Effect of axial length and age on the visual outcome of patients with idiopathic epiretinal membrane after pars plana vitrectomy

Minami, Sakiko; Shinoda, Hajime; Shigeno, Yuta; Nagai, Norihiro; Kurihara, Toshihide; Watanabe, K.; Sonobe, Hideki; Takagi, Hitoshi; Ozawa, Yoko

doi:10.1038/s41598-019-55544-6

Cited by 9 publications

(4 citation statements)

References 42 publications

(35 reference statements)

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“…We found that a shorter AL was a risk factor for PVR-C, irrespective of surgical invasion; PVR formation may progress easily in eyes with a shorter AL. The impact of a shorter AL on the vitreoretinal condition was discussed in our previous study; the visual outcome of iERM after pars plana vitrectomy was poor in eyes with a shorter AL, although the post-operative best-corrected visual acuity improved in comparison with the preoperative value [15]. We discussed that eyes with a shorter AL may have an undetached or incompletely detached posterior vitreous.…”

Section: Discussionmentioning

confidence: 67%

“…The J-RD Registry, which was established referring to previous population-based studies [14], collected data from 3446 participants with retinal detachment, who were registered at 26 qualified institutions. In this study, we analyzed the risk factors of patients who exhibited PVR at baseline, i.e., before surgery, and focused on the conditions of retinal detachment and native features of the eyes, i.e., axial length (AL), with the potential to affect the posterior vitreous condition, with respect to liquefaction and detachment [15]. We previously reported that a shorter AL was related to relatively poor postoperative visual outcomes in patients with an idiopathic epiretinal membrane (iERM).…”

Section: Introductionmentioning

confidence: 99%

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Shorter Axial Length Is a Risk Factor for Proliferative Vitreoretinopathy Grade C in Eyes Unmodified by Surgical Invasion

Minami

Uchida

Nagai

et al. 2021

JCM

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Purpose: To investigate the risk factors for the development of proliferative vitreoretinopathy grade C (PVR-C), independent of prior surgical invasion. Methods: Patients who underwent surgery for rhegmatogenous retinal detachment were prospectively registered with the Japan-Retinal Detachment Registry, organized by the Japanese Retina and Vitreous Society, between February 2016 and March 2017. Data obtained from general ophthalmic examinations performed before and at 1, 3, and 6 months after surgery were analyzed. Results: We included 2013 eyes of 2013 patients (men, 1326 (65.9%); mean age, 55.2 ± 15.2 years) from amongst 3446 registered patients. Preoperative PVR-C was observed in 3.6% of patients. Propensity score matching revealed that a shorter axial length (AL) was a risk factor for preoperative PVR-C (OR (Odds Ratio), 0.81; 95%CI (Confidence Interval), 0.69 to 0.96; p = 0.015), which was a risk factor for surgical failure (OR, 4.22; 95%CI, 1.12 to 15.93; p = 0.034); the association was particularly significant for eyes with an AL < 25.0 mm (p = 0.016), while it was insignificant for eyes with an AL ≥ 25.0 mm. Conclusions: A shorter AL was related to the development of PVR-C before surgical invasion. Our results will help elucidate the fundamental pathogenesis of PVR and caution clinicians to meticulously examine eyes with a shorter AL to detect retinal detachment before PVR development.

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Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Shorter Axial Length Is a Risk Factor for Proliferative Vitreoretinopathy Grade C in Eyes Unmodified by Surgical Invasion

Minami

Uchida

Nagai

et al. 2021

JCM

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“…None of these biomarkers can be tissue or disease specific, although their increased expression as well as just their presence can be of great diagnostic and prognostic value ( Strimbu and Tavel, 2010 ). Last, it is important to mention that some OCT parameters could be used to predict postoperative visual outcomes in patients with iERM treated with PPV ( Minami et al, 2019 ).…”

