M Maier1, R Schumann2,3, J Friedrich4, J Klaas4, C Haritoglou5. 1. Augenklinik, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Str. 22, 81675, München, Deutschland. Mathias.Maier@mri.tum.de. 2. Klinikum der Universität München, Campus Innenstadt, Mathildenstr. 8, 80336, München, Deutschland. 3. Augenzentrum im Brienner Hof, Brienner Str. 12, 80333, München, Deutschland. 4. Augenklinik, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Str. 22, 81675, München, Deutschland. 5. Augenklinik Herzog Carl Theodor, Nymphenburger Str. 43, 80335, München, Deutschland.
Abstract
BACKGROUND: Biomarkers are characteristic biological measurable signs and objective parameters to detect the state of health. Besides functional and temporal factors, imaging biomarkers play an increasingly important role. In full-thickness and lamellar defects of the macula numerous imaging parameters have been described. This knowledge resulted in new classifications for both clinical pictures, which are based on important biomarkers of these clinical pictures and characteristic features of described subtypes. METHODS: Imaging biomarkers for full-thickness and lamellar macular defects are described with respect to the classification and their functional prognostic importance. The importance of these biomarkers is presented. RESULTS: The current classification of full-thickness and lamellar macular defects is based on structural biomarkers. Biomarkers are important for prognostic and therapeutic evaluation and they have an impact on the surgical strategy. There are various surgical strategies for treatment of full-thickness macular holes depending on the size of the foramen and other biomarkers. The inverted ILM flap technique improves the closure rate of large macular holes. In lamellar macular holes showing signs of progression an early surgical intervention results in a good anatomical and functional prognosis. CONCLUSION: Multimodal diagnostics provide important preoperative, intraoperative, and postoperative features for macular holes and lamellar macular holes, which are essential biomarkers for the exact classification, the therapeutic strategy and for assessment of the prognosis.
BACKGROUND: Biomarkers are characteristic biological measurable signs and objective parameters to detect the state of health. Besides functional and temporal factors, imaging biomarkers play an increasingly important role. In full-thickness and lamellar defects of the macula numerous imaging parameters have been described. This knowledge resulted in new classifications for both clinical pictures, which are based on important biomarkers of these clinical pictures and characteristic features of described subtypes. METHODS: Imaging biomarkers for full-thickness and lamellar macular defects are described with respect to the classification and their functional prognostic importance. The importance of these biomarkers is presented. RESULTS: The current classification of full-thickness and lamellar macular defects is based on structural biomarkers. Biomarkers are important for prognostic and therapeutic evaluation and they have an impact on the surgical strategy. There are various surgical strategies for treatment of full-thickness macular holes depending on the size of the foramen and other biomarkers. The inverted ILM flap technique improves the closure rate of large macular holes. In lamellar macular holes showing signs of progression an early surgical intervention results in a good anatomical and functional prognosis. CONCLUSION: Multimodal diagnostics provide important preoperative, intraoperative, and postoperative features for macular holes and lamellar macular holes, which are essential biomarkers for the exact classification, the therapeutic strategy and for assessment of the prognosis.
Authors: Jean Pierre Hubschman; Andrea Govetto; Richard F Spaide; Ricarda Schumann; David Steel; Marta S Figueroa; Jerry Sebag; Alain Gaudric; Giovanni Staurenghi; Christos Haritoglou; Kazuaki Kadonosono; John T Thompson; Stanley Chang; Ferdinando Bottoni; Ramin Tadayoni Journal: Br J Ophthalmol Date: 2020-02-27 Impact factor: 4.638
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