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New Lutein-based Dyes vs Standard Synthetic Dyes in Vitreoretinal Interface Surgery

SCIENTIFIC POSTER 2016_New Lutein-based Dyes vs Standard Synthetic Dyes in Vitreoretinal Interface Surgery Purpose: To compare anatomic, functional, microperimetric and electrofunctional outcomes among patients affected by vitreoretinal interface-associated disorders undergoing vitrectomy + epiretinal membrane and/or internal limiting membrane peeling by using new lutein-based dyes or standard synthetic dyes. Materials and Methods: This is...

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Double Inverted Flap Technique for Stage IV MH

Aim: To present a modification of the conventional inverted flap technique in stage IV macular hole surgery. Technique: After a core vitrectomy and trypan blue-assisted ILM peeling. Two vertical tears were created, temporal and nasal, to the fovea. Boht flaps were folded over the fovea creating a large ILM peeling. Air fluid exchange was followed by SF6 25% injection. Results: Six eyes of 6 patients were treated with this technique and...

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My Way to Perform the Inverted Flap Technique for MH

Introduction: Full-thickness idiopathic macular holes are foveal anatomic defects with a complete interruption of all retinal layers. This results in a significant visual impact for the patient. Current surgical options are constantly under debate, particularly after the new International Vitreomacular Traction Study Group classification. Various surgical options have been proposed to boost the closure rates in this disorder, namely...

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Why Did I Choose the Inverted ILM Flap Technique?

Simple surgical maneouver. Better anatomical results. Earlier visual recovery. Large and difficult macular holes may be succesfully closed with this technique. No additional equipment/ dye etc. is necessary. Enables hole closure in different indications (traumatic, high myopia). It allows succesful treatment of myopic macular hole with retinal detachment. Reoperations are predictable, logic and easy to perform. Temporal inverted ILM...

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Clinical Experience of Ocriplasmin for Vitreomacular Traction and MH

Purpose: To evaluate the anatomical and functional results after ocriplasmin (JETREA, ThromboGenics NV, Iselin, NJ, USA) injection in patients with vitreomacular traction (VMT) with or without macular hole (MH). Methods: Fifteen prospective patients with VMT were treated with a single ocriplasmin injection and followed-up at baseline, 1 week, 1, 3 and 6 months. ETDRS best-corrected visual acuity (BCVA), intraocular pressure and...

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Morpho-functional Evaluation of the Ganglion Cell Complex After MH and ILM Peeled with Tano Diamond Scrapper

To evaluate the functionality and the thickness of the ganglion cell complex (GCC) in sixteen patients with full-thickness macular hole underwent ILM peeling and scraping with Tano Diamond Duster Membrane Scraper (DDMS). Three-port pars plana vitrectomy with a 23-gauge system was performed with ILM peeling. After Dual Blue staining, air was used as tamponade. Before performing fluid/air exchange, the hole edges were repeatetdly massaged...

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3 Cases of MH that Lately Closed when the Patient Respected his Positioning

Macular hole are frequently operated using gas tamponnade, requiring a face-down positioning. However, some suggest that this positioning is not so important whereas others consider that tamponnading is not necessary. In the EVRS MH study, we showed that 85% of macular holes would close; ranging from 95% in small holes to 40% in complex situations. However, patients are frequently complaining about the face-down positioning,...

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A Wrong Decision: Surgery of Lamellar Retinal Hole (A Case Report)

SCIENTIFIC POSTER 2016_A Wrong Decision Surgery of Lamellar Retinal Hole (A Case Report) Lidmila Prochazkova Objective: Our case report presents the course of a lamellar hole surgery and subsequent macular hole surgeries in a female patient aged 56 years. Introduction: Macular hole is a fovea defect in full thickness. It is caused by both tangential and saggital traction of posterior hyaloid in macular area. Macular hole progressively...

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Full Thickness MH After ND-YAG Laser Posterior Capsulotomy: The Importance of Evaluation of Vitreoretinal Interface

SCIENTIFIC POSTER 2016_Full Thickness MH After ND-YAG Laser Posterior Capsulotomy The Importance of Evaluation of Vitreoretinal Interface Umut Karaca Purpose: To present a case of full-thickness macular hole (FTMH) formation after Nd-YAG laser posterior capsulotomy, and discuss the underlying pathology. Case Report: A 60-year-old male patient followed for dry age related macular degeneration underwent Nd-YAG laser posterior capsulotomy for...

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Outcome of IVT of Ocriplasmin for Symptomatic Vitreomacular Adhesion

SCIENTIFIC POSTER 2016_Outcome of IVTY of Ocriplasmin for Symptomatic Vitreomacular Adhesion Mostafa Elgohary Purpose: To evaluate the rate of release of vitreomacular adhesion (VMA), anatomical changes and visual outcome following intravitreal ocriplasmin injection for the treatment of symptomatic VMA with and without full-thickness macular hole (FTMH). Methods: This is a retrospective, interventional, case-series of 12 eyes of 11...

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Outcome of Vitreomacular Traction Syndrome: Natural Course vs Vitrectomy vs Ocriplasmin

SCIENTIFIC POSTER 2016_Outcome of Vitreomacular Traction Syndrome Natural Course vs Vitrectomy vs Ocriplasmin Constantinos Demosthenous Purpose: Posterior Vitreous Detachment (PVD) is a common eye condition related with the normal aging of vitreous gel. However, the presence of persistent vitreomacular adhesions exerting tractional forces may be associated with the disruption of foveal anatomy thereby causing symptoms of visual...

