Ophthalmologica最新文献

{"title":"Pars Plana Vitrectomy with or without Internal Limiting Membrane Peel for Epiretinal Membrane: A Systematic Review and Meta-Analysis.","authors":"Andrew Mihalache, Ryan S Huang, Haleema Ahmed, Nikhil S Patil, Marko M Popovic, Peter J Kertes, Rajeev H Muni","doi":"10.1159/000534851","DOIUrl":"10.1159/000534851","url":null,"abstract":"<p><strong>Background: </strong>The safety and effectiveness of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling remains poorly understood for the treatment of epiretinal membrane (ERM).</p><p><strong>Objectives: </strong>Our study aims to compare the safety and effectiveness of PPV with and without ILM peeling for ERM.</p><p><strong>Methods: </strong>A systematic literature search was conducted on Ovid MEDLINE, Embase, Cochrane Library, and Google Scholar from January 2000 to January 2023 for comparative studies reporting visual and anatomical outcomes for patients with ERM that received PPV with or without ILM peeling. Primary outcomes included best-corrected visual acuity (BCVA) at last study observation and change in BCVA from baseline. Secondary outcomes included retinal thickness (RT) at last study observation, change in RT from baseline, risk of ERM recurrence, and adverse events. A random-effects meta-analysis was performed. Risk of bias of randomized controlled trials was assessed using the Risk of Bias 2 tool of observational studies using the Risk of Bias in Non-randomized Studies of Interventions-I tool. The certainty of evidence of outcomes was evaluated using Grading of Recommendations, Assessment, Development and Evaluation criteria.</p><p><strong>Results: </strong>Nineteen studies reporting on 1,291 eyes at baseline were included. PPV with and without ILM peel achieved a similar BCVA at last study observation (p = 0.68) and change in BCVA from baseline (p = 0.79). These findings remained consistent irrespective of whether simultaneous phacoemulsification was performed. PPV with ILM peel achieved a significantly lower incidence of ERM recurrence (risk ratio [RR] = 0.26, 95% CI = [0.13, 0.51], p &lt; 0.0001) and additional surgery (RR = 0.17, 95% CI = [0.04, 0.74], p = 0.02) compared to PPV without ILM peel.</p><p><strong>Conclusion: </strong>PPV with and without ILM peel achieved a similar BCVA at last study observation in ERM patients. Patients treated with PPV and ILM peel also had a reduced risk of ERM recurrence and lower reoperation risk. These conclusions are associated with a moderate certainty of evidence and potential for bias from multiple non-randomized studies.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71413289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve-Month Outcomes of Three Episcleral Surgeries in Treatment of Rhegmatogenous Retinal Detachment.","authors":"Zigan Zhou, Binghua Guo, Hantao Zhou, Chen Yang, Jinghao Mei, Chuying Deng, Ronghan Wu, Zhong Lin","doi":"10.1159/000539854","DOIUrl":"10.1159/000539854","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the long-term outcomes of conventional scleral buckling (CSB), modified scleral buckling (MSB), and scleral encircling (SE) in the treatment of rhegmatogenous retinal detachment and identify factors influencing the outcomes.</p><p><strong>Methods: </strong>This comparative, retrospective cohort study assigned patients to CSB, MSB, and SE groups. The follow-up was 12 months, and the reattachment rate, complication rate, visual acuity, number of newly discovered tears during surgery, and changes in diopters were compared among the three surgeries. Influential factors on anatomical and functional reattachment were identified.</p><p><strong>Results: </strong>There were no significant differences in the primary reattachment rate, overall complication rate, or best corrected visual acuity at 6 or 12 months among the three groups. The MSB group had a higher number of newly discovered tears during surgery compared with the other two groups. At 12 months of post-surgery, the SE group displayed the greatest change of diopter, whereas the MSB group showed the least change. The surgical approach did not influence the primary reattachment rate. Long-term visual outcomes were influenced by factors including sex, preoperative visual acuity, macular status, and duration of symptoms.</p><p><strong>Conclusion: </strong>MSB is an effective method for treating rhegmatogenous retinal detachment. Its advantages include the ability to identify smaller tears and induce minimal changes in diopter.