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Factors Influencing Visual Acuity Following Vitrectomy for Exudative Age-related Macular Degeneration
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ABSTRACTS
gical techniques consisted of conventional methods (358 eyes) and scalping methods (109 eyes) with retinal pigment scalping of the macular hole basis added in such cases: reoperation, hole size (more than 0.4 disc diameter), duration of symptoms (more than 2 years). Long term incidence of reopening was predicted by life table method. After we compared reopened cases with non-reopened cases, the variables of gender, stage, biocular occurrence, age, duration of symptoms, hole size, preoperative visual acuity, refraction axial length ratio, and intraoperative retinal tears were used for the multiple regression. Results: Reopening was found in 20 eyes (5.6%) treated by conventional methods and in 10 eyes (9.2%) treated by scalping methods. Survival ratio was 87% for the conventional methods in 6 years and 79% for the scalping methods in 5 years. The variables influencing reopening were as follows: conventional methods: gender (r ⫽ 0.065, P ⫽ .19), biocular occurrence (r ⫽ 0.12, P ⫽ .026), and refraction axial length ratio (r ⫽ ⫺0.11, P ⫽ .045); scalping methods: hole size (r ⫽ 0.14, P ⫽ .25). Conclusions: Incidence of reopening in scalping methods was high. The variables that influenced reopening after macular hole surgery were biocular occurrence and refraction axial length ratio in conventional methods. The shape of the eye may be related to reopening. (J Jpn Ophthalmol Soc 104:483–8, 2000) Kazuyuki Kumagai,* Nobuchika Ogino,* Seiji Demizu,* Kazunari Atsumi,† Hideyuki Kurihara,‡ Masayoshi Iwaki,§ Hitoshi Ishigooka储 and Naoko Tachi¶ *Shinjo Ophthalmologic Institute; †Department of Ophthalmology, Kami-iida First General Hospital; ‡ Kurihara Ophthalmologic Institute; §Department of Ophthalmology, Aichi Medical University; 储Department of Ophthalmology, Kyoto Katsura Hospital; ¶Department of Ophthalmology, Shinseikai Toyama Hospital PII S0021-5155(00)00317-8
Factors Influencing Visual Acuity Following Vitrectomy for Exudative Agerelated Macular Degeneration Purpose: We investigated the influence of various factors on visual results in patients undergoing surgical removal of choroidal neovascular membranes (CNVM) caused by age-related macular degeneration (AMD). Subjects and Methods: This study was performed in 55 eyes of 55 patients who underwent surgical removal of CNVM for AMD and followed them for 6
months or more. The criterion for surgical eligibility was active subfoveal choroidal neovascular membrane of 0.5 or more disc diameter above the retinal pigment epithelium with visual acuity of 0.3 or worse. We investigated the influence of various factors on the logarithm of the minimum angle of resolution (log MAR) final visual acuity. The factors were age, symptom duration, preoperative log MAR visual acuity, CNVM diameter, mean deviation with visual field analyzer, previous laser treatment, posterior vitreous detachment, findings of indocyanine green angiography, operative complications, and recurrence of CNVM. Results: Better preoperative visual acuity, shorter symptom duration, and smaller CNVM diameter were correlated with better postoperative final visual acuity. Conclusions: Surgical excision of subfoveal CNVM may be the better therapeutic choice in selected cases with AMD. (J Jpn Ophthalmol Soc 104:489–94, 2000) Hiroyuki Shimada, Takako Isomae, Saho Shimizu and Mitsuko Yuzawa Department of Ophthalmology, Surugadai Hospital of Nihon University PII S0021-5155(00)00316-6
Light and Electron Microscopic Study of the Retina in a Patient with Congenital Glaucoma Purpose: The morphological observation of the human retinal changes caused by severely elevated intraocular pressure (IOP) in congenital glaucoma. Method: Light and electron microscopy. Subjects: One eye of a 15-year-old boy diagnosed as having congenital glaucoma was obtained after he had suffered from severe visual disturbance and ocular pain because of extensive elevated IOP, corneal leucoma, and exophthalmos. Results: Ganglion cells and nerve fibers in the inner layer were lost and replaced by Müller cell processes. The cellular elements in the outer layer were regularly arranged, but these cytoplasmic organelles were not very well developed. Most of the cellular elements of the whole retina contained many dense bodies. The retinal capillaries in the nerve fiber layer were lost or severly damaged, but some of these in the inner plexiform layer were intact. In the retinal arteries and veins marked thickening of the adventitial tissues was observed. These tissues consisted of remarkably in-
