Retina (Philadelphia, Pa.)最新文献

{"title":"STRUCTURAL OUTCOME AFTER SURGERY FOR STAGE 5 RETINOPATHY OF PREMATURITY BASED ON THE NEW INTERNATIONAL CLASSIFICATION: ICROP 3.","authors":"Fukutaro Mano,&nbsp;Chiharu Iwahashi,&nbsp;Kazuki Kuniyoshi,&nbsp;Shunji Kusaka","doi":"10.1097/IAE.0000000000003541","DOIUrl":"https://doi.org/10.1097/IAE.0000000000003541","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the outcomes of vitrectomy for Stage 5 retinopathy of prematurity (ROP) based on the International Classification of Retinopathy of Prematurity third edition, in which Stage 5 ROP is divided into three subgroups.</p><p><strong>Methods: </strong>Fifty-four eyes of 34 patients with Stage 5 ROP who underwent vitrectomy between 2004 and 2020 were retrospectively analyzed. Data including sex, gestational age and weight at birth, International Classification of Retinopathy of Prematurity 3 subcategories, perioperative use of intravitreal bevacizumab injection and laser photocoagulation, surgical procedure and complications, final retinal reattachment, and follow-up period were collected.</p><p><strong>Results: </strong>Complete retinal reattachment was achieved in 16 eyes (88.9%) with Stage 5A and 13 eyes (39.4%) with Stage 5B ( P = 0.0003, Wilcoxon rank-sum test). Three patients with Stage 5C were considered inoperable. Postoperative anatomical failure was significantly associated with stage (Stage 5B vs. 5A; odds ratio, 17.986; 95% confidence interval, 3.712-148.502; P = 0.0001, multivariate logistic regression analysis). Intraoperative intravitreal bevacizumab was significantly associated with lower postoperative incidence of vitreous hemorrhage and glaucoma ( P = 0.041, chi-square test).</p><p><strong>Conclusion: </strong>Staging of preoperative anatomical features based on International Classification of Retinopathy of Prematurity 3 is a useful predictor for final anatomical success. Intraoperative intravitreal bevacizumab might reduce postoperative complication risks.</p>","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"1950-1957"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40706236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DETECTION AND LOCALIZATION OF RETINAL BREAKS IN ULTRAWIDEFIELD FUNDUS PHOTOGRAPHY USING a YOLO v3 ARCHITECTURE-BASED DEEP LEARNING MODEL.","authors":"Richul Oh,&nbsp;Baek-Lok Oh,&nbsp;Eun Kyoung Lee,&nbsp;Un Chul Park,&nbsp;Hyeong Gon Yu,&nbsp;Chang Ki Yoon","doi":"10.1097/IAE.0000000000003550","DOIUrl":"https://doi.org/10.1097/IAE.0000000000003550","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to develop a deep learning model for detecting and localizing retinal breaks in ultrawidefield fundus (UWF) images.</p><p><strong>Methods: </strong>We retrospectively enrolled treatment-naive patients diagnosed with retinal break or rhegmatogenous retinal detachment and who had UWF images. The YOLO v3 architecture backbone was used to develop the model, using transfer learning. The performance of the model was evaluated using per-image classification and per-object detection.</p><p><strong>Results: </strong>Overall, 4,505 UWF images from 940 patients were used in the current study. Among them, 306 UWF images from 84 patients were included in the test set. In per-object detection, the average precision for the object detection model considering every retinal break was 0.840. With the best threshold, the overall precision, recall, and F1 score were 0.6800, 0.9189, and 0.7816, respectively. In the per-image classification, the model showed an area under the receiver operating characteristic curve of 0.957 within the test set. The overall accuracy, sensitivity, and specificity in the test data set were 0.9085, 0.8966, and 0.9158, respectively.</p><p><strong>Conclusion: </strong>The UWF image-based deep learning model evaluated in the current study performed well in diagnosing and locating retinal breaks.