Retinal Diseases: Clinical Presentation, Treatment, and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 22460

Special Issue Editor

1. Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
2. Laboratory of Images, Signals and Intelligent Systems (LISSI, EA N ° 3956), University Paris-Est Créteil, Créteil, France
Interests: retina; multimodal imaging; optical coherence tomography; optical coherence tomography angiography; fundus autofluorescence; age-related macular degeneration; inherited retinal diseases; deep learning

Special Issue Information

Dear Colleagues,

On behalf of the Journal of Clinical Medicine Editorial Team, I am delighted to present a Special Issue entitled “Retinal Diseases: Clinical Presentation, Treatment and Management”.

Paradigms concerning the management of retinal diseases have been shifting rapidly over the last decade, due to, on one hand, the extraordinary advances in retinal imaging, and, on the other hand, remarkable therapeutic advances. Multimodal imaging not only allows a refined assessment of retinal diseases today but also provides new biomarkers of therapeutic response, which can further aid the clinician in planning the treatment strategy.

This Special Issue aims to highlight recent developments in retinal diseases and the influence these advancements have had on their management. Contributions include a broad scope of research, from retinal diagnostic imaging to therapeutic approaches to retinal diseases.

The published papers will describe new developments in these areas. This Special Issue will accept high-quality articles containing original research results as well as review articles of exceptional merit.

Kind regards,

Dr. Alexandra Miere
Guest Editor

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Keywords

  • retina
  • retinal diseases
  • imaging
  • biomarkers
  • anti-VEGF therapy

Published Papers (11 papers)

