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Optic nerve tortuosity and displacements during horizontal eye movements in healthy and highly myopic subjects

Wang, Xiaofei; Chang, Stanley; Grinband, Jack; Yannuzzi, Lawrence A; Freund, K Bailey; Hoang, Quan V; Girard, Michael Ja
AIMS/OBJECTIVE:(1) To assess the morphology and 3-dimensional (3D) displacements of the eye globe and optic nerve (ON) in adduction/abduction using MRI. (2) To assess differences between healthy emmetropic and highly myopic (HM) subjects. METHODS:MRI volumes of both eyes from 18 controls and 20 HM subjects in primary gaze, abduction and adduction (15°) were postprocessed. All ONs were manually segmented and fitted to a 3D curve to assess ON tortuosity. ON displacements were evaluated in four quasicoronal planes which were perpendicular to the ON in primary gaze and were 3 mm apart. RESULTS:Axial length was higher in the HM group (28.62±2.60 vs 22.84±0.89 mm; p<0.0001). Adjusted ON tortuosities (ie, ON tortuosities estimated before myopia onset) were lower in HM eyes (0.9063±0.0591) versus controls (1.0152±0.02981) in primary gaze, adduction (0.9023±0.05538 vs 1.0137±0.0299) and abduction (0.9100±0.0594 vs 1.0182±0.0316); p<0.0001 for all cases. In all eyes, ON displacements in adduction were significantly different from those in abduction in the naso-temporal direction (p<0.0001 in all planes) but not in the supero-inferior direction. ON displacements in the posterior segments of the ON were smaller in the HM group in both gaze directions and were larger in the anterior-most ON segment in adduction only. CONCLUSION/CONCLUSIONS:The adjusted tortuosity of the ON was significantly lower in HM eyes, suggesting that eyes destined towards HM exhibited higher ON traction forces during eye movements before the onset of myopia. Our ON metrics may be valuable to explore a potential link between eye movements and axial elongation.
PMID: 34039559
ISSN: 1468-2079
CID: 4888022

Response to RE: Bacillary Layer Detachment Due to Macular Neovascularization

Soh, Yu Qiang; Hoang, Quan V; Freund, K Bailey; Jung, Jesse J
PMID: 34173360
ISSN: 1539-2864
CID: 4925932

Bacillary Layer Detachment Due to Macular Neovascularization

Jung, Jesse J; Soh, Yu Qiang; Yu, Daryle Jason G; Rofagha, Soraya; Lee, Scott S; Freund, K Bailey; Hoang, Quan V
PURPOSE/OBJECTIVE:To describe the clinical and multimodal imaging (MMI) features of bacillary layer detachment (BD), and its response to intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, in eyes with macular neovascularization (MNV). DESIGN/METHODS:Retrospective, observational case series. METHODS:Fourteen eyes (14 patients, 7 male) were imaged with spectral-domain optical coherence tomography (OCT), and either fluorescein angiography or OCT angiography. Therapeutic response was monitored with serial imaging and best-corrected visual acuity (BCVA) assessments. RESULTS:Mean age was 75±13 (range: 45-96) years, with mean follow-up duration of 27±21 (range: 1-56) months. Neovascular age-related macular degeneration (nAMD) was found in 71% (10/14) eyes. Type 2 MNV lesions were associated with BD in all 14 eyes. Subretinal hemorrhage was noted in 79% (11/14) eyes. BD promptly resolved following intravitreal anti-VEGF therapy in all eyes. Baseline BCVA improved from LogMar 0.84±0.32 (Snellen equivalent 20/138) to LogMar 0.48±0.31 (Snellen equivalent 20/60) at last follow-up, with treatment of the MNV. CONCLUSIONS:Type 2 MNV and subretinal hemorrhage are associated with BDs, which may be due to a rapid influx of exudative fluid into the potential space between the external limiting membrane and ellipsoid zone. Intravitreal anti-VEGF therapy results in rapid resolution of BDs and visual improvement in most eyes.
PMID: 33625111
ISSN: 1539-2864
CID: 4794662

3-D assessment of gaze-induced eye shape deformations and downgaze-induced vitreous chamber volume increase in highly myopic eyes with staphyloma

