Macular Microvascular Modifications in Progressive Lamellar Macular Holes

Catania, Fiammetta; Allegrini, Davide; Nembri, Alessandra; F, Confalonieri; Zollet, Piero; Crincoli, Emanuele; Romano, Mario R.

doi:10.3390/diagnostics11091717

Cited by 10 publications

(8 citation statements)

References 27 publications

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“…Furthermore, the size of the VD was correlated with the BCVA in these eyes [ 42 ]. Catania and colleagues [ 43 ] compared OCTA parameters in eyes with LMH that progressively lost tissue to those which remained stable. Eyes with progressive tissue loss manifested decreased foveal VD in the SCP, and decreased perfusion density in both the SCP, DCP and parafoveal areas.…”

Section: Multimodal Imagingmentioning

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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Section: Multimodal Imagingmentioning

confidence: 99%

Primary Lamellar Macular Holes: To Vit or Not to Vit

Bradshaw

2022

JCM

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“…ERM is the most common type of fibrocellular proliferation found at the vitreoretinal interface [ 14 , 15 ]. Since the perfect timing and indication for surgery are still debated, it is of utmost importance to provide the most detailed prognostic information possible before and after the operation.…”

Section: Discussionmentioning

confidence: 99%

“…An example of how segmentation of retinal layers was performed is shown in Figure 1 . According to variation in BCVA improvement after treatment, the population was further divided into 4 groups, showing either: No variation or improvement < 15 ETDRS letters (3 Snellen lines) [ 14 , 15 ] from preoperative (GROUP 1); or Immediate (1 month after surgery) improvement of visual acuity without further improvements at later follow-ups (GROUP 2); or Immediate (1 month after surgery) improvement of visual acuity with further improvements at later follow-ups (GROUP 3); or Delayed improvement of visual acuity (no or minimal change at 1 month follow-up and >15 ETDRS letter change at 3 or 6 months follow up) (GROUP 4). …”

Section: Methodsmentioning

confidence: 99%

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Variability of Visual Recovery with Time in Epiretinal Membrane Surgery: A Predictive Analysis Based on Retinal Layer OCT Thickness Changes

Romano

Catania

Vallejo-Garcia

et al. 2023

JCM

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Purpose: To correlate postoperative optical coherence tomography (OCT) thickness changes of each retinal layer with different patterns of visual recovery after idiopathic epiretinal membrane (ERM) surgery in a cohort of patients showing no known risk factors for poor visual recovery at preoperative imaging. Methods: Best corrected visual acuity (BCVA) and OCT images were acquired preoperatively and 1 month, 3 months and 6 months postoperatively. Patients were divided into four groups according to postoperative BCVA improvement: improvement < 15 ETDRS letters (GROUP 1), immediate improvement of BCVA without further improvements at later follow-ups (GROUP 2), immediate improvement of BCVA with further improvements at later follow-ups (GROUP 3) and delayed improvement of BCVA (GROUP 4). Results: Eighty-five patients were included. GROUP1 was the only one characterized by retinal nerve fiber layer (RNFL) thickness increase and ganglion cell layer/central macular thickness (GCL/CMT) ratio decrease at 1 month and outer nuclear layer (ONL) thickness decrease at 3 and 6 months. GROUP 2 was the only one showing a decrease in GCL/inner plexiform layer (GCL/IPL) ratio at 1 month. GROUP 3 and 4 showed higher preoperative RNFL thickness compared to the other, and GROUP 4 manifested a late increase in RNFL thickness at 6 months. Conclusions: Different patterns of VA recovery are associated with specific layer thickness changes. If further confirmed, this would help detect those cases characterized by poor or delayed visual recovery despite the absence of other known imaging risk factors.

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“…Moreover, patients with previous stroke, vascular dementia, severe chronic kidney disease, or collagenopathies were excluded from the study because of the potential influence of these conditions on OCTA quantitative parameters. 11 , 12 Ophthalmic exclusion criteria were ruled out with the support of slit lamp examination and multimodal imaging acquired with Solix Fullrange OCT (Optovue Inc). Diabetic retinopathy staging was assessed for each eye by a senior retinal specialist relying on slit lamp fundus examination and wide field fundus photographs.…”

Section: Methodsmentioning

confidence: 99%