Retina-The Journal of Retinal and Vitreous Diseases最新文献

{"title":"A Novel Surgical Technique for Macular Manipulation in Highly Myopic Eyes With Long Axial Length.","authors":"Takayuki Baba, Tomohiro Nizawa, Takehito Iwase, Daisuke Shimizu","doi":"10.1097/IAE.0000000000004195","DOIUrl":"10.1097/IAE.0000000000004195","url":null,"abstract":"<p><strong>Purpose: </strong>The authors developed a novel surgical technique tailored for highly myopic eyes characterized by extended axial lengths. Myopic eyes are prone to macular complications including macular schisis, full-thickness macular holes, and retinal detachment, which can cause severe vision loss. A pars plana vitrectomy is necessary in these cases. However, because of the considerable distance between the posterior pole and the cannula, regular forceps cannot reach the macula in some cases. To overcome this, the authors inserted a trocar more posteriorly after localizing the ora serrata.</p><p><strong>Methods: </strong>First, the authors placed two ports and performed partial vitrectomy without the infusion of balanced salt solution to reduce the intraocular pressure. Subsequently, the authors observed the peripheral retina localized to the ora serrata by scleral indentation using forceps. After the precise marking of the area, a third trocar was inserted and its position and placement confirmed intraoperatively.</p><p><strong>Results: </strong>Surgical maneuvers including a removal of the internal limiting membrane were safely performed using regular forceps through the posteriorly located cannula.</p><p><strong>Conclusion: </strong>The described technique offers a solution to the challenges posed by the extended axial lengths of highly myopic eyes during vitreoretinal surgery. By inserting the trocar more posteriorly, surgeons can enhance accessibility to the macula without requiring specialized equipment or extensive maneuvers.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":"45 3","pages":"579-582"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INCIDENCE AND RISK FACTORS FOR PROGRESSION OF PACHYCHOROID DISEASE SPECTRUM.","authors":"Angie Hon Chi Fong, Jinzhi Zhao, Wendy Meihua Wong, Beau Fenner, Shaun Sim, Anna C S Tan, Xin Yi Su, Kelvin Y C Teo, Chui Ming Gemmy Cheung","doi":"10.1097/IAE.0000000000004336","DOIUrl":"10.1097/IAE.0000000000004336","url":null,"abstract":"<p><strong>Purpose: </strong>To report the 1-year progression rate and associated risk factors in an Asian cohort of patients with pachychoroid disease spectrum phenotype.</p><p><strong>Methods: </strong>The authors report the 1-year findings from a prospective observational study, recruiting subjects with subfoveal choroidal thickness of ≥300 µm. Each eye was evaluated at baseline and at month 12 according to a standardized protocol including visual acuity and multimodal imaging.</p><p><strong>Results: </strong>A total of 223 eyes of 133 participants (mean age 59.23 ± 9.18 years, 27.1% female) finished 1-year follow-up. Distribution of baseline diagnosis was uncomplicated pachychoroid (43 eyes), pachychoroid pigment epitheliopathy (108 eyes), central serous chorioretinopathy (54 eyes), and pachychoroid neovasculopathy (18 eyes). There was no significant change in the mean best-corrected visual acuity or subfoveal choroidal thickness. Fourteen eyes (6.3%) evolved to a different pachychoroid disease spectrum diagnosis, but there was no significant change in the mean best corrected visual acuity (BCVA) Logarithm of the minimum angle of resolution 0.15 ± 0.18 (Snellen equivalent 20/30) versus 0.07 ± 0.11 (Snellen equivalent 20/25), (P = 0.18) or subfoveal choroidal thickness (426.8 ± 59.2 vs. 456.3 ± 89.5, P = 0.49). Incident neovascularization developed in eight eyes (3.6%, five from pachychoroid pigment epitheliopathy, three from central serous chorioretinopathy). Seven patients received treatment (three anti-vascular endothelial growth factor [VEGF] and four photodynamic therapy). Factors associated with developing neovascularization include older age, smoking, and the presence of shallow irregular retinal pigment epithelium elevation on optical coherence tomography.</p><p><strong>Conclusion: </strong>At 1 year, pachychoroid disease spectrum remains relatively stable with low progression rate. Older age, smoking, and the presence of shallow irregular retinal pigment epithelium elevation were associated with higher rates of neovascular complications.