabetic patients. Long-term vision loss can be avoided by following early DME treatment guidelines in everyday life. Hence, there are various therapeutic approaches for DME management. Currently, the first-line treatment for DME is anti-VEGF family drugs, such as ranibizumab, brolucizumab, bevacizumab, and aflibercept. Nevertheless, relapses of the disease, inadequate response, and resistance during anti-VEGF therapy are still seen because of the intricate pathophysiological foundation of the disease. Consequently, there is an excellent requirement for therapeutic approaches to advance and become better at controlling diseases more satisfactorily and require fewer treatments overall. We conducted a thorough literature search in the current review to present a comprehensive overview of the primary data about the current DME therapeutic agents. We also covered the novel advances in DME management and probable future treatments being investigated and developed. This review recommended that Large clinical trials should afford sufficient evidence to support these innovative treatment modalities.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of human amniotic membrane plug transplantation in cases of macular hole. A scoping review.","authors":"Miguel A Quiroz-Reyes, Erick A Quiroz-Gonzalez, Miguel A Quiroz-Gonzalez, Virgilio Lima-Gomez","doi":"10.1186/s40942-024-00600-1","DOIUrl":"10.1186/s40942-024-00600-1","url":null,"abstract":"<p><strong>Background: </strong>Recently, there has been a surge of literature utilizing the human amniotic membrane (hAM) to manage cases of macular holes. In this scoping review, we aimed to systematically narrate the literature to identify cases of macular holes that are managed using hAM and explore the visual and anatomical outcomes to inform future research questions.</p><p><strong>Methods: </strong>This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A detailed database search strategy (Scopus, Embase, Medline, and Cochrane Central) was developed to identify English-language published articles that reported using hAM to manage macular holes. All human clinical studies were included for a narrative data synthesis divided across study types.</p><p><strong>Results: </strong>The database search identified 82 articles, of which 34 were eligible for full-text review (0 randomized controlled trials (RCTs), 12 non-RCTs, 10 retrospective reviews, ten published case reports, and two clinical trial registries). The non-RCTs included patients with macular holes related to a wide range of retinal diseases, including retinal detachment, recurrent holes, and high myopia. Only two non-RCTs reported comparative data with a control group, but the study characteristics differed, and quantitative synthesis was impossible. Most retrospective interventional series and individual case reports reported a success rate of 93 -100% in hole closure and improvement in best-corrected visual acuity. None of the studies reported adverse effects after a hAM transplantation.</p><p><strong>Conclusion: </strong>The hAM effectively seals macular holes without any safety concerns, improving anatomical and visual outcomes in all macular holes.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of conventional internal limiting membrane versus pars plana vitrectomy without peeling for small idiopathic macular hole.","authors":"Maria Ludovica Ruggeri, Alberto Quarta, Paola Marolo, Lucio Zeppa, Lorenzo Motta, Matteo Gironi, Lisa Toto, Michele Reibaldi, Rodolfo Mastropasqua","doi":"10.1186/s40942-024-00599-5","DOIUrl":"10.1186/s40942-024-00599-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to compare functional and anatomical changes in patients with small full thickness macular holes (FTMHs) who underwent pars plana vitrectomy (PPV) with or without Internal limiting membrane (ILM) peeling.</p><p><strong>Methods: </strong>42 eyes of 42 patients diagnosed for FTMHs (< 250 micron) were included in our prospective interventional study. Main outcome measures were: Best Corrected Visual Acuity (BCVA), Macular hole closure rate, Ellipsoid Zone (EZ) and External Limiting Membrane (ELM) recover, Vessel Density in both Superficial (VDSCP) and deep (VDDCP) capillary plexus, Macular pigment Optical density (MPOD) and mean Central Macular Sensitivity (CMS).Patients were randomly divided into \"peeling group\" (21 patients), in which the ILM peeling maneuver was performed and \"no-peeling group\" (21 patients) in which the ILM was not peeled off. Examinations were repeated one month (T1), three months (T2) and six months (T3) after surgery.