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Idiopathic ERM and Metamorphopsia: A New Tool for Pre- and Post-operative Evaluation

SCIENTIFIC POSTER 2016_Idiopathic ERM and Metamorphopsia A New Tool for Pre- and Post-operative Evaluation Elisa Buschini Idiopathic epiretinal membrane (IERM) is defined as an avascular proliferation of different types of cells between the posterior vitreous cortex (PVC) and the internal limiting membrane (ILM). A premacular membrane can remain asymptomatic for much time or it can cause blurred vision. Furthermore, IERM can contract...

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Macular Changes After Uneventful Phaco in Diabetic Patients and Risk Factors Contributing to Increase Retina Thickness

SCIENTIFIC POSTER 2016_Macular Changes After Uneventful Phaco in Diabetic Patients and Risk Factors Contributing to Increase Retina Thickness Maaly Abdel Fattah Introduction: The incidence of subclinical macular edema after uneventful phacoemulsification has become an issue of safety for this frequently performed operation. Advances in phacoemulsification techniques and intraocular lens design have led to improved outcomes following...

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Micropulse Laser 577 nm: A Perfect « Second Line » Treatment for ME ?

Purpose: The authors report several tips and tricks increasing efficiency of 577 nm Micropulse Laser (MIP) in treatment of macular oedema recurrence in eyes with previous ILM peeling surgery. Methods: The study is a retrospective clinical study of sub threshold laser treatment as a tissue-sparing laser photocoagulation for ME. Eyes included underwent treatment for ME due different pathologies (Diabetic Retinopathy, branch or central...

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Safety and Efficacy of Intravitreal Preservative-free Triamcinolone for ME Secondary to Diabetes or Retinal Vein Occlusion

Purpose: To evaluate the efficacy and safety of preservative-free triamcinolone acetonide injectable suspension (Taioftal) for the treatment of macular edema secondary to diabetes or retinal vein occlusion. Design, Setting & Participants: From January 2015 to December 2015, at Ospedale Maggiore of Bologna, a retrospective study was conducted on patients suffering from macular edema secondary to diabetes or retinal vein occlusion....

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Combined Intravitreal Anti-VEGF & Subtenon Corticosteroids in AMD Reduces ME Recurrence and Increases Delay Between IVTs

Purpose:  To evaluate, with time, efficiency of combined treatment using Anti-VEGF & subtenon corticosteroids in ME recurrence in AMD Material and methods: All kinds of CNV in AMD were included in this retrospective study (classic, minimally classic, occult, PEDs…). Both Ranibizumab and Aflibercept were used and associated with subtenon corticosteroids. Corticosteroid was mostly bethamethasone acetate vs triamcinolone...

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New Sharing-economy in Ophthalmology : The Trojan Horse of Multiple IVTs with Easy Protocols Guidelines

Purpose: Report of some common attitudes in medical retinal practice with multiple IVTs, issues pertaining to high risk of over-standardization, lower necessity of an expert medical advice and short-time possibilities of low-cost evolution excluding ophthalmologists Methods: Protocols with IVTs required for AMD or ME treatments are analysed and we have pointed out several medical contestations of these protocols. Results: Nowadays...

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Vitreo-retinal Interface in Non-tractional DME

Vitrectomy is a well-known technique for dealing with “tractional DME”. Most doctors however prefer medical treatment for “non-tractional” DME. Recently performed, ME EVRS study proved that vitrectomy may be a valuable treatment option for “non-tractional” DME. The aim of this presentation is to show the vitreo-retinal relationship in “nontractional DME” revealed during the surgery, pointing that in...

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Incidence and Risk Factors of Cystoid Macular Edema After Retinal Detachment Surgery

Purpose : To evaluate the incidence rate of cystoid macular edema (CME) after uncomplicated primary operation on retinal detachment (RD) and to identify risk factors associated with postoperative CME. Methods : Retrospective interventional case series of consecutive patients that underwent one RD repair either by primary vitrectomy or external procedure during a 3 years period starting on January 2012. Postoperative CME was defined as...

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The Paradox of ILM Peeling: It Is Traumatic but it Works…Why ?

ILMP is challenged because it may injure the Retinal Fiber and the Retinal Ganglion cells layers. And indeed ILMP tears Muller Cells (MC) endfeet, and eventually retinal astrocytes, and endothelial cells. However numerous studies as well as routine clinical practice have long shown that well-conducted Vitrectomy-ILMP can reabsorb macular edema and improve visual acuity in the majority of cases. It is acknowledged today that EGFR (Epidermal...

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Inverted ILM Flap Technique for MH in High Myopia: A Case Report

Purpose: To report the surgical technique and efficacy of the inverted internal limiting membrane (ILM) flap technique for an idiopathic macular hole (MH) in high myopia. Case presentation: A 47-year-old female with a full thickness macular hole with foveoschisis underwent pars plana vitrectomy with 23 gauge plus transconjunctival system, ILM peeling and SF6 gas tamponade. Axial length was 29.96mm and best corrected visual acuity was 0.06...

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Subthreshold Diode Micropulse Laser for the Treatment of Clinically Significant DME Less than 400 μ

Purpose: To assess effect of micropulse diode laser (MPDL) on best corrected visual acuity (BCVA) and central foveal thickness (CFT) in treatment of clinically significant diabetic macular oedema (CSME) as compared to conventional argon green laser (CGL) treatment. Design: Single-center, prospective, interventional, comparative study. Methods: Twenty four patients (40 eyes) with diabetic CSME were randomly assigned to MPDL (n=20) or CGL...

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Micropulse Contiguous Grid Laser for Diffuse DME

Objective: To investigate micropulse contiguous grid laser in fovea involved DDME and to correlate SD-OCT structural changes with resolution target visual fields. Purpose: To investigate micropulse contiguous grid laser in the treatment of eyes with DDME involving the fovea, and second, to correlate OCT findings with resolution target visual field (RTVF) measurements of threshold acuity at fixation, best acuity measured at any intercept...