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":"45 3","pages":"426-434"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PNEUMATIC DISPLACEMENT AND INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR, WITH OR WITHOUT INTRAVITREAL TISSUE PLASMINOGEN ACTIVATOR, INJECTION FOR SUBMACULAR HEMORRHAGE.","authors":"Patraramon Chotikkakamthorn, Patama Bhurayanontachai, Pichai Jirarattanasopa, Wantanee Dangboon Tsutsumi, Thada Tantisarasart, Mansing Ratanasukon","doi":"10.1097/IAE.0000000000004337","DOIUrl":"10.1097/IAE.0000000000004337","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the outcomes of intravitreal gas and anti-vascular endothelial growth factor (anti-VEGF), with or without tissue plasminogen activator (tPA), injection for submacular hemorrhage (SMH).</p><p><strong>Methods: </strong>The authors retrospectively enrolled patients with SMH treated with intravitreal gas and anti-VEGF, with or without tPA (tPA and non-tPA groups, respectively), injection between 2014 and 2021, and data were collected at the preoperative visit and at 1-, 3-, 6-, and 12-month follow-ups. The primary outcome was the final best-corrected visual acuity, and the secondary outcomes were central subfield thickness, degree of blood displacement, and incidence of vitreous hemorrhage.</p><p><strong>Results: </strong>Herein, 38 eyes received intravitreal gas, anti-VEGF, and tPA injections, whereas 89 eyes received intravitreal gas and anti-VEGF injections. At 12 months, no significant intergroup difference was detected (P = 0.94), except the slightly greater central subfield thickness change in the non-tPA group (P = 0.03). Complete SMH displacement occurred in 35 (tPA = 92.1%) and 89 (non-tPA = 89.9%) eyes, with higher vitreous hemorrhage incidence in the non-tPA group (odds ratio 7.03, P = 0.004).</p><p><strong>Conclusion: </strong>In pneumatic displacement combined with anti-VEGF therapy in SMH, adjunctive tPA use did not alter the visual and anatomical outcomes, although the vitreous hemorrhage risk in large SMH was reduced.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":"45 3","pages":"394-401"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SUBRETINAL PIGMENT EPITHELIUM OPTICALLY EMPTY STRUCTURES IN POLYPOIDAL CHOROIDAL VASCULOPATHY: A Novel Optical Coherence Tomography Finding.","authors":"Kelvin Yi Chong Teo, Yu Jeat Chong, Chui Ming Gemmy Cheung","doi":"10.1097/IAE.0000000000004327","DOIUrl":"10.1097/IAE.0000000000004327","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the appearance of a novel optical coherence tomography (OCT) feature in polypoidal choroidal vasculopathy and report its prevalence in a clinical cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed the OCT and indocyanine green angiography images of eyes with polypoidal choroidal vasculopathy. Main outcome measures included the appearance, prevalence, and longitudinal changes of \"optically empty subretinal pigment epithelium (RPE) structures\" on OCT and correlate them with indocyanine green angiography and OCT angiography.</p><p><strong>Results: </strong>We evaluated OCT of 55 patients. Each patient had monthly OCT from baseline to month 12. Presence of sub-RPE optically empty structures at any visit was detected in 10 eyes (7 at baseline, three during follow-up). These lesions are located under the RPE and are characterized by homogenously hyporeflective content similar to the vitreous cavity, which appear optically empty. Additional features include hypertransmission tail into choroid, round/polygonal in shape surrounded by thin wall and fuzzy overlying RPE. When compared with indocyanine green angiography, these structures can be colocalized to the area of pooling associated with polypoidal lesions but can persist after polyp regression. No flow signal was detected within the center of these optically empty structures.</p><p><strong>Conclusion: </strong>Sub-RPE optically empty structures likely represent spaces not filled with blood and are distinct from the lumen of a polypoidal lesion.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":"45 3","pages":"435-445"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RETINAL DISPLACEMENT AFTER IDIOPATHIC MACULAR HOLE SURGERY: Layer by Layer Analysis.","authors":"Tommaso Rossi, Giorgio Querzoli, Guido Ripandelli, Luca Placentino, Mariacristina Parravano, David H Steel, Mario R Romano","doi":"10.1097/IAE.0000000000004352","DOIUrl":"10.1097/IAE.0000000000004352","url":null,"abstract":"<p><strong>Purpose: </strong>To measure the displacement of retinal vascular plexi and choriocapillaris after pars plana vitrectomy for idiopathic macular hole, using optical coherence tomography angiography, and correlate it with clinical data.