Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis

Claudia Bru&egrave;, Andrea Saitta, Michele Nicolai, Cesare Mariotti, Alfonso GiovanniniOphthalmology, Department of Neuroscience, Marche Polytechnic University, Ancona, ItalyBackground: The purpose of this study was to evaluate the role of spectral domain optical coherence tomography (SD-OC...

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Autores principales:	Bru&egrave; C, Saitta A, Nicolai M, Mariotti C, Giovannini A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/35ebc84c708d4248a3f80b0bb2e4a246
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spelling	oai:doaj.org-article:35ebc84c708d4248a3f80b0bb2e4a2462021-12-02T07:42:38ZEpiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis1177-54671177-5483https://doaj.org/article/35ebc84c708d4248a3f80b0bb2e4a2462013-01-01T00:00:00Zhttp://www.dovepress.com/epiretinal-membrane-surgery-for-combined-hamartoma-of-the-retina-and-r-a12018https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Claudia Bru&egrave;, Andrea Saitta, Michele Nicolai, Cesare Mariotti, Alfonso GiovanniniOphthalmology, Department of Neuroscience, Marche Polytechnic University, Ancona, ItalyBackground: The purpose of this study was to evaluate the role of spectral domain optical coherence tomography (SD-OCT), MP-1 microperimetry, and fundus autofluorescence imaging for planning surgical procedures in combined hamartomas of the retina and retinal pigment epithelium (CHR-RPE) and following epiretinal membrane removal.Methods: In an interventional retrospective case series, six consecutive subjects with CHR-RPE underwent vitrectomy and epiretinal membrane peeling, with 4 years of follow-up. Each underwent complete ophthalmic examination, including best corrected visual acuity, fundus examination, fundus fluorescein angiography, SD-OCT, MP-1, and fundus autofluorescence at one, 6, 12, and 48 months.Results: Six eyes from six subjects with CHR-RPE were studied (mean age 31 &plusmn; 14 years). All patients were phakic and five were male (83.3%). Lesions were unilateral, ie, three macular, two juxtapapillary and macular, and one pericentral. Preoperative best corrected visual acuity was 0.3 &plusmn; 0.08 Snellen, with significant improvement to 0.9 &plusmn; 0.17 Snellen (P = 0.001) at 4 years of follow-up. Mean retinal sensitivity within the central 20&deg; field improved from 16.6 &plusmn; 1.84 dB to 18.8 &plusmn; 0.96 dB (P = 0.07). There was also a statistically significant reduction in the visual defect (P = 0.04). SD-OCT demonstrated that the epiretinal membranes were completely removed in all but one patient, with significantly decreased macular edema on follow-up at one, 6, 12, and 48 months (P = 0.001). A positive correlation was shown between preoperative macular sensitivity and postoperative best corrected visual acuity. Fundus autofluorescence demonstrated a block in background autofluorescence at the site of the lesion, and hyperautofluorescsence at the edematous retina overlain by the epiretinal membrane.Conclusion: Surgery is an effective treatment for CHR-RPE. SD-OCT, fundus autofluorescence, and MP-1 are valuable and noninvasive tools to guide surgical procedures for CHR-RPE. To the best of our knowledge, this study represents the first use of MP-1 in CHR-RPE in conjunction with SD-OCT and fundus autofluorescence imaging for better guided surgery as well as anatomical and functional prognosis.Keywords: vitrectomy, epiretinal membrane, combined hamartoma of the retina and retinal pigment epitheliumBru&egrave; CSaitta ANicolai MMariotti CGiovannini ADove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 179-184 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Bru&egrave; C Saitta A Nicolai M Mariotti C Giovannini A Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis
description	Claudia Bru&egrave;, Andrea Saitta, Michele Nicolai, Cesare Mariotti, Alfonso GiovanniniOphthalmology, Department of Neuroscience, Marche Polytechnic University, Ancona, ItalyBackground: The purpose of this study was to evaluate the role of spectral domain optical coherence tomography (SD-OCT), MP-1 microperimetry, and fundus autofluorescence imaging for planning surgical procedures in combined hamartomas of the retina and retinal pigment epithelium (CHR-RPE) and following epiretinal membrane removal.Methods: In an interventional retrospective case series, six consecutive subjects with CHR-RPE underwent vitrectomy and epiretinal membrane peeling, with 4 years of follow-up. Each underwent complete ophthalmic examination, including best corrected visual acuity, fundus examination, fundus fluorescein angiography, SD-OCT, MP-1, and fundus autofluorescence at one, 6, 12, and 48 months.Results: Six eyes from six subjects with CHR-RPE were studied (mean age 31 &plusmn; 14 years). All patients were phakic and five were male (83.3%). Lesions were unilateral, ie, three macular, two juxtapapillary and macular, and one pericentral. Preoperative best corrected visual acuity was 0.3 &plusmn; 0.08 Snellen, with significant improvement to 0.9 &plusmn; 0.17 Snellen (P = 0.001) at 4 years of follow-up. Mean retinal sensitivity within the central 20&deg; field improved from 16.6 &plusmn; 1.84 dB to 18.8 &plusmn; 0.96 dB (P = 0.07). There was also a statistically significant reduction in the visual defect (P = 0.04). SD-OCT demonstrated that the epiretinal membranes were completely removed in all but one patient, with significantly decreased macular edema on follow-up at one, 6, 12, and 48 months (P = 0.001). A positive correlation was shown between preoperative macular sensitivity and postoperative best corrected visual acuity. Fundus autofluorescence demonstrated a block in background autofluorescence at the site of the lesion, and hyperautofluorescsence at the edematous retina overlain by the epiretinal membrane.Conclusion: Surgery is an effective treatment for CHR-RPE. SD-OCT, fundus autofluorescence, and MP-1 are valuable and noninvasive tools to guide surgical procedures for CHR-RPE. To the best of our knowledge, this study represents the first use of MP-1 in CHR-RPE in conjunction with SD-OCT and fundus autofluorescence imaging for better guided surgery as well as anatomical and functional prognosis.Keywords: vitrectomy, epiretinal membrane, combined hamartoma of the retina and retinal pigment epithelium
format	article
author	Bru&egrave; C Saitta A Nicolai M Mariotti C Giovannini A
author_facet	Bru&egrave; C Saitta A Nicolai M Mariotti C Giovannini A
author_sort	Bru&egrave; C
title	Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis
title_short	Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis
title_full	Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis
title_fullStr	Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis
title_full_unstemmed	Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis
title_sort	epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/35ebc84c708d4248a3f80b0bb2e4a246
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Epiretinal membrane surgery for combined hamartoma of the retina and retinal pigment epithelium: role of multimodal analysis

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