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of a New Monofocal Intraocular Lens in Patients Undergoing Phacovitrectomy for Idiopathic Epiretinal Membrane.","authors":"Tomislav Jukić, Gentian Bajraktari, Nenad Vukojević, Martin Oroz, Andrea Radolović, Krešimir Mandić, Miro Kalauz","doi":"10.1159/000540362","DOIUrl":"10.1159/000540362","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to evaluate the clinical outcomes and quality of life of newly generated monofocal intraocular lens (IOL) in patients diagnosed with idiopathic epiretinal membrane (IEM) following phacovitrectomy.</p><p><strong>Methods: </strong>In this prospective study, 42 patients with IEM and cataract underwent pars plana vitrectomy. They were divided into the ICB00 group (21 patients) and the ZCB00 group (21 patients). Data collected before and after the surgery were compared between the two groups, including uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), vision-related quality of life (VRQOL), intraocular pressure, contrast sensitivity (CS), and central macular thickness (CMT).</p><p><strong>Results: </strong>The preoperative characteristics of the two groups showed no significant differences. However, at the 6-month follow-up after surgery, there were significant improvements in UDVA (p &lt; 0.001), UIVA (p &lt; 0.001), VRQOL (p &lt; 0.001), CS (p &lt; 0.001), and CMT (p &lt; 0.001) compared to baseline. Notably, the Eyhance ICB00 group showed a significantly higher UCIVA value at 6 months post-surgery when compared to the Tecnis ZCB00 group (p = 0.001), while other parameters did not show significant differences between the groups.</p><p><strong>Conclusion: </strong>The Eyhance IOL significantly improved both intermediate and distance visual acuity, with no notable difference in quality of life or CS compared to the Tecnis ZCB00 IOL after IEM removal. It appears to be a favorable choice for combined cataract and vitreoretinal surgery, offering enhanced vision for daily tasks and a promising alternative to traditional monofocal IOLs.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravitreal Triamcinolone Acetonide for Diabetic Macular Edema and Macular Edema Secondary to Retinal Vein Occlusion: A Meta-Analysis.","authors":"Andrew Mihalache, Amin Hatamnejad, Nikhil S Patil, Marko M Popovic, Peter J Kertes, Miguel Cruz-Pimentel, Rajeev H Muni","doi":"10.1159/000533443","DOIUrl":"10.1159/000533443","url":null,"abstract":"<p><strong>Background: </strong>The comparative safety and efficacy of different doses of intravitreal triamcinolone acetonide (IVTA) for diabetic macular edema (DME) and macular edema (ME) secondary to retinal vein occlusion (RVO) is unclear.</p><p><strong>Objectives: </strong>This meta-analysis aimed to compare the safety and efficacy of different doses of IVTA in this setting.</p><p><strong>Methods: </strong>A systematic literature search for randomized clinical trials (RCTs) was conducted on Cochrane Library, Ovid MEDLINE, and EMBASE from January 2005 to May 2022. Studies that reported on patients with DME or ME secondary to RVO that received treatment with different doses of IVTA were included. A random-effects meta-analysis was performed. Cochrane's Risk of Bias Tool 2 was used to assess the risk of bias, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines were used to assess certainty of evidence.</p><p><strong>Results: </strong>Five RCTs reporting on 1,041 eyes at baseline were included in this meta-analysis. In eyes with ME secondary to RVO, high-dose (4 mg) IVTA achieved a significantly better change in best-corrected visual acuity (WMD = -4.75 ETDRS letters, 95% CI = [-7.73, -1.78], p = 0.002) and reduction in retinal thickness (WMD = -93.02 μm, 95% CI = [-153.23, -32.82], p = 0.002) at months 4-6 compared to low-dose (1-2 mg) IVTA. However, high-dose IVTA had a higher risk of intraocular pressure-related adverse events (RR = 2.99, 95% CI = [1.05, 8.50], p = 0.04) and cataract surgery (RR = 5.67, 95% CI = [3.09, 10.41], p &lt; 0.00001) than low-dose IVTA in eyes with ME secondary to RVO. These efficacy and safety differences in high-dose and low-dose IVTA were not observed in DME eyes.</p><p><strong>Conclusions: </strong>The RCT evidence in this setting is limited. High-dose IVTA achieved greater improvements in visual acuity and reductions in retinal thickness than low-dose IVTA at months 4-6. However, high-dose IVTA had a less favorable safety profile than low-dose IVTA. The significance of these outcomes was based on patients with ME secondary to RVO, but not DME.