Spectral Domain Optical Coherence Tomography in the Diagnosis and Management of Vitreoretinal Interface Pathologies

Barak, Yoreh; Ihnen, Mark; Schaal, Shlomit

doi:10.1155/2012/876472

Cited by 41 publications

(39 citation statements)

References 45 publications

(70 reference statements)

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“…23, 29 However, the contraction of myofibroblasts within the more complex type of ERM has been proposed to exert a tangential traction at the VRI, which can result in retinal puckering, thickening, folding, or detachment, together with vascular distortion. 27, 29, 30, 31 Contraction of complex ERM can therefore exert profound effects on vision 29 and significantly increase the effect of any VMA. VMT and any associated ERM can also be associated with changes in the retinal vasculature.…”

Section: Pathophysiology Of Vitreomacular Traction and Macular Holementioning

confidence: 99%

Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment

Steel

Lotery

2013

Eye

209

166

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Posterior vitreous detachment (PVD) is a common phenomenon in the aging eye. However, this may be complicated by persistent symptomatic vitreomacular adhesions that exert tractional forces on the macula (vitreomacular traction; VMT). VMT itself may be associated with epiretinal membrane formation and the development of idiopathic macular holes (IMH). Such pathologies may cause visual disturbances, including metamorphopsia, photopsia, blurred vision, and decreased visual acuity, which impact an individual's quality of life. Technologies such as optical coherence tomography allow an increasingly more accurate visualisation of the macular anatomy, including quantification of macular hole characteristics, and this facilitates treatment decision-making. Pars plana vitrectomy remains the primary treatment option for many patients with VMT or IMH; for the latter, peeling of the inner limiting membrane (ILM) of the retina has shown improved outcomes when compared with no ILM peeling. The development of narrow-gauge transconjunctival vitrectomy systems has improved the rate of visual recovery following surgery. Ocriplasmin, by degrading laminin and fibronectin at the vitreoretinal interface, may allow induction of PVD in a non-invasive manner. Indeed, clinical studies have supported its use as an alternative to surgery in certain patient populations. However, further research is still needed with respect to greater understanding of the pathophysiology underlying the development of VMT and IMH.

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Section: Pathophysiology Of Vitreomacular Traction and Macular Holementioning

confidence: 99%

Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment

Steel

Lotery

2013

Eye

209

166

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“…Clinically relevant vitreomacular adhesions, macular holes, and pseudoholes have been documented by conventional time domain OCT [70,95,96,97,98]. A posterior hyaloid membrane is seen in 57% of patients with idiopathic macular holes on OCT but is detected biomicroscopically in less than half of these patients [99,100,101].…”

Section: Clinical Assessmentmentioning

confidence: 99%

The Vitreous, the Retinal Interface in Ocular Health and Disease

2013

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The vitreous is a complex structure whose composition and appearance change with age. Anomalous adhesions between the posterior vitreous face and the retinal surface are the cause of numerous vitreoretinal complications, while the presence of an intact posterior hyaloid provides a scaffold for vascular growth and anteroposterior traction. This review summarizes what is known about the biochemistry of the vitreous, the process of posterior vitreous detachment (PVD) development, and the available clinical approaches to examining the vitreous and its interface. A pooled analysis of studies looking at the presence of a complete, partial or absent PVD in a number of macular and retinal diseases allows us to establish odds ratios for these various states. From this emerge both protective and disease-associated states in conditions such as proliferative diabetic retinopathy, macular edema, and age-related macular degeneration. With the emergence of pharmacological means to separate the posterior hyaloid, a better understanding of the possible role of the vitreous in tractional syndromes is required.

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“…The advent of the spectral-domain OCT (SD-OCT) allowed better visualization of the vitreoretinal interface and posterior vitreous cortex and is widely used in the diagnosis and management of many diseases including: vitreomacualar traction (VMT), epiretinal membrane (ERM) [21], lamellar holes, pseudoholes and full thickness macular holes [20, 22]. However, swept-source OCT (SS-OCT) has enabled higher speed, longer imaging range and lower sensitivity roll-off compared with SD-OCT. SS-OCT uses a longer wave length and has less variation in sensitivity with depth (roll-off) compared with SD-OCT [15].…”

Section: Vitreous Structures Imagingmentioning

confidence: 99%

Novel perspectives on swept-source optical coherence tomography

Lavinsky

2016

Int J Retin Vitr

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Technologies for multimodal digital imaging of vitreoretinal diseases have improved the accuracy of diagnosis and the depth of the knowledge of the mechanisms of disease and their response to treatments. Optic coherence tomography (OCT) has become a mandatory tool for the management and for the follow-up of retinal pathologies. OCT technology evolved in the last two decades from time-domain to spectral domain and recently to the swept-source OCTs (SS-OCT). SS-OCT improved the depth of imaging and the scan speed, thus adding novel algorithms and features such as for vitreous and vitreoretinal interface evaluation, choroid segmentation and mapping, OCT angiography and En-face OCT. The multimodal approach using SS-OCT is expected to advance the understanding of retinal pathologies such as age related macular degeneration, diabetic maculopathy, central serous chorioretinopathy, the pachychoroid spectrum and macular telangiectasia. Surgical vitreoretinal diseases such as vitreo-macular traction syndrome, epiretinal membrane, retinal detachment, proliferative vitreoretinal retinopathy and diabetic traction retinal detachment also will be better understood and documented with SS-OCT. This technology also provides great utility for a broad spectrum of ophthalmic pathologies including glaucoma, uveitis, tumors and anterior segment evaluation.

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Spectral Domain Optical Coherence Tomography in the Diagnosis and Management of Vitreoretinal Interface Pathologies

Cited by 41 publications

References 45 publications

Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment

Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment

The Vitreous, the Retinal Interface in Ocular Health and Disease

Novel perspectives on swept-source optical coherence tomography

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