Evaluation of neuroretinal integrity in optical coherence tomography‐graded eyes with partial‐thickness macular holes

Stino, Heiko; Wassermann, Lorenz; Ristl, Robin; Abela-Formanek, Claudette; Georgopoulos, Michael; Sacu, Stefan; Schmidt‐Erfurth, Ursula; Pollreisz, Andreas

doi:10.1111/aos.15156

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Thus, a complete anatomical and visual regression was never reported at 1 year following non-surgical, non-invasive treatment. Stino et al (2022) recently described the time-course following partial thickness macular holes. In this study epi-retinal proliferation was associated with worsening of visual acuity, which was accompanied by neuro-retinal tissue loss with wider foveal cavities and thinner foveal floors.…”

Section: Discussionmentioning

confidence: 99%

Combined pulses of light and sound in the retina with nutraceuticals may enhance the recovery of foveal holes

Pinelli¹,

Berti²,

Scaffidi³

et al. 2022

Archives Italiennes De Biologie

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The present manuscript stems from evidence, which indicates that specific wavelength produce an activation of the autophagy pathway in the retina. These effects were recently reported to synergize with the autophagy-inducing properties of specific phytochemicals. The combined administration of photo-modulation and phytochemicals was recently shown to have a strong potential in eliciting the recovery in the course of retinal degeneration and it was suggested as a non-invasive approach named "Lugano protocol" to treat age-related macular degeneration (AMD). Recent translational findings indicate that the protective role of autophagy may extend also to acute neuronal injuries including traumatic neuronal damage. At the same time, very recent investigations indicate that autophagy activation and retinal anatomical recovery may benefit from sound exposure. Therefore, in the present study, the anatomical rescue of a traumatic neuronal loss at macular level was investigated in a patient with idiopathic macular hole by using a combined approach of physical and chemical non-invasive treatments. In detail, light exposure was administered in combination with sound pulses to the affected retina. This treatment was supplemented by phytochemicals known to act as autophagy inducers, which were administered orally for 6 months. This combined administration of light and sound with nutraceuticals reported here as Advanced Lugano's Protocol (ALP) produced a remarkable effect in the anatomical architecture of the retina affected by the macular hole. The anatomical recovery was almost complete at roughly one year after diagnosis and beginning of treatment. The structural healing of the macular hole was concomitant with a strong improvement of visual acuity and the disappearance of metamorphopsia. The present findings are discussed in the light of a synergism shown at neuronal level between light and sound in the presence of phytochemicals to stimulate autophagy and promote proliferation and neuronal differentiation of retinal stem cells.

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Section: Discussionmentioning

confidence: 99%

Combined pulses of light and sound in the retina with nutraceuticals may enhance the recovery of foveal holes

Pinelli¹,

Berti²,

Scaffidi³

et al. 2022

Archives Italiennes De Biologie

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“…Some observational case series suggest that LMH are relatively stable conditions [ 47 , 93 , 108 , 109 , 110 ]. Forty one eyes were followed for an average of 37 months with time domain OCT. LMH were diagnosed according to the following four criteria: irregular central foveal thinning, opening of the inner foveal layers, intraretinal splitting and intact foveal photoreceptors [ 8 , 25 , 108 ].…”

Section: Natural Historymentioning

confidence: 99%

“…A recent retrospective longitudinal case series, which used the recent classification proposed by Hubschman et al [ 17 ], reported that visual acuity remained stable in eyes with ERM foveoschisis, LMH and MPH. These eyes had a mean follow up of 10, 11 and 19 months, respectively [ 109 ].…”

Section: Natural Historymentioning

confidence: 99%

Primary Lamellar Macular Holes: To Vit or Not to Vit

Bradshaw

2022

JCM

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There is a wide spectrum of macular conditions that are characterized by an irregular foveal contour caused by a break in the inner fovea. These include full-thickness macular hole (FTMH), foveal pseudocyst, lamellar macular hole (LMH) and macular pseudohole (MPH). Clinical examination of vitreomacular interface disorders is notoriously poor in differentiating these conditions. These conditions were initially described with slit-lamp biomicroscopy, and the main goal was to distinguish an FTMH from the others. The introduction of optical coherence tomography (OCT) has revolutionized our understanding of the foveal microstructural anatomy and has facilitated differentiating these conditions from an FTMH. However, the definitions of the other conditions, particularly LMH, has evolved over the past two decades. Initially the term LMH encompassed a wide spectrum of clinical conditions. As OCT became more widely used and observations became more refined, two different phenotypes of LMH became apparent, raising the question of different pathogenic mechanisms for each phenotype. Tractional and degenerative pathological mechanisms were proposed. Epiretinal membranes (ERMs) associated with each phenotype were identified. Typical ERMs were associated with a tractional mechanism, whereas an epiretinal proliferation was associated with a degenerative mechanism. Epiretinal proliferation represents Müller cell proliferation as a reactive process to retinal injury. These two types of ERM were differentiated by their characteristics on SD-OCT. The latest consensus definitions take into account this phenotypic differentiation and classifies these entities into LMH, MPH and ERM foveoschisis. The initial event in both ERM foveoschisis and LMH is a tractional event that disrupts the Müller cell cone in the foveola or the foveal walls. Depending on the extent of Müller cell disruption, either a LMH or an ERM foveoschisis may develop. Although surgical intervention for LMH remains controversial and no clear guidelines exist for pars plana vitrectomy (PPV), eyes with symptomatic, progressive ERM foveoschisis and LMH may benefit from surgical intervention.

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