</p><p><strong>Results: </strong>Although significant improvements in terms of MPOD, CMS, VDSCP and VDDCP over time (p < 0.001) no significant differences were found between the peeling and no peeling group. Conversely, FTMHs closure was achieved in all cases (100%) in the peeling group, whereas 10% of cases in the no peeling group experienced the hole re-opening at T3, with reported different rates of ELM/EZ recover between the two groups. Nevertheless, BCVA improved significantly (p < 0.001) but without significant differences between the two groups.</p><p><strong>Conclusions: </strong>No significant differences were found in terms of anatomical and functional outcomes between the peeling or not the ILM in small FTMHs at 6 months follow-up.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lack of floater perception in eyes with asteroid hyalosis and its direct implications on laser vitreolysis.","authors":"Elie Zaher, Yonatan Blumenthal, Eytan Z Blumenthal","doi":"10.1186/s40942-024-00601-0","DOIUrl":"10.1186/s40942-024-00601-0","url":null,"abstract":"<p><strong>Purpose: </strong>To present a novel optical model explaining why the vast majority of patients with Asteroid Hyalosis (AH) do not perceive any floaters. This changes our understanding of floater perception and undermines the operation mode of YAG laser vitreolysis.</p><p><strong>Methods: </strong>Relying on a previously published model of floater perception based on astronomical equations of a solar eclipse, and on ultrasound images of the vitreous in three eyes with AH, we explain why such patients do not perceive floaters in spite of opaque bodies filling their entire vitreous, to the point of, in severe cases of AH, obscuring the fundus view during ophthalmoscopy.</p><p><strong>Main outcome measures: </strong>Developing an optical model of light rays that can quantify the maximal distance upon which a vitreous floater or opacity will cast a shadow on the retina.</p><p><strong>Results: </strong>Calculations using the proposed model demonstrated that with a 3 mm pupil, for a floater located between 1.5 mm and 2 mm from the retina, its shortest diameter must be > 215 microns and > 286 microns, respectively, to be perceived. Since AH floaters, based on ultrasound imaging, do not exist in the most peripheral 1.5 mm of the vitreous, it becomes understandable why these patients are asymptomatic.</p><p><strong>Conclusions: </strong>Based on the proposed model and our findings, we deduced that even large, degenerative floaters whose width is usually narrower than a large retinal vein (125 microns), must be located very close to the retina and hence are not the floaters that are aimed at when performing YAG laser vitreolysis. We speculate that in successful cases, YAG vitreolysis works by a different mechanism, most likely a shock wave that displaces floaters further away from the retina. Hence, vitreolysis might not necessarily require the laser be aimed at the floaters, as symptomatic floaters may be located in the outer 1.5-2.0 mm of the vitreous body, a very risky zone for YAG laser shots.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of ChatGPT in the diagnosis, management, education, and research of retinal diseases: a scoping review.","authors":"Victor C F Bellanda, Mateus Lins Dos Santos, Daniel Araujo Ferraz, Rodrigo Jorge, Gustavo Barreto Melo","doi":"10.1186/s40942-024-00595-9","DOIUrl":"https://doi.org/10.1186/s40942-024-00595-9","url":null,"abstract":"<p><strong>Purpose: </strong>This scoping review aims to explore the current applications of ChatGPT in the retina field, highlighting its potential, challenges, and limitations.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, MEDLINE, and Embase, to identify relevant articles published from 2022 onwards. The inclusion criteria focused on studies evaluating the use of ChatGPT in retinal healthcare. Data were extracted and synthesized to map the scope of ChatGPT's applications in retinal care, categorizing articles into various practical application areas such as academic research, charting, coding, diagnosis, disease management, and patient counseling.</p><p><strong>Results: </strong>A total of 68 articles were included in the review, distributed across several categories: 8 related to academics and research, 5 to charting, 1 to coding and billing, 44 to diagnosis, 49 to disease management, 2 to literature consulting, 23 to medical education, and 33 to patient counseling. Many articles were classified into multiple categories due to overlapping topics. The findings indicate that while ChatGPT shows significant promise in areas such as medical education and diagnostic support, concerns regarding accuracy, reliability, and the potential for misinformation remain prevalent.