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Research

13 pages, 718 KiB  
Article
Ophthalmological Impairments at Five and a Half Years after Preterm Birth: EPIPAGE-2 Cohort Study
by Thibaut Chapron, Véronique Pierrat, Georges Caputo, Mathilde Letouzey, Elsa Kermorvant-Duchemin, Youssef Abdelmassih, William Beaumont, Amandine Barjol, Guylene Le Meur, Valérie Benhamou, Laetitia Marchand-Martin, Pierre-Yves Ancel and Héloïse Torchin
J. Clin. Med. 2022, 11(8), 2139; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11082139 - 11 Apr 2022
Cited by 1 | Viewed by 1509
Abstract
We report the 51/2 year prevalence of visual and oculomotor impairments in preterm children born at 24–34 weeks’ gestation (WG) using the population-based cohort study EPIPAGE-2, set in France, 2011. The main outcomes were imputed prevalence of refractive errors (REs), strabismus, and [...] Read more.
We report the 51/2 year prevalence of visual and oculomotor impairments in preterm children born at 24–34 weeks’ gestation (WG) using the population-based cohort study EPIPAGE-2, set in France, 2011. The main outcomes were imputed prevalence of refractive errors (REs), strabismus, and binocular visual acuity (VA). Children were clinically assessed by specially trained pediatricians. The population was also analyzed in terms of cerebral palsy at 51/2 years (no CP, stage 1, stage 2, or stage 3–5) and retinopathy of prematurity in the neonatal period (no ROP, stage 1 or 2, or severe ROP). Among the 4441 children included, 2718 (weighted percentage 58.7%) were clinically assessed. REs were reported in 43.1% (95% confidence interval 37.6–48.4), 35.2% (32.7–37.6), and 28.4% (25.0–31.8) of children born at 24–26, 27–31, and 32–34 WG (p < 0.01), respectively; strabismus rates were 19.5% (14.6–24.4), 14.8% (12.9–16.7), and 8.3% (6.2–10.4) (p < 0.001), respectively. Moderate/severe visual deficiencies (VA < 3.2/10) were present in 1.7% (0.2–3.3) of children born at 24–26 WG, and in less than 1% in other groups. A suboptimal VA 5/10–6.3/10 was measured in 40.6% (35.3–45.8) of children born at 24–26 WG, 35.8% (33.5–38.1) at 27–31 WG, and 33.7% (30.4–37.0) at 32–34 WG. CP and ROP were associated with strabismus and RE. The association between CP and VA was strong, while it was not observed for ROP. In this large cohort of preterm-born children, we found a high prevalence of RE and strabismus regardless of WG, supporting the need for specific attention in this population. High prevalence of suboptimal VA could be challenging for these children at the age of reading and writing acquisition. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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8 pages, 1026 KiB  
Article
Quantitative Analysis of Choriocapillaris Using Swept-Source Optical Coherence Tomography Angiography in Eyes with Angioid Streaks
by Hoang Mai Le, Eric H. Souied, Safa Halouani, Enrico Borrelli, Thibaut Chapron, Giuseppe Querques and Alexandra Miere
J. Clin. Med. 2022, 11(8), 2134; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11082134 - 11 Apr 2022
Cited by 2 | Viewed by 1238
Abstract
Purpose: to quantitatively analyze choriocapillaris perfusion using swept-source optical coherence tomography angiography (SS-OCTA) in eyes presenting with angioid streaks in comparison with control eyes. Methods: Macular 6 × 6 mm SS-OCTA scans were retrospectively analyzed in eyes with angioid streaks and in control [...] Read more.
Purpose: to quantitatively analyze choriocapillaris perfusion using swept-source optical coherence tomography angiography (SS-OCTA) in eyes presenting with angioid streaks in comparison with control eyes. Methods: Macular 6 × 6 mm SS-OCTA scans were retrospectively analyzed in eyes with angioid streaks and in control eyes. En face choriocapillaris flow images were compensated with en face choriocapillaris structure images, followed by the Phansalkar local thresholding method (with a window radius of four and eight pixels). Quantitative analysis was performed in the four peripheral 1 × 1 mm corners of the 6 × 6 mm SS-OCTA image to include equidistant and comparable regions. The percentage of flow deficits (FD%), the number and size of the flow deficits (FDs) and the total area of FDs were then calculated. Results: 54 eyes of 31 patients were included in the study: 27 eyes diagnosed with angioid streaks and 27 controls. Analysis of the four 1 × 1 mm peripheral corners of the 6 × 6 mm SS-OCTA image showed that eyes with angioid streaks had a higher FD% compared to the control group (47.62 ± 8.06 versus 38.90 ± 6.38 using a radius of four pixels (p < 0.001); 48.37 ± 7.65 versus 39.66 ± 6.51 using a radius of eight pixels (p < 0.001). The average size of FDs as well as the total area size of the FDs were significantly higher in eyes with angioid streaks compared to control eyes (p < 0.001). Eyes with angioid streaks present reduced choriocapillaris flow compared to control eyes. Decreased choriocapillaris perfusion may contribute, among other factors, to the development of neovascularization and atrophy in patients with angioid streaks. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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8 pages, 1435 KiB  
