Authors
Panova I. E.
Doctor of Medicine, Professor, Vice-Director for Science1
Samkovich E. V.
MD, PhD, Ophtalmologist1
ORCID 0000-0002-5573-5712
Ankudinova S. V.
MD, PhD., Methodologist, Organizational and Methodological Department1
Penzeva K. V.
MD, PhD, Ophtalmologist1
1 - S. Fyodorov «Eye Microsurgery» Federal State Institution, St. Petersburg Branch, Saint-Petersburg, Russian Federation
Corresponding Author
Samkovich Elena; e-mail: e.samkovich@mail.ru.
Conflict of interest
None declared.
Funding
The study had no sponsorship.
Abstract
Optical coherence tomography (OCT) technology has determined the possibility of in vivo study of morphostructural and morphometric changes in the central zone of the retina, including epiretinal proliferation. Scanning laser ophthalmoscopy (SLO) allows assessing changes in the vitreoretinal interface and chorioretinal complex «at different depths», the use of this method for lamellar macular holes (LMR) can be used not only for diagnosis, but also for assessing changes and the extent of the process. Purpose. To determine the possibilities of SLO in diagnosing and assessing the prevalence of epiretinal proliferation in lamellar macular holes in comparison with OCT data. Material and methods. In a study conducted on the basis of S. Fyodorov Eye Microsurgery Federal State Institution, Saint Petersburg branch, 48 patients with an established diagnosis of LMR were included, while epiretinal proliferation was diagnosed in 27 (52.6%) patients by OCT. SLO was performed in 21 patients with epiretinal proliferation diagnosed by OCT. Results. The best visualization of epiretinal proliferation was achieved by processing the image with a decrease in the intensity of red and an increase in blue and green. With epiretinal proliferation, there was a lower maximum correctable visual acuity and pronounced structural changes in the retina: a foveolar tubercle in 6 (12.5%) patients, a violation of the ellipsoidal zone in 10 (20.8%) of 48 patients, while its length was 110.26ｱ19.85 ｵm. An inverse correlation was established between the values of the epiretinal proliferation area and the index of the minimum retinal thickness (R=-0.7, P=0.005), which indirectly confirms the gradual loss of retinal tissue during LMR due to the development of epiretinal proliferation. Conclusion. The performance of SLO allows visualization of epiretinal proliferation and determination of its area, which can be useful both in the dynamic observation of LMR and in planning surgical treatment for this pathology.
Key words
scanning laser ophthalmoscopy, lamellar macular holes, epiretinal proliferation
DOI
References
1. Zhogolev K.S., BayborodovYa.V. Lamellyarnye makulyarnye razryvy: evolyuciya predstavlenij o patogeneze i klinicheskoj kartine. Razvitie diagnosticheskih podhodov. Sovremennaya klassifikaciya. [Lamellar macular holes: the evolution of ideas about pathogenesis and the clinical picture. The development of diagnostic approaches. Modern classification.] Oftal知ologicheskie vedomosti [Ophthalmological gazette] 2020; 13(2): 77-88, doi: 10.17816/OV16334 (In Russ.)
2. Gass J.D. Lamellar macular hole: a complication of cystoid macular edema after cataract extraction: a clinicopathologic case report. Transactions of the American Ophthalmological Society 1975; 73: 231-250, doi: 10.1001/archopht.1976.03910030391008
3. Pang C.E., Spaide R.F., Freund K.B. Epiretinal proliferation seen in association with lamellar macular holes: a distinct clinical entity. Retina 2014; 34(8): 1513-1523, doi: 10.1097/IAE.0000000000000163
4. Hubschman J.P., Govetto A., Spaide R.F., Schumann R., Steel D., Figueroa M.S., Sebag J., Gaudric A., Staurenghi G., Haritoglou C., Kadonosono K., Thompson J.T., Chang S., Bottoni F., Tadayoni R. Optical coherence tomography-based consensus definition for lamellar macular hole. Br J Ophthalmol 2020; 104(12): 1741-1747, doi: 10.1136/bjophthalmol-2019-315432
5. Itoh Y., Levison A.L., Kaiser P.K., et al. Prevalence and characteristics of hyporeflective preretinal tissue in vitreomacular interface disorders. Br J Ophthalmol 2016; 100: 399-404, doi: 10.1136/bjophthalmol-2015-306986
6. Zampedri E., Romanelli F., Semeraro F., Parolini B., Frisina R. Spectral-domain optical coherence tomography findings in idiopathic lamellar macular hole. Graefe's archive for clinical and experimental ophthalmology 2017; 255(4): 699-707, doi: 10.1007/s00417-016-3545-1
7. Stoyukhina A.S., Musatkina I.V. Morfogenez melanom horioidei v svete opticheskoj kogerentnoj tomografii. [Morphogenesis of choroidal melanomas in OCT imaging.] Vestnik Oftalmologii [Bulletin of ophthalmology] 2018; 134(5, part. 2): 186-194, doi: 10.17116/oftalma2018134051186 (In Russ.)