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10353149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Deep Learning Model for Detecting Rhegmatogenous Retinal Detachment Using Ophthalmologic Ultrasound Images.","authors":"Huihang Wang, Xuling Chen, Xiaocui Miao, Shumin Tang, Yijun Lin, Xiaojuan Zhang, Yingying Chen, Yihua Zhu","doi":"10.1159/000535798","DOIUrl":"10.1159/000535798","url":null,"abstract":"<p><strong>Introduction: </strong>Rhegmatogenous retinal detachment (RRD) is one of the most common fundus diseases. Many rural areas of China have few ophthalmologists, and ophthalmologic ultrasound examination is of great significance for remote diagnosis of RRD. Therefore, this study aimed to develop and evaluate a deep learning (DL) model, to be used for automated RRD diagnosis based on ophthalmologic ultrasound images, in order to support timely diagnosis of RRD in rural and remote areas.</p><p><strong>Methods: </strong>A total of 6,000 ophthalmologic ultrasound images from 1,645 participants were used to train and verify the DL model. A total of 5,000 images were used for training and validating DL models, and an independent testing set of 1,000 images was used to test the performance of eight DL models trained using four different DL model architectures (fully connected neural network, LeNet5, AlexNet, and VGG16) and two preprocessing techniques (original, original image augmented). Receiver operating characteristic (ROC) curves were used to analyze their performance. Heatmaps were generated to visualize the process of the best DL model in the identification of RRD. Finally, five ophthalmologists were invited to diagnose RRD independently on the same test set of 1,000 images for performance comparison with the best DL model.</p><p><strong>Results: </strong>The best DL model for identifying RRD achieved an area under the ROC curve (AUC) of 0.998 with a sensitivity and specificity of 99.2% and 99.8%, respectively. The best preprocessing method in each model architecture was the application of original image augmentation (average AUC = 0.982). The best model architecture in each preprocessing method was VGG16 (average AUC = 0.998).</p><p><strong>Conclusion: </strong>The best DL model determined in this study has higher accuracy, sensitivity, and specificity than the ophthalmologists' diagnosis in identifying RRD based on ophthalmologic ultrasound images. This model may provide support for timely diagnosis in locations without access to ophthalmologic care.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138807544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Postoperative Axial Rotation of the Toric Intraocular Lens in Cataract Surgery Combined with Vitrectomy versus Cataract Surgery Alone.","authors":"Tsuyoshi Mito, Hidetoshi Ishida, Yusuke Seki, Takuro Shirayama, Yuki Ukai, Hiroshi Sasaki","doi":"10.1159/000539986","DOIUrl":"10.1159/000539986","url":null,"abstract":"<p><strong>Introduction: </strong>This study compared the postoperative axial rotation of the toric intraocular lens (T-IOL) after cataract surgery combined with vitrectomy versus cataract surgery alone.</p><p><strong>Methods: </strong>This retrospective, non-randomized, observational study enrolled patients who underwent cataract surgery combined with vitrectomy in one eye and cataract surgery alone in the contralateral eye. AcrySof Toric IOLs (Alcon Laboratories) were implanted in both eyes of the same patient. The axial rotation of the T-IOL was analyzed 3 months postoperatively using photographs obtained during and after surgery. In the combined group, T-IOL axial alignment was performed before vitrectomy. Preoperative corneal astigmatism and postoperative residual astigmatism were also compared in both groups.</p><p><strong>Results: </strong>This study examined 36 eyes of 18 patients (74.7 ± 6.8 years). The axial rotation was 2.94 ± 1.70° in the cataract group versus 3.06 ± 2.34° in the combined group 3 months postoperatively, and the difference lacked significance (p = 0.98). In the combined group, the mean axial rotation during surgery was 2.17 ± 1.80°. Axial rotation within 5° was observed in 17 of 18 eyes (94.4%) in the cataract group and 16 of 18 eyes (88.9%) in the combined group, with no significant difference (p = 0.54). The comparison of postoperative residual astigmatism with preoperative corneal astigmatism revealed a significant improvement from 1.49 ± 0.40 D to 0.39 ± 0.47 D in the cataract group (p &lt; 0.0001) and from 1.61 ± 0.40 D to 0.42 ± 0.43 D in the combined group (p &lt; 0.0001).</p><p><strong>Conclusions: </strong>The postoperative axial rotation of the T-IOL in eyes that underwent cataract surgery combined with vitrectomy was stable and comparable to that of eyes that underwent cataract surgery alone.