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PubMed2002

Optical coherence tomographic findings of the anterior segment after nonpenetrating deep sclerectomy.

PURPOSE: To evaluate the efficacy of optical coherence tomography for the analysis of anterior segment after glaucoma surgery. DESIGN: Interventional case report. METHODS: In a 79-year-old man with primary open-angle glaucoma, optical coherence tomography was performed on the left eye after nonpenetrating deep sclerectomy. RESULTS: Optical coherence tomography showed thinning of the conjunctiva over the filtering bleb, presence of a space under the scleral flap that is considered as a lake, and presence of fibrous tissue in the bleb. CONCLUSION: This case indicates that optical coherence tomography, a noninvasive, noncontact optical imaging modality, may be useful for analysis of the anterior segment after glaucoma surgery.

Aged↗
PubMed2002

Retinal atrophy in idiopathic central serous chorioretinopathy.

PURPOSE: To study retinal atrophy in idiopathic central serous chorioretinopathy (ICSC). DESIGN: Observational case series. METHODS: Twenty-four eyes in 23 consecutive patients aged 33 to 67 years and 50 eyes in 25 healthy volunteers aged 24 to 70 years were studied. Observational procedures included: biomicroscopy, fundus photography, fluorescein angiography, optical coherence tomography, photocoagulation. Retinal thickness after resolution of detachment, definite attenuation being defined as foveal thickness less than the mean -2 SD in healthy volunteers; duration of symptoms; best-corrected visual acuity (BCVA). RESULTS: Definite retinal attenuation, retinal thickness ranging from 51% to 74% of normal, was found in nine eyes of nine patients with idiopathic central serous chorioretinopathy (ICSC). Their duration of symptoms was longer (P =.0014) and their BCVA was lower (P =.015) than eyes in patients with normal-range foveal thickness who, nevertheless, had thinner foveae than healthy subjects (P =.10). The most severe reduction of foveal thickness, to half the normal (three eyes of three patients), was associated with BCVA 0.5 or less, multifocal retinal pigment epithelial abnormalities, and more than 10 years' duration of symptoms. Retinal attenuation was seen only after a duration of symptoms of more than 4 months, being most pronounced in the photoreceptor layer, particularly in the fovea. CONCLUSION: Foveal attenuation in ICSC is associated with more than 4 months' duration of symptoms and persistent BCVA reduction despite resolution of the serous detachment. We found no other likely cause of atrophy than the prolonged absence of contact between photoreceptors and retinal pigment epithelial cells.

Adult↗
PubMed2002

Choroidal neovascularization in primary hyperoxaluria.

PURPOSE: To report a case of primary hyperoxaluria in which choroidal neovascularization developed bilaterally. DESIGN: Observational case report. METHODS: A 22-year-old man with a history of type I primary hyperoxaluria complained of a slow but progressive loss of vision in both eyes for the preceding 8 months. The clinical, fluorescein, and ocular coherence tomography findings are reported. RESULTS: Fluorescein angiography confirmed the presence of choroidal neovascularization in both eyes at the edge of previous macular scars. Ocular coherence tomography scans were obtained to better characterize the clinical pathology. CONCLUSION: In a patient with type 1 primary hyperoxaluria, the presence of choroidal neovascularization in both eyes outside but adjacent to an area of previous macular scarring is reported. These findings are in harmony with the assumption that mechanical factors from the oxalate deposition promote choroidal neovascularization.

Adult↗
PubMed2002

Relation between optical coherence tomography and optical pachymetry measurements of corneal swelling induced by hypoxia.