Section: Retinal Diseases: the Mechanisms Behind Clinical Manifestatimentioning

confidence: 99%

Biomarkers of Neurodegeneration and Precision Therapy in Retinal Disease

et al. 2021

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Vision-threatening retinal diseases affect millions of people worldwide, representing an important public health issue (high social cost) for both technologically advanced and new-industrialized countries. Overall RD group comprises the retinitis pigmentosa, the age-related macular degeneration (AMD), the diabetic retinopathy (DR), and idiopathic epiretinal membrane formation. Endocrine, metabolic, and even lifestyles risk factors have been reported for these age-linked conditions that represent a “public priority” also in this COVID-19 emergency. Chronic inflammation and neurodegeneration characterize the disease evolution, with a consistent vitreoretinal interface impairment. As the vitreous chamber is significantly involved, the latest diagnostic technologies of imaging (retina) and biomarker detection (vitreous) have provided a huge input at both medical and surgical levels. Complement activation and immune cell recruitment/infiltration as well as detrimental intra/extracellular deposits occur in association with a reactive gliosis. The cell/tissue aging route shows a specific signal path and biomolecular profile characterized by the increased expression of several glial-derived mediators, including angiogenic/angiostatic, neurogenic, and stress-related factors (oxidative stress metabolites, inflammation, and even amyloid formation). The possibility to access vitreous chamber by collecting vitreous reflux during intravitreal injection or obtaining vitreous biopsy during a vitrectomy represents a step forward for an individualized therapy. As drug response and protein signature appear unique in each single patient, therapies should be individualized. This review addresses the current knowledge about biomarkers and pharmacological targets in these vitreoretinal diseases. As vitreous fluids might reflect the early stages of retinal sufferance and/or late stages of neurodegeneration, the possibility to modulate intravitreal levels of growth factors, in combination to anti-VEGF therapy, would open to a personalized therapy of retinal diseases.

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“…Several studies have demonstrated a remarkable improvement in vision and life quality after ERM surgeries. [7][8][9][10] Therefore, ERM surgeries are essential for elderly patients. However, for some elders, advanced age remains a barrier to undergo ERM surgery.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic Epiretinal Membrane Surgery in Patients Aged Over 80 Years: Efficacy and Safety

Li,

Yang,

et al. 2023

OPTH

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Purpose To evaluate the efficacy and safety of idiopathic epiretinal membrane (ERM) surgery in patients aged over 80 years. Methods Consecutive patients who underwent pars plana vitrectomy (PPV) combined with ERM and internal limiting membrane (ILM) peeling with retrobulbar anesthesia were recruited. Based on age, the patients were divided into the elderly group (≥ 80 years of age) and the control group (< 80 years of age). The best-corrected visual acuity (BCVA) and surgical complications were regarded as the main measurement indicators. Results This study included 43 eyes from 43 patients aged 80 to 91 years and 86 eyes from 86 patients aged 54 to 79 years. Surgical intervention substantially improved BCVA both in the elderly and control groups (p = 0.005 and p < 0.001, respectively). Statistical analyses showed no significant difference in the incidence of surgical complications between the two groups (p = 0.631). The operations in either group were not delayed or canceled for the reason of complications of retrobulbar anesthesia, severe anxiety, or physical discomfort in the perioperative period. Moreover, no patient required a second operation. Also, no stroke, myocardial infarction, or death occurred during the follow-up period. All the surgical complications were treated satisfactorily. Conclusion Our outcomes indicate that PPV combined with ERM and ILM peeling with retrobulbar anesthesia is effective and safe in elderly patients aged 80 years or older. Based on age alone, we believe that advancing age should not be the risk factor for idiopathic ERM surgery.

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Effect of axial length and age on the visual outcome of patients with idiopathic epiretinal membrane after pars plana vitrectomy

Cited by 9 publications

References 42 publications

Shorter Axial Length Is a Risk Factor for Proliferative Vitreoretinopathy Grade C in Eyes Unmodified by Surgical Invasion

Shorter Axial Length Is a Risk Factor for Proliferative Vitreoretinopathy Grade C in Eyes Unmodified by Surgical Invasion

Biomarkers of Neurodegeneration and Precision Therapy in Retinal Disease

Idiopathic Epiretinal Membrane Surgery in Patients Aged Over 80 Years: Efficacy and Safety

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