To compare stereopsis and foveal microstructure after internal limiting membrane peeling and inverted internal limiting membrane flap technique in patients with macular hole.
Retrospective ...observational study.
Sixty-six patients with macular hole were included, of whom 41 underwent 25-gauge pars-plana vitrectomy with complete internal limiting membrane peeling (Peeling group) and 25 with the inverted flap technique (Inverted group). We evaluated stereopsis using the Titmus Stereo Test and the TNO stereo test, best-corrected visual acuity, macular hole closure rate, and foveal microstructure with optical coherence tomography before and at 3, 6, and 12 months after surgery.
Stereopsis and foveal microstructure.
Preoperatively, no difference was observed in the base and minimum diameters of macular hole, Titmus Stereo Test score, TNO stereo test score, and best-corrected visual acuity between the Peeling and Inverted groups. The macular hole closure rate in the Peeling and Inverted groups were 97.6% and 100%, respectively, with no significant difference between groups. At 12 months postoperatively, Titmus Stereo Test score (2.1 ± 0.4 in the peeling and 2.2 ± 0.4 in the inverted groups), TNO stereo test score (2.3 ± 0.4 and 2.2± 0.5), and best-corrected visual acuity (0.20 ± 0.18 and 0.24 ± 0.25) were not significantly different between groups (p = 0.596, 0.332, respectively). The defect of the external limiting membrane was more common in the Inverted group than in the Peeling group at 6 months after surgery (5.4 vs. 28.0%; p < 0.05). No statistically significant inter-group differences were noted in the ellipsoid zone defect ratio throughout the follow-up period.
There was no difference in postoperative stereopsis nor foveal microstructure between the internal limiting membrane peeling group and the inverted group in patients with macular hole.
Purpose
To quantify aniseikonia following intravitreal ranibizumab (IVR) in patients with branch retinal vein occlusion (BRVO) and assess the relationship between aniseikonia and retinal ...microstructure.
Study design
Prospective observational study.
Methods
This study included 50 patients undergoing IVR treatment for unilateral BRVO. The degree of aniseikonia and best-corrected visual acuity (BCVA) was examined, and retinal microstructure was assessed with optical coherence tomography (OCT) before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on OCT images, we assessed central retinal thickness (CRT), presence of the epiretinal membrane, and serous retinal detachment (SRD), as well as status of the external limiting membrane and ellipsoid zone.
Results
At baseline, mean aniseikonia was − 1.0 ± 2.5%, ranging from − 11.0 to + 6.0%. Nine out of 50 patients had micropsia (18%), one had macropsia (2%), and 40 had no aniseikonia (80%). After 6 months of treatment, mean aniseikonia was − 0.7 ± 1.5%, ranging from − 4.5 to + 3.5%. BCVA significantly improved after treatment (P < 0.001), but aniseikonia did not change (P = 0.73). In patients with BRVO who had micropsia (≤ − 2.0%) at baseline, mean aniseikonia significantly improved from − 4.8 ± 3.3% to − 0.9 ± 1.4% (P < 0.05). Aniseikonia after treatment significantly correlated with BCVA (P < 0.05) and the presence of SRD at baseline (P < 0.05).
Conclusion
Majority of eyes with aniseikonia in BRVO had micropsia. The BCVA as well as the micropsia improved following treatment with IVR for BRVO. BCVA and the presence of SRD were predictors of post-treatment aniseikonia.
The study aimed to evaluate changes in stereopsis and vision-related quality of life (VR-QOL) in patients with central retinal vein occlusion (CRVO) following intravitreal ranibizumab injection (IVR) ...and investigate the relationship between stereopsis and VR-QOL. This study included 23 treatment-naïve patients with non-ischemic CRVO and 13 age-matched normal controls. Stereopsis, best-corrected visual acuity (BCVA), VR-QOL, and retinal microstructures were examined pre-treatment and 12 months post-treatment. The Titmus Stereo Test (TST) and TNO stereotest (TNO) were used to evaluate stereopsis. VR-QOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25). IVR immediately and significantly improved the TST values, TNO values, composite VFQ-25 score, BCVA, and central foveal thickness in patients with CRVO. The 12-month post-treatment TST and TNO values were significantly worse in the CRVO group compared to those in the normal group. At the baseline, the composite VFQ-25 score significantly correlated only with the TST value. Multivariate analysis revealed significant associations between the 12-month post-treatment composite VFQ-25 score and the baseline and 12-month post-treatment TNO values. In conclusion, IVR immediately improved stereopsis in CRVO, albeit below normal levels. Stereopsis (not visual acuity) was associated with pre- and post-treatment VR-QOL in patients with CRVO.
