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.
Purpose
To investigate stereopsis and other visual functions in patients with unilateral epiretinal membrane (ERM) and to identify vision-related parameters affecting stereopsis.
Methods
This ...prospective study included 63 consecutive patients who were scheduled to undergo vitrectomy for unilateral idiopathic ERM. We examined stereopsis (Titmus Stereo Test, TST; TNO stereotest, TNO), best-corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia, and degree of aniseikonia preoperatively and 6 months postoperatively.
Results
Preoperatively, we observed significant correlation between TST scores and other vision-related parameters except severity of metamorphopsia and between TNO score and all the vision-related parameters. Multiple regression analysis showed that preoperative TST and TNO scores were significantly associated with the degree of aniseikonia (both
P
< 0.01). ERM surgery significantly improved stereopsis, BCVA, contrast sensitivity, and metamorphopsia, but not aniseikonia. Postoperatively, TST was significantly associated with BCVA, and TNO showed association with BCVA and aniseikonia. Postoperative TST and TNO scores showed significant correlation with preoperative aniseikonia (
P
< 0.005 and
P
< 0.001, respectively).
Conclusions
Impairment of stereopsis in patients with unilateral ERM was considered to be due to retinally induced aniseikonia. Aniseikonia did not improve by surgery, and preoperative aniseikonia can be a prognostic factor for postoperative stereopsis.
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.
To quantify metamorphopsia in patients undergoing vitrectomy for idiopathic macular hole (MH) and to investigate the relationship between metamorphopsia and foveal microstructure.
This is ...prospective, consecutive, interventional study. Fifty-one eyes of MH were included. Severity of metamorphopsia was quantified using the M-CHARTS and foveal microstructure was assessed with optical coherence tomography preoperatively and at 3 months, 6 months postoperatively. Based on the optical coherence tomography images, the authors quantified minimum and base diameters of MH, macular thickness, defect lengths of external limiting membrane, ellipsoid zone and interdigitation zone, and the area of intraretinal cysts within the fluid cuff.
Mean metamorphopsia score was significantly improved from 0.82 to 0.44. Postoperative mean and horizontal metamorphopsia scores were correlated with preoperative base diameters of MH, defect lengths of external limiting membrane, and the area of cysts in fluid cuff. Multiple regression analysis revealed that postoperative mean and horizontal metamorphopsia scores were significantly positively relevant to the area of intraretinal cysts within the fluid cuff. Postoperative vertical metamorphopsia score was also correlated with the area of intraretinal cysts within the fluid cuff.
Vitrectomy for MH improved metamorphopsia. Postoperative metamorphopsia was associated with the preoperative area of intraretinal cysts within the fluid cuff.
To study the early anatomic choroidal alterations in eyes with chronic central serous chorioretinopathy (CSCR) undergoing photodynamic therapy (PDT).
Multicenter retrospective cohort study.
A total ...of 77 patients and 81 eyes with chronic CSCR treated with PDT and 64 untreated fellow eyes were evaluated. Central macular thickness (CMT) and choroidal features including subfoveal choroidal thickness (SFCT), total choroidal area (TCA), luminal choroidal area (LCA), and stromal choroidal area (SCA) were analyzed. Choroidal vascularity index (CVI) was calculated in all study eyes at baseline and at 1- and 3-months post-PDT.
In eyes receiving PDT, Snellen visual acuity (VA) significantly improved at months 1 and 3 (P < .001). CMT and SFCT showed a significant reduction from baseline at months 1 and 3 (P < .001), whereas TCA and LCA showed a significant decrease only at the 1-month follow-up visit. Baseline mean TCA and LCA were 2.30 ± 1.41 mm2 and 1.23 ± 0.73 mm2, respectively, and decreased to 2.07 ± 1.21 mm2 and 1.08 ± 0.63 mm2 at the 1-month follow-up visit, respectively (P = .01). No significant changes were recorded for SCA and CVI. In the fellow eye group, VA, CMT, and all choroidal parameters showed no differences between baseline and any follow-up visits (all P > .05).
After PDT for chronic CSCR we observed sustained reductions in CMT and SFCT, while reductions in TCA and LCA were only noted at the 1-month follow-up interval. These choroidal parameters may provide additional quantitative biomarkers to evaluate the anatomic response to therapy but await further prospective validation.
