Inflammation and Macular Oedema after Pars Plana Vitrectomy

Romano, Vito; Angi, Martina; Scotti, Fabrizio; Grosso, Renata del; Romano, Davide; Semeraro, Francesco; Vinciguerra, Paolo; Costagliola, Ciro; Romano, Mario R.

doi:10.1155/2013/971758

Cited by 52 publications

(42 citation statements)

References 91 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Almost any intraocular procedure can be complicated by the development of CME, including surgery for cataract, glaucoma, and cornea and vitreoretinal disorders. However, while many advances have been made in our knowledge regarding the incidence, predisposing factors, visual outcomes, and therapeutic options for CME after cataract surgery, less information is available for CME after vitreoretinal surgery [57].…”

Section: Cystoid Macular Edemamentioning

confidence: 99%

“…Topical treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids aims at decreasing the production of inflammatory molecules involved in the breakdown of the blood-retinal barrier. Topical NSAIDs have been shown to be able to reach the vitreous chamber in significant concentrations to produce structural and clinical changes [57]. Systemic steroids, on the opposite, were not able to give significant functional and anatomical improvements in patients with postsurgical CME after vitreoretinal procedures.…”

Section: Cystoid Macular Edemamentioning

confidence: 99%

See 1 more Smart Citation

Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography

Cicinelli

Marchese

Bandello

et al. 2019

Journal of Ophthalmology

View full text Add to dashboard Cite

Aim. To summarize the spectrum of optical coherence tomography (OCT) and OCT angiography (OCTA) features after full-thickness macular hole (MH) repair surgery. Methods. A PubMed engine search was carried out using the terms “Macular Hole,” “Optical Coherence Tomography,” and “Optical Coherence Tomography Angiography.” All reports published in English up to October 2018, irrespective of their publication status, were included. Tomographic signs analyzed were divided according to the involved portion of the retina in “inner retinal layers” and “external retinal layers.” Despite predominantly involving the inner retinal layers, cystoid macular edema (CME) has been treated as a separate entity. Finally, report on vessel density (VD) changes and the foveal avascular zone (FAZ) area modifications have been included. Results. Different clinical findings can be observed on OCT of patients who underwent MH repair surgery. There is general consent that retinal thinning involving primarily the retinal nerve fiber layer and the ganglion cell layer takes place after surgery. In the postoperative period, the outermost retinal layers get progressively restored. Persistent defects in the ellipsoid zone or in the external limiting membrane correlate with worse postoperative visual outcome. OCTA has globally demonstrated that eyes after MH closure show a reduction in macular and paramacular VD and smaller FAZ areas, compared with control or fellow eyes. Conclusion. Clinicians should be aware of the most common tomographic findings to properly manage each condition. In addition, significant advantages for the postoperative application of OCT and OCTA include noninvasiveness, rapid and simple execution, repeatability, and precise measurements.

show abstract

Section: Cystoid Macular Edemamentioning

confidence: 99%

Section: Cystoid Macular Edemamentioning

confidence: 99%

Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography

Cicinelli

Marchese

Bandello

et al. 2019

Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Vasogenic macular oedema (MO) develops as a result of breakdown of the blood-retina barrier and inability of the cellular mechanisms (neuronal and glial) in the retina to decompensate and restore the integrity of the layers to normal [3]. MO is a common pathological endpoint of many pathological ocular entities, including diabetic retinopathies, retinal vein occlusion, retinal surface pathologies and inflammatory conditions (uveitis or inflammation after ocular surgery) [2,4]. Deterioration of central visual acuity is common to all of the above conditions, making MO a highly troublesome pathology for the patient and a therapeutic challenge for the ophthalmological community.…”

Section: Introductionmentioning

confidence: 99%

Long-term efficacy and duration of action of dexamethasone implant, in vitrectomised and non-vitrectomised eyes with persistent diabetic macular oedema

Bastakis

Dimopoulos

Stavrakakis

et al. 2018

Eye

View full text Add to dashboard Cite

Purpose To evaluate the efficacy and duration of action of an intravitreal (dexamethasone (Ozurdex)) implant in vitrectomised and non-vitrectomised eyes with persistent diabetic macular oedema (DMO). Methods We retrospectively analysed the records for 18 eyes that had or had not been vitrectomised but required an intravitreal dexamethasone implant for DMO after a poor response to anti-vascular endothelial growth factor. Optical coherence tomography and visual acuity (VA) examinations were performed before and 1, 3 and 6 months after implantation. The six months following implantation constituted one treatment round; up to three rounds were studied. Results Ten of 18 eyes had undergone vitrectomy. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were significantly improved by months 1-3 after implantation of the Ozurdex device in all rounds of treatment. The BCVA and CMT deteriorated gradually after month 3 through to month 6 post implantation. There were no statistically significant differences between the vitrectomised and non-vitrectomised groups at any time point. When the implantation interval was <6 weeks from the end of each treatment round, the improvement in BCVA and CMT was obvious even after 18 months of treatment. Conclusions Vitrectomy did not have a negative effect on the duration of action or efficacy of the Ozurdex implant in patients with persistent DMO. The implant started working from the first month after implantation regardless of whether vitrectomy had or had not been performed. The maximum functional and anatomic improvement was achieved in the first 3 months post implantation in all treatment rounds.

show abstract

“…The exact aetiology of CMO after RD repair is unclear but inflammation is thought to be an important mechanism. 2 , 3 Spontaneous resolution of CMO within 2 years postoperatively has been reported in up to 76% of cases. 4 Many strategies have been employed to manage CMO after RD surgery, with varying degrees of success.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Fluocinolone Acetonide (ILUVIEN) Implant for the Treatment of Refractory Cystoid Macular Oedema After Retinal Detachment Repair

Alfaqawi¹,

Sarmad²,

Ayesh³

et al. 2018

tjo

View full text Add to dashboard Cite

Cystoid macular oedema (CMO) is one of the most frequent postoperative macular complications to cause partial visual recovery after successful retinal detachment (RD) repair. Refractory CMO is difficult to treat and many strategies have been employed with varying degrees of success. We report for the first time the use of ILUVIEN implant to treat refractory CMO after successful RD repair. A 65-year-old female presented with right eye full-thickness macular hole and underwent pars plana vitrectomy, internal limiting membrane peeling and cryotherapy with gas tamponade with 12% C3F8. She subsequently developed right eye macula-on RD and proliferative vitreoretinopathy and required multiple procedures for successful retinal reattachment. Later, she developed CMO that responded to intravitreal triamcinolone injections and intravitreal dexamethasone 0.7-mg implants but recurrence of CMO continued to be a problem. After receiving ILUVIEN intravitreal implant, her visual acuity improved and CMO resolved without recurrence for 13 months. Refractory CMO after RD repair is difficult to treat and in a quarter of cases will not improve without treatment. Our case shows that a single ILUVIEN implant maintained anatomical dry fovea and improved vision. This also demonstrates that ILUVIEN is an effective management strategy to reduce the need for repeated treatments.

show abstract

Inflammation and Macular Oedema after Pars Plana Vitrectomy

Cited by 52 publications

References 91 publications

Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography

Inner Retinal Layer and Outer Retinal Layer Findings after Macular Hole Surgery Assessed by means of Optical Coherence Tomography

Long-term efficacy and duration of action of dexamethasone implant, in vitrectomised and non-vitrectomised eyes with persistent diabetic macular oedema

Intravitreal Fluocinolone Acetonide (ILUVIEN) Implant for the Treatment of Refractory Cystoid Macular Oedema After Retinal Detachment Repair

Contact Info

Product

Resources

About