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Gómez Resa María - One of the best experts on this subject based on the ideXlab platform.
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Indentación macular combinada con vitrectomía pars plana como tratamiento de la patología del estafiloma posterior
'Universitat Autonoma de Barcelona', 2015Co-Authors: Gómez Resa MaríaAbstract:La patología macular traccional constituye una de las principales causas de pérdida de visión severa de los altos miopes. La liberación de las tracciones vítreas y epirretinianas es fundamental para el éxito quirúrgico. La técnica quirúrgica más empleada actualmente es la vitrectomía pars plana con disección de la membrana limitante interna, que ha demostrado ser útil en el tratamiento de la foveosquisis miópica y el desprendimiento de Retina por agujero macular. Sin embargo, la presencia de un estafiloma posterior limita estos resultados. Por ello, realizamos un estudio prospectivo, protocolizado e intervencionista con 91 ojos de 87 pacientes para evaluar la eficacia y la seguridad de la indentación macular con indentador de Ando combinada con vitrectomía pars plana y disección de la membrana limitante interna en el tratamiento de la patología traccional del ojo alto miope con estafiloma posterior. Se obtuvo una mejoría significativa de la agudeza visual tanto en el grupo de las foveosquisis miópicas como en los desprendimientos de Retina por agujero macular. No se encontraron diferencias respecto a los resultados anatómicos y visuales entre los subgrupos de foveosquisis miópicas (foveosquisis aislada, desprendimiento foveal o agujero macular de espesor completo), obteniéndose el éxito anatómico en todos los casos. La indentación macular obtuvo mejores resultados visuales como técnica de primera elección en los desprendimientos de Retina por agujero macular comparado con su uso como técnica de rescate tras una vitrectomía pars plana fracasada. La agudeza visual final fue similar independientemente de la obtención del cierre macular en los casos de desprendimiento de Retina por agujero macular. La indentación macular previno la progresión de la foveosquisis a desprendimiento de Retina por agujero macular, y la recidiva del desprendimiento de Retina aunque el agujero macular permaneciera abierto en el postoperatorio.Traction maculopathy is one of the leading causes of severe vision loss in high myopic eyes. The release of the vitreous and epiRetinal traction is critical for surgical success. Pars plana vitrectomy with internal limiting membrane peeling is currently the most widely surgical technique used, which has proven useful in the treatment of myopic foveoschisis and macular hole Retina Detachment. However, the presence of a posterior staphyloma limits these results. Therefore, we conducted a prospective, interventional with 91 eyes of 87 patients to evaluate the efficacy and safety of macular buckling combined with pars plana vitrectomy and internal limiting membrane peeling. A significant improvement in visual acuity in both myopic foveoschisis group and Retinal Detachment due to macular hole group was obtained. No differences were found regarding the anatomical and visual results between subgroups of myopic foveoschisis (isolated foveoschisis, foveal Detachment or full-thickness macular hole), as we obtained the anatomical success in all cases. Macular buckling obtained better visual results as first choice technique in Retinal Detachments due to macular hole compared to use as rescue technique after a previous pars plana vitrectomy. Visual acuity was similar irrespective of obtaining macular closure in cases of Retinal Detachment macular hole. Macular buckling prevented foveoschisis progression to Retinal Detachment due to macular hole and Retinal Detachment recurrence although the macular hole remained open after surgery