PURPOSE: To determine the relation between optical coherence tomography (OCT) and optical pachymetry (OP) measurements of corneal swelling induced by hypoxia. DESIGN: Experimental study. METHODS: One randomly selected eye of 20 noncontact lens wearers (10 males and 10 females, age 35.6 +/- 9.6 years) was patched during 3 hours of soft contact lens (SCL) wear while the contralateral eye acted as control. Central corneal thickness of both eyes was measured before and after SCL wear using OCT and OP in randomized order. RESULTS: Baseline central corneal thickness was 523.6 +/- 33.0 microm (mean +/- standard deviation [SD]) measured with OCT and 490.6 +/- 25.5 microm with OP. Immediately after contact lens removal, corneal thickness measured with OCT increased by 13.8 +/- 2.3% compared with 12.1 +/- 1.8% (paired t test: P <.001) measured with OP. Thereafter, corneal thickness decreased at the rate of 5.6% per hour for OCT and 5.4% per hour for OP. The difference in thickness between instruments before lens insertion, which was 33 microm compared with the difference after lens removal (edematous cornea), which ranged from 46 to 41 microm. The difference between instruments decreased during the corneal deswelling period after lens removal. The correlation coefficient between OCT and OP was 0.914 before lens insertion and 0.932 after lens removal. CONCLUSION: This study has demonstrated the difference of corneal thickness measured with OCT and OP. Although both instruments are correlated highly in all conditions tested, OCT may overestimate corneal thickness in normal and edematous corneas.

Adult↗
PubMed2002

Comparison between retinal thickness analyzer and optical coherence tomography for assessment of foveal thickness in eyes with macular disease.

PURPOSE: To use the retinal thickness analyzer (RTA) and optical coherence tomography (OCT) scanners for quantitative measurement of retinal thickness in eyes with macular disease. DESIGN: In a cross-sectional study, 44 patients (55 eyes) with macular disease and sufficient media clarity to visualize the fundus using clinical biomicroscopy underwent an ophthalmologic examination, fluorescein angiography, RTA, and OCT during the same visit. METHODS: Foveal and foveal center (foveolar) retinal thickness measurements were obtained by RTA and by OCT. RESULTS: Retinal thickness measurements were obtained by OCT in all 55 eyes and by RTA in 34 eyes (62%, primarily due to interference from media opacities). In the 34 eyes in which measurements were obtained by both instruments, mean foveal thickness was 291 and 269 microm for OCT and RTA, respectively; foveolar thickness was 277 and 265 microm, respectively. OCT and RTA measurements of foveal thickness were strongly correlated (intraclass correlation coefficient = 0.89), as were measurements of the foveolar thickness (intraclass correlation coefficient = 0.94). Topographic maps generated by the two techniques yielded qualitatively similar information. CONCLUSIONS: Overall, there was excellent agreement between RTA and OCT measurements. Each technique has advantages that may make its use preferable in a particular subgroup of eyes or to describe a particular disease process. An important consideration is that media opacities create less interference for OCT than for RTA, so that in study populations with a moderate-to-high prevalence of media opacity, images can be obtained in a greater percentage of eyes by OCT than by RTA.

Aged↗
PubMed2002

Spontaneous closure of traumatic macular hole.

PURPOSE: To investigate the mechanism by which traumatic macular hole closes spontaneously. DESIGN: Consecutive observational case series of three patients with unilateral traumatic macular hole who consulted medical staff at the Kansai Medical University between 1997 and 2000. METHODS: Three patients who sustained unilateral blunt trauma to the eye and developed traumatic macular hole were followed with ophthalmic examination, fundus photography, fluorescein angiography, and optical coherence tomography (OCT). RESULTS: Case 1 was an 11-year-old boy. He had neither a macular hole nor prominent macular edema at his first consultation, but a macular hole opened 3 weeks later. OCT showed macular edema and a full-thickness macular hole. The tissue around the edge of the macular hole protruded inward toward the center and finally closed spontaneously 18 weeks later. Case 2 was a 19-year-old man. He had a tiny rough-edged macular hole at his first consultation with a local ophthalmologist. OCT showed macular hole enlargement and worsening of the macular edema during follow up. The macular hole finally closed 4 months after injury. Case 3 was a 15-year-old boy. He had a tiny rough-edged macular hole at his first consultation with a local ophthalmologist. The macular hole finally closed 6 months after injury. CONCLUSION: Macular hole can be a result of severe damage from ocular concussion or damage to the retina. For 6 months following injury, traumatic macular hole should probably be observed rather than surgically repaired, because of the possibility that the macular hole may close spontaneously.