Purpose
To evaluate the vision-related quality of life (VR-QOL) before and after intravitreal ranibizumab injections (IVR) for central retinal vein occlusion (CRVO) and to investigate subscale items ...of VR-QOL in detail.
Study design
A multicenter, open-label, prospective and comparative study.
Methods
Twenty-three patients with treatment naïve CRVO and 22 age-matched normal controls were included. VR-QOL was assessed by 25-Item Visual Function Questionnaire (VFQ-25) before and up to 12 months post-treatment. The VFQ-25 composite score and 12 subscales were compared between CRVO patients and normal controls.
Results
The VFQ-25 composite scores of CRVO patients showed significant improvement throughout the treatment period compared with baseline. The VFQ-25 composite scores both before and after treatment for CRVO were significantly lower than in normal controls. The subscale items, including general health, general vision, near activities, social functioning, mental health, role difficulties, dependency, and peripheral vision in CRVO, were significantly lower than in the normal controls even after treatment.
Conclusion
Vision-related QOL was low in patients with CRVO before treatment and improved with IVR. In spite of the improvements, several subscale items remained lower than in normal controls following treatment. Attention should be paid to the patients with CRVO and their decreased visual, social and psychological QOL.
The aim of the present study was to investigate changes in metamorphopsia in patients with diabetic macular edema (DME) following intravitreal aflibercept injection (IVA) with the treat and extend ...(TAE) regimen for a year. We performed a post hoc analysis of a multicenter, open-label, single-arm, prospective study. The study included 20 patients with DME. All eyes received 3 monthly loading injections of 2 mg aflibercept, followed by a TAE regimen. Every visit, the severity of metamorphopsia and the best-corrected visual acuity (BCVA) were evaluated, and optical coherence tomography (OCT) images were obtained. The severity of metamorphopsia was measured using M-CHARTS. The metamorphopsia scores before treatment and at 1, 2, 3, 6 and 12 months following treatment were 0.25 ± 0.23, 0.21 ± 0.15, 0.19 ± 0.23, 0.14 ± 0.16, 0.17 ± 0.20 and 0.10 ± 0.17, respectively, with significant improvement from before treatment to 3 and 12 months following treatment (p < 0.05 and p < 0.005, respectively). At the time of macular edema resolution, the presence of an epiretinal membrane (ERM) was associated with the metamorphopsia score (p < 0.05). In conclusion, the metamorphopsia score in patients with DME improved following IVA with the TAE regimen for one year. The presence of ERM was associated with the metamorphopsia score.
To quantify stereopsis and other visual functions in patients with unilateral branch retinal vein occlusion (BRVO) and to investigate vision-related parameters that affect stereopsis.
Prospective ...observational study.
Forty-five patients undergoing intravitreal ranibizumab (IVR) treatment for unilateral BRVO.
We examined stereopsis using the Titmus stereo test (TST) and TNO stereotest (TNO), best corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia and degree of aniseikonia before and 6 months after IVR.
Visual functions that affect stereopsis.
Baseline stereopsis in patients with BRVO was 2.7 ± 0.6 (range, 1.6-3.5) in the TST and 2.8 ± 0.5 (range, 1.8-3.3) in TNO. TST and TNO scores were significantly correlated with BCVA and letter contrast sensitivity at baseline (P < 0.001) but not with other visual functions. IVR treatment significantly improved stereopsis, BCVA, and letter contrast sensitivity. After treatment, TST scores were significantly correlated with BCVA (P < 0.001), letter contrast sensitivity (P < 0.001), and aniseikonia (P < 0.01). TNO scores were significantly correlated with BCVA (P < 0.01) and letter contrast sensitivity (P < 0.01). TST and TNO scores after treatment were significantly correlated with BCVA at baseline (P < 0.01 for both).
Deterioration of stereopsis in patients with BRVO was associated with changes in visual acuity and contrast sensitivity after treatment. Initial visual acuity is a prognostic factor for posttreatment stereopsis.