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Indentación macular combinada con vitrectomía pars plana como tratamiento de la patología del estafiloma posterior
Bellaterra : Universitat Autònoma de Barcelona, 2015Co-Authors: Gómez Resa María, Universitat Autònoma De Barcelona. Departament De CirurgiaAbstract:Premi Extraordinari de Doctorat concedit pels programes de doctorat de la UAB per curs acadèmic 2017-2018La patología macular traccional constituye una de las principales causas de pérdida de visión severa de los altos miopes. La liberación de las tracciones vítreas y epirretinianas es fundamental para el éxito quirúrgico. La técnica quirúrgica más empleada actualmente es la vitrectomía pars plana con disección de la membrana limitante interna, que ha demostrado ser útil en el tratamiento de la foveosquisis miópica y el desprendimiento de Retina por agujero macular. Sin embargo, la presencia de un estafiloma posterior limita estos resultados. Por ello, realizamos un estudio prospectivo, protocolizado e intervencionista con 91 ojos de 87 pacientes para evaluar la eficacia y la seguridad de la indentación macular con indentador de Ando combinada con vitrectomía pars plana y disección de la membrana limitante interna en el tratamiento de la patología traccional del ojo alto miope con estafiloma posterior. Se obtuvo una mejoría significativa de la agudeza visual tanto en el grupo de las foveosquisis miópicas como en los desprendimientos de Retina por agujero macular. No se encontraron diferencias respecto a los resultados anatómicos y visuales entre los subgrupos de foveosquisis miópicas (foveosquisis aislada, desprendimiento foveal o agujero macular de espesor completo), obteniéndose el éxito anatómico en todos los casos. La indentación macular obtuvo mejores resultados visuales como técnica de primera elección en los desprendimientos de Retina por agujero macular comparado con su uso como técnica de rescate tras una vitrectomía pars plana fracasada. La agudeza visual final fue similar independientemente de la obtención del cierre macular en los casos de desprendimiento de Retina por agujero macular. La indentación macular previno la progresión de la foveosquisis a desprendimiento de Retina por agujero macular, y la recidiva del desprendimiento de Retina aunque el agujero macular permaneciera abierto en el postoperatorio.Traction maculopathy is one of the leading causes of severe vision loss in high myopic eyes. The release of the vitreous and epiRetinal traction is critical for surgical success. Pars plana vitrectomy with internal limiting membrane peeling is currently the most widely surgical technique used, which has proven useful in the treatment of myopic foveoschisis and macular hole Retina Detachment. However, the presence of a posterior staphyloma limits these results. Therefore, we conducted a prospective, interventional with 91 eyes of 87 patients to evaluate the efficacy and safety of macular buckling combined with pars plana vitrectomy and internal limiting membrane peeling. A significant improvement in visual acuity in both myopic foveoschisis group and Retinal Detachment due to macular hole group was obtained. No differences were found regarding the anatomical and visual results between subgroups of myopic foveoschisis (isolated foveoschisis, foveal Detachment or full-thickness macular hole), as we obtained the anatomical success in all cases. Macular buckling obtained better visual results as first choice technique in Retinal Detachments due to macular hole compared to use as rescue technique after a previous pars plana vitrectomy. Visual acuity was similar irrespective of obtaining macular closure in cases of Retinal Detachment macular hole. Macular buckling prevented foveoschisis progression to Retinal Detachment due to macular hole and Retinal Detachment recurrence although the macular hole remained open after surgery
Universitat Autònoma De Barcelona. Departament De Cirurgia - One of the best experts on this subject based on the ideXlab platform.