Article
Clinical Characteristics and Multimodal Imaging Findings of Central Serous Chorioretinopathy in Women versus Men
by Elodie Bousquet, Héloïse Torres-Villaros, Julien Provost, Martine Elalouf, Anthony Gigon, Irmela Mantel, Aurélie Timsit and Francine Behar-Cohen
J. Clin. Med. 2022, 11(6), 1706; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11061706 - 19 Mar 2022
Cited by 4 | Viewed by 4287
Abstract
(1) The aim of this study was to compare the clinical characteristics and multimodal imaging findings of central serous chorioretinopathy (CSCR) between women and men. (2) Women and men with CSCR were compared in terms of their age and risk factors, the clinical [...] Read more.
(1) The aim of this study was to compare the clinical characteristics and multimodal imaging findings of central serous chorioretinopathy (CSCR) between women and men. (2) Women and men with CSCR were compared in terms of their age and risk factors, the clinical form of their disease, multimodal imaging findings and the presence of macular neovascularization (MNV) on optical coherence tomography (OCT)-angiography. (3) Results: The data of 75 women and 75 men were compared. The women were significantly older than the men (52.2 years versus 45.7 years; p < 0.001). Corticosteroid intake was more frequent in the women (56% versus 40%; p = 0.05). The women had a single foveal subretinal detachment more often than the men (73.3% versus 46.9%; p < 0.001) and they often had fewer gravitational tracks (16.3% versus 29.6%; p = 0.03). On mid-phase indocyanine green angiography, hyperfluorescent plaques were detected less often in the women than in the men (48% versus 72.2%, p = 0.001). MNV was detected on OCT-angiography in 35.9% of the women and in 13.3% of the men (p = 0.004). (4) In the women, CSCR occurs at an older age, is more often unifocal foveolar, and is associated with a higher rate of MNV. The reasons for these gender-related differences remain to be determined. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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9 pages, 8375 KiB  
Article
Comparison of Ultra-Wide Field Photography to Ultra-Wide Field Angiography for the Staging of Sickle Cell Retinopathy
by Héloise Torres-Villaros, Franck Fajnkuchen, Fatima Amari, Lucie Janicot and Audrey Giocanti-Aurégan
J. Clin. Med. 2022, 11(4), 936; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11040936 - 11 Feb 2022
Cited by 1 | Viewed by 1428
Abstract
Sickle cell retinopathy (SCR) is classified by Goldberg based on peripheral vascular changes. Ultra-wide field (UWF) imaging has enhanced visualization of the peripheral retina. However, there is no consensus on the optimal imaging technique for the screening of SCR. We performed a monocentric [...] Read more.
Sickle cell retinopathy (SCR) is classified by Goldberg based on peripheral vascular changes. Ultra-wide field (UWF) imaging has enhanced visualization of the peripheral retina. However, there is no consensus on the optimal imaging technique for the screening of SCR. We performed a monocentric observational cross-sectional study to compare UWF fundus photography (UWF-FP) with UWF angiography (UWF-FA). All patients who underwent UWF-imaging (Optos, PLC, Scotland, UK) for screening of sickle cell retinopathy between January 2016 and December 2019 were retrospectively included. Eyes with previous laser treatment or concomitant retinal disease were excluded. UWF-FP images were graded based on the Goldberg classification by four graders with various degrees of experience. UWF-FA pictures were reviewed by an independent retina specialist. Differences in Goldberg staging across UWF-FP and UWF-FA were assessed. A total of 84 eyes of 44 patients were included. Based on UWF-FA, most eyes were stage 2 (77.4%) and 19 were stage 3 (22.6%). The pre-retinal neovascularization detection sensitivity on UWF-FP was 52.6 to 78.9%, depending on the graders. UWF-FA led to a later Goldberg stage of retinopathy, in most cases from stage 1 to stage 2. Neovascularization (stage 3) was not detected by our graders on UWF-FP in 21.1 to 57.9% of eyes. UWP-FP tends to underestimate Goldberg stages of retinopathy compared with UWF-FA and is less accurate when detecting neovascularization in sickle cell retinopathy, which has a direct impact on therapeutic management and prognosis. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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10 pages, 3911 KiB  
Article
Reduced Vessel Density in the Mid-Periphery and Peripapillary Area of the Superficial Capillary Plexus in Non-Proliferative Diabetic Retinopathy
by Amira Chaher, Franck Fajnkuchen, Sandrine Tabary and Audrey Giocanti-Aurégan
J. Clin. Med. 2022, 11(3), 532; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11030532 - 21 Jan 2022
Cited by 1 | Viewed by 1384
Abstract
Our aim in this study was to assess the vessel density (VD) and vessel skeleton density (VSD) in the nasal area of the superficial capillary plexus (SCP) of diabetic subjects without diabetic retinopathy (DR), or in those with a non-proliferative diabetic retinopathy (NPDR), [...] Read more.
