Episode 2: Journal Club - VR Surgery

In the first of our monthly Journal Clubs, Ferdinando Bottoni and Carsten Meyer present their publications on optic disc pit maculopathy and a retinal expansion technique for persistent macular holes respectively. A short synopisis of each paper is given below.

The papers were discussed with the authors by a panel chaired by David Steel, Grazia Pertile and Marta Figueroa.

Bottoni F, Cereda M, Secondi R, Bochicchio S, Staurenghi G. Vitrectomy for optic disc pit maculopathy: a long-term follow-up study. Graefes Arch Clin Exp Ophthalmol. 2018 Apr;256(4):675-682.

Synopsis: In a retrospective non-comparative study of patients with optic disc pit maculopathy treated with vitrectomy alone, complete resolution of fluid in and under the fovea was achieved in 8 of 10 eyes (80%) without additional treatment.  One additional patient experienced a retinal detachment requiring further surgery. In the successful cases macular detachment resolved in a mean of 14 months after surgery. Postoperative BCVA improved significantly from a mean of 0.63 logMAR compared to a preoperative mean of 0.27 logMAR.  Nine eyes (82%) had a postoperative BCVA of 0.5 or better.

The authors concluded that vitrectomy with induction of alone was a safe and successful therapeutic option for the treatment of optic disc pit maculopathy.

Vitrectomy for optic disc pit maculopathy: a long-term follow-up study - PubMed (nih.gov)

 

Meyer CH, Szurman P, Haritoglou C, Maier M, Wolf A, Lytvynchuk L, Priglinger S, Hillenkamp J, Wachtlin J, Becker M, Mennel S, Koss MJ. Application of subretinal fluid to close refractory full thickness macular holes: treatment strategies and primary outcome: APOSTEL study. Graefes Arch Clin Exp Ophthalmol. 2020 Oct;258(10):2151-2161.

In a retrospective non-comparative study by 12 surgeons on 41 eyes with persistent macular holes, the authors reported on their initial surgical, anatomical and functional experience with a technique of retinal expansion by applying balanced saline solution underneath the edges of the holes to free up subretinal adhesions which they postulated had inhibited primary closure. The PMH were closed with this technique in 35 out of the 41 eyes (85%) at 6 weeks after surgery. The postoperative BCVA improved to 0.22 from 0.1 pre op. The application of SR-fluid was not associated with major intraoperative adverse effects. The authors concluded that the technique could achieve a fast and immediate anatomical closure in many cases without serious adverse events.

Application of subretinal fluid to close refractory full thickness macular holes: treatment strategies and primary outcome: APOSTEL study - PubMed (nih.gov)