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Intervals between Intravitreal Injections Using a Treat-and-Extend Protocol in a Real-Life Context in AMD: The LIRE Study.","authors":"Pierre Leroux, Emilie Agard, Jérémy Billant, Antoine Levron, Hugo Bouvarel, Yannis Badri, Ikrame Douma, Pierre Pradat, Corinne Dot","doi":"10.1159/000535806","DOIUrl":"10.1159/000535806","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to assess the outcome of long treat-and-extend (TE) anti-VEGF intravitreal injection (IVI) intervals (≥every 12 weeks [Q12W]) in neovascular age-related macular degeneration (nAMD). The aims of this retrospective study were to determine the proportion of nAMD eyes treated ≥ Q12W, to analyze their longitudinal, functional, and anatomical outcomes, and to compare functional and anatomical outcomes between eyes that rapidly versus slowly reached a Q12W regimen and between eyes directly treated with versus initiating lately the TE regimen.</p><p><strong>Methods: </strong>All patients receiving IVIs for nAMD were screened. The longitudinal, functional, and anatomical characteristics of Q12W-treated eyes were reported at different timepoints.</p><p><strong>Results: </strong>Ninety-one eyes were included (38% of our total nAMD cohort). The mean TE regimen time to reach a Q12W interval was 20.1 ± 16.2 months. During this time, a mean number of 12.1 ± 9.3 IVIs were needed. The mean best-corrected visual acuity was 68 letters at the time of diagnosis and was maintained (p &gt; 0.05). Eyes that rapidly reached a Q12W interval had a shorter follow-up before TE regimen initiation (p = 0.04) and received fewer IVIs (p = 0.02) than eyes that slowly reached a Q12W interval. Eyes directly treated with the TE regimen reached a Q12W interval more rapidly than eyes with late TE initiation. The neovascularization subtype was not a predictor of outcome in TE-treated eyes.</p><p><strong>Conclusion: </strong>≥Q12W eyes represent an important part of the nAMD population in our real-life study. No baseline anatomical characteristics were associated with the outcome under a TE regimen, although early TE regimen initiation allowed extending more rapidly the IVI interval.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138807548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fundus Autofluorescence Patterns in Subretinal Hemorrhages Associated with Neovascular Age-Related Macular Degeneration.","authors":"Zofia Anna Nawrocka, Jerzy Nawrocki","doi":"10.1159/000535865","DOIUrl":"10.1159/000535865","url":null,"abstract":"<p><strong>Introduction: </strong>Submacular hemorrhage (SMH) is a vision-threatening complication of neovascular age-related macular degeneration (AMD). The exact treatment scheme is not established yet. The aim of the current study was to describe surgical results and fundus autofluorescence (FAF) patterns after pars plana vitrectomy (ppV) + subretinal tissue plasminogen activator (tPA) + anti-vascular endothelial growth factor (VEGF) and intravitreal tPA + anti-VEGF + sulfur hexafluoride (SF6) tamponade and to compare them to intravitreal tPA + anti-VEGF + SF6 in the treatment of SMH in the course of AMD.</p><p><strong>Materials and methods: </strong>We performed FAF imaging in patients with a previous SMH in the course of AMD with a duration of &lt;60 days treated with vitrectomy with subretinal anti-VEGF and tPA and intravitreal anti-VEGF, tPA, and SF6 administration (group 1) or intravitreal tPA + anti-VEGF + SF6 (group 2). In all eyes, a throughout ophthalmic examination, fluorescein angiography, and spectral domain optical coherence tomography (SD-OCT) were done for diagnosis. SD-OCT was performed monthly during treatment.</p><p><strong>Results: </strong>Three FAF patterns were observed in both groups. Pattern one (normal autofluorescence) was observed in 5/18 in group one and 5/21 group two. Pattern two was observed in 6/18 in group one and 7/21 in group two. Pattern three was noted in 7/18 in group one and 5/21 in group two. Improvement in visual acuity was statistically significant for both groups: 0.01 Snellen (2.0 logMAR) to 0.11 Snellen (0.96 logMAR) in group one (p = 0.019) and 0.11 Snellen (0.96 logMAR) to 0.33 Snellen (0.48 logMAR) in group two (p = 0.0007). Central retinal thickness also decreased with statistical significance for both groups (p &lt; 0.05).</p><p><strong>Conclusion: </strong>FAF patterns did not depend on the treatment used, but solely on the duration of SMH before treatment. SMH if not treated prompt enough might cause long-standing photoreceptor and retinal pigment epithelium defect, which is represented by hypo- and hyperautofluorescence. Performing a subretinal injection of tPA and anti-VEGF does not cause any defects associated with the injection site. That might be associated with previous local internal limiting membrane peeling, which reduces the injection pressure. Not only prompt treatment of SMH but also further continuation of anti-VEGF treatment is mandatory to maintain vision.