8. Stoyukhina A.S. Vozmozhnosti OKT v differencial'noj diagnostike VMD i novoobrazovanij horioidei central'noj lokalizacii. [ﾎﾑﾒ abilities in differential diagnostic of AMD and central localization choroidal tumors.] Tochka Zreniya. Vostok-Zapad [Point of View. East-West] 2018; 2: 87-90. doi: 10.25276/2410-1257-2018-2-87-90 (In Russ.)
9. Balashevich L.I., Baiborodov Ya.V., Zogolev K.S. Patologiya vitreomakulyarnogo interfejsa. Obzor literatury v voprosah i otvetah. [Vitreomacular interface pathology. Review of foreign literature in questions and answers.] Oftal'mohirurgiya [Fyodorov Journal of Ophthalmic Surgery] 2014; (4): 109-114. (In Russ.)
10. Shpak A.A., Shkvorchenko D.O., Vedernikova O.Y., Hurdaeva A.G. Lamellyarnye makulyarnye razryvy. [Lamellar macular holes.] Oftal'mohirurgiya [Fyodorov Journal of Ophthalmic Surgery] 2019; (2): 76-80, doi: 10.25276/0235-4160-2019-2-76-75 (In Russ.)
11. Bottoni F., Deiro A.P., Giani A., Orini C., Cigada M., Staurenghi G. The natural history of lamellar macular holes: a spectral domain optical coherence tomography study. Graefe's archive for clinical and experimental ophthalmology. 2013; 251(2): 467-475, doi: 10.1007/s00417-012-2044-2
12. Podoleanu A.G., Dobre G.M., Cucu R.G., Rosen R., Garcia P., Nieto J., Will D., Gentile R., Muldoon T., Walsh J., Yannuzzi L.A., Fisher Y., Orlock D., Weitz R., Rogers J.A., Dunne S., Boxer A. Combined multiplanar optical coherence tomography and confocal scanning ophthalmoscopy. J Biomed Opt. 2004; 9(1): 86-93, doi: 10.1117/1.1627778
13. Rudolph G.; Kalpadakis P.; Bechmann M., Haritoglou C., Kampik A. Scanning laser ophthalmoscope-evoked multifocal ERG (SLO-mfERG) in patients with macular holes and normal individuals. Eye (Lond.) 2003; 17(7): 801-8, doi: 10.1038/sj.eye.6700502
14. Webb R.H., Hughes G.W., Pomerantzeff O. Flying spot TV ophthalmoscope. Appl Opt. 1980; 1; 19(17): 2991-7, doi:10.1364/AO.19.002991
15. von Rückmann A., Fitzke F.W., Fan J., Halfyard A., Bird A.C. Abnormalities of fundus autofluorescence in central serous retinopathy. Am J Ophthalmol. 2002; 133(6): 780-6, doi: 10.1136/bjo.79.5.407
16. Alyab弾va Zh.Yu. Novye gorizonty skaniruyushchej lazernoj oftal'moskopii. [New horizons of scanning laser ophthalmoscopy.] RMZh. Klinicheskaya oftal知ologiya [Russian medical journal. Clinical ophthalmology] 2005; 1: 4. (In Russ.)