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Definition of Cystoid Macular Degeneration in DME

Purpose: To describe cystoid macular degeneration (CMD) which had no clear definition in diabetic macular edema (DME) and to investigate related characteristics. Method: Retrospective study. Two hundred fifty one eyes of 179 patients who had cystic changes in OCT were enrolled. The horizontal and vertical diameters of the biggest cyst in the area of 1000µm from the center of the fovea were measured for the definition of CMD. The analysis...

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Microstructural Changes Depicted by OCT in DME: Insight into Pathomorphology and Tailored Management

The introduction of OCT and intravitreal pharmacotherapy has revolutionized the management of diabetic macular edema (DME). So far, central retinal thickness (CRT) is the most commonly used measure to quantify DME in randomized controlled trials and by retinal physicians in clinical practice. However, various studies showed that CRT has a modest correlation with visual acuity in DME and this relation is sometimes paradoxical. This...

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Five Year Old MH After Multiple Surgeries for RD

Contact Details: Email: jerzy_n@poczta.onet.pl Cell Phone: /+48606379620

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Three Year Old MH

Contact Details: Email: ddd@club-internet.fr Cell Phone: /+33685555202

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Secondary Surgery in MH Failures

MH surgery remains one of the most frequently performed surgery. It is usually successful when performed earlier and when MH diameter does not exceed 500 um. There are several techniques used to ensure the success after MH surgery in long standing cases or big macular holes. There are techniques which use the instrument to put the edges of the hole closer. There are techniques of IOL flap implantation, which remain technically very...

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Large MH Previously Operated

Case of 74 year old woman with large macular hole. After the first operation with classical technique 23G MIVS PPV. Posterior Hyaloid removal, ILM blu staining assisted regulated SF6 endotamponade the hole was not closed and had also raised margins. Rejection of gas bubble and positioning tight for 7 days did not produced the hoped reattachment of the edges and the closure of the hole.Reoperation and tamponade with heavy silicone and...

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Flying Flap

Contact Details: Email: ppnves@gmail.com Cell Phone:...

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Macular Buckling

Pathologic myopic eyes are proned to have choroidal effusions during ocular surgeries. This case had macular hole related retinal detachment who had a previous vitrectomy without success. She was offered to have a macular buckling surgery and vitrectomy. A limited subretinal hemorrhage was noted at the beginning of the surgery. We stopped at that moment and observed the choroidal hemorrhage for 10 minutes. Since it did not tend to enlarge,...

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Comparison of Clinical Characteristics in Myopic Traction Maculopathy with and Without MH

So Hyun Bae_SCIENTIFIC POSTER 2015 Purpose: To compare the clinical characteristics of myopic traction maculopathy (MTM) with and without macular hole (MH). Methods: This retrospective study included the patients with MTM who underwent vitrectomy. The eyes were subdivided into 2 groups based on the presence of MH. Clinical features were assessed including age, sex, axial length, visual acuity, posterior staphyloma, chorioretinal atrophy and...

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Delicate Procedure for Internal Limiting Membrane Peeling in Macular Edema

Iurii Belyi_SCIENTIFIC POSTER 2015_1 Purpose: To develop an optimized mechanical method of internal limiting membrane peeling. Method: We observed 3 patients with cystic macular edema of various etiologies. All patients were examined before and after the operation for: best corrected visual acuity (BCVA), intraocular pressure, perimetry, optical coherence tomography (OCT) (Stratus, Carl Zeiss Meditec) and retina photography. According to...

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Anatomical & Functional Results After Different Treatment Modalities in Serous Macular Detachment Accompanying DME

Mehmet Demir_SCIENTIFIC POSTER 2015_1 Aim: To investigate the effect of application of a variety of treatment modalities on central macular thickness (CMT), serous macular detachment height (SMD) and best corrected visual acuity (BCVA) in diabetic macular edema (DME) with serous macular detachment. Methods: Eighteen eyes of 15 female and 20 eyes of 13 male Type 2I diabetic patients with DME and SMD applied to Retina Clinic were included in...

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Triamcinolone Versus Ranibizumab Intravitreal Injection Combined with Grid Laser Photocoagulation in the Management of Diffuse DME

The present study was conducted at Mansoura Health Insurence Hospital, Mansoura, Egypt. The study included 136 eyes diabetic patients, 80 males 56 females. All eyes had diffuse diabetic macular edema (DME). The best corrected visual acuity was tested. Fluorescein angiography (FA) and OCT were preformed. The 136 eyes were divided into two groups. Group I included 72 eyes which were subjected to intravitreal injection of triamcinolone (4 mg,...

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Flucinolone Acetate Intravitreal Implant in the Treatment of Persistent and Chronic DME. A Tertiary Multicentre Study

Introduction: Diabetic macular oedema (DMO) is a well known complication of diabetes. Until the last decade argon laser was considered the gold standard treatment of clinically significant macular oedema. Recent landmark studies (READ2, RESTORE, Relight, DRCR.net protocol I) shifted the focus of treatment towards intravitreal injections of anti-VEGF. However, anti-VEGF showed a limited effect in chronic CMO. The FAME study revealed...

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Posterior SubTenon Triamcinolone Acetonide Treatment in DME Cases

Burak ERDEN_SCIENTIFIC POSTER 2015 Aim: To evaluate the efficacy and safety of posterior subTenon triamcinolone acetonid injection in diabetic macular edema cases Material/Method: 13 eyes of 12 diabetic macular edema patients ( 7 M, 5 F ) were enrolled into this retrospective study. 40 mg triamcinolone acetonide was injected into the subTenon space via blunt tip cannula through a minor conjunctival incision in the inferonasal quadrant...