Adolescent↗
PubMed2002

Spontaneous resolution of bilateral stage 1 macular holes documented by optical coherence tomography.

PURPOSE: To describe a case of spontaneous resolution of bilateral stage 1 macular holes documented using optical coherence tomography. DESIGN: Observational case report. METHODS: A patient presented with blurring and distortion in the right eye. Optical coherence tomography showed a stage 1 macular hole manifested as a foveal pseudocyst. The left eye appeared normal. RESULTS: On 6-month follow-up, symptoms had resolved in the right eye but had developed in the left eye. Optical coherence tomography revealed normal anatomy in the right eye with a foveal pseudocyst in the left eye. At 10 months, the patient was asymptomatic and had normal foveal anatomy in both eyes on optical coherence tomography. CONCLUSION: Stage 1 macular holes may appear as foveal pseudocysts on optical coherence tomography. In such cases, optical coherence tomography can provide definitive diagnostic information when clinical examination is equivocal. The observation and spontaneous resolution of bilateral stage 1 holes documented by optical coherence tomography are unique and interesting events of which a MEDLINE search found no previous reports.

Diagnostic Techniques, Ophthalmological↗
PubMed2002

Evaluation of pulse corticosteroid therapy for vogt-koyanagi-harada disease assessed by optical coherence tomography.

PURPOSE: To evaluate the rapid effects of pulse corticosteroid therapy on the serous retinal detachment found at the acute phase of Vogt-Koyanagi-Harada disease. DESIGN: Interventional case series. METHODS: Nine Japanese patients determined to be at the acute phase of Vogt-Koyanagi-Harada disease with serous retinal detachment were treated with pulse corticosteroid therapy. Optical coherence tomography was used to follow the resolution of the retinal detachment. RESULTS: Optical coherence tomography images showed a marked decrease in the retinal detachment immediately after the first intravenous injection of corticosteroid and subsequent resolution. CONCLUSION: The rapid improvement of serous retinal detachment associated with Vogt-Koyanagi-Harada disease following pulse corticosteroid therapy supports an early therapeutic mechanism related to improved permeability of capillaries and permeability of the blood-retinal barrier rather than an anti-inflammatory or immunosuppressive action.

Acute Disease↗
PubMed2002

Optical coherence tomography findings in adult-onset foveomacular vitelliform dystrophy.

PURPOSE: The purpose of this article is to analyze cross-sectional images of a subretinal macular lesion, using optical coherence tomography (OCT) in eyes with adult-onset foveomacular vitelliform dystrophy (AOFVD), to compare thickness of the neurosensory retina over the lesion with best-corrected visual acuity (BCVA) of each eye, and to compare OCT tomograms of AOFVD patients with OCT of Best disease. DESIGN: Observational case series. METHODS: This is a retrospective study which took place in a clinical practice. Forty-three patients (72 eyes) with AOFVD and 12 patients (24 eyes) with Best's disease were studied. The observation procedures used were biomicroscopic fundus examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). The main outcome measures were a description of the typical picture of AOFVD in OCT tomograms, the relationship between the neurosensory retinal thickness over the lesion, the BCVA expressed in decimal terms, and a comparison with description of OCT in Best disease. RESULTS: Of the 43 patients affected by AOFVD, 29 had bilateral macular lesions. Fluorescein angiography showed a central hypofluorescent spot surrounded by an irregular hyperfluorescent ring in 65 of the 72 eyes. Indocyanine green angiography demonstrated a central nonfluorescent spot and a hyperfluorescent area surrounding the central spot in 22 of 27 eyes examined. In all 72 eyes of 43 patients, OCT showed a well-defined central region of thickening in the reflective band representing the retinal pigment epithelium (RPE). The relationship between the thickness of neurosensory retina over the lesion and BCVA was significant (P =.001, r(2) = 0.61). Optical coherence tomography in all 24 eyes with Best disease showed a well-defined central serous retinal detachment. CONCLUSION: In the 72 eyes with AOFVD, FA and ICGA presented different features. Instead, OCT tomograms showed a well-defined subretinal thickening of the RPE in all the eyes. The lack of difference in OCT patterns between cases with or without the hypofluorescent spot on angiography was useful for confirming the diagnosis of AOFVD. Moreover, a reduced visual acuity was evident in patients with a thinner neurosensory retinal layer over AOFVD lesion. Finally, OCT images were also useful for distinguishing AOFVD from Best disease.