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Indentación macular combinada con vitrectomía pars plana como tratamiento de la patología del estafiloma posterior
Bellaterra : Universitat Autònoma de Barcelona, 2015Co-Authors: Gómez Resa María, Universitat Autònoma De Barcelona. Departament De CirurgiaAbstract:Premi Extraordinari de Doctorat concedit pels programes de doctorat de la UAB per curs acadèmic 2017-2018La patología macular traccional constituye una de las principales causas de pérdida de visión severa de los altos miopes. La liberación de las tracciones vítreas y epirretinianas es fundamental para el éxito quirúrgico. La técnica quirúrgica más empleada actualmente es la vitrectomía pars plana con disección de la membrana limitante interna, que ha demostrado ser útil en el tratamiento de la foveosquisis miópica y el desprendimiento de Retina por agujero macular. Sin embargo, la presencia de un estafiloma posterior limita estos resultados. Por ello, realizamos un estudio prospectivo, protocolizado e intervencionista con 91 ojos de 87 pacientes para evaluar la eficacia y la seguridad de la indentación macular con indentador de Ando combinada con vitrectomía pars plana y disección de la membrana limitante interna en el tratamiento de la patología traccional del ojo alto miope con estafiloma posterior. Se obtuvo una mejoría significativa de la agudeza visual tanto en el grupo de las foveosquisis miópicas como en los desprendimientos de Retina por agujero macular. No se encontraron diferencias respecto a los resultados anatómicos y visuales entre los subgrupos de foveosquisis miópicas (foveosquisis aislada, desprendimiento foveal o agujero macular de espesor completo), obteniéndose el éxito anatómico en todos los casos. La indentación macular obtuvo mejores resultados visuales como técnica de primera elección en los desprendimientos de Retina por agujero macular comparado con su uso como técnica de rescate tras una vitrectomía pars plana fracasada. La agudeza visual final fue similar independientemente de la obtención del cierre macular en los casos de desprendimiento de Retina por agujero macular. La indentación macular previno la progresión de la foveosquisis a desprendimiento de Retina por agujero macular, y la recidiva del desprendimiento de Retina aunque el agujero macular permaneciera abierto en el postoperatorio.Traction maculopathy is one of the leading causes of severe vision loss in high myopic eyes. The release of the vitreous and epiRetinal traction is critical for surgical success. Pars plana vitrectomy with internal limiting membrane peeling is currently the most widely surgical technique used, which has proven useful in the treatment of myopic foveoschisis and macular hole Retina Detachment. However, the presence of a posterior staphyloma limits these results. Therefore, we conducted a prospective, interventional with 91 eyes of 87 patients to evaluate the efficacy and safety of macular buckling combined with pars plana vitrectomy and internal limiting membrane peeling. A significant improvement in visual acuity in both myopic foveoschisis group and Retinal Detachment due to macular hole group was obtained. No differences were found regarding the anatomical and visual results between subgroups of myopic foveoschisis (isolated foveoschisis, foveal Detachment or full-thickness macular hole), as we obtained the anatomical success in all cases. Macular buckling obtained better visual results as first choice technique in Retinal Detachments due to macular hole compared to use as rescue technique after a previous pars plana vitrectomy. Visual acuity was similar irrespective of obtaining macular closure in cases of Retinal Detachment macular hole. Macular buckling prevented foveoschisis progression to Retinal Detachment due to macular hole and Retinal Detachment recurrence although the macular hole remained open after surgery
мальцев дмитрий сергеевич - One of the best experts on this subject based on the ideXlab platform.
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artificial intelligence and machine learning for optical coherence tomography based diagnosis in central serous chorioretinopathy
Ophthalmology, 2019Co-Authors: A N Kulikov, куликов алексей николаевич, Ekaterina Yu Malahova, малахова екатерина юрьевна, Dmitrii S Maltsev, мальцев дмитрий сергеевичAbstract:The aim of the present study was to examine the potential of machine learning for identification of isolated neurosensory Retina Detachment and Retinal pigment epithelium (RPE) alterations as diagnostic criteria of central serous chorioretinopathy (CSC). Material and methods. Patients with acute CSC in whom a standard ophthalmic examination and optical coherence tomography (OCT) using RTVue-XR Avanti (Angio Retina HD scan protocol, 6 × 6 mm) was performed were included in the study. 10-μm en face slab above the RPE layer was used to create ground truth masks. Learning aims were defined as identification of 3 classes of structural abnormalities on OCT cross-sectional scans: class 1 – subRetinal fluid, class 2 – RPE abnormalities, and class 3 – leakage points. Data for each of the 3 classes included: 4800/1400 training/test images for class 1, 2000/802 training/test images for class 2, and 1504/408 training/test images for class 3. Unet-similar architecture was used for segmentation of abnormalities on OCT cross-sectional scans. Results. Analysis of test sets revealed sensitivity, specificity, precision, and F1-score for detection of subRetinal fluid of 0.61, 0.99, 0.99, and 0.76, respectively. For detection of RPE abnormalities sensitivity, specificity, precision, and F1-score were 0.14, 0.95, 0.94 and 0.24, respectively. For detection of leakage point sensitivity, specificity, precision, and F1-score were 0.06, 1.0, 1.0, and 0.12, respectively. Conclusions. Thus, machine learning demonstrated high potential in the OCT-based identification of structural abnormalities associated with acute CSC (neurosensory Retina Detachment and RPE alterations). Topical identification of the leakage point appears to be possible using large learning sets.