</p><p><strong>Conclusion: </strong>ChatGPT offers substantial potential in advancing retinal healthcare by supporting clinical decision-making, enhancing patient education, and automating administrative tasks. However, its current limitations, particularly in clinical accuracy and the risk of generating misinformation, necessitate cautious integration into practice, with continuous oversight from healthcare professionals. Future developments should focus on improving accuracy, incorporating up-to-date medical guidelines, and minimizing the risks associated with AI-driven healthcare tools.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New high-resolution prototype versus standard spectralis optical coherence tomography in patients with central serous chorioretinopathy.","authors":"Lorenzo Ferro Desideri, Luc Hennebert, Yousif Subhi, Martin Zinkernagel, Rodrigo Anguita","doi":"10.1186/s40942-024-00598-6","DOIUrl":"https://doi.org/10.1186/s40942-024-00598-6","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the accuracy of High-Resolution OCT in detecting biomarkers associated with central serous chorioretinopathy (CSC) compared to standard OCT.</p><p><strong>Methods: </strong>We conducted a cross-sectional study involving CSC patients who underwent High-Resolution and standard OCT during the same visit. Using the SPECTRALIS High-Res OCT device (Heidelberg Engineering, Heidelberg, Germany), macular B-scans were obtained and compared with those acquired using a SPECTRALIS HRA + OCT device (Heidelberg Engineering, Heidelberg, Germany). Qualitative assessments were performed, and statistical analyses compared the performance of both OCT modalities.</p><p><strong>Results: </strong>Thirty-one patients diagnosed with CSC were included with a mean age of 56.3 years (± 10.2). Among them, 29% (n = 9) were classified as acute CSC (aCSC), while 71% (n = 22) had chronic CSC (cCSC). High-Resolution OCT outperformed standard OCT in detecting microstructural changes in the outer retinal layers, including a higher prevalence of disrupted interdigitation zone (IZ) (29% vs. 6%, p = 0.003) and retinal pigment epithelium (RPE) disruption (12% vs. 2%, p = 0.0024). Intergrader agreement was high (Cohen's Kappa = 0.85).</p><p><strong>Conclusion: </strong>High-Resolution OCT demonstrates promise in identifying critical biomarkers associated with CSC, particularly disruptions in the IZ and RPE. Further validation in larger cohorts is required to confirm their clinical relevance in patients with CSC.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of pre-operative findings and post-operative outcomes in primary and secondary macular holes at a tertiary eye hospital in South India.","authors":"Shubham Darade, Rupal Kathare, Ayushi Choudhary, Gaurang Sehgal, Jay Chhablani, Kanika Godani, Naresh Kumar Yadav, Priyanka Gandhi, Prathiba Hande, Rubble Mangla, Vishma Prabhu, Ramesh Venkatesh","doi":"10.1186/s40942-024-00597-7","DOIUrl":"https://doi.org/10.1186/s40942-024-00597-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare demographics, clinical characteristics, and post-surgical outcomes between idiopathic and secondary full-thickness macular holes (MHs).</p><p><strong>Methods: </strong>A retrospective analysis of 348 eyes from 339 patients treated between June 2017 and December 2023 was conducted. The study included both idiopathic and secondary MHs, excluding cases where surgery was not performed or lacked sufficient follow-up. Demographic data, visual acuity (VA), ocular characteristics, and optical coherence tomography measurements were analyzed.</p><p><strong>Results: </strong>Idiopathic MHs were identified in 308 eyes (89%), and secondary MHs in 40 eyes (11%). Idiopathic MH patients were older (mean age: 68.26 vs. 60.13 years; p = 0.001) and more commonly female (63% vs. 40%; p = 0.005). Post-surgical closure was achieved in 86% of all MHs, with a median VA improvement of 15 ETDRS letters (3 Snellen lines). However, secondary MHs had a lower closure rate (67% vs. 89%, p = 0.001) and less VA improvement (2 lines vs. 3 lines, p = 0.001) compared to idiopathic MHs. Significant differences in maximal basal diameter and diameter hole index were noted between the groups.</p><p><strong>Conclusions: </strong>Secondary MHs, accounting for 11% of surgical cases, show poorer anatomical and visual outcomes than idiopathic MHs. Despite lower success rates, early surgical intervention in secondary MHs is recommended to enhance outcomes. Differentiating between idiopathic and secondary MHs is crucial for optimal management.