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138807546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal Limiting Membrane Peeling and Inverted Flap Technique in Macular Hole: Postoperative Metamorphopsia and Optical Coherence Tomography.","authors":"Tomoya Murakami, Fumiki Okamoto, Yoshimi Sugiura, Iori Izumi, Aoi Iioka, Shohei Morikawa, Takahiro Hiraoka, Tetsuro Oshika","doi":"10.1159/000537846","DOIUrl":"10.1159/000537846","url":null,"abstract":"<p><strong>Introduction: </strong>We compared postoperative metamorphopsia and optical coherence tomography (OCT) findings between eyes that underwent internal limiting membrane (ILM) peeling and the inverted flap (IF) technique for macular hole (MH).</p><p><strong>Methods: </strong>This retrospective analysis included 64 eyes of 64 patients with idiopathic MH whose MH was closed after initial surgery. Thirty-nine patients were treated with pars plana vitrectomy (PPV) with ILM peeling, and 25 patients were treated with PPV with the IF technique. Best corrected visual acuity (BCVA), severity of metamorphopsia, and OCT images were collected before and 3, 6, and 12 months postoperatively. Based on the OCT images, the status of the external limiting membrane (ELM) and ellipsoid zone and the presence of hyperreflective plugs were assessed.</p><p><strong>Results: </strong>At baseline and 3, 6, and 12 months postoperatively, BCVA and severity of metamorphopsia were not significantly different between groups. The status of the ELM was significantly worse in the IF group than in the ILM peeling group at 3 and 6 months postoperatively. Significantly more hyperreflective plugs were observed in the IF group than in the ILM peeling group at 3 and 6 months postoperatively. Stepwise multiregression analysis revealed that hyperreflective plugs were significantly associated with the severity of metamorphopsia at 12 months postoperatively.</p><p><strong>Discussion/conclusion: </strong>The alterations on the OCT were fewer in the ILM peeling group than in the IF group, while no significant differences were observed in postoperative severity of metamorphopsia between groups. Metamorphopsia was worse in eyes with hyperreflective plugs.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of Myopic Maculopathy Based on the ATN Classification System.","authors":"Rongrong Zhang, Jiarui Xue, Minmin Zheng, Xiao Cao, Chenhao Li, Changfan Wu","doi":"10.1159/000535881","DOIUrl":"10.1159/000535881","url":null,"abstract":"<p><strong>Introduction: </strong>Myopic maculopathy is a sight-threatening disease, which causes irreversible vision faults and central vision loss. The purpose of this study is evaluating the risk factors of the myopic maculopathy progression according to the ATN classification system.</p><p><strong>Methods: </strong>Clinic data of 69 high myopia patients aged older than 40 years with a follow-up time of more than 2 years, who underwent fundus photography and OCT examination were retrospectively collected. Fundus changes were evaluated with ATN classification at the first and last follow-up times. The related factors affecting progress including axial length (AL), spherical equivalence (SE), subfoveal choroidal thickness (SFCT), disc-foveal distance (DFD), optic disc tilt, and parapapillary atrophy (PPA) were analyzed.</p><p><strong>Results: </strong>This study included 69 high-myopia patients with mean age 54.29 ± 10.41 years. The progression rate of myopic maculopathy (MM) was approximately 25.56%. Elongated DFD (5.37 ± 0.11 mm vs. 4.86 ± 0.37 mm; p &lt; 0.001) and thinner SFCT (138.52 ± 29.38 μm vs. 184.87 ± 48.72 μm; p = 0.008) at baseline were linked with MM progression. In multiple logistic regression analysis, DFD was a substantial hazard risk factor (adjusted OR = 1.672, 95% CI: 1.135-2.498, p &lt; 0.05) after adjusting for age, AL and SFCT. Receiver operating characteristic curve showed that DFD might serve as a predictor to discriminate the MM progression with a cut-off value of 5.15 mm and a substantial receiver operating characteristic curve area (AUC: 0.794). Compared with the non-progression group, the progression group had older age (p &lt; 0.001), longer AL (p = 0.001), higher optic disc tilt rate (p &lt; 0.001), and higher proportion of pre-existing PPA (p = 0.038) at baseline, the differences were statistically significant.</p><p><strong>Conclusion: </strong>Based on the ATN classification system, we found that the progression of MM was related to older age, longer AL, high disc tilt, pre-existing PPA, thinner SFCT, and longer DFD. The parameter of DFD was an important factor affecting the progression of MM, which is considered to have a higher probability of progression when the length is beyond 5.15 mm.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}