Recurrent spontaneous closure—dynamics of a full-thickness macular hole in relation to the vitreous: a case report [Der rezidivierende Spontanverschluss – Dynamik eines durchgreifenden Makulaforamens in Korrelation mit dem Glaskörper]
Kneifl M.,Krankenhaus Barmherzige Bruder Linz |
Falasinnu J.,Krankenhaus Barmherzige Bruder Linz |
Miesbauer P.,Krankenhaus Barmherzige Bruder Linz |
Reinelt P.,Krankenhaus Barmherzige Bruder Linz |
Schonherr U.,Krankenhaus Barmherzige Bruder Linz
Spektrum der Augenheilkunde | Year: 2016
Purpose: To describe the well documented course of spontaneous closure of a full-thickness macular hole with a recurrence one year later and subsequent renewed closure within 2 weeks. Material and methods: A single case report. A 68-year old male patient came to our hospital and was diagnosed as having a full thickness macular hole. 6 weeks later the hole closed spontaneously. After another year the patient presented himself with a renewed full thickness macular hole and further 2 weeks later the OCT showed another closure with an associated improvement of his visual acuity. Conclusions: Although spontaneous closure of an idiopathic macular hole is rare, shortly before an operation one should check the situation by performing an OCT investigation and look for any potential tendency to closure. © 2016, Springer-Verlag Wien.
PubMed | Krankenhaus Barmherzige Bruder Linz
Type: | Journal: Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft | Year: 2016
The aim of this user observational study was to illustrate the effectiveness of intravitreal operative medication administration (IVOM) in the clinical routine.A monocentric, single arm, prospective study.Included in this study were all patients in whom a macular edema was diagnosed during an ophthalmological examination at the Barmherzigen Brdern Hospital in Linz from November 2012 to August 2014 and who were treated as outpatients or day clinic patients with IVOM using anti-vascular endothelial growth factor (VEGF). The parameters measured during the clinical routine were as follows: best corrected visual acuity (BCVA) using the early treatment diabetic retinopathy study (ETDRS) chart, central optical coherence tomography (OCT) thickness, diagnosis and possible prior treatment with IVOM. Following diagnosis, the IVOM was administered in 6week intervals and a final control with measurement of the named parameters (approximately 19 weeks after diagnosis). If edema was present a further 3stage series (19 weeks) was initiated. In the case of a dry condition the further controls were performed by a private practitioner and the patient only presented again if macular edema reoccurred. A control of the patients with dry results at regular intervals was not planned.A total of 1492 eyes from 1184 patients with an average age of 75.6 11.3 years were included in the study according to the abovenamed criteria. Choroidal neovascularization (CNV) with age-related macular degeneration (AMD) was diagnosed in 879 eyes and 314 eyes were treated for diabetic macular edema (DME). Of the eyes 122 (8.2%) were affected by branch vein thrombosis (AVT) and 63 (4.2%) from central vein thrombosis (CVT). In 47 (3.2%) eyes macular edema with myopic CNV (mCNV) was detected and 67 eyes (4.5%) were not further classified under others. In all groups a gain in letters could be achieved in the EDTRS chart even after the first IVOM series: AMD+ 3.4, DME+ 1.3, AVT+ 6.1, CVT+ 10.1 and mCNV+ 7.0. Patients who were treated with IVOM for the first time showed on average a better response than those previously treated with IVOM.As in many other studies our data also underline the necessity for intravitreal injections for treatment of macular edema. Even if a 6week interval does not nowadays correspond to the current guidelines, we could achieve a stabilization of vision and do not shy away from comparison with large studies, such as the Marina study. In order to provide the increasing numbers of patients the best treatment in the future, an attempt at targeted implementation of resources must be made and if necessary symptoms which can be conservatively treated should be delegated to the private sector.