Table of Contents - WOC 2012

WOC2012 Abstract Book
PO-RET-195
A New Approach to Surgical Treatment of Large Macular Hole
Umanets Nicolay (1) , Brazhnikova ELena (1) , Levitska Galina (1)
1. The Filatov Institute of Eye Diseases and Tissue Therapy
Purpose. To improve the closure rate of large macular hole (LMH) (400 µm
and above). Methods. 20 patients (20 eyes) with idiopathic and traumatic LMH
underwent one vitrectomy (VE) with internal limiting membrane (ILM) peeling
and in cases where no closure was initially achieved (2 eyes) low invasive
additional long-lasting gas tamponade (20% C3F8) was used. Results. The
closure of LMH after one surgery was achieved in 85% of cases and after
additional gas tamponade by 20 % C3F8 - in 95% of cases. One case of
retinal detachment after first VE was treated successfully by second VE -
standard technique without additional manipulation of macula with 20% C3F8
tamponade. The final closure rate was 100%. Conclusion. In surgery of LMH
it is preferable to use long-living gases as a tamponade agent. Additional
gas tamponade is effective as the second procedure for cases with no initial
closure.
PO-RET-196
Macular hole formation following successful pneumatic scleral
buckle (PSB).
Rao Prasan (1)
1. Welcare Hospital LLC
Objective To utilize ocular coherence tomography (OCT) imaging to describe
the occurrence of early-onset full-thickness macular hole following a successful
pneumatic scleral buckle (PSB) surgery for macula on rhegmatogenous
retinal detachment. METHODS We reviewed the case records of 26 patients
who underwent PSB for a macula on, superior rhegmatogenous retinal
detachment. All patients underwent a full ophthalmic evaluation including
OCT imaging at 1, 2, 3, 4 weeks, then at 3 months. RESULTS All patients
had a successful reattachment of the retina on the first postoperative day and
no foveal detachment. However, three patients presented with worsening of
vision following an initial maintenance of the pre-operative visual acuity. All
these patients were male patients (mean age - 43.3 years), demonstrated a
full-thickness macular hole on clinical and OCT examination between the 2nd
and 3rd postoperative week. There was posterior vitreous detachment in all
patients, only 1 patient showed an associated epimacular membrane. OCT
images of the fellow eye were normal, however preoperatively, 2 patients had
mild to moderate pigment in the vitreous. CONCLUSION This study describes
the occurrence of full-thickness macular hole in the 2nd and 3rd post-operative
week in macula on rhegmatogenous retinal detachment.
PO-RET-197
Vitrectomy for recalcitrant non-tractional diffuse diabetic macular
edema.
Rao Prasan (1)
1. Welcare Hospital LLC
Purpose: To determine the efficacy of vitrectomy combined with internal limiting
peeling (ILM) peeling and intravitreal triamcinolone acetonide (ivTA) injection in
treating recalcitrant non-tractional diffuse diabetic macular edema.
Methods: Retrospective interventional study including patients with macular
edema > 6 months, treated with either intravitreal avastin, laser or ivTA was
performed. Eyes with macular ischaemia or traction were excluded. All eyes
underwent a standard procedure of pars plana vitrectomy, ILM peeling, ivTA
injection.
Results: Ten eyes of ten patients were included in the study. Mean follow-up
was 9 months. A statistically significant reduction in the macular thickness was
found at 1 month and 6 months. Visual acuity improved in 4 (40%) of 10 eyes,
remained unchanged in 3 (30%) of 10 eyes, and worsened in 3 (30%) of 10
eyes. Recurrence of macular edema was noted in 30% eyes. Complications
included mild vitreal bleed (10%), transient increase in intraocular pressure
(30%), progression of cataract (20%).
Conclusion: Triple procedure (vitrectomy, ILM peeling, ivTA) produces short
term improvement in macular thickness and functional outcome, probably
improves the natural evolution of chronic diabetic macular edema.
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PO-RET-198
Measurement of serum and vitreous concentrations of anti-type II
collagen antibody in diabetic retinopathy
Nakaizumi Atsuko (1) , Sugiyama Tetsuya (1) , Oku Hidehiro (1) , Ikeda Tsunehiko
(1) (2)
, Nakamura Kimihiko
1. Department of Ophthalmology, Osaka Medical College
2. Nakamura Eye Cclinic
Objective: The blood-retinal barrier (BRB) integrity in diabetic retinopathy (DR)
protects the retinal microenvironment. When this integrity is lost, type II
collagen (II-C), a major matrix protein of vitreous fluid, is exposed to blood.
We therefore investigated the levels of anti-II-C IgG antibody in vitreous fluid
and serum.
Methods: We compared the levels of anti-II-C IgG antibody in the vitreous fluid
and serum in 17 patients with DR and 15 control patients with?non-inflammatory
eye diseases, by enzyme-linked immunosorbent assay (ELISA). We also used
a streptozotocin (STZ) rat model of DR to measure the level of anti-II-C IgG
antibody in the retinas of those animals compared with the level in normal rats
by ELISA.
Results: In the DR patients, serum levels of anti-II-C IgG antibody were higher
than those in the control subjects (p < 0.05). However, most of the anti-II-C
IgG antibody in the vitreous was undetectable, and there was no significant
difference found between STZ rats and normal rats.
Conclusions: We conclude that serum levels of anti-II-C antibody might reflect
the progression of DR. Further investigation is needed to verify this, and to
investigate whether measuring anti-II-C antibody levels is useful for assessing
the prognosis of diabetic microangiopathy.
PO-RET-199
VITREOMACULAR TRACTION SYNDROME ASSOCIATED WITH
PRESUMED ALAGILLE SYNDROME.
Stathopoulos Christina (1) , Guex-Crosier Yan (1) , Venetz Jean-Pierre (2) ,
Wolfensberger Thomas J (1)
1. Hopital Ophtalmique Jules Gonin
2. Centre Hospitalier Universitaire Vaudois, Centre de Transplantation
PURPOSE : Ophthalmological findings in patients with Alagille syndrome
(AGS), include posterior embryotoxon, pigmentary retinopathy and optic disc
anomalies. We present a case of vitreomacular traction syndrome in a patient
with presumed AGS. METHODS : Main outcome measure: visual acuity (VA)
and central macular thickness (CMT) on OCT.
Results: A 52 year old male with presumed AGS was investigated for visual
loss in the right eye (VA=0.5). Fundus examination revealed severe peripheral
retinal atrophy, peripapillary neovascularisation and macular edema associated
with an epiretinal membrane formation (CMT=306µm). In the presence
of systemic immune-modulating therapy (renal transplantation), systemic
infection was ruled out by a laboratory work-up. 15 months later, VA in the right
eye decreased to 0.1 with increased cystoid macular edema associated with
a vitreomacular traction syndrome (CMT=584µm). The patient refused any
surgical therapy. 16 months later, VA in the right eye was counting fingers and
OCT showed traction related macular retinal detachment. (CMT=890µm). The
patient underwent vitrectomy with membrane peeling. Three months later, VA
improved to 0.25 and macular edema decreased to 383µm on OCT.
Conclusion: Vitreomacular traction syndrome may be part of a broad spectrum
of ocular abnormalities seen in AGS and may respond well to surgical therapy.