A N Kulikov - One of the best experts on this subject based on the ideXlab platform.
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artificial intelligence and machine learning for optical coherence tomography based diagnosis in central serous chorioretinopathy
Ophthalmology, 2019Co-Authors: A N Kulikov, куликов алексей николаевич, Ekaterina Yu Malahova, малахова екатерина юрьевна, Dmitrii S Maltsev, мальцев дмитрий сергеевичAbstract:The aim of the present study was to examine the potential of machine learning for identification of isolated neurosensory Retina Detachment and Retinal pigment epithelium (RPE) alterations as diagnostic criteria of central serous chorioretinopathy (CSC). Material and methods. Patients with acute CSC in whom a standard ophthalmic examination and optical coherence tomography (OCT) using RTVue-XR Avanti (Angio Retina HD scan protocol, 6 × 6 mm) was performed were included in the study. 10-μm en face slab above the RPE layer was used to create ground truth masks. Learning aims were defined as identification of 3 classes of structural abnormalities on OCT cross-sectional scans: class 1 – subRetinal fluid, class 2 – RPE abnormalities, and class 3 – leakage points. Data for each of the 3 classes included: 4800/1400 training/test images for class 1, 2000/802 training/test images for class 2, and 1504/408 training/test images for class 3. Unet-similar architecture was used for segmentation of abnormalities on OCT cross-sectional scans. Results. Analysis of test sets revealed sensitivity, specificity, precision, and F1-score for detection of subRetinal fluid of 0.61, 0.99, 0.99, and 0.76, respectively. For detection of RPE abnormalities sensitivity, specificity, precision, and F1-score were 0.14, 0.95, 0.94 and 0.24, respectively. For detection of leakage point sensitivity, specificity, precision, and F1-score were 0.06, 1.0, 1.0, and 0.12, respectively. Conclusions. Thus, machine learning demonstrated high potential in the OCT-based identification of structural abnormalities associated with acute CSC (neurosensory Retina Detachment and RPE alterations). Topical identification of the leakage point appears to be possible using large learning sets.
Xue Wang - One of the best experts on this subject based on the ideXlab platform.
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tamponade in surgery for Retinal Detachment associated with proliferative vitreoretinopathy
Cochrane Database of Systematic Reviews, 2014Co-Authors: Stephen G Schwartz, Harry W Flynn, Wen Hsiang Lee, Xue WangAbstract:Background Retinal Detachment (RD) with proliferative vitreoretinopathy (PVR) often requires surgery to restore normal anatomy and to stabilize or improve vision. PVR usually occurs in association with recurrent RD (that is, after initial Retinal re-attachment surgery), but occasionally may be associated with primary RD. Either way, for both circumstances a tamponade agent (gas or silicone oil) is needed during surgery to reduce the rate of postoperative recurrent RD. Objectives The objective of this review was to assess the relative safety and effectiveness of various tamponade agents used with surgery for RD complicated by PVR. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (the Cochrane Library 2019, Issue 1), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2019), Embase (January 1980 to January 2019), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to January 2019), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 2 January 2019. Selection criteria We included randomized controlled trials (RCTs) on participants undergoing surgery for RD associated with PVR that compared various tamponade agents. Data collection and analysis Two review authors screened the search results independently. We used the standard methodological procedures expected by Cochrane. Main results We identified four RCTs (601 participants) that provided data for the primary and secondary outcomes. Three RCTs provided data on visual acuity, two reported on macular attachment, one on Retinal reattachment and another two on adverse events such as RD, worsening visual acuity and intraocular pressure. Study