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OCT Analysis in Case of Spontaneous MH After Silicone Oil Removal in PDVR B Case

Piotr Fryczkowski_SCIENTIFIC POSTER 2015 Case of proliferative diabetic vitreoretinopathy in 38 year old male with juvenile diabetes. Poster shows spontaneous macular hole formation with macular detachment in OCT one month after silicone oil removal. We reject vitrectomy as a treatment because in the first operation ILM was removed up to the temporal arcades. After double injections of 25% SF6 macula attached, and the hole remains flat...

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The Efficacy of Ocriplasmin in the Treatment of Symptomatic Vitreomacular Traction

Katarzyna Michalska-Malecka_SCIENTIFIC POSTER 2015 The Aim: The aim of the research was to evaluate the influence of ocriplasmin intravitreal injection on the changes in vitreomacular traction and on improvements in visual acuity. Patients & Methods: The analysis included patients who were treated in the University Centre of Ophthalmology and Oncology, Independent Public Clinical Hospital, Medical University of Silesia in Katowice, and...

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Topographic Changes of the Macula After Closure of Macular Hole

Kang Yeun Pak_SCIENTIFIC POSTER 2015 Purpose: To investigate the topographic changes of the macula after closure of macular hole (MH) using vitrecotmy and the internal limiting membrane peeling. Methods: The custom program was used to compare the position of the retinal vessels in the macula between pre- and postoperation. Fundus photographs before and after MH surgery were selected for the following analysis, only if the same fundus camera...

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Efficacy of Idiopathic Macular Hole Retreatment After Primary Pars Plana Vitrectomy

Martina Rubesova_SCIENTIFIC POSTER 2015 Purpose: The aim of this study was to evaluate the efficacy of retreatment of macular hole in patients in whom primary pars plana vitrectomy (PPV) did not lead to the anatomical closure of the full-thickness defect, and to analyse the causes of its failure. Methods: Patients after primary surgical treatment by pars plana vitrectomy with a peeling of internal limiting membrane (IML) and gas tamponade...

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Correlation Between VA and Both Angiographic & Tomographic Imaging Findings in Common Causes of ME

Maha Shahin_SCIENTIFIC POSTER 2015 Purpose: To investigate the correlation between the area of fluorescein leakage and central foveal thickness (CFT) in common causes of macular edema with visual acuity (VA). Method: A consecutive series of 111 eyes (71 patients) with macular edema was included. The study had 3 different groups: Group I (71 eyes) with diabetic macular edema, group II (29 eyes) with edema secondary to vein occlusion and...

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Intravitreal Dexamethasone Implant for Chronic DME Resistant to Ranibizumab Injections

Nil İrem Uçgun_SCIENTIFIC POSTER 2015 Purpose: To assess the effect of intravitreal dexamethasone (DEX) 0,7 mg implant (Ozurdex) in patients with chronic diabetic macular edema resistant to prior intravitreal (IV) monthly 5 dose Ranibizumab. Materials & Methods: Twenty five eyes of 24 patients were included the study. Before and after IV DEX implant visual acuity, central macular thickness (CMT) and intraocular pressure (IOP) were...

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Myopic Foveoschisis & ERM – A Surgical Challenge

Purpose: To report a case of myopic foveoschisis treated with 23 g pars plana vitrectomy (PPV) assisted with a lutein-based dye. Methods: We report a case of a fourty-five years old female patient who presented with decreased visual acuity and complaints of metamorphopsia on her right eye with 6 months duration. Ophthalmologic examination revealed an epiretinal membrane and foveoschisis of the right eye. She has high myopia (-20,00...

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Perfluoro-n-octane Assisted ILM Free Flap Technique for Recurrent MH

It is challenging to achieve hole closure in chronic large macular holes or highly myopic eyes. Recently, various surgical techniques have been introduced using the ILM, and we also reported a technique to cover a macular hole with a Internal Limiting Membrane (ILM) inverted flap as a single layer using Perfluoro-n-octane(PFO). However, these procedures are not feasible f or recurrent macular hole that the ILM around the macular hole has...

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Idiopathic Macular Hole: A Funny Trick and Different Inverted ILM Flap Techniques

Introduction: Idiopathic full thickness macular holes are foveal anatomic defects with interruption of all neurosensory retinal layers, resulting in visual and functional alterations with significant impact on the patient’s quality of life. Currently, the best therapeutic approach for macular holes is still being debated, after the new classification by the International Vitreomacular Study Group. Several surgical methods have been...

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Vitrectomy in Treatment Naive Diabetic Macular Edema

This movie presents the idea behind vitrectomy in treatment naive diabetic macular edema with and without epiretinal membranes. Surgical technique with ILM peeling will be demonstrated in multiple cases. Everything will be documented with SD-OCT and Swept Source OCT images. Intrasurgically, vitreomacular traction is present in most cases of diabetic macular edema, even if not visible in OCT images. Finally, surgical anatomic and functional...

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ILM Peeling with and Without Adjunctive Triamcinolone – Did the ME Study Make a Difference ?

Background: Before the EVRTS-Meeting in Dresden 2012 we always used adjunctive Triamcinolone at the end of epiretinal membrane surgery with ILM-peeling, thinking, that this would reduce postoperative macular edema. However, in reaction to the results of the ME-Study, published in Dresden in 2012 which suggest that cortisone hinders the edema-lowering effect of ILM-peeling, we discontinued the use of adjunctive Triamcinolone in all cases...

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Dexamethasone Implant in Pseudophakic CME

SCIENTIFIC POSTER_Jesus Zarallo Gallardo Pseudophakic cystoid macular edema is a condition presenting after complicated or even uncomplicated cataract surgery. Although it can be subclinic in many cases and self-limited, sometimes it is a recalcitrant disease that limits the results of an otherwise perfect surgery. The therapeutical options for this edema include oral acetazolamide, sub-Tenon corticosteroid injection, intravitreal...