ABSTRACTS
gical techniques consisted of conventional methods (358 eyes) and scalping methods (109 eyes) with retinal pigment scalping of the macular hole basis added in such cases: reoperation, hole size (more than 0.4 disc diameter), duration of symptoms (more than 2 years). Long term incidence of reopening was predicted by life table method. After we compared reopened cases with non-reopened cases, the variables of gender, stage, biocular occurrence, age, duration of symptoms, hole size, preoperative visual acuity, refraction axial length ratio, and intraoperative retinal tears were used for the multiple regression. Results: Reopening was found in 20 eyes (5.6%) treated by conventional methods and in 10 eyes (9.2%) treated by scalping methods. Survival ratio was 87% for the conventional methods in 6 years and 79% for the scalping methods in 5 years. The variables influencing reopening were as follows: conventional methods: gender (r ⫽ 0.065, P ⫽ .19), biocular occurrence (r ⫽ 0.12, P ⫽ .026), and refraction axial length ratio (r ⫽ ⫺0.11, P ⫽ .045); scalping methods: hole size (r ⫽ 0.14, P ⫽ .25). Conclusions: Incidence of reopening in scalping methods was high. The variables that influenced reopening after macular hole surgery were biocular occurrence and refraction axial length ratio in conventional methods. The shape of the eye may be related to reopening. (J Jpn Ophthalmol Soc 104:483–8, 2000) Kazuyuki Kumagai,* Nobuchika Ogino,* Seiji Demizu,* Kazunari Atsumi,† Hideyuki Kurihara,‡ Masayoshi Iwaki,§ Hitoshi Ishigooka储 and Naoko Tachi¶ *Shinjo Ophthalmologic Institute; †Department of Ophthalmology, Kami-iida First General Hospital; ‡ Kurihara Ophthalmologic Institute; §Department of Ophthalmology, Aichi Medical University; 储Department of Ophthalmology, Kyoto Katsura Hospital; ¶Department of Ophthalmology, Shinseikai Toyama Hospital PII S0021-5155(00)00317-8
Factors Influencing Visual Acuity Following Vitrectomy for Exudative Agerelated Macular Degeneration Purpose: We investigated the influence of various factors on visual results in patients undergoing surgical removal of choroidal neovascular membranes (CNVM) caused by age-related macular degeneration (AMD). Subjects and Methods: This study was performed in 55 eyes of 55 patients who underwent surgical removal of CNVM for AMD and followed them for 6
months or more. The criterion for surgical eligibility was active subfoveal choroidal neovascular membrane of 0.5 or more disc diameter above the retinal pigment epithelium with visual acuity of 0.3 or worse. We investigated the influence of various factors on the logarithm of the minimum angle of resolution (log MAR) final visual acuity. The factors were age, symptom duration, preoperative log MAR visual acuity, CNVM diameter, mean deviation with visual field analyzer, previous laser treatment, posterior vitreous detachment, findings of indocyanine green angiography, operative complications, and recurrence of CNVM. Results: Better preoperative visual acuity, shorter symptom duration, and smaller CNVM diameter were correlated with better postoperative final visual acuity. Conclusions: Surgical excision of subfoveal CNVM may be the better therapeutic choice in selected cases with AMD. (J Jpn Ophthalmol Soc 104:489–94, 2000) Hiroyuki Shimada, Takako Isomae, Saho Shimizu and Mitsuko Yuzawa Department of Ophthalmology, Surugadai Hospital of Nihon University PII S0021-5155(00)00316-6
Light and Electron Microscopic Study of the Retina in a Patient with Congenital Glaucoma Purpose: The morphological observation of the human retinal changes caused by severely elevated intraocular pressure (IOP) in congenital glaucoma. Method: Light and electron microscopy. Subjects: One eye of a 15-year-old boy diagnosed as having congenital glaucoma was obtained after he had suffered from severe visual disturbance and ocular pain because of extensive elevated IOP, corneal leucoma, and exophthalmos. Results: Ganglion cells and nerve fibers in the inner layer were lost and replaced by Müller cell processes. The cellular elements in the outer layer were regularly arranged, but these cytoplasmic organelles were not very well developed. Most of the cellular elements of the whole retina contained many dense bodies. The retinal capillaries in the nerve fiber layer were lost or severly damaged, but some of these in the inner plexiform layer were intact. In the retinal arteries and veins marked thickening of the adventitial tissues was observed. These tissues consisted of remarkably in-