Hoang, Quan V; Chang, Stanley; Yu, Daryle Jason Go; Yannuzzi, Lawrence A; Freund, K Bailey; Grinband, Jack
PURPOSE/OBJECTIVE:To determine if the stress of normal eye movements results in gaze-induced globe deformations, vitreous chamber axial length and vitreous chamber axial volume (VCAV) change in highly myopic eyes. METHODS:A prospective imaging study was performed on 82 eyes of 43 patients with high myopia (>27 mm of axial length) with a clinical diagnosis of staphyloma. Three-dimensional MRI scans were acquired while subjects gazed in five directions (primary, nasal, temporal, superior and inferior). Surface renderings were generated, and a processing pipeline was created to automate alignment of the eye and to measure VCAV within 5.5 mm of the visual axis for each eye in every gaze. The degree of gaze-induced globe deformation was determined by calculating the Dice coefficient to assess the degree of overlap of the sclera at each eccentric gaze with that found in primary gaze. Each eccentric gaze VCAV was compared to VCAV in primary gaze using a fixed-effects regression allowing for subject-specific and eye-specific effects. RESULTS:(p=0.002, 95% CI 1.71 to 7.86). CONCLUSION/CONCLUSIONS:Significant gaze-induced globe deformation was noted in all gazes, but a reversible, instantaneous VCAV increase occurred only in downgaze, which is consistent with studies supporting the association of environmental factors such as near work with myopia development and progression.
PMID: 32830122
ISSN: 1468-2079
CID: 4575042

Clinical Characteristics, Choroidal Neovascularization and Predictors of Visual Outcomes in Acquired Vitelliform Lesions

Balaratnasingam, Chandrakumar; Hoang, Quan V; Inoue, Maiko; Curcio, Christine A; Dolz-Marco, Rosa; Yannuzzi, Nicolas A; Dhrami-Gavazi, Elona; Yannuzzi, Lawrence A; Freund, K Bailey
PURPOSE: To quantify the temporal properties of the acquired vitelliform lesion (AVL) lifecycle, define the clinical characteristics of choroidal neovascularization (NV) in this setting and determine the predictors of long-term visual outcomes. DESIGN: Retrospective cohort study METHODS: Clinical and imaging data from 199 eyes of 124 consecutive patients with AVLs associated with age-related macular degeneration (AMD) and adult-onset foveomacular vitelliform dystrophy (AOFVD) were analyzed. Volumetric calculations of vitelliform material were determined using spectral-domain optical coherence tomography and the temporal properties of the AVL lifecycle were quantified. The clinical characteristics of NV were assessed as were the predictors of final best-corrected visual acuity (BCVA) and change in BCVA. RESULTS: Mean age was 79.2+/-12.1 years. AVLs grew and collapsed at approximately the same rate (P = 0.275). Fifteen eyes (7.5%) developed NV of which all were type 1. In 13 of these eyes, NV occurred during the collapse phase of the AVL lifecycle, after the peak AVL volume was reached. The risk of NV (P = 0.006) and the decline in BCVA (P = 0.001) were both significantly greater among eyes with AMD. Foveal atrophy was the characteristic most significantly associated with final BCVA and change in BCVA from baseline (both P < 0.0005). The development of NV was not predictive of long-term visual outcomes (all P = 0.216). CONCLUSIONS: Complications associated with AVLs typically occur during the collapse phase of the AVL lifecycle. Visual outcomes and risk of NV are related to the underlying disease associated with AVLs.
PMID: 27640006
ISSN: 1879-1891
CID: 2254732

LONG-TERM RETROSPECTIVE ANALYSIS OF VISUAL ACUITY AND OPTICAL COHERENCE TOPOGRAPHIC CHANGES AFTER SINGLE VERSUS DOUBLE PEELING DURING VITRECTOMY FOR MACULAR EPIRETINAL MEMBRANES