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Evaluation of Retinal Layer Thickness According to Preoperative OCT Pattern After Idiopathic ERM

SCIENTIFIC POSTER_Hee Seong Yoon Purpose: To evaluate the changes in each retinal layer thickness according to preoperative optical coherence tomography(OCT) patterns after idiopathic epiretinal membrane (ERM) removal and to investigate the correlation between retinal layer thickness and visual improvement. Methods: The medical records of 63 patients (63 eyes) who underwent vitrectomy with ILM peeling for idiopathic ERM and followed for...

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MH Formation in a Patient with PVD

We present a case of a 53 year old male who had macular hole surgery in the left eye. The right eye of the patient had a normal macular examination with posterior vitreous detachment confirmed with Optical Coherence Tomography. During follow up we observed a macular hole formation. Our case is a good demonstration of macular hole formation occurred with the tangential forces in a patient with complete posterior vitreous detachment.

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Retinal Vascular Tortuosity and Recurrent ME in Crohn Disease: A Rare Ocular Manifestation or an Independent Vascular Pathology?

SCIENTIFIC POSTER_Silvia Monteiro_2 Introduction: Crohn’s disease (CD) is primarily considered an inflammatory condition of the small and large intestine, although associated extraintestinal inflammation is relatively common. Extra-intestinal manifestations of CD occur in one third of patients. Ocular complications are infrequent, occurring in less than 10% of cases, but can be associated with significant morbidity. Ocular manifestations...

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Comparative Evaluation of Vitrectomy Peeling with vs without Triamcinolone for Idiopathic ERM

Purpose: Compare anatomical and functional results of pars plana vitrectomy (PPV) with peeling of the internal limiting membrane (ILM) with and without per-operative intravitreal injection of triamcinolone for the treatment of idiopathic macular epiretinal membrane (IMEM). Setting: The intravitreal triamcinolone is used by some surgeons as a co-adjuvant to surgical treatment of idiopathic epiretinal membranes; however, to date little...

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Visual and Structural Outcome of MH Surgery

SCIENTIFIC POSTER_Vanessa Lemos Purpose: To evaluate the visual and structural outcomes of macular hole (MH) surgery and its correlation with base diameter, height and minimum linear diameter of MH. Methods and Materials: This retrospective study included a total of 44 eyes (41 patients) with idiopathic MH underwent pars plana vitrectomy, internal limiting membrane peeling and intraocular gas tamponade with a mininum follow-up period of 6...

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Characteristics and Surgical Outcome of MH Developed After RRD Repair

SCIENTIFIC POSTER_Joo Yeon Kim Purpose: To report the characteristics and surgical outcomes of macular holes (MHs) that develop after rhegmatogenous retinal detachment (RD) repair. Methods: A retrospective chart review was performed in patients who developed a full-thickness macular hole after RD repair between May 2010 to July 2013. The eyes underwent MH repair with pars plana vitrectomy, internal limiting membrane peeling and gas...

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Spontaneous Closure of a Myopic MH in a Vitrectomized Eye

We report on a 50 years-old female patient who underwent pars plana vitrectomy for a dropped nucleus and developed thereafter a myopic macular hole. The hole closed spontaneously during follow up. The patient had been referred to our clinic for a dropped nucleus on both eyes, and she underwent subsequent pars plana vitrectomy. We did not implant an intraocular lens because of the high myopic refraction. After surgery her visual acuity was...

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ME in Usher Syndrome: Several Cases Treated with Dexamethasone Implant

Purpose: To investigate the outcomes in Usher Syndrome-associated macular edema treated with intravitreal dexamethasone implant. Method: 4 patients treated with dexamethasone implant for macular edema in Usher Syndrome. Documented by ophthalmic evaluation, OCT and fundus photography. Results: Significant increase in visual acuity due to an improvement of macular edema in all cases. Conclusions: Intravitreal implant of dexamethasone may be...

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A Case of Whiplash Maculopathy: Long-term Evolution

SCIENTIFIC POSTER_Miriam Garcia Fernandez_1 Advantages: To report a case of unilateral traumatic retinopathy due to a whiplash injury and its long-term course. Methods: A 62-year-old man was involved in a traffic accident and had a history of flexion-extension and neck trauma, but no bone injury or thorakic compression by the seatbelt. He noticed an immediate moderate visual deterioration in his right eye, which remained unchanged. One year...

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Glaucoma and Vitreoretinal Interface Diseases

Methods: Retrospective descriptive study of a case report based on clinical records information, patient observation, surgery record and complimentary diagnostic tests analysis. Results: A 75-year-old male, previously diagnosed with ACG, presented with progressively bilateral decreased visual acuity. Best corrected visual acuity (BCVA) was 4/10 in right eye (RE) and 6/10 in left eye (LE). RE intraocular pressure (IOP) control was achieved...

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My Tips for Improved Outcomes in Macular Hole Surgery

The authors present “My Way” for Macular Hole surgical approach. Reports in the literature are largely retrospective, making direct comparison of surgical strategies and methods difficult.The authors expose their tips and rationale for surgical approach that they believe is a contribution to improved outcomes. Tip 1 – Idiopathic Macular Holes are actually secondary to Vitreo Macular Traction (VMT) Tip 2 – In macular holes...

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The Role of OCT in Management of VMT

OCT is a prime technique for studying vitreo-retinal interface, from which it is possible to establish the diagnosis of vitreomacular traction. A recently proposed new classification of the pathology of vitreo-retinal interface based on microstructural retinal images provided by SD-OCT allows better discussion about the therapeutic decision. However identifying a diagnosis cannot be the sole basis for treatment decision. The OCT allows us...

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Macular Hole and VMT in Fellow Eye…How to Approach?