Our aim in this study was to assess the vessel density (VD) and vessel skeleton density (VSD) in the nasal area of the superficial capillary plexus (SCP) of diabetic subjects without diabetic retinopathy (DR), or in those with a non-proliferative diabetic retinopathy (NPDR), and to evaluate the relationship between the VD and VSD and the severity of DR. In this prospective study, the VD and VSD in the SCP were measured and analyzed on 6 × 6-mm macular and nasal optical coherence tomography angiography scans. The three concentric circles of the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid were used and divided into zones numbered from 1 to 9 in the macular area and from 1 to 8 in the nasal area. The VD was significantly lower in the nasal peripapillary area (p = 0.0028), and both the VD and VSD were significantly lower in the macular area (p = 0.0131 and p = 0.0132, respectively) in patients with more severe DR. The SD was significantly lower in zones 5 (p = 0.0315) and 6 (p = 0.0324) in the nasal grid in patients with more severe DR. We showed a lower superficial capillary flow in the nasal periphery and peripapillary area in patients with more severe DR. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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10 pages, 6220 KiB  
Article
Treatment outside the Recommended Guidelines for Retinopathy of Prematurity (ROP): Prevalence, Characteristics, and Issues
by Daniel Lemaître, Amandine Barjol, Youssef Abdelmassih, Caroline Farnoux, Gilles C. Martin, Florence Metge, Thibaut Chapron and Georges Caputo
J. Clin. Med. 2022, 11(1), 39; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11010039 - 22 Dec 2021
Cited by 2 | Viewed by 2327
Abstract
This study aims to assess the prevalence and characteristics of preterm infants with retinopathy of prematurity (ROP) treated outside the recommended guidelines. In this retrospective monocentric cohort, we included all premature children treated in our department for ROP by laser photoablation or anti-VEGF [...] Read more.
This study aims to assess the prevalence and characteristics of preterm infants with retinopathy of prematurity (ROP) treated outside the recommended guidelines. In this retrospective monocentric cohort, we included all premature children treated in our department for ROP by laser photoablation or anti-VEGF intravitreal injection. The main outcome was treatment of both eyes for ROP less severe than pre-threshold type 1, treated outside ETROP guidelines. A total of 114 children received treatment for ROP in our department, among whom 32 (28.1%) children received treatment for indications outside the ETROP guidelines for both eyes. The indications outside the guidelines were persistent stage 2 or 3 ROP that showed no evidence of regression after 41 weeks of corrected gestational age (11 children; 34.4%), pre-plus stage (11; 34.4%), difficulties in disease staging (7; 21.9%), type 2 ROP with plus disease (2; 6.2%), and treatment due to logistical difficulties (1; 3.1%; hospitalized in neonatal units hundreds of miles away from our department, with no fundus examination possible in the neonatal unit). To resume, in our cohort, 28.1% of children received treatment for ROP less severe than pre-threshold type 1 both eyes. The main indications for off-label treatment were the persistence of active ROP during follow-up and the presence of pre-plus-stage disease. Our data suggest the need to update ROP treatment criteria to reflect real-life practices. Additional studies are required in order to evaluate the long-term benefits and side effects of treatments outside the recommended indications, and to establish revised treatment guidelines. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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11 pages, 1493 KiB  
Article
Macular Hemorrhage Due to Age-Related Macular Degeneration or Retinal Arterial Macroaneurysm: Predictive Factors of Surgical Outcome
by Mitta Pierre, Adam Mainguy, Irini Chatziralli, Kaivon Pakzad-Vaezi, Jorge Ruiz-Medrano, Bahram Bodaghi, Anat Loewenstein, Jayakrishna Ambati, Marc D. de Smet, Ramin Tadayoni and Sara Touhami
J. Clin. Med. 2021, 10(24), 5787; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10245787 - 10 Dec 2021
Cited by 7 | Viewed by 2451
Abstract
Objective: The study aimed to determine the outcomes and prognostic factors of vitrectomy, subretinal injection of tissue-plasminogen activator and gas tamponade in macular hemorrhage (MaH) due to age-related macular degeneration (AMD) or retinal arterial macroaneurysm (RAM). Methods: The study design utilized a multicentric [...] Read more.