</p>","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"1889-1896"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MACULAR MICROVASCULATURE IN X-LINKED RETINOSCHISIS: Optical Coherence Tomography and Optical Coherence Tomography Angiography Study.","authors":"Hye Ji Kwon,&nbsp;You Na Kim,&nbsp;Chan Hong Min,&nbsp;Yoon Jeon Kim,&nbsp;Junyeop Lee,&nbsp;Joo Yong Lee,&nbsp;Young Hee Yoon","doi":"10.1097/IAE.0000000000003539","DOIUrl":"https://doi.org/10.1097/IAE.0000000000003539","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate the macular microvasculature of X-linked retinoschisis (XLRS) and identify correlations between vascular changes, structural changes, and functional outcome.</p><p><strong>Methods: </strong>Genetically confirmed XLRS patients and heathy control subjects underwent complete ophthalmic examination, dilated funduscopic examination, optical coherence tomography, and optical coherence tomography angiography. Schisis distribution, outer plexiform layer discontinuation, photoreceptor layer thickness, and photoreceptor outer segment length were reviewed using optical coherence tomography. Vascular flow density and foveal thickness at foveal and parafoveal area were measured using optical coherence tomography angiography.</p><p><strong>Results: </strong>A total of 17 eyes of 9 XLRS patients and 22 eyes of 11 control subjects were examined from July 2018 to August 2020. Flow density in the deep capillary plexus at foveal and parafoveal area decreased in XLRS patients compared with control subjects (P = 0.014 and 0.001, respectively), whereas foveal avascular zone area and perimeter remarkably increased (P = 0.015 and 0.001, respectively). Although outer and total retinal layers were significantly thicker in XLRS, inner retinal layer was thinner with reduced photoreceptor layer thickness and shortened photoreceptor outer segment length (P < 0.001 and P < 0.001, respectively). Foveal flow loss in deep capillary plexus, foveal avascular zone enlargement, thinner inner retina and photoreceptor layer thickness, and shortened photoreceptor outer segment length correlated with best-corrected visual acuity.</p><p><strong>Conclusion: </strong>X-linked retinoschisis eyes exhibit decreased flow density in the deep capillary plexus and variable foveal avascular zone with enlarged perimeter. Structural deterioration of the photoreceptor best reflects the degenerative changes, whereas microvascular alteration shows considerable correlation with functional outcome in XLRS.</p>","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"1939-1949"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLINICAL CHARACTERISTICS OF EALES DISEASE AND THE EFFICACY OF DIFFERENT INTERVENTIONS FOR NEOVASCULAR COMPLICATIONS.","authors":"Xin-Yu Zhao,&nbsp;Shi-Yu Cheng,&nbsp;Wen-Fei Zhang,&nbsp;Li-Hui Meng,&nbsp;You-Xin Chen","doi":"10.1097/IAE.0000000000003534","DOIUrl":"https://doi.org/10.1097/IAE.0000000000003534","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical features and manifestations of Eales disease and the efficacy of different interventions.</p><p><strong>Methods: </strong>The databases PubMed, EMBASE, and Ovid from inception until February 2021 were searched. Pooled analyses included 1) presenting features, 2) symptoms and signs, and 3) postoperative vision outcomes and complications. Statistical analyses were conducted with R software version 3.6.3.</p><p><strong>Results: </strong>Forty-seven studies involving 3,557 patients and 4,959 eyes were included. The pooling results showed that Eales disease was male dominated (94%), bilateral involvement (64%), and mainly occurred in adolescents. Approximately 83% of patients were positive in Mantoux test, and 31% of patients have vitreous tap polymerase chain reaction positive for tuberculosis genome. More than half of the patients had decreased vision at the first clinic visit. The common signs of Eales disease included sclerotic vessels (83%), neovascularization of retina elsewhere (64%) and periphlebitis (51%). Macular changes could be detected in 24% of patients. The most common complication was vitreous hemorrhage, followed by cataracts and retinal detachment. Photocoagulation was directed at nonperfusion or neovascularization areas, with a decrease in the incidence of later pars plana vitrectomy (19%). Anti-vascular endothelial growth factor treatment was suggested for vitreous hemorrhage, which could achieve high visual acuity improvement rate (82%) while increasing the possibility of retinal detachment (18%). Pars plana vitrectomy was indicated in cases with persistent vitreous hemorrhage or retinal detachment, with 56% of patients obtaining visual improvement. Still, 17% of patients needed a second pars plana vitrectomy, mainly because of recurrent vitreous hemorrhage or retinal detachment.