17. Kochergin S.A., Slonimsky S.Yu., Ovsyanko A.A., Gupalo O.D. Nekotorye aspekty primeneniya skaniruyushchej lazernoj oftal'moskopii v diagnostike oftal'mopatologii. [Some aspects of scanning laser ophthalmoscopy in the diagnostics of ophthalmopathology.] Oftal知ologiya [Ophtalmology] 2017; 14(3): 227-232, doi: 10.18008/1816-5095-2017-3-227-232 (In Russ.)
18. Anisimov A.A, Boiko E.V, Churashev S.V., et al. Konfokal'naya lazernaya skaniruyushchaya oftal'moskopiya kak dopolnitel'nyj metod diagnostiki regmatogennoj otslojki setchatki. Aktual'nye problemy oftal'mologii: VIII Vseros. nauch. konf. molodyh uchenyh: Sb. nauch. rabot. Pod red. B.E. Malyugina. [Confocal laser scanning ophthalmoscopy as an additional diagnostic method for rhegmatogenous retinal detachment. Actual problems of ophthalmology: VIII All-Russia scientific conference of Young Scientists: Coll. scientific work. Edited by B.E. Malyugin.] Moscow: Ophthalmology, 2013: 26. (In Russ.)
19. Astakhov Yu.S., Lisochkina A.B., Nechiporenko P.A. Issledovanie autoflyuorescencii glaznogo dna s pomoshch'yu konfokal'nogo skaniruyushchego lazernogo oftal'moskopa. [The study of fundus autofluorescence by confocal scanning laser ophthalmoscope.] Oftal知ologicheskie vedomosti [Ophthalmological gazette] 2008; 1(3): 40-45. (In Russ.)
20. Guro M.Yu., Potapova V.N., Khzardzhan Yu.Yu., Sharifova O.Sh. Znachenie registracii autoflyuorescencii glaznogo dna i skaniruyushchej lazernoj oftal'moskopii v diagnostike i lechenii central'noj seroznoj horioretinopatii. [The value of recording fundus autofluorescence and scanning laser ophthalmoscopy in the diagnosis and treatment of central serous chorioretinopathy.] Vestnik Orenburgskogo gosudarstvennogo universiteta [Bulletin of the Orenburg State University] 2012; (12): 41-43. (In Russ.)
21. Kelly J.P., Weiss A.H., Zhou Q., Schmode S., Dreher A.W. Imaging a child's fundus without dilation using a handheld confocal scanning laser ophthalmoscope. Arch Ophthalmol. 2003;121(3): 391-6, doi: 10.1001/archopht.121.3.391
22. Nakakura S., Okamoto A., Nagasato D., Tabuchi H., Kiuchi Y. Hypotony maculopathy obtained by retro-mode retinal imaging. Ophthalmology 2015; 122(1): 216-7, doi: 10.1016/j.ophtha.2014.08.045
23. dellʼOmo R., De Turris S., dellʼOmo E., Costagliola C. Visualization of Lamellar Hole-Associated Epiretinal Proliferation With Blue-Reflectance Imaging. Retina 2018; 38(5): e34-e35, doi: 10.1097/IAE.0000000000002048
24. Zhogolev K.S., Panova I.E. Funkcional'nye, OKT-morfometricheskie i strukturnye pokazateli setchatki v monitoringe techeniya lamellyarnyh makulyarnyh razryvov. [Functional, OCT-morphometric and structural parameters of the retina in monitoring the course of lamellar macular holes.] Sovremennyye tekhnologii v oftal知ologii [Modern technologies in ophthalmology] 2020; (1): 319-324, doi: 10.25276/2312-4911-2020-2-319-324 (In Russ.)
25. Zhogolev K.S., Bayborodov Ya.V. Sovremennye predstavleniya o taktike lecheniya pacientov s neskvoznymi makulyarnymi razryvami: nablyudat' ili operirovat'? [Modern notions about the tactics of treatment of patients with non-full thickness macular holes: to observe or to operate?] Oftal知ologicheskie vedomosti [Ophthalmological gazette] 2019; 12(1): 37-44, doi: 10.17816/OV2019137-44 (In Russ.)