Purpose
To evaluate contrast sensitivity (CS) in patients with branch retinal vein occlusion (BRVO) following intravitreal ranibizumab injection (IVR), and to investigate the relationship between CS ...and retinal microstructure.
Design
A retrospective, observational case series.
Methods
We included 23 eyes with treatment naïve BRVO followed up for 6 months after treatment. Best-corrected visual acuity (BCVA), letter contrast sensitivity (LC), and 10% low contrast visual acuity (LCVA) were measured. All tests were performed before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on optical coherence tomography (OCT) images, we assessed central retinal thickness (CRT), presence of serous retinal detachment (SRD), and status of the external limiting membrane (ELM) and ellipsoid zone (EZ).
Results
IVR treatment significantly improved CS (LC:
P
< 0.0001, LCVA:
P
= 0.004) as well as BCVA (
P
= 0.015) and CRT (
P
< 0.0001). LC and LCVA at 6 months after treatment were significantly correlated with presence of SRD before treatment. At 6 months after treatment, LCVA was significantly correlated with pre-treatment CRT (
P
= 0.042). In patients with good baseline BCVA, LCVA showed significant improvements (
P
= 0.022) although their BCVA did not change. In patients with poor improvement in BCVA, LC and LCVA also showed significant improvements (
P
= 0.008,
P
= 0.005).
Conclusion
IVR treatment for BRVO improves both BCVA and CS. Even in patients without any improvement in visual acuity, CS does improve.
To evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO), and to assess the relationship between metamorphopsia and ...inner retinal microstructure and other factors. Thirty-three treatment-naïve eyes of 33 patients with macular edema caused by BRVO with at least 12 months of follow-up were included. The degree of metamorphopsia was quantified using the M-CHARTS. Retinal microstructure was assessed with spectral-domain optical coherence tomography. Disorganization of the retinal inner layers (DRIL) at the first month after resolution of the macular edema (early DRIL) and at 12 months after treatment (after DRIL) was studied. Central retinal thickness (CRT), and status of the external limiting membrane as well as ellipsoid zone were also evaluated. IVR treatment significantly improved best-corrected visual acuity (BCVA) and CRT, but the mean metamorphopsia score did not improve even after 12 months. Post-treatment metamorphopsia scores showed a significant correlation with pre-treatment metamorphopsia scores (P < 0.005), the extent of early DRIL (P < 0.05) and after DRIL (P < 0.05), and the number of injections (P < 0.05). Multivariate analysis revealed that the post-treatment mean metamorphopsia score was significantly correlated with the pre-treatment mean metamorphopsia score (P < 0.05). IVR treatment significantly improved BCVA and CRT, but not metamorphopsia. Post-treatment metamorphopsia scores were significantly associated with pre-treatment metamorphopsia scores, the extent of DRIL, and the number of injections. Prognostic factor of metamorphopsia was the degree of pre-treatment metamorphopsia.
To evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO) and to assess the relationship between retinal ...microstructure and metamorphopsia.
Subjects were 39 eyes of 39 patients with branch retinal vein occlusion. The severity of metamorphopsia was quantified using the M-CHARTS before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on optical coherence tomography (OCT) images, we assessed central retinal thickness (CRT) and status of the external limiting membrane (ELM) and ellipsoid zone (EZ). The association between retinal microstructure and metamorphopsia was analyzed in 24 eyes with treatment-naïve branch retinal vein occlusion.
Intravitreal ranibizumab injection treatment significantly improved best-corrected visual acuity (BCVA) and central retinal thickness (P < 0.0001, P < 0.0001, respectively), but metamorphopsia did not improve by treatment. Posttreatment metamorphopsia scores showed a significant correlation with duration of symptoms (P < 0.05) and pretreatment metamorphopsia scores (P < 0.01). Posttreatment metamorphopsia score was significantly worse in patients with disruption of external limiting membrane (P < 0.05).
In patients with branch retinal vein occlusion, intravitreal ranibizumab injection treatment significantly improved best-corrected visual acuity and central retinal thickness, but not metamorphopsia. The severity of posttreatment metamorphopsia was significantly associated with duration of symptoms, degree of pretreatment metamorphopsia, and posttreatment integrity of external limiting membrane.
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