Objective: The study aimed to determine the outcomes and prognostic factors of vitrectomy, subretinal injection of tissue-plasminogen activator and gas tamponade in macular hemorrhage (MaH) due to age-related macular degeneration (AMD) or retinal arterial macroaneurysm (RAM). Methods: The study design utilized a multicentric retrospective case series design of consecutive patients undergoing surgery between 2014 and 2019. Results: A total of 65 eyes from 65 patients were included in the study. Surgery was performed after a mean period of 7.1 days. Displacement of MaH was achieved in 82% of the eyes. Mean best-corrected visual acuity (BCVA) improved from 20/500 to 20/125 at month(M)1 and M6 (p < 0.05). At M6, BCVA worsening was associated with an older age at diagnosis (p = 0.0002) and higher subretinal OCT elevation of MaH (p = 0.03). The use of treat and extend (TE) (OR = 16.7, p = 0.001) and small MaH fundus size (OR = 0.64 and 0.74 for horizontal and vertical fundus size, p < 0.05) were predictive of a higher likelihood of obtaining a countable BCVA at M1. Baseline BCVA was predictive of postoperative BCVA (p < 0.05). Retinal detachment and MaH recurrence occurred in 3% and 9.3% of cases at M6. Conclusion: MaH surgery stabilizes or improves BCVA in 85% of cases. Younger age at diagnosis, better baseline BCVA figures, smaller subretinal MaH height and use of TE regime were predictive of the best postoperative outcomes. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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10 pages, 1186 KiB  
Article
Deep Learning to Distinguish ABCA4-Related Stargardt Disease from PRPH2-Related Pseudo-Stargardt Pattern Dystrophy
by Alexandra Miere, Olivia Zambrowski, Arthur Kessler, Carl-Joe Mehanna, Carlotta Pallone, Daniel Seknazi, Paul Denys, Francesca Amoroso, Eric Petit and Eric H. Souied
J. Clin. Med. 2021, 10(24), 5742; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10245742 - 08 Dec 2021
Cited by 5 | Viewed by 2291
Abstract
(1) Background: Recessive Stargardt disease (STGD1) and multifocal pattern dystrophy simulating Stargardt disease (“pseudo-Stargardt pattern dystrophy”, PSPD) share phenotypic similitudes, leading to a difficult clinical diagnosis. Our aim was to assess whether a deep learning classifier pretrained on fundus autofluorescence (FAF) images can [...] Read more.
(1) Background: Recessive Stargardt disease (STGD1) and multifocal pattern dystrophy simulating Stargardt disease (“pseudo-Stargardt pattern dystrophy”, PSPD) share phenotypic similitudes, leading to a difficult clinical diagnosis. Our aim was to assess whether a deep learning classifier pretrained on fundus autofluorescence (FAF) images can assist in distinguishing ABCA4-related STGD1 from the PRPH2/RDS-related PSPD and to compare the performance with that of retinal specialists. (2) Methods: We trained a convolutional neural network (CNN) using 729 FAF images from normal patients or patients with inherited retinal diseases (IRDs). Transfer learning was then used to update the weights of a ResNet50V2 used to classify the 370 FAF images into STGD1 and PSPD. Retina specialists evaluated the same dataset. The performance of the CNN and that of retina specialists were compared in terms of accuracy, sensitivity, and precision. (3) Results: The CNN accuracy on the test dataset of 111 images was 0.882. The AUROC was 0.890, the precision was 0.883 and the sensitivity was 0.883. The accuracy for retina experts averaged 0.816, whereas for retina fellows it averaged 0.724. (4) Conclusions: This proof-of-concept study demonstrates that, even with small databases, a pretrained CNN is able to distinguish between STGD1 and PSPD with good accuracy. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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8 pages, 991 KiB  
Article
Changes in Treatment Patterns and Globe Salvage Rate of Advanced Retinoblastoma in Korea: Efficacy of Intra-Arterial Chemotherapy
by Dong Hyun Lee, Jung Woo Han, Seung Min Hahn, Byung Moon Kim, Chuhl Joo Lyu, Sung Chul Lee, Dong Joon Kim and Christopher Seungkyu Lee
J. Clin. Med. 2021, 10(22), 5421; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10225421 - 20 Nov 2021
Cited by 6 | Viewed by 1364
Abstract
(1) Background: To analyze changes in treatment patterns for advanced retinoblastoma over time and differences in globe salvage rates; (2) Methods: Retrospective, observational case-control study of 97 eyes of 91 patients with advanced retinoblastoma (Group D and E).; (3) Results: Patients were divided [...] Read more.
(1) Background: To analyze changes in treatment patterns for advanced retinoblastoma over time and differences in globe salvage rates; (2) Methods: Retrospective, observational case-control study of 97 eyes of 91 patients with advanced retinoblastoma (Group D and E).; (3) Results: Patients were divided into two groups based on whether they were treated before or after intraarterial chemotherapy (IAC) was introduced in our center in 2010. Before 2010, primary treatment pattern was enucleation, which was performed in 57.6% of cases, whereas primary treatment pattern after 2010 was IAC combined with intravenous chemotherapy (IVC), which was performed in 78.1%. Intravitreal chemotherapy (IVitC) has been performed to treat vitreous and subretinal seeding since 2015. The 5-year globe salvage rate of IVC alone was 24.0% for Group D and 0% for Group E, whereas that of IVC–IAC was 50.4% for Group D and 49.7% for Group E. Whether IVitC was performed or not did not significantly contribute to globe salvage rate. There was one metastatic death in the IVC alone group.; (4) Conclusions: Primary treatment pattern changed from enucleation to IAC-based treatment, which can now save nearly half of eyes with advanced retinoblastoma with excellent safety profile and survival rate. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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13 pages, 2797 KiB  