Adolescent↗
PubMed2002

Evaluation of successful macular hole surgery by optical coherence tomography and multifocal electroretinography.

PURPOSE: To evaluate successful macular hole surgery using optical coherence tomography (OCT) and multifocal electroretinography (MFERG). DESIGN: Interventional case series. METHODS: In a prospective study, 20 eyes of 20 patients with successful surgery for stage II, III, or IV idiopathic macular hole were evaluated by best-corrected visual acuity (BCVA), ocular examination, OCT, and MFERG preoperatively and 1, 3, 6, and 12 months postoperatively. For statistical analysis, the paired t test and nonparametric methods were used, as well as the Spearman analysis. RESULTS: Postoperatively, all 20 eyes of 20 patients had anatomic closure of the macular hole confirmed by OCT. The center of the fovea, measured by OCT from the retinal pigment epithelium to the inner retinal surface, had a mean +/- SD thickness of 116.5 +/- 30.9 microm (range, 68-175 microm) 1 year postoperatively. Best-corrected visual acuity significantly improved (preoperative mean +/- standard deviation [SD] value, 0.131 +/- 0.081 and 1 year postoperative mean +/- SD value, 0.407 +/- 0.193). Multifocal electroretinography values area 1 (0-2.8 degrees) and area 2 (2.8-9 degrees from the center of the fovea) significantly improved (preoperative mean +/- SD values 3.10 +/- 1.334 nV/deg(2) and 3.573 +/- 1.545 nV/deg(2), respectively, and 1 year postoperative +/- SD mean values, 5.53 +/- 1.208 nV/deg(2) and 4.748 +/- 1.404 nV/deg(2), respectively). The thickness of the fovea, measured by OCT, significantly correlated with the BCVA 1 year postoperatively. One year postoperative MFERG values areas 1 and 2 were not correlated with 12-month BCVA and OCT findings. CONCLUSIONS: Twelve months postoperatively BCVA and MFERG values significantly improved in this series of eyes with successful macular hole surgery. Optical coherence tomography findings were correlated to BCVA, but MFERG values were not correlated to BCVA and OCT findings, 1 year postoperatively.

Aged↗
PubMed2002

Detachment of subfoveal choroidal neovascularization in age-related macular degeneration.

PURPOSE: To report the entity of partial detachment and folding of subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). DESIGN: Interventional case reports. METHODS: Review of the features of CNV detachment in two patients with CNV due to ARMD by contact lens slit-lamp biomicroscopy, fluorescein angiography, optical coherence tomography, and three-dimensional confocal scanning laser indocyanine green (ICG) angiography. RESULTS: One patient out of approximately 300 (0.5%) ARMD patients treated by photodynamic therapy (PDT) developed partial CNV detachment and folding 6 weeks after the second PDT treatment. Another patient out of approximately 100 (1.0%) ARMD patients treated by transpupillary thermotherapy (TTT) developed partial CNV detachment and folding 6 weeks after the second TTT treatment. The CNVs were large (2,500 microm to 4,500 microm) and located between the retina and the retinal pigment epithelium. In each, these findings were clearly visualized by slit-lamp biomicroscopy. Fluorescein angiography demonstrated an associated retinal pigment epithelium tear in one patient. Optical coherence tomography showed distinctive features and confocal scanning laser ICG further delineated the detached folded CNV. The best-corrected visual acuity improved in one patient from 20/80 to 20/40 and in the other from counting fingers at 6 feet to 20/200 after the CNV detachment. CONCLUSIONS: Partial CNV detachment and folding represent a unique, not previously reported, and possibly favorable outcome of PDT and TTT. The low energy and selectivity of these treatments may explain this phenomenon.