</p><p><strong>Conclusion: </strong>Eales disease most commonly affects young men. It has diverse clinical features, and management should be based on the progression of the disease.</p>","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"1975-1988"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Technique to Drain Suprachoroidal Fluid With a 27-Gauge Needle During Vitrectomy.","authors":"Takeshi Iwase,&nbsp;Eimei Ra,&nbsp;Hiroko Terasaki","doi":"10.1097/IAE.0000000000002594","DOIUrl":"https://doi.org/10.1097/IAE.0000000000002594","url":null,"abstract":"Supplemental Digital Content is Available in the Text.","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"2004-2007"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/IAE.0000000000002594","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37334050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfluorocarbon Liquid-Assisted Inverted Limiting Membrane Flap Technique Combined With Subretinal Fluid Drainage for Macular Hole Retinal Detachment in Highly Myopic Eyes.","authors":"Zizhong Hu,&nbsp;Xunyi Gu,&nbsp;Huiming Qian,&nbsp;Kang Liang,&nbsp;Weiwei Zhang,&nbsp;Jiangdong Ji,&nbsp;Qin Chen,&nbsp;Qinghuai Liu,&nbsp;Ping Xie","doi":"10.1097/IAE.0000000000002600","DOIUrl":"https://doi.org/10.1097/IAE.0000000000002600","url":null,"abstract":"Supplemental Digital Content is Available in the Text.","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"2008-2012"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/IAE.0000000000002600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37391983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFECTS OF INTRAVITREAL BEVACIZUMAB THERAPY ON GLOMERULAR FILTRATION RATES IN PATIENTS TREATED FOR PROLIFERATIVE DIABETIC RETINOPATHY.","authors":"David A Camp,&nbsp;David A Price,&nbsp;Ashley E Neiweem,&nbsp;Denis Jusufbegovic","doi":"10.1097/IAE.0000000000003562","DOIUrl":"https://doi.org/10.1097/IAE.0000000000003562","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether the repeated use of intravitreal bevacizumab injections in treatment of proliferative diabetic retinopathy is associated with a long-term decline in the glomerular filtration rate (GFR).</p><p><strong>Methods: </strong>Three hundred charts were retrospectively reviewed, of which 60 patients met the criteria for inclusion. The criteria were as follows: reception of at least one bevacizumab injection, baseline GFR before initial bevacizumab injection, and end GFR 6 to 24 months after baseline. Analysis controlled for time between baseline and end GFR measurements, blood pressure, hemoglobin A1C, race, sex, age, and use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. Significance testing was performed with step-wise multiple linear regression. The significance threshold was 5%, and all tests were two-sided.</p><p><strong>Results: </strong>Patients received a range of 1 to 17 injections (average 3.6). The average baseline GFR was 76 ± 38 mL/minute, and the end GFR was 63 ± 39 mL/min. The number of injections patients received was not associated with end GFR ( P = 0.72), GFR reduction ( P = 0.88), or percent GFR reduction ( P = 0.49).</p><p><strong>Conclusion: </strong>Increased number of intravitreal bevacizumab injections at therapeutic dosage was not associated with reduced GFR in patients with proliferative diabetic retinopathy. This study supports that intravitreal antivascular endothelial growth factor agents are renally safe.