</p><p><strong>Methods: </strong>Retrospective series with a 6-month follow-up. Records included Best Corrected Visual Acuity, M-charts, structural optical coherence tomography, and optical coherence tomography angiography. Coronal displacement was calculated comparing consecutive images across the 6.4 mm × 6.4 mm field and concentric circular regions of 0.5, 1.5, and 3.0 mm radii . Each circular region was further divided in four quadrants indicated as follows: SuperoTemporal; SuperNasal; InferoTemporal; InferoNasal.</p><p><strong>Results: </strong>The study comprised 33 patients (11 men and 22 women) with 68.9 ± 10.2 years mean age, similar among sexes. Macular hole closed in 31/33 (93.9%) of cases and Best Corrected Visual Acuity improved from mean 20/62 (0.50 ± 0.62 logarithm of Minimum Angle of Resolution) to 20/47 (0.23 ± 0.63 logarithm of Minimum Angle of Resolution; P = 0.0064). Vertical and horizontal metamorphopsia decreased from 0.98 ± 0.68 to 0.51 ± 0.59° ( P = 0.0028) and 0.84 ± 0.63 to 0.29 ± 0.45° ( P < 0.001), respectively. The average retinal displacement was 81.2 ± 44.1 µ m for the superficial plexus and 79.4 ± 45.7 µ m for the deep one, both greater than the choriocapillaris displacement (60.9 ± 20.2 µ m; P < 0.05). The temporal and superior quadrants displaced more than the others ( P < 0.05). Macular hole size correlated to retinal displacement within the central 0.5-mm radius area at all layers ( P < 0.05 in all cases).</p><p><strong>Conclusion: </strong>Macular hole closure is associated with significant retinal displacement of all retinal layers and choriocapillaris remodeling. Surgical peeling removes the constraining effect of the internal limiting membrane and promotes a multilayered displacement that fills the retinal defect, likely due to a change in the equilibrium of forces between the contractile retinal structures: the larger superficial retinal vessels and the retinal nerve fiber layer.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"410-419"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PATHOGENESIS, PROGNOSIS, AND SURGICAL OUTCOMES OF FULL-THICKNESS MACULAR HOLES IN MACULAR TELANGIECTASIA TYPE 2: A Literature Review.","authors":"Matteo Mario Carlà, Mattia Cusato, Lorenzo Hu, Stanislao Rizzo","doi":"10.1097/IAE.0000000000004375","DOIUrl":"10.1097/IAE.0000000000004375","url":null,"abstract":"<p><strong>Purpose: </strong>Macular telangiectasia type 2 (MacTel2) is a rare disorder, affecting retina's vascular structure, and MacTel2-associated full-thickness macular holes (MHs) are extremely rare in general population. Since their management is still controversial, this literature review was aimed to gather evidences on the surgical management of MacTel2-associated MHs.</p><p><strong>Methods: </strong>A retrospective review on the Cochrane Central, PubMed, Web of Science, and ClinicalTrials.gov databases for articles regarding MacTel2 and MHs. The search period was set from January 2000 to February 2024, and any kind of article was taken into account.</p><p><strong>Results: </strong>We took into account 10 studies analyzing surgical outcomes of MacTel2-associated MHs, with a total number of 95 treated eyes. Different surgical techniques were used, with a better anatomical outcome after internal limiting membrane inverted flap surgery but with very controversial functional outcomes. In a comparative report, internal limiting membrane peeling alone (34 eyes) was associated with a 47% anatomical success rate, internal limiting membrane inverted flap (22 eyes) with 90% successful closure, and autologous retinal transplantation (five eyes) with a 100% success rate but without visual improvement.</p><p><strong>Conclusion: </strong>Since the exact pathophysiology of MacTel2 macular holes is not clear yet, even if the internal limiting membrane inverted flap technique could be an effective treatment for these patients, visual outcomes are poor. This underlines the necessity of a deeper comprehension of the pathophysiology of the disease and the development of new surgical approaches.