Jung, Jesse J; Hoang, Quan V; Ridley-Lane, Megan L; Sebrow, Dov B; Dhrami-Gavazi, Elona; Chang, Stanley
PURPOSE/OBJECTIVE:To determine the long-term effect of internal limiting membrane with associated epiretinal membrane (ERM) peeling versus single peeling alone in terms of best-corrected visual acuity and anatomical outcomes on spectral-domain optical coherence tomography. METHODS:This retrospective comparative cohort study of patients who had follow-up of >1 year and underwent surgery for ERM by a single surgeon (S.C.) from January 1, 2008 to December 31, 2012 compared cases in which the internal limiting membrane was stained with brilliant blue G to facilitate double peeling (n = 42) and single peeling (n = 43) of the ERM alone for up to 3 years of follow-up. For continuous variables, an independent two-tailed t-test was performed. For binary variables, the Fisher's exact test was performed. Statistical significance was defined as P < 0.05. RESULTS:Eighty-five of 142 patients fit the inclusion criteria. At the last follow-up, the single-peeling group were more likely to have ERM remaining in the central fovea postoperatively (P = 0.0020, becoming significant by postoperative Year 1, P = 0.022) and less likely to develop inner retinal dimpling (P = 0.000, becoming significant by postoperative Month 3, P = 0.015). At 3 years, central foveal thickness had decreased in the single-peeling group by -136.9 µm and by -84.1 μm in the double-peeling group, which was not significantly different (P = 0.08). Mean best-corrected visual acuity improved in both the groups at all time points. There was no statistically significant difference between the 2 groups at 3 years (P = 0.44; single-peeling group, 0.32 ± 0.42, Snellen 20/42; double-peeling group, 0.23 ± 0.27, Snellen 20/34). CONCLUSION/CONCLUSIONS:Brilliant blue G-assisted internal limiting membrane peeling for ERM results in a more thorough removal of residual ERM around the paracentral fovea. However, there is no difference in long-term best-corrected visual acuity at 3 years and a greater likelihood of inner retinal dimpling.
PMCID:5077635
PMID: 27124883
ISSN: 1539-2864
CID: 3102572

Reply

Hoang, Quan V; Freund, K Bailey
PMID: 27617548
ISSN: 1539-2864
CID: 2246852

Comparison of OCT Angiography and Conventional Fluorescein Angiography in the Evaluation of Collateralization in Acute versus Chronic Branch or Hemi Retinal Vein Occlusion [Meeting Abstract]

Jones, Bryan Paul; Chen, Michael H; Jung, Jesse J; Hoang, Quan V; Inoue, Maiko; Bala, Chandra; Freund, KBailey; Yannuzzi, Lawrence A; Rofagha, Soraya; Lee, Scott
ISI:000394210601149
ISSN: 0146-0404
CID: 2492262

Ultra-widefield Indocyanine Green Angiography in Central Serous Chorioretinopathy and Pachychoroid Pigment Epitheliopathy [Meeting Abstract]

Jung, Jesse J; Hoang, Quan V; Rofagha, Soraya; Sarraf, David; Freund, KBailey
ISI:000394210601032
ISSN: 0146-0404
CID: 2492252

Radius of curvature changes in spontaneous improvement of foveoschisis in highly myopic eyes [Case Report]

Hoang, Quan V; Chen, Ching-Lung; Garcia-Arumi, Jose; Sherwood, Pamela R; Chang, Stanley
BACKGROUND:Myopic foveoschisis is the splitting of retinal layers overlying staphyloma in highly myopic patients that can lead to vision loss. We assess possible contributing mechanisms to the formation of foveoschisis by examining two cases of spontaneous improvement of myopic foveoschisis and employ a radius of curvature (ROC) measure to track posterior scleral curvature over time. METHODS:A retrospective, non-comparative case series was performed and optical coherence tomography images were analysed. Retinal pigment epithelial layer ROC was calculated from manually segmented images through the posterior scleral curvature apex. RESULTS:Two cases of myopic foveoschisis with foveal detachments in the left eye (OS) were studied. Both patients had high myopia (either <-10 D or >30 mm in axial length). One case occurred in a treatment-naive patient who improved after 4 months of observation. On initial presentation, OS posterior scleral ROC was 12.35 mm and decreased to 12.15 mm at the time of resolution. The other case occurred in a patient who was followed for 7 years, had previously underwent pars plana vitrectomy and removal of epiretinal membrane, experienced recurrence of foveoschisis and then spontaneously improved without further posterior segment surgery. There was an uncomplicated cataract extraction in the interim. Posterior scleral ROC was 4.05 mm on presentation, 4.10 during recurrence, 3.55 mm after cataract extraction and 3.75 mm at resolution. CONCLUSIONS:Spontaneous improvement of myopic foveoschisis may be due to changes in tractional forces from the internal limiting membrane, cortical vitreous or staphyloma or, alternatively, from a delayed or fluctuant recovery course after intervention.
PMCID:4795994
PMID: 26130673
ISSN: 1468-2079
CID: 5456682