</p>","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"1926-1930"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40420943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudo-Vitelliform Detachment as A Complication of Tilted Disk Syndrome.","authors":"Priscille de Laage de Meux,&nbsp;Eric H Souied,&nbsp;Salomon Y Cohen","doi":"10.1097/IAE.0000000000003555","DOIUrl":"https://doi.org/10.1097/IAE.0000000000003555","url":null,"abstract":"","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"e44-e45"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40617765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXTREME MACULAR SCHISIS-SIMULATING RETINAL DETACHMENT IN EYES WITH PATHOLOGIC MYOPIA.","authors":"Kengo Uramoto,&nbsp;Takeshi Azuma,&nbsp;Takashi Watanabe,&nbsp;Hiroyuki Takahashi,&nbsp;Tae Igarashi-Yokoi,&nbsp;Noriaki Shimada,&nbsp;Kyoko Ohno-Matsui","doi":"10.1097/IAE.0000000000003544","DOIUrl":"https://doi.org/10.1097/IAE.0000000000003544","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the clinical and imaging characteristics, natural course, and surgical outcomes of pathologic myopic eyes with an extreme macular schisis simulating a retinal detachment (EMSSRD).</p><p><strong>Methods: </strong>The data of 617 highly myopic eyes with myopic traction maculopathy were studied. The diagnosis of EMSSRD in the optical coherence tomography images was made based on a high elevation of the retina (>500 µ m), less obvious columnar structures, and the presence of thin remnants of outer retinal tissues above the retinal pigment epithelium.</p><p><strong>Results: </strong>Among 617 eyes, 25 eyes had an EMSSRD. All of the eyes with an EMSSRD had macular atrophy caused by myopic macular neovascularization. In the five eyes they had progressed to MHRD, the retinal detachment started away from the macular atrophy. Among the 10 eyes which required surgery, there was no significant difference in the presurgical and postsurgical best-corrected visual acuity between the eyes operated because of a worsening of the EMSSRD and the eyes operated because of a progression to MHRD.</p><p><strong>Conclusion: </strong>In severely myopic eyes with macular neovascularization-related macular atrophy, a novel condition termed EMSSRD can be present. The optical coherence tomography images resemble those of a MHRD except the presence of thin remnants of the retina remaining on the retinal pigment epithelium.</p>","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"1836-1843"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40633617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INCREASED DISTANCE FROM THE CLINIC LEADS TO HIGHER LOSS TO FOLLOW-UP AFTER PARS PLANA VITRECTOMY IN DIABETIC PATIENTS.","authors":"John R Deans,&nbsp;Roshan George,&nbsp;Khalid Aldaas,&nbsp;Eric D Van Buren,&nbsp;J Niklas Ulrich","doi":"10.1097/IAE.0000000000003540","DOIUrl":"https://doi.org/10.1097/IAE.0000000000003540","url":null,"abstract":"<p><strong>Purpose: </strong>The importance of consistent outpatient follow-up for management of diabetic eye disease has been well-established. The objective of this study was to identify patient factors associated with being lost to follow-up in postsurgical patients after undergoing pars plana vitrectomy for diabetic eye disease.</p><p><strong>Methods: </strong>The charts of diabetic patients undergoing pars plana vitrectomy for nonclearing vitreous hemorrhage at an academic medical center by a single surgeon between 2012 and 2019 were reviewed. The rates of loss to follow-up during the postoperative period were compared based on patient distance from the clinic and insurance status.</p><p><strong>Results: </strong>A total of 144 patients met inclusion criteria. A total of 45 patients (31.25%) were lost to follow-up during the 3-month postoperative period. The rate of loss to follow-up increased with every postoperative visit and was significantly higher for patients living greater than 30 miles from the clinic versus patients living within 30 miles from the clinic. There was no statistically significant difference in loss to follow-up based on insurance status.</p><p><strong>Conclusion: </strong>Increased distance from the clinic presents a challenge to providing safe and effective postsurgical care to diabetic patients. This presents opportunities for comanagement or other creative strategies to improve postsurgical follow-up rates for at-risk patients.</p>","PeriodicalId":377573,"journal":{"name":"Retina (Philadelphia, Pa.)","volume":" ","pages":"1921-1925"},"PeriodicalIF":3.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40331928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}