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"375-382"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPLIT OUTER PLEXIFORM LAYER APPEARANCE REPRESENTS AN ACQUIRED CONE DYSFUNCTION PHENOTYPE OF AUTOIMMUNE RETINOPATHY.","authors":"Timothy M Boyce, Christopher Fortenbach, Matthew Thurtell, Edwin M Stone, Ian C Han","doi":"10.1097/IAE.0000000000004332","DOIUrl":"10.1097/IAE.0000000000004332","url":null,"abstract":"<p><strong>Purpose: </strong>Autoimmune retinopathy (AIR) is a poorly understood condition with a wide phenotypic spectrum and heterogeneous findings on clinical examination and imaging. In this study, the authors characterize the clinical features of a recently described phenotypic subtype of AIR with a distinct split outer plexiform layer appearance on OCT.</p><p><strong>Methods: </strong>This was a retrospective, observational study of patients with a diagnosis of AIR seen at the University of Iowa between January 2007 and September 2023 who were found to have decreased visual acuity, central scotoma on visual field testing, split outer plexiform layer appearance on OCT, and abnormal light-adapted electroretinogram, consistent with an acquired cone dysfunction. Clinical course and multimodal imaging and physiologic testing were reviewed.</p><p><strong>Results: </strong>Ten patients were identified in the retrospective cohort. All patients presented with bilateral, asymmetric, subacute, and progressive central vision loss. A diagnosis of cancer was present or subsequently diagnosed in 5 out of 10 patients (50%). Overall, 40% of patients underwent treatment with immunosuppressives, and one patient underwent tumor resection, with partial visual recovery seen.</p><p><strong>Conclusion: </strong>Patients with split outer plexiform layer appearance on OCT have an acquired cone dysfunction that is important to recognize as treatment in some cases may result in improved or stabilized visual function.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":"45 3","pages":"522-531"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PNEUMATIC RETINOPEXY FOR GIANT RETINAL TEAR-ASSOCIATED RETINAL DETACHMENT: A Retrospective Cohort Study.","authors":"Miguel Cruz-Pimentel, Mohammed Alfalah, Wei Wei Lee, Isabela Martins-Melo, Jovi C Wong, Neda Pirouzmand, Aurora Pecaku, Sueellen Demian, Faryal Maniyali, Peter J Kertes, Rajeev H Muni","doi":"10.1097/IAE.0000000000004344","DOIUrl":"10.1097/IAE.0000000000004344","url":null,"abstract":"<p><strong>Purpose: </strong>To report the technique and long-term outcomes of patients with giant retinal tear-associated retinal detachment treated with pneumatic retinopexy (PnR).</p><p><strong>Methods: </strong>Retrospective cohort study. All patients presenting with giant retinal tear-associated retinal detachment with tears in the superior ten-clock hours who underwent primary PnR were included in this study .</p><p><strong>Results: </strong>Thirty-one patients were included in the study. Of these, 61.2% (19 of 31) achieved primary reattachment rate (PARR) with PnR at 3 months and 58.0% (18 of 31) at the final follow-up. Patients included in this study had a median follow-up of 24 months (interquartile range 46.5 months). The absence of retinal tears elsewhere at baseline was associated with a final PARR of 80% (16 of 20) ( P = 0.007). Thirteen eyes required pars plana vitrectomy after a failed PnR. Two eyes required the intraoperative use of perfluorocarbon liquids. No eyes required silicone oil. Visual acuity improved significantly from baseline to the last follow-up. Final anatomical reattachment rate was 100% (31 of 31).</p><p><strong>Conclusion: </strong>For selected cases of giant retinal tear associated retinal detachments affecting the superior ten-clock hours, PnR could be a possible treatment option when patients consent to extra visits and the surgeon has substantial expertise. When lacking this extensive experience and comfort with PnR, pars plana vitrectomy remains the treatment that is most likely to result in a primary anatomical reattachment. Although this study provides guidance on PnR technique for giant retinal tear associated retinal detachments, it is essential to note that the reported PARR may be contingent on the expertise of the surgeon/center, and the authors recommend that those new to PnR first gain substantial experience in cases meeting clinical trial criteria.