To evaluate contrast sensitivity (CS) in patients with epiretinal membrane (ERM) following vitrectomy and to investigate the relationship between CS and foveal microstructures with spectral-domain ...optical coherence tomography (SD-OCT).
Thirty-one eyes of 31 patients with ERM were included. We examined CS with a CSV-1000E chart, a logMAR best-corrected visual acuity (BCVA), and foveal microstructure by using SD-OCT before and at 6 months after surgery. From the CS data, the area under the log contrast sensitivity function (AULCSF) was calculated. Based on the OCT images, we quantified the mean thickness of the ganglion cell layer (GCL), the inner nuclear layer (INL), and the outer retinal layer (outer nuclear layer and outer plexiform layer ONL+OPL). The status of the photoreceptor inner and outer segment junction (IS/OS) and external limiting membrane (ELM) was also evaluated.
Vitrectomy significantly improved logMAR BCVA and AULCSF. Even in patients with poor improvement of visual acuity (changes in logMAR BCVA by surgery was ≤0.2), postoperative AULCSF significantly increased by treatment (P < 0.05). Postoperative AULCSF showed a significant correlation with preoperative (P < 0.05) and postoperative (P < 0.05) ONL+OPL thickness, whereas other parameters were not relevant. Postoperative logMAR BCVA significantly correlated with postoperative status of IS/OS (P < 0.05) and preoperative ONL+OPL thickness (P < 0.05).
In patients with ERM, CS improved even though their visual acuity did not recover significantly by vitrectomy. CS was associated with the thickness of outer retinal layer.
Absorbable polyethylene glycol-based synthetic sealant (PEG sealant) polymerizes under xenon illumination and forms a clear, flexible, and firmly adherent hydrogel. The intraocular biocompatibility ...of PEG sealant and efficacy for closing retinal breaks were evaluated.
In an in vitro study, retinal detachment with a tear was created in porcine eyecups after vitreous gel removal. Polyethylene glycol-based synthetic sealant was applied to cover the tear and polymerized with a 40-second application of xenon light. Retinal adhesion strength was tested by forcefully squirting balanced salt solution (BSS) onto the retinal tear. Polyethylene glycol-based synthetic sealant was soaked in the BSS, incubated at 37°C, and the pH measured periodically over 72 hours. In an in vivo study, PEG sealant was injected into the vitreous cavity of the left eyes of rabbits. Ophthalmologic examinations were performed and bilateral ERGs were recorded simultaneously before and 28 days after injection. The eyes were enucleated for histological evaluation.
Adhesion of PEG sealant to the retina was good in BSS. A forceful squirt of BSS onto the retinal tear covered with PEG sealant did not detach the retina; the retinal tear without PEG sealant detached immediately. The pH of the BSS containing PEG sealant was between 7.2 and 8.2. No inflammatory reaction was observed in the eyes throughout 28 days of follow-up. The ERGs recorded before and after injection showed typical patterns. Histological examinations did not reveal any abnormality or inflammation.
Polyethylene glycol-based synthetic sealant appeared to effectively seal retinal breaks and was not toxic to the eye.
To evaluate stereopsis in patients undergoing vitrectomy for epiretinal membrane and to investigate the relationship between stereopsis and foveal microstructures.
This study included 55 eyes of 55 ...patients who underwent vitrectomy for unilateral epiretinal membrane and 27 age-matched normal subjects. We examined stereopsis using the Titmus Stereo Test, TNO stereotest, and, optical coherence tomography before surgery and 6 months after surgery. Central foveal thickness, central retinal thickness at the parafovea (CRT-3 mm), macular volume, and retinal layer thickness were measured with the optical coherence tomography software and an image-processing program.
Epiretinal membrane surgery significantly improved stereopsis in Titmus Stereo Test and in TNO. Stereopsis after surgery was significantly worse than in normal subjects. In stepwise multiple regression analysis, preoperative stereopsis showed a significant association with preoperative CRT-3 mm. Postoperative stereopsis was significantly correlated with postoperative inner nuclear layer thickness. Postoperative Titmus Stereo Test and TNO were significantly related to preoperative CRT-3 mm and preoperative macular volume and inner nuclear layer thickness, respectively.
Vitrectomy for epiretinal membrane improved stereopsis, albeit not to a normal level. Titmus Stereo Test, a stereotest with a smaller index, was related to CRT-3 mm, whereas TNO with a larger index was correlated with retinal volume of the entire posterior pole and mean inner nuclear layer thickness.
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