Aged↗
PubMed2003

Early postoperative retinal thickness changes and complications after vitrectomy for diabetic macular edema.

PURPOSE: To determine the early postoperative changes in retinal thickness and complications after pars plana vitrectomy for diabetic macular edema. DESIGN: Consecutive interventional case series. METHODS: Studied retrospectively, pars plana vitrectomy was performed on 65 consecutive eyes of 63 patients with diabetic macular edema. The follow-up interval ranged from 6 to 36 months (12.6 +/- 7.4 months [mean +/- standard deviation (SD)]). The indications of pars plana vitrectomy in this study were (1) diffuse diabetic macular edema, (2) preoperative visual acuity less than 20/40, and (3) noneffective macular photocoagulation therapy. Preoperative and postoperative examinations by stereoscopic biomicroscopy, color fundus photography of the macula and optical coherence tomography (OCT) were performed on all eyes. Preoperatively, direct photocoagulation to microaneurysms in the macula had been performed in 48 eyes, and focal/grid photocoagulation had been performed in five eyes. Preoperative examination showed that epiretinal membranes were observed in 20 eyes, cystoid macular edema in 40 eyes, and 23 eyes had a complete posterior vitreous detachment (PVD). Epimacular membranes, removed during surgery, were examined histopathologically. RESULTS: The postoperative mean best-corrected visual acuity (logarithm of the minimum angle of resolution [logMAR] = 0.696 +/- 0.491 [mean +/- SD]) was significantly better than the preoperative mean best-corrected visual acuity (0.827 +/- 0.361; P <.0001; Wilcoxon signed-rank test). The final visual acuity improved by 2 or more lines in 32 of 65 eyes (45%), remained unchanged in 32 of 65 eyes (49%), and exacerbated after the surgery in 4 of 65 eyes (6%) due to neovascular glaucoma (2 eyes) and residual cystoid macular edema (2 eyes). The postoperative foveal retinal thickness (224.9 +/- 116.9 microm) at the last visit was significantly thinner than the preoperative foveal retinal thickness (463.7 +/- 177.3 microm; P <.0001; Wilcoxon signed-rank test). The foveal retinal thickness did not decrease linearly but fluctuated: The mean postoperative retinal thickness had decreased significantly 7 days after surgery, then remained unchanged for approximately 1 month, and thereafter gradually decreased until 4 months. The intraoperative and postoperative complications included peripheral retinal tear in 3 of 65 (4.6%) eyes, postoperative rhegmatogenous retinal detachment in 1 of 65 (1.5%) eyes, neovascular glaucoma in 3 of 65 (5%) eyes, recurrent vitreous hemorrhage in 1 of 65 (1.5%) eyes, hard exudates in the center of the macula in 3 of 56 (4.6%) eyes, postoperative epiretinal membrane formation in 9 of 65 (13.8%) eyes, and a lamellar macular hole in 1 of 65 (1.5%) eyes. CONCLUSIONS: Vitrectomy for diabetic macular edema is an effective procedure for reducing the edema and improving visual acuity. Because the postoperative reduction in retinal thickness is not complete until 4 months, the assessment of vitrectomy on foveal thickness should not be made until this time. In addition, there are severe complications from vitrectomy for diabetic macular edema, and careful preoperative and postoperative examinations and surgical methods are required.

Adult↗
PubMed2003

Optical coherence tomography for evaluating diabetic macular edema before and after vitrectomy.