Article
The Effect of Selective Retina Therapy with Automatic Real-Time Feedback-Controlled Dosimetry for Chronic Central Serous Chorioretinopathy: A Randomized, Open-Label, Controlled Clinical Trial
by Ji-young Lee, Min-hee Kim, Seung-hee Jeon, Seung-hoon Lee and Young-jung Roh
J. Clin. Med. 2021, 10(19), 4295; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10194295 - 22 Sep 2021
Cited by 7 | Viewed by 1623
Abstract
This prospective randomized controlled trial evaluated the safety and efficacy of real-time feedback-controlled dosimetry (RFD)-guided selective retina therapy (SRT) in chronic central serous chorioretinopathy (CSC). Forty-four participants with chronic CSC were included and randomly assigned to the control group or SRT group. The [...] Read more.
This prospective randomized controlled trial evaluated the safety and efficacy of real-time feedback-controlled dosimetry (RFD)-guided selective retina therapy (SRT) in chronic central serous chorioretinopathy (CSC). Forty-four participants with chronic CSC were included and randomly assigned to the control group or SRT group. The SRT laser system with RFD-guidance was applied to cover the entire leakage area. If SRF remained at the 6-week follow-up visit, re-treatment and rescue SRT was performed for the SRT group and crossover group, respectively. The rate of complete resolution of subretinal fluid (SRF), mean SRF height, and mean retinal sensitivity were compared between the two groups at 6-weeks post-treatment. The complete SRF resolution rate in all SRT-treated eyes was evaluated at 12-weeks post-treatment. The rate of complete SRF resolution was significantly higher in the SRT group (63.6%) than in the control group (23.8%) at 6-weeks post-treatment (p = 0.020). The mean SRF height at 6 weeks after SRT was significantly lower in the SRT group (p = 0.041). Overall, SRT-treated eyes showed complete SRF resolution in 70.3% of eyes at 12-weeks post-treatment. RFD-guided SRT was safe and effective to remove SRF in chronic CSC patients during the 3-month follow-up period. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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10 pages, 607 KiB  
Article
Shorter Axial Length Is a Risk Factor for Proliferative Vitreoretinopathy Grade C in Eyes Unmodified by Surgical Invasion
by Sakiko Minami, Atsuro Uchida, Norihiro Nagai, Hajime Shinoda, Toshihide Kurihara, Norimitsu Ban, Hiroto Terasaki, Hitoshi Takagi, Kazuo Tsubota, Taiji Sakamoto and Yoko Ozawa
J. Clin. Med. 2021, 10(17), 3944; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10173944 - 31 Aug 2021
Cited by 1 | Viewed by 1389
Abstract
Purpose: To investigate the risk factors for the development of proliferative vitreoretinopathy grade C (PVR-C), independent of prior surgical invasion. Methods: Patients who underwent surgery for rhegmatogenous retinal detachment were prospectively registered with the Japan-Retinal Detachment Registry, organized by the Japanese Retina and [...] Read more.
Purpose: To investigate the risk factors for the development of proliferative vitreoretinopathy grade C (PVR-C), independent of prior surgical invasion. Methods: Patients who underwent surgery for rhegmatogenous retinal detachment were prospectively registered with the Japan-Retinal Detachment Registry, organized by the Japanese Retina and Vitreous Society, between February 2016 and March 2017. Data obtained from general ophthalmic examinations performed before and at 1, 3, and 6 months after surgery were analyzed. Results: We included 2013 eyes of 2013 patients (men, 1326 (65.9%); mean age, 55.2 ± 15.2 years) from amongst 3446 registered patients. Preoperative PVR-C was observed in 3.6% of patients. Propensity score matching revealed that a shorter axial length (AL) was a risk factor for preoperative PVR-C (OR (Odds Ratio), 0.81; 95% CI (Confidence Interval), 0.69 to 0.96; p = 0.015), which was a risk factor for surgical failure (OR, 4.22; 95% CI, 1.12 to 15.93; p = 0.034); the association was particularly significant for eyes with an AL < 25.0 mm (p = 0.016), while it was insignificant for eyes with an AL ≥ 25.0 mm. Conclusions: A shorter AL was related to the development of PVR-C before surgical invasion. Our results will help elucidate the fundamental pathogenesis of PVR and caution clinicians to meticulously examine eyes with a shorter AL to detect retinal detachment before PVR development. Full article
(This article belongs to the Special Issue Retinal Diseases: Clinical Presentation, Treatment, and Management)
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