A 68-years-old patient,female,with loss of vision in the right eye (count fingers) and symptoms of deterioration visual acuity and distorted vision in the left eye. The OCT showed a full thickeness macular hole in the right eye and a vitreomacular traction in the left eye. The issue in discussion is: The aproach to the right eye. Wich are the options of treatment for the left eye??: Vitrectomy?? Pharmacologic Vitreolysis?? The authors...

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ERM with Unusual Foveolar Adhesion

Purpose: Epiretinal membranes (ERM) are collections of collagenous cells that occur on the inner surface of the central retina and can lead to visual changes because of their effect on the underlying retina. This ocular pathology was first described by Iwanoff in 1865, and it has been shown to be a relatively common entity, occurring in about 7% of the population. ERM occur more frequently in the older population and both sexes appear to...

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Easy Tool to Dissect Severe Posterior Pole Proliferation

Advantages: Peeling of severe fibrovascular proliferation of the posterior pole using a 25-gauge Atkinson retrobulbar needle with a bent tip and ILM forceps. This technique allows the surgeon to find a cleavage plane with an inexpensive and ‘easy to build’ tool in the absence of more sophisticated tools. Methods: The authors report the case of a 13-year-old boy with a chronic intermediate uveitis in his left eye, which underwent a...

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Improvements in Visual Acuity After Treatment of Vitreomacular Traction and Full-Thickness Macular Hole With Ocriplasmin

Advantages: Vitreomacular traction (VMT) is a progressive retinal disorder that can result in visual distortions and loss of vision that until recently did not have a pharmacological treatment option. Phase 3 clinical trials showed that a single intravitreal injection of ocriplasmin (125 µg) results in a significantly higher proportion of patients achieving anatomic resolution of VMT and closure of full-thickness macular hole (FTMH)...

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Temporal Inverted Flap Technique for MH Closure. A Comparative Study

Advantage: The aim of this study is to present the comparative non-randomised study of Temporal Inverted Flap Technique vs. Classic ILM Flap Technique for Macular Hole Closure. Methods: This is a single center, comparative study. 43 eyes of 39 patients mean age 67, were operated with classic ILM Flap technique (Group A) and 44 eyes of 40 patients, mean age 66, were operated on using only a temporal flap of ILM (Group B). In group B, ILM...

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Long Lasting Macular Hole Surgery: My Way

Long lasting macular holes happen in clinical practice and they remain a surgical challenge. EVRS MH study performed in 2013 revealed that failure rate is 4 times higher in long lasting macular holes, so they should be operated as soon as possible. But what to do if the macular hole was not operated at the early stage? How to perform surgery to minimalize the failure rate? There are some controversies as far as triamcinolone use during...

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Reoperation of Failed MH Closure

Problem: Postoperative persistentmacular hole after standard surgery with ILM peeling is a rare but possible finding. The strategy for further treatment is still under debate and ample treatment recommendations have been published. The aim is to report the surgical outcome with the radial retinal incisions technique. Methods: Sseven eyes underwent a second procedure in which five full-thickness neurosensory retina radial incisions were...

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ILM Graft for Persistent MH After Primary Surgical Failure

Advantages: To describe a new surgical technique for macular hole closure using a patch of internal limiting membrane for persisting macular holes who have underwent pars plana vitrectomy with internal limiting membrane peeling. Methods: Six eyes of 6 patients presented to our hospital with persistent macular holes after having underwent pars plana vitrectomy, internal limiting membrane (ILM) peeling and gas tamponade. All patients...

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Inverted ILM Flap in MH with Poor Prognosis

Advantages: Inverted ILM flap technique can achieve good anatomical and functional success in large, long standing macular holes or in non idiopathic macular holes (as macular holes related to myopia, post vitrectomy for retinal detachment or post ocular trauma). Methods: Since July 2009 inverted ILM flap technique has been performed in macular hole with poor anatomical prognosis. ILM is incompletly peeled around the border of the hole...

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27 G One Pars Plana Port Vitrectomy with a Reflow Strategy for Macular Diseases

Advantages: To report our results for macular hole using anterior chamber infusion during the reverse zonular flow “Re-flow” (personal technique) one port pars plana 27-gauge vitrectomy technique. Methods: A retrospective analysis of 10 eyes which underwent re-flow one port 27-gauge vitrectomy with the infusion in the anterior chamber for macular hole. This technique was used to decrease the turbulence of fluids in the vitreous...

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Efficacy of Ocriplasmin in Patients with Vitreomacular Traction

Background/Advantages: Since May 2013 ocriplasmin (Jetrea, Alcon) has been available on the German market for the treatment of vitreomacular traction (VMT) including when associated with a macular hole of less than or equal to 400 microns. The main aim of this study was to treat a more homogenous group of patients with specific baseline characteristics with ocriplasmin, and to compare the results with those of previous trials. Patient...

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Symptomatic VMT: 27 G Surgical Way vs Injections!

Advantages: In selected cases of VMT, pharmacologic treatment is proposed but the effect is not 100%. The mini MIVS approach obtained complete result but with the risk of surgery and the stimulation of the cataract. My way is a modification of the Oshima technique using a 27 G approach, reflow strategy, slit lamp illumination and only one pars plana port approach with forceps without vitrectomy in this phakic patient. Methods: The use of...

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Elevated Gliosis & Central Foveal Thickness as Prognosis Factors of PPV & ERM Peeling Outcomes

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Purpose: To assess the value of the central foveal thickness (CFT) and the area of the epiretinal membrane (ERM), which is not in contact with the retinal structure, as a prognostic factor for ERM surgery outcome Methods: Retrospective consecutive study including 50 eyes of 41 patients with the diagnosis of ERM. All eyes underwent pars...