PURPOSE: To report the use of optical coherence tomography (OCT) for evaluation of diffuse diabetic macular edema (DME) before and after vitrectomy. DESIGN: Interventional case series. METHODS: A retrospective study was made of 15 consecutive eyes of 13 patients that had vitrectomy for diffuse DME and OCT preoperatively and postoperatively. In seven eyes of six patients (group 1), vitrectomy was performed because of vitreomacular traction observed on biomicroscopy or OCT. In the other eight eyes of seven patients (group 2), vitrectomy was performed for DME not responsive to laser photocoagulation, with no vitreomacular traction on biomicroscopy or OCT. RESULTS: Mean +/- standard deviation (SD) follow-up after vitrectomy was 18 +/- 10 months (range, 6 to 33 months). In group 1, mean +/- SD retinal thickness decreased significantly from 661 +/- 181 microm preoperatively to 210 +/- 32 microm at the end of follow-up (P =.018). Median best-corrected visual acuity (BCVA) improved from 20/100 before surgery (range, 20/250 to 20/50) to 20/80 at the end of follow-up (range, 20/250 to 20/25; P =.046). In one eye in group 1, vitreomacular traction was only observed on OCT and not on biomicroscopy. In group 2, mean +/- SD retinal thickness decreased from 522 +/- 103 microm preoperatively to 428 +/- 121 microm at the end of follow-up (P =.2). Median BCVA was 20/100 before vitrectomy (range, 20/320 to 20/63) and 20/200 at the end of follow-up (range, 20/250 to 20/63; P =.78). CONCLUSIONS: Vitrectomy was beneficial in eyes with diffuse DME combined with vitreomacular traction but not in eyes without traction. Optical coherence tomography allowed diagnosis of subtle vitreomacular traction and provided precise preoperative and postoperative assessments of macular thickness.

Adult↗
PubMed2003

Resolution of diabetic cystoid macular edema associated with spontaneous vitreofoveal separation.

PURPOSE: To report spontaneous resolution of diabetic cystoid macular edema (CME) associated with spontaneous vitreofoveal separation. DESIGN: Interventional case series. METHODS: Optical coherence tomography (OCT) was performed on three eyes of three diabetic patients with CME before and after vitreofoveal separation. RESULTS: In all three eyes, OCT showed cystic changes at the fovea with a slightly detached posterior hyaloid, which remained attached to the optic disk and the fovea. After spontaneous separation of the hyaloid at the fovea, there was resolution of the cystic cavities and restoration of the foveal depression. CONCLUSIONS: In some eyes of diabetic patients, CME is caused by a vitreous traction. Resolution of CME may occur after spontaneous vitreofoveal separation.

Adult↗
PubMed2003

Foveal hypoplasia demonstrated in vivo with optical coherence tomography.

PURPOSE: We demonstrate foveal hypoplasia by optical coherence tomography (OCT). DESIGN: Observational case report. METHODS: Foveal hypoplasia was demonstrated in a 79-year-old man with decreased vision since childhood using fundus photography, fluorescein angiography, and OCT scans through four meridians of the central foveal. RESULTS: The OCT showed extension of all neurosensory retinal layers through the area in which the fovea would normally be located. CONCLUSION: Optical coherence tomography can be used to demonstrate foveal hypoplasia.

Aged↗
PubMed2003

Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia.

