Intravitreal Expansile Gas in the Treatment of Early Macular Hole: Reappraisal

Abstract

Purpose: To study the effects of intravitreal injection (IVI) of expansile gas for early macular holes (EMH). Methods: Prospective interventional case series. Twelve eyes of 12 patients with EMH (stage 2) underwent IVI of perfluoropropane 0.2 ml followed by 5 days’ facedown positioning. Results: Six cases (50%) achieved vitreous-macula separation. Three cases (25%) had hole closure with vision improvement; one of them developed rhegmatogenous retinal detachment (RRD) and hole re-opening. Another case with persistent hole also developed RRD. Seven of the 9 cases without hole closure and the one where the hole re-opened had vitrectomy, all resulting in hole closure and vision improvement. Duration of symptoms had borderline significance for hole closure (p = 0.11) and subsequent visual improvement (p = 0.03). Conclusion: With its low success rate, IVI of gas may not be a good option for EMH. Complications include retinal detachment. The procedure seems to not affect hole closure with subsequent vitrectomy.

Vitreomacular Changes after Intravitreal Gas Injection for Idiopathic Impending or Early Macular Hole: An Optical Coherence Tomography Study

“…In our series, 1 case in the impending MH group developed FTMH after VMT resolution, and 4 cases in the early FTMH group had enlarged MH sizes after the release of traction. Similar findings were also observed by other intravitreal gas studies [2][3][4] . Our results showed unfavorable outcomes of MH closure with a primary success rate of only 23.1%.…”

Intravitreal gas for symptomatic vitreomacular adhesion: a synthesis of the literature

“…A total of 91 eyes from 90 patients with sVMA were included from one nonrandomized controlled study, six uncontrolled studies and two individual case reports (Table 1) (Chan et al 1995;Costa et al 2001;Jorge et al 2006;Mori et al 2007;Gupta & McHugh 2011;Chen et al 2012;Rodrigues et al 2013;Day et al 2016;Yu et al 2016). A total of 91 eyes from 90 patients with sVMA were included from one nonrandomized controlled study, six uncontrolled studies and two individual case reports (Table 1) (Chan et al 1995;Costa et al 2001;Jorge et al 2006;Mori et al 2007;Gupta & McHugh 2011;Chen et al 2012;Rodrigues et al 2013;Day et al 2016;Yu et al 2016).…”

“…Of 106 articles, 106 abstracts were assessed as potentially eligible, from which nine articles were deemed eligible after full-text review. A total of 91 eyes from 90 patients with sVMA were included from one nonrandomized controlled study, six uncontrolled studies and two individual case reports (Table 1) (Chan et al 1995;Costa et al 2001;Jorge et al 2006;Mori et al 2007;Gupta & McHugh 2011;Chen et al 2012;Rodrigues et al 2013;Day et al 2016;Yu et al 2016). Additional, anonymous participant-level VA data were obtained from one study author as this information was not available in his report, in accordance with PRISMA guidance (Rodrigues et al 2013).…”

Wet age-related macular degeneration refractory to aflibercept but responsive to systemic everolimus

“…In the Study Assessing double-masKed Uveitis tREAtrement 1 study, patients with uveitis were randomized to 44, 440, and 880 mcg of intravitreal sirolimus. 13 The primary outcome was the control of inflammation-the 440 and 880 mcg groups were the intervention arms and compared with the 44 mcg group, which was the minimal dose calculated to have any therapeutic effect according to regression models. Although the Correspondence e18 CAN J OPHTHALMOL-VOL.…”