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Status of the Choroid Before and After Vitrectomy with ILM Peeling for Idiopathic ERM

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Advantages: The aim of this study is to evaluate the choroidal thickness and the outer choroidoscleral boundary before and after vitrectomy for idiopathic epiretinal membrane in one eye and in the unaffected fellow eye and in healthy volunteers. Methods: A prospective, cross-sectional study will be presented. Twenty-one patients with...

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Are Macular Holes only a Vitreoretinal Interface Disease?

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Advantages: The aim of this study is to report on choroidal thickness and the morphology of the outer choroidoscleral boundary in Swept Source OCT in patients with full thickness macular holes before and after surgery. The secondary goal is to compare the morphology of the choroid with their fellow eyes and with healthy...

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The EVRS Macular Hole Study Results

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Spectral Domain OCT Analysis of MH Closure in Inverted Limiting Membrane Flap Technique

Advantages: To evaluate anatomical foveal microstructure and functional visual recovery associated with closure of idiopathic macular holes in the inverted internal limiting membrane (ILM) flap technique, and standard internal limiting membrane peeling technique. Methods: We describe the spectral domain OCT findings of 30 eyes that underwent surgery for macular hole closure (vitrectomy, ILM peeling with staining, air or gas tamponade, and...

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OCT Guided MH Form Factor as a Predictor of Surgical Outcome in Indocyanine Green Assisted ILM Peeling in the Treatment of Non-idiopathic Full Thickness MH

Poster Satya Pal Raji Background: To evaluate the role of Optical Coherence Tomography guided hole form factor (HFF) in the surgical outcome for non-idiopathic full thickness macular holes. Methods: In this prospective interventional study 27 eyes of 27 subjects (24 males (88.9%) and 3 females (11.1%)) with mean age of 28.57 +20.155 (SD 16.54) Non – Idiopathic full thickness macular holes and no other confounding factors were...

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Results of Idiopathic MH Surgeries

Advantages: To evaluate anatomical and functional results of idiopathic macular holes (IMH) surgeries. Methods: At the Ophthalmology department at Masaryk Hospital in Usti nad Labem we performed from January 1st 2011 until December 31st 2012 in total 36 surgeries due to IMH in 30 patients, while in 6 patients (16.7%) both eyes underwent surgery. In all patients we performed the 23G PPV with membrana limitans interna (MLI) peeling and a...

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MH After Intravitreal Ranibizumab Injection for DME

Poster Jaeryung Oh Purpose: To report a case of macular hole formed after intravitreal ranibizumab injection in diabetic macular edema. Case summary: A 76-year-old woman with a 30-year history of type 2 diabetes visited the clinic presenting with the complaint of decreased vision in her right eye. The best-corrected visual acuity of the right eye was 6/20, and 6/12 in the left eye. Intraocular pressure was 20 mmHg in her right eye and she...

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3 Cases of MH Following Intravitreal Injection with Ranibizumab

Poster Youngduk Kim Purpose: To report three cases of macular hole formation in patients who was administered intravitreal ranibizumab. Method: The first case was a 72-year-old man with age related macular degeneration and vitreomacular adhesion. The second case was a 76-year-old woman with subretinal haemorrhage and high PED. She was diagnosed with ARMD. The third case was 51-year-old woman with subretinal haemorrhage and high myopia....

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The Effect of Pathologic Myopia on the Result of MH Surgery

Poster Hakyoung Kim To evaluate the presence of pathologic myopia could affect the result of macular hole surgery.

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MH Combined with Ruptured Retinal Arterial Macro Aneurysm

Poster Young Joon Jo We report a case of macular hole with ruptured retinal arterial macro aneurysm. 84-year-old female had decreased vision 2 days ago. With fundus examination, dense preretinal and subretinal hemorrhage with ruptured retinal arterial macro aneurysm was detected, we planned vitrectomy for preretinal hemorrhage. After core vitrectomy, ICG assisted ILM peeling was done. After dense subILM hemorrhage was removed. MH was...

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Surgical Results in Bilateral Full-thickness MH After Laser-assisted in Situ Keratomileusis for Myopia

Poster 3 Miriam Garcia-Fernandez Advantages: To report the surgical results in a case of bilateral full-thickness macular hole (FTMH) after laser-assisted in situ keratomileusis (LASIK) for myopia. Methods: A 53-year-old Spanish woman who had undergone LASIK for the correction of myopia in her right and left eye (10 years ago) was referred to our department with a complaint of decreased visual acuity (VA) in both eyes. A complete ocular...

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1% Topical Brinzolamide, First Results of Clinical Outcomes on ME in Vitrectomized Eyes

This study reports the effects of 1% topical Brinzolamide on macular oedema in glaucomatous pseudophakic eyes which have previously sustained vitrectomy and peeling of the internal limiting membrane (ILM). Conditions: In seven cases of glaucomatous pseudophakic eyes with previous vitrectomy and ILM peeling, chronic macular oedema occurred . There was not a good tonometric compensation with ß-blockers and no response to topical (NSAIDs) in...

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Comparison of Success Rate According to the Duration of Prone Positioning After MH Surgery

Poster Young-suk Chang Purpose: To investigate the optimal duration of postoperative prone positioning after macular hole (MH) surgery by the comparison of the anatomical success rate. Methods: The clinical records were reviewed of all patients treated at Kim’s eye hospital between February 1, 2006 and February 28, 201 3, for an idiopathic macular hole. Coexisting ocular disease such as glaucoma, diabetic retinopathy, retinal vessel...

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Lens Status and Outcomes of Idiopathic MH Surgery

Poster 1 Osman Cekic To report the effect of lens status on anatomical and functional outcomes of idiopathic macular hole surgery.

