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Kyorin University School of Medicine, Department of Ophthalmology, Tokyo, Japan.
Ophthalmology (Impact Factor: 6.14). 04/2013; 120(4):878-9. DOI: 10.1016/j.ophtha.2012.12.013
Source: PubMed
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    ABSTRACT: Vitrectomy has been successfully used for treating idiopathic macular holes. Although macular hole surgery has been successful and is generally regarded as a safe procedure, various complications have been reported. The authors report eight patients with symptomatic peripheral visual field loss occurring after vitrectomy for macular holes. Over a 3-year period, vitrectomy with removal of the posterior cortical vitreous and fluid-gas exchange was performed on 50 eyes of 47 patients with idiopathic macular holes. Eight patients reported visual field loss postoperatively, and Goldmann visual fields were obtained. The clinical characteristics and outcomes of the group of patients with visual field loss were compared with the group of patients without visual field loss. Postoperatively, significant peripheral visual field loss was documented in eight patients. The macular holes were anatomically closed in seven eyes (87.5%) of these patients compared with 37 (88.1%) of 42 eyes in the group of patients with no symptomatic visual field loss. The visual field loss was not associated with age, sex, macular hole stage, postoperative intraocular pressure, or history of hypertension or coronary artery disease. The etiology of visual field loss was unclear in six patients. Vitrectomy for idiopathic macular holes can result in significant peripheral visual field loss. The etiology of this complication usually is unknown.
    Ophthalmology 08/1996; 103(7):1069-77. DOI:10.1097/00006982-199616060-00027 · 6.14 Impact Factor
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    ABSTRACT: To characterize the infrared (IR) and fundus autofluorescence (FAF) images of eyes with optic disc pit maculopathy. A retrospective non-comparative study of three patients with optic disc pit maculopathy who were followed by optical coherence tomography (OCT) and retinal angiography (Heidelberg retina angiograph 2) before and after vitreous surgery without laser photocoagulation. The areas of serous retinal detachment and inner retinal schisis were dark in the IR and FAF images preoperatively; and they changed to brighter areas following reattachment of the retina. There was an increase in the granular hyperfluorescence in the FAF images accompanied by an increase in the number of subretinal precipitates. OCT showed a thickening of the photoreceptor outer segments. The outer retinal layer defect initially appeared bright in the IR images and hypofluorescent or hyperfluorescent in the FAF images. The outer retinal layer defect became larger with a reduction of the outer retinal schisis and increased retinal detachment, but then became smaller with the resolution of the retinal detachment. All cases had a resolution or reduction of the retinal detachment and retinal schisis after the vitrectomy. The IR and FAF images in eyes with optic disc pit maculopathy reflect the changes in the inner and outer retinal layers corresponding with the stage of recovery of the disease.
    Clinical and Experimental Ophthalmology 04/2010; 38(7):669-77. DOI:10.1111/j.1442-9071.2010.02311.x · 2.35 Impact Factor
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    ABSTRACT: To evaluate the efficacy of vitrectomy and gas tamponade, without laser photocoagulation to the margin of the optic nerve, for the treatment of macular detachment associated with an optic disc pit. Noncomparative interventional case series. Eleven consecutive patients (8-47 years of age) who presented with unilateral macular detachment associated with an optic disc pit. Pars plana vitrectomy, induction of posterior vitreous detachment (PVD), and gas tamponade were performed, with postoperative facedown positioning for 1 week. The presence of a double-layer detachment consisting of an inner layer separation and an outer layer detachment was observed in 10 of 11 eyes either preoperatively or postoperatively. Patients were observed for 10 to 98 months (mean, 47) after surgery. Anatomic outcome and visual acuity were retrospectively analyzed for all eyes. Optical coherence tomography was used to observe anatomic changes in the macula in some eyes. Complete retinal reattachment was achieved in 10 of 11 eyes, although these eyes required nearly 1 year to reach this state. The one eye with persistent retinal detachment was observed to have a marked reduction of the detachment by 10 months postoperatively. No recurrences were observed. Visual acuity improvement was documented in 7 of 11 eyes. These results suggest that vitrectomy with induction of PVD and gas tamponade, without additional laser treatment, is successful in reattaching the macula and improving central vision in most patients with optic disc pit maculopathy.
    Ophthalmology 09/2005; 112(8):1430-5. DOI:10.1016/j.ophtha.2005.02.013 · 6.14 Impact Factor