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel drip-irrigative technique for enhanced epiretinal perfluorocarbon liquid clearance during vitreoretinal surgery.","authors":"Jingli Guo, Victoria Y Gu, Yuhan Zhou, Peiquan Zhao, Dongsheng Zhao","doi":"10.1186/s40942-024-00591-z","DOIUrl":"10.1186/s40942-024-00591-z","url":null,"abstract":"<p><strong>Purpose: </strong>To present a novel intraoperative application technique of basic salt solution (BSS) perfusate to address residual epiretinal perfluorocarbon liquid (PFCL) droplets.</p><p><strong>Methods: </strong>Following standard liquid-gas exchange and aspiration of visible PFCL using a flute needle, the adjuvant drip-irrigative method is employed. A 2mL needle containing BSS is introduced and maneuvered circumferentially around the posterior pole while injecting BSS intermittently to obviate droplet presence. Subsequently, droplets lying flat to the surface drain via the flute needle, and the process if repeated until no droplets are visible.</p><p><strong>Results: </strong>Among 112 consecutive patients diagnosed with rhegmatogenous retinal detachment (RDD) with at least 3 months follow-up, 109 patients (109 eyes, [97%]) experienced no PFCL-related complications follow pars plana vitrectomy. Among three patients with PFCL-related complications, two (2 eyes) presented with residual droplets on the retinal surface during silicone oil retrieval, and one (1 eyes) had PFCL migration to the anterior chamber. No patients experienced sub-retinal/ sub-foveal PFCL or iatrogenic injury.</p><p><strong>Conclusion: </strong>This adjuvant drip-irrigative technique offers enhanced droplet visibility, reduced risk of iatrogenic retinal damage, and ease of application. Findings reported suggest the potential of this approach as a standard practice when using PFCL to mitigate complications.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatic fever and long-term use of benzathine penicillin as possible risk factors for extensive macular atrophy with pseudodrusen in a Brazilian cohort.","authors":"Carlos Augusto Moreira-Neto, Rafaella Atherino Schmidt Andujar, John Chii Tyng Chao, Huber Vasconcelos, Fábio Eduardo Eberhardt Alves, Gabriela Doná Rodrigues, Bruno Hirt, Jayme Arana, Eduardo Cunha Souza, André Maia, Juliana Maria Ferraz Sallum, Carlos Augusto Moreira","doi":"10.1186/s40942-024-00592-y","DOIUrl":"10.1186/s40942-024-00592-y","url":null,"abstract":"<p><strong>Background: </strong>Although there has been a large increase in the number of extensive macular atrophy with pseudodrusen (EMAP) cases, the basic aspects of this disease remain unknown. Brazilian patients have a common past history of rheumatic fever (RF) and/or benzathine penicillin (BP) treatment possibly related to the disease. We analyzed how RF and BP might be correlated with EMAP in Brazilian patients.</p><p><strong>Design: </strong>Observational, retrospective, case-control study.</p><p><strong>Methods: </strong>The databases of three private eye clinics in Brazil were searched for patients with an EMAP-like appearance. Each patient was asked about a previous history of RF and/or long-term use of BP. Patients underwent best-corrected visual acuity (BCVA) measurement, color fundus imaging, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT) imaging, and electroretinography (ERG). The following characteristics were analyzed: subretinal drusenoid deposits (SDD), pigment mottling, retinal pigment epithelial/basement membrane (RPE/BM) separation, outer retinal or RPE atrophy, and identification of a paving stone-like appearance. The choroidal thickness was measured using enhanced depth imaging OCT. The central atrophic area was measured manually on ultra-wide-field FAF.</p><p><strong>Results: </strong>A total of 154 eyes of 77 patients (women, 66.2%; mean age, 58.6 years) with EMAP were included; 90.9% of patients were diagnosed with RF; 94.8% had been treated with BP and treatment was started at an average age of 7.3 years (mean duration, 11.8 years). The treatment duration was significant for the area of atrophy (P = 0.027) in which each 1-year increase in treatment duration led to an average reduction of 6.91 mm² in area. The age at diagnosis of RF was significant (P = 0.026) for SDD. The increase of 1 year in the diagnosis of RF (late disease) led to a reduction of 24% in the chance of central SDD being present. On OCT, 65.5% eyes had SDD and more than 70% had a split RPE/BM and outer retinal or RPE atrophy. The choroidal thickness in patients with EMAP was significantly (P < 0.001) thinner than the control group. The ERG was abnormal in all eyes.</p><p><strong>Conclusion: </strong>These findings may suggest a relation between RF and EMAP in Brazilian patients. Patients with EMAP should be questioned about a history of RF.</p>","PeriodicalId":14289,"journal":{"name":"International Journal of Retina and Vitreous","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}