Medical and Surgical Retina - Recent Innovation, New Perspective, and Applications [Working Title]
The primary management for epiretinal membrane (ERM) is membrane peel after pars plana vitrectomy... more The primary management for epiretinal membrane (ERM) is membrane peel after pars plana vitrectomy. However, the rates of postoperative recurrence of epiretinal membrane reported range from 10 to 21%. Internal limiting membrane (ILM) peeling combined with ERM removal has been introduced in an attempt to diminish this recurrence. Some studies showed that this method largely prevented the recurrence compared with those without ILM peeling. Conversely, other studies demonstrated that combined ERM and ILM peeling did not provide a lower recurrence rate. Since the ILM is formed by the basal lamina of Muller cells, removal of this structure must be pondered due to possible mechanical and functional damage to those important cells. In this chapter, current data on this topic are covered.
We describe the case of a 15-year-old girl with decreased visual acuity associated with elevated ... more We describe the case of a 15-year-old girl with decreased visual acuity associated with elevated intraocular pressure in both eyes and angle closure on gonioscopy. She also presented attenuation of retinal vessels and optic disc pallor with large excavation in the left eye. Ultrasound biomicroscopy revealed an anteriorly positioned ciliary body and absence of ciliary sulcus, confirming the plateau iris configuration. Spectral-domain optical coherence tomography revealed a bilateral cystoid macular edema. Genetic screening revealed heterozygous variants of the Crumbs homolog 1 (CRB1) gene (c.2843G>A and c.2506C>A). The patient underwent trabeculectomy for intraocular pressure control and topical treatment for macular edema. This case highlights the importance of performing gonioscopy and evaluating intraocular pressure in patients with a shallow anterior chamber despite young age. In addition, it also shows the importance of genetic screening, when available, in elucidating the diagnosis and providing patients and their families' information on the patient's prognosis and possible therapeutic options.
Age-related Macular Degeneration (AMD) is an acquired retina disease that can potentially cause s... more Age-related Macular Degeneration (AMD) is an acquired retina disease that can potentially cause significant central visual impairment. Optical coherence tomography (OCT) applied to the study of retinal pathologies has revolutionized the understanding and management of AMD, especially with the technology of full-depth imaging (FDI) Spectral Domain (SD) OCT. With the increasing amount of data from several important studies using SD-OCT and OCT-angiography (OCT-A) we can now better classify and more accurately decode AMD. The purpose of this chapter is to describe the most important AMD biomarkers recently discovered using SD OCT. Understanding AMD phenotype is very important to define prognosis and individualized forms of treatment and follow up. Biomarkers on OCT have been crucial for a better understanding of AMD.
Medical and Surgical Retina - Recent Innovation, New Perspective, and Applications [Working Title]
The primary management for epiretinal membrane (ERM) is membrane peel after pars plana vitrectomy... more The primary management for epiretinal membrane (ERM) is membrane peel after pars plana vitrectomy. However, the rates of postoperative recurrence of epiretinal membrane reported range from 10 to 21%. Internal limiting membrane (ILM) peeling combined with ERM removal has been introduced in an attempt to diminish this recurrence. Some studies showed that this method largely prevented the recurrence compared with those without ILM peeling. Conversely, other studies demonstrated that combined ERM and ILM peeling did not provide a lower recurrence rate. Since the ILM is formed by the basal lamina of Muller cells, removal of this structure must be pondered due to possible mechanical and functional damage to those important cells. In this chapter, current data on this topic are covered.
We describe the case of a 15-year-old girl with decreased visual acuity associated with elevated ... more We describe the case of a 15-year-old girl with decreased visual acuity associated with elevated intraocular pressure in both eyes and angle closure on gonioscopy. She also presented attenuation of retinal vessels and optic disc pallor with large excavation in the left eye. Ultrasound biomicroscopy revealed an anteriorly positioned ciliary body and absence of ciliary sulcus, confirming the plateau iris configuration. Spectral-domain optical coherence tomography revealed a bilateral cystoid macular edema. Genetic screening revealed heterozygous variants of the Crumbs homolog 1 (CRB1) gene (c.2843G>A and c.2506C>A). The patient underwent trabeculectomy for intraocular pressure control and topical treatment for macular edema. This case highlights the importance of performing gonioscopy and evaluating intraocular pressure in patients with a shallow anterior chamber despite young age. In addition, it also shows the importance of genetic screening, when available, in elucidating the diagnosis and providing patients and their families' information on the patient's prognosis and possible therapeutic options.
Age-related Macular Degeneration (AMD) is an acquired retina disease that can potentially cause s... more Age-related Macular Degeneration (AMD) is an acquired retina disease that can potentially cause significant central visual impairment. Optical coherence tomography (OCT) applied to the study of retinal pathologies has revolutionized the understanding and management of AMD, especially with the technology of full-depth imaging (FDI) Spectral Domain (SD) OCT. With the increasing amount of data from several important studies using SD-OCT and OCT-angiography (OCT-A) we can now better classify and more accurately decode AMD. The purpose of this chapter is to describe the most important AMD biomarkers recently discovered using SD OCT. Understanding AMD phenotype is very important to define prognosis and individualized forms of treatment and follow up. Biomarkers on OCT have been crucial for a better understanding of AMD.
Uploads