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"383-393"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INCIDENCE OF CENTRAL SEROUS CHORIORETINOPATHY AND ITS ASSOCIATION WITH GYNECOLOGICAL DISEASES IN WOMEN: A Population-Based Nested Case-Control Study.","authors":"Ju-Yeun Lee, Eunbee Noe, Chang Ki Yoon, Eun Kyoung Lee, Un Chul Park, Kunho Bae","doi":"10.1097/IAE.0000000000004334","DOIUrl":"10.1097/IAE.0000000000004334","url":null,"abstract":"<p><strong>Purpose: </strong>Although the exact pathogenesis of central serous chorioretinopathy (CSC) remains unclear, some factors are known to be sex-specific. We aimed to investigate the incidence and systemic associations for CSC in women.</p><p><strong>Methods: </strong>This population-based nested case-control study included East Asian women whose medical claims data were obtained from the Korean National Health Insurance Service database. Patients newly diagnosed with CSC between 2017 and 2019 were assigned to the CSC group and matched to healthy controls in a 1:4 ratio by age, gender, and index date. The incidence of CSC in women and its association with gynecologic comorbidities and corticosteroid use before the index date (2008-2017) were analyzed.</p><p><strong>Results: </strong>The study matched 3,789 patients with CSC with 15,156 controls. The 3-year cumulative incidence of CSC in women was 27.13 (95% confidence interval [CI], 27.06-27.19) per 100,000 people. Multivariate logistic analysis showed a significantly increased association of CSC in patients with pre-eclampsia (adjusted odds ratio, 2.66; 95% CI, 1.86-3.81) (P < 0.001), endometriosis (adjusted odds ratio, 1.19; 95% CI, 1.03-1.38) (P < 0.001), steroid injections alone (adjusted odds ratio, 1.29; 95% CI, 1.16-1.43) (P < 0.001), and combination use of oral and injected steroid (adjusted odds ratio, 1.34; 95% CI, 1.23-1.47) (P < 0.001) compared with the controls.</p><p><strong>Conclusion: </strong>This study provides nationwide population-based data on the incidence of CSC in Asian women and suggests that exposure to specific gynecological comorbidities and intensive corticosteroid use are associated with the development of CSC in women.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":"45 3","pages":"541-547"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EARLY SILICONE OIL OPACIFICATION IN THE ABSENCE OF EMULSIFICATION IS CAUSED BY AN INCREASED LEVEL OF SILICONE DIOXIDE.","authors":"Maximilian Hammer, Leoni Britz, Manuel Ben Böhmann, Lorenz Herbster, Marcel Muuss, Jonathan Herth, Sebastian Cionoiu, Holger Krisp, Martin Stephan Spitzer, Sabrina Wohlfart, Philipp Uhl, Gerd Uwe Auffarth","doi":"10.1097/IAE.0000000000004324","DOIUrl":"10.1097/IAE.0000000000004324","url":null,"abstract":"<p><strong>Background/purpose: </strong>In October 2023, other cases with early silicone oil opacification within hours after intraocular implantation in the absence of emulsification occurred. Although multiple, small series of this phenomenon are now documented during the past decade, the cause was never unmasked. In this study, we analyzed explanted patient samples, unused samples of the affected, and a control batch of the same silicone oil.</p><p><strong>Methods: </strong>The oils were examined on their optical and viscosimetric properties, interfacial tension, and for the presence of particles. Contamination was investigated using inductively coupled plasma mass spectrometry, thermogravimetric analyses, and Raman spectroscopy. Cytotoxicity examination in ARPE-19 cells was performed. The oil's effect on pH changes of aqueous solutions and the oil's defoaming ability were analyzed.</p><p><strong>Results: </strong>The affected batch passed all regulatory limits. However, the affected batch showed an elevated turbidity already before implantation. Three thousand-fold magnification revealed dispersed particles only in the affected batch. Contamination analyses revealed the absence of other elements, indicating a silicon-containing contamination. The affected batch showed no in vitro cytotoxicity but altered viscosimetric properties and a lower pH of the hydrophilic phase after inducing emulsification. Both batches did not show relevant defoaming properties.</p><p><strong>Conclusion: </strong>The results obtained combined with information from suppliers and the manufacturer suggest an elevated level of silica particles as the cause of the opacification. Based on these results, the manufacturer and suppliers of the latest affected batch adjusted cutoff values for turbidity measurements and introduced turbidity measurements of the raw material before distillation. Other manufacturers should follow these preventive measures.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"491-500"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}