PURPOSE: To report the prevalence of foveal retinal detachment without macular hole in a large number of highly myopic eyes using optical coherence tomography (OCT), and to clarify the demographic characteristics associated with foveal retinal detachment in these eyes. DESIGN: A consecutive, prospective, observational case series. METHODS: In 134 eyes of 78 consecutive patients with high myopia (refractive error of -8 diopters or more), we performed complete ophthalmic examinations and studied cross-sectional images of the macula with OCT. The patients were divided into two groups according to the presence (group 1, n = 78 eyes of 45 patients) or absence (group 2, n = 56 eyes of 33 patients) of posterior staphyloma. Slit-lamp examination with a Goldmann three-mirror lens indicated that none of the eyes had a macular hole. RESULTS: In seven of 78 eyes (9.0%) with posterior staphyloma (group 1), OCT revealed foveal retinal detachment. Two of the seven eyes had foveal retinoschisis. Optical coherence tomography revealed no retinal detachment or retinoschisis in any eye without posterior staphyloma (group 2). Visual acuity of the seven eyes with foveal retinal detachment ranged from 20/40 to 20/200. Two of the seven eyes had visual acuity 20/50 or better. No patients complained of recent, progressive visual impairment. All seven eyes with foveal retinal detachment had severe myopic fundus changes (focal chorioretinal atrophy or bare sclera). CONCLUSIONS: In highly myopic eyes with posterior staphyloma, the prevalence of foveal retinal detachment without macular hole was 9.0%. In eyes with this type of retinal detachment, visual acuity varies and foveal retinal detachment tends to be missed on routine examination. Periodic examination using OCT is recommended for highly myopic eyes with severe myopic degenerative changes and posterior staphyloma.

Adolescent↗
PubMed2003

Intravitreal triamcinolone for refractory pseudophakic macular edema.

PURPOSE: To evaluate the efficacy of intravitreal triamcinolone in refractory pseudophakic cystoid macular edema. DESIGN: A prospective, interventional case series. METHODS: Three eyes of three patients with longstanding pseudophakic cystoid macular edema following uncomplicated cataract surgery, refractory to any medication, were treated with 8 mg of intravitreal triamcinolone. All three eyes were evaluated before injection and throughout follow-up with the Early Treatment Diabetic Retinopathy Study's visual acuity chart, fluorescein angiography, and macular mapping using optical coherence tomography. RESULTS: A month after intravitreal triamcinolone injection, a dramatic decrease in macular thickness was noted by optical coherence tomography in all three eyes (from a mean of 502-233 microm). Mean improvement in visual acuity was 3.7 Snellen lines. Two to 4 months after triamcinolone injection, however, the edema recurred in all cases, to the same degree as before the injection, combined with a decrease in vision. Two eyes underwent a second injection of triamcinolone, and macular thickness decreased, but the edema again recurred 3 months after injection. CONCLUSION: Intravitreal injection of triamcinolone induces striking regression, within 1 month, of chronic refractory macular edema. This regression appears to be transient, however, even after a second injection.

Aged↗
PubMed2003

Mapping posterior vitreous detachment by optical coherence tomography in eyes with idiopathic macular hole.

PURPOSE: To determine the relationship between posterior vitreous detachment and idiopathic macular hole. DESIGN: Observational case series. METHODS: In a prospective study, the posterior hyaloid face was scanned from the posterior pole to the far periphery by optical coherence tomography in 25 eyes (22 patients) with an idiopathic macular hole (stage 1 = 1, stage 2 = 7, stage 3 = 10, and stage 4 = 7), and a map of the posterior vitreous detachment was constructed. RESULTS: One eye with a stage 1 macular hole had a posterior vitreous detachment confined to the vascular arcade, but attached to the fovea. In all seven eyes at stage 2, the detached posterior hyaloid enlarged upward beyond the superior vascular arcade, but stopped at the margin of inferior vascular arcade. In two cases, the posterior vitreous detachment also extended temporally and superonasally. In all cases, the vitreous face remained attached to the fovea. Six of the 10 eyes at stage 3 had larger partial posterior vitreous detachment that extended not only upward, but also beyond the inferior vascular arcade, while in the other four eyes, the size and position of the posterior vitreous detachment was similar to stage 2 macular holes. However, unlike stage 2, the posterior vitreous detachment included the fovea in all eyes. All seven eyes with a stage 4 macular hole had complete posterior vitreous detachment that extended to the far periphery in all directions. CONCLUSION: There is a close correlation between the stage of the macular hole and the degree of posterior vitreous detachment. This close correlation suggests that progression of idiopathic macular hole is related to enlargement of the posterior vitreous detachment.

Aged↗