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Spontaneous Closure of Stage IV Idiopathic MH and Late Reopening as a Lamellar MH

Poster 5 Joaquin Castro Navarro To report a case of spontaneous closure of stage IV full-thickness idiopathic macular hole (FTMH) and late reopening as a lamellar macular hole. Methods: A 67-year-old Spanish man was referred to our hospital with a complaint of decreased vision in his right eye and metamorphopsia for approximately 11 months. He did not report any trauma. A complete ocular examination, including, among others, determination...

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Can Retinitis Pigmentosa Influence MH Surgical Results?

Poster 2 Joaquin Castro Navarro Advantages: To report a case of unilateral recurrent macular hole in a patient affected by retinitis pigmentosa (RP). Methods: A 64-year-old woman, with the previous diagnosis of RP, was referred to our department with a complaint of central visual loss in her left eye (LE) for 12 months. A complete ocular exploration, including determination of Best Corrected Visual Acuity (BCVA) (decimal notation),...

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A Dramatic Complication After Idiopathic MH Surgery: Retinal Phototoxicity

Poster 1 Joaquin Castro Navarro Advantages: To report three cases of retinal phototoxicity caused by Xenon light during idiopathic macular hole surgery. Methods: Three eyes (3 patients), two females and one male with idiopathic macular hole, underwent three-port pars plana vitrectomy (Accurus, ALCON, Fort Worth, Tx, EUA) with internal limiting membrane peeling and fluid-gas exchange and fluid-gas exchange (C3F8) due to the presence of an...

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Surgical Treatment of Macular Hole Complicating Behçet’s Uveitis

Poster 3 Salim Ben Yahia Advantages: To report 2 cases of macular hole in patients with Behçet’s uveitis, and the results of surgical treatment. Methods: We report 2 young patients, diagnosed with Behçet’s uveitis, who developed a macular hole. Review of 2 patients’ charts, fluorescein angiography, optical coherence tomography, and results of surgical treatment. Effectiveness / Safety: The two patients were treated by...

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Differentiated Surgical Tactics for Idiopathic Macular Hole

Poster Ural Altynbaev An algorithm for a differentiated approach to the removal of the ILM and the choice of tamponade in surgery for stage 2 – 4 macular holes. Methods: The study included 110 patients with stage 2 – 4 idiopathic macular holes. All patients received a partial posterior vitrectomy with removal of the posterior hyaloid membrane. Then for patients with MH of up to 500 microns we aspirated fluid of bed of macular...

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Macular Photocoagulation Assisted by Intravitreal Bevacizumab (IVB) Versus Triamcinolone (IVTA) in Diabetic Macular Edema with Serous Macular Detachment

Advantage: Diabetic macular edema (DME) with serous macular detachment (SMD) responds poorly to laser treatment due to presence of subretinal fluid but has been seen to resolve following both IVB and IVTA. Re-injections maybe required owing to their limited period of action. We, thus, compared the efficacy of IVTA and IVB followed by laser photocoagulation, in treating DME with SMD. Methods: In this prospective interventional case...

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Intravitreal Diclofenac for Macular Edema (ME) in Branch Retinal Vein Occlusion (BRVO)

Advantage: Various modes of pharmacological intervention like posterior subtenon triamcinolone, intravitreal triamcinolone and bevacizumab, have been seen to be useful in macular edema in BRVO. However, use of triamcinolone has risk of cataract and glaucoma development while bevacizumab is an expensive drug. Intravitreal diclofenac has been found to be effective in decreasing diabetic macular edema but has not been used in macular edema...

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Ozurdex in Vitrectomized Eyes

Purpose: To define the effectiveness of dexamethasone implant in macular edema in vitrectomized eyes. Methods: Two eyes of 2 patients, (one with diabetic macular edema, the other with macular edema secondary to central retinal vein occlusion) who had been treated with intravitreal anti-VEGFs, triamcinolone, laser photocoagulations and vitrectomy + ILM peeling earlier without any response, were treated with IV dexamethasone implant as a...

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Micropulsed Laser: The New Standard for Macular Edema?

Methods: We present the use of 577 nm micro pulsed laser for several types of macular edema such as diabetic macular edema (DME) and edema secondary to vascular occlusions. One hundred thirty-six eyes of 109 diabetic patients and twenty-six eyes of 26 patients with branch retinal vein occlusion (BRVO) were treated with yellow micro pulsed diode laser in highly confluent manner. ETDRS best corrected visual acuity, High definition optical...

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Targeted PRP Directed By Optos Wide Field Fluorescein Angiography To Treat Severe DME

12 Patients with severe DME (CMT > 350 microns) were prospectively enrolled. Wide field Optos fluorescein angiography to determine areas of poor peripheral perfusion. Patients then underwent an injection of Avastin and PRP directed to areas of poor perfusion. Two more monthly injections of Avastin were given. If at the end of 4 months observation period DME persisted, wide field angiography was repeated and more PRP was applied to areas...

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Efficacy of Anti-VEGF Drugs for Macular Edema in Vitrectomized Eyes

Macular edema may be present in eyes that have undergone vitrectomy for a number of reasons (despite ILM peeling). Are anti-VEGF drugs effective in these cases and how should they be used? The paper attempts to answer this question through a comparative study of a limited number of vitrectomized eyes of patients who receive anti-VEGF treatment for macular edema versus a control group which have undergone vitrectomy without...

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Intravitreal Implant of Dexamethasone for the Treatment of Refractory Vitrectomy Induced Cystoid Macular Edema

Advantages: Surgically induced cystoid macular edema (SICME) is a complication that can occur after various types of intra-ocular surgeries. SICME could be seen following glaucoma surgery, iridotomies, penetrating keratoplasty, scleral buckling, anterior vitrectomy and pars plana vitrectomy (PPV). The incidence of SICME is usually higher in more complicated procedure (combined procedures). There are several articles documenting that SICME...

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