Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes

Jeroni Nadal,1–3 Elisa Carreras,2,3 Maria Isabel Canut,1–3 Rafael I Barraquer1–3 1Centro de Oftalmologia Barraquer, 2Universitat Autònoma de Barcelona, 3Instituto Barraquer, Barcelona, Spain Background: Hypotony maculopathy (HM) changes may persist, and vis...

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Autores principales:	Nadal J, Carreras E, Canut MI, Barraquer RI
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/07c3e0f06cd148c78526005ade12ad0e
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spelling	oai:doaj.org-article:07c3e0f06cd148c78526005ade12ad0e2021-12-02T07:01:55ZVitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes1177-5483https://doaj.org/article/07c3e0f06cd148c78526005ade12ad0e2015-05-01T00:00:00Zhttp://www.dovepress.com/vitrectomy-and-internal-limiting-membrane-peeling-for-macular-folds-se-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Jeroni Nadal,1–3 Elisa Carreras,2,3 Maria Isabel Canut,1–3 Rafael I Barraquer1–3 1Centro de Oftalmologia Barraquer, 2Universitat Autònoma de Barcelona, 3Instituto Barraquer, Barcelona, Spain Background: Hypotony maculopathy (HM) changes may persist, and visual acuity remains poor, despite normalization of intraocular pressure (IOP). The aim of this study was to evaluate the visual and anatomical results of pars plana vitrectomy (PPV), internal limiting membrane (ILM) peeling, and 20% SF6 gas tamponade in five myopic patients with HM.Methods: This retrospective interventional study was conducted at the Barraquer Center of Ophthalmology, a tertiary care center in Barcelona, Spain, and included five eyes from five consecutive patients (aged 55.4±13.1 years) with HM caused by different conditions. All the patients were treated with 23-gauge PPV, ILM peeling, and 20% SF6 gas tamponade. Preoperative and postoperative evaluation was performed using anterior and posterior biomicroscopy and best corrected visual acuity (BCVA) by logMAR charts.Results: Before surgery, median spherical equivalent was -13.1 (range -7, -19) diopters of myopia. Preoperatively, four cases presented IOP <6.5 mmHg for 3 (range 2–8) weeks. In three of these four cases, IOP >6.5 mmHg was achieved over 16 (range 16–28) weeks, without resolution of HM; increased IOP was not achieved in the remaining case treated 2 weeks after diagnosis of HM. One case presented IOP >6.5 mmHg with HM for 28 weeks before surgery. Preoperative BCVA was 0.7 (range 0.26–2.3) logMAR, and 0.6 (range 0.3–0.7) logMAR and 0.5 (range 0.2–1) logMAR, respectively, at 4 and 12 months after surgery. There was no statistically significant difference between preoperative and postoperative BCVA. Hyperpigmentation lines in the macular area were observed in three cases with hypotony. These lines progressed after surgery despite resolution of the retinal folds in the three cases, and BCVA decreased in parallel in two of these cases.Conclusion: PPV with ILM peeling followed by gas tamponade is a good alternative for the treatment of HM in myopic patients. However, persistent choroidal folds may compromise BCVA. We therefore recommend initiating treatment as early as possible. Keywords: hypotony maculopathy, retinal pigment epithelial hyperpigmentation, macular folds, retinal pigment epithelium, vitrectomyNadal JCarreras ECanut MIBarraquer RIDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 859-864 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Nadal J Carreras E Canut MI Barraquer RI Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes
description	Jeroni Nadal,1–3 Elisa Carreras,2,3 Maria Isabel Canut,1–3 Rafael I Barraquer1–3 1Centro de Oftalmologia Barraquer, 2Universitat Autònoma de Barcelona, 3Instituto Barraquer, Barcelona, Spain Background: Hypotony maculopathy (HM) changes may persist, and visual acuity remains poor, despite normalization of intraocular pressure (IOP). The aim of this study was to evaluate the visual and anatomical results of pars plana vitrectomy (PPV), internal limiting membrane (ILM) peeling, and 20% SF6 gas tamponade in five myopic patients with HM.Methods: This retrospective interventional study was conducted at the Barraquer Center of Ophthalmology, a tertiary care center in Barcelona, Spain, and included five eyes from five consecutive patients (aged 55.4±13.1 years) with HM caused by different conditions. All the patients were treated with 23-gauge PPV, ILM peeling, and 20% SF6 gas tamponade. Preoperative and postoperative evaluation was performed using anterior and posterior biomicroscopy and best corrected visual acuity (BCVA) by logMAR charts.Results: Before surgery, median spherical equivalent was -13.1 (range -7, -19) diopters of myopia. Preoperatively, four cases presented IOP <6.5 mmHg for 3 (range 2–8) weeks. In three of these four cases, IOP >6.5 mmHg was achieved over 16 (range 16–28) weeks, without resolution of HM; increased IOP was not achieved in the remaining case treated 2 weeks after diagnosis of HM. One case presented IOP >6.5 mmHg with HM for 28 weeks before surgery. Preoperative BCVA was 0.7 (range 0.26–2.3) logMAR, and 0.6 (range 0.3–0.7) logMAR and 0.5 (range 0.2–1) logMAR, respectively, at 4 and 12 months after surgery. There was no statistically significant difference between preoperative and postoperative BCVA. Hyperpigmentation lines in the macular area were observed in three cases with hypotony. These lines progressed after surgery despite resolution of the retinal folds in the three cases, and BCVA decreased in parallel in two of these cases.Conclusion: PPV with ILM peeling followed by gas tamponade is a good alternative for the treatment of HM in myopic patients. However, persistent choroidal folds may compromise BCVA. We therefore recommend initiating treatment as early as possible. Keywords: hypotony maculopathy, retinal pigment epithelial hyperpigmentation, macular folds, retinal pigment epithelium, vitrectomy
format	article
author	Nadal J Carreras E Canut MI Barraquer RI
author_facet	Nadal J Carreras E Canut MI Barraquer RI
author_sort	Nadal J
title	Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes
title_short	Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes
title_full	Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes
title_fullStr	Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes
title_full_unstemmed	Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes
title_sort	vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/07c3e0f06cd148c78526005ade12ad0e
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Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes

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