Characteristics Participants' characteristics varied across studies and across intervention groups, with an age range between 21 to 89 years, and were predominantly men. The Silicone Study was conducted in the USA and consisted of two RCTs: (silicone oil versus sulfur hexafluoride (SF6) gas tamponades; 151 participants) and (silicone oil versus perfluropropane (C3F8) gas tamponades; 271 participants). The third RCT compared heavy silicone oil (a mixture of perfluorohexyloctane (F6H8) and silicone oil) with standard silicone oil (either 1000 centistokes or 5000 centistokes; 94 participants). The fourth RCT compared 1000 centistokes with 5000 centistokes silicone oil in 85 participants. We assessed most RCTs at low or unclear risk of bias for most 'Risk of bias' domains. Findings Although SF6 gas was reported to be associated with worse anatomic and visual outcomes than was silicone oil at one year (quantitative data not reported), at two years, silicone oil compared to SF6 gas showed no evidence of a difference in visual acuity (33% versus 51%; risk ratio (RR) 1.57; 95% confidence interval (CI) 0.93 to 2.66; 1 RCT, 87 participants; low-certainty evidence). At one year, another RCT comparing silicone oil and C3F8 gas found no evidence of a difference in visual acuity between the two groups (41% versus 39%; RR 0.97; 95% CI 0.73 to 1.31; 1 RCT, 264 participants; low-certainty evidence). In a third RCT, participants treated with standard silicone oil compared to those receiving heavy silicone oil also showed no evidence of a difference in the change in visual acuity at one year, measured on logMAR scale ( mean difference -0.03 logMAR; 95% CI -0.35 to 0.29; 1 RCT; 93 participants; low-certainty evidence). The fourth RCT with 5000-centistoke and 1000-centistoke comparisons did not report data on visual acuity. For macular attachment, participants treated with silicone oil may probably experience more favorable outcomes than did participants who received SF6 at both one year (quantitative data not reported) and two years (58% versus 79%; RR 1.37; 95% CI 1.01 to 1.86; 1 RCT; 87 participants; low-certainty evidence). In another RCT, silicone oil compared to C3F8 at one year found no evidence of difference in macular attachment (RR 1.00; 95% CI 0.86 to 1.15; 1 RCT, 264 participants; low-certainty evidence). One RCT that compared 5000 centistokes to 1000 centistoke reported that Retinal reattachment was successful in 67 participants (78.8%) with first surgery and 79 participants (92.9%) with the second surgery, and no evidence of between-group difference (1 RCT; 85 participants; low-certainty evidence). The fourth RCT that compared standard silicone oil with heavy silicone oil did not report on macular attachment. Adverse events In one RCT (86 participants), those receiving standard 1000 centistoke silicone oil compared with those of the 5000 centistoke silicone oil showed no evidence of a difference in intraocular pressure elevation at 18 months (24% versus 22%; RR 0.90; 95% CI 0.41 to 1.94; low-certainty evidence), visually significant cataract (49% versus 64%; RR 1.30; 95% CI 0.89 to 1.89; low-certainty evidence), and incidence of Retina Detachment after the removal of silicone oil (RR 0.36 95% CI 0.08 to 1.67; low-certainty evidence). Another RCT that compared standard silicone oil with heavy silicone oil suggests no difference in Retinal Detachment at one year (25% versus 22%; RR 0.89; 95% CI 0.54 to 1.48; 1 RCT; 186 participants; low-certainty evidence). Retinal Detachment was not reported in the RCTs that compared silicone oil versus SF6 and silicone oil versus to C3F8. Authors' conclusions There do not appear to be any major differences in outcomes between C3F8 and silicone oil. Silicone oil may be better than SF6 for macular attachment and other short-term outcomes. The choice of a tamponade agent should be individualized for each patient. The use of either C3F8 or standard silicone oil appears reasonable for most patients with RD associated with PVR. Heavy silicone oil, which is not available for routine clinical use in the USA, may not demonstrate evidence of superiority over standard silicone oil.