Abstract：
OBJECTIVE: To demonstrate the methodology and efficacy of using scanning laser ophthalmoscopy (SLO) and dynamic optical coherence tomography (OCT) to identify and treat symptomatic vitreous floaters using yttrium-aluminum garnet laser vitreolysis (YLV).
METHODS: This is a case series highlighted from a cross sectional retrospective study conducted at the Vitreous Retina Macula Specialists of Toronto. Forty eyes from thirty-five patients were treated with YLV between November 2018 and December 2020 for symptomatic floaters and imaged with SLO and dynamic OCT. Patients were re-treated with YLV if they reported ongoing significant vision symptoms during follow-up which correlated to visible opacities on exam and or imaging. Three cases will be highlighted to present the practical applications of SLO and dynamic OCT imaging for YLV treatment.
RESULTS: Forty treated eyes were enrolled in this study, with twenty-six eyes (65%) requiring at least one repeat YLV treatment following the first treatment due to ongoing symptomatic floaters. Following the first YLV, there was a significant improvement in overall mean best corrected visual acuity compared to before treatment (0.11 ± 0.20 LogMAR units vs. 0.14 ± 0.20 LogMAR units, p = 0.02 (paired t test)). Case 1 demonstrates a dense, solitary vitreous opacity that has been localized with dynamic OCT imaging to track its movements and retinal shadowing with the patient\'s eye movements. Case 2 shows the utility of adjusting the fixation target to monitor the movement of vitreous opacities in real-time. Case 3 exhibits an association between decreased symptom burden and vitreous opacity density after YLV.
CONCLUSIONS: Image-guided YLV facilitates the localization and confirmation of vitreous opacities. SLO and dynamic OCT of the vitreous can provide a real-time evaluation of floater size, movement, and morphology, to help clinicians target treatment and monitoring of symptomatic floaters.
METHODS: This is a case series highlighted from a cross sectional retrospective study conducted at the Vitreous Retina Macula Specialists of Toronto. Forty eyes from thirty-five patients were treated with YLV between November 2018 and December 2020 for symptomatic floaters and imaged with SLO and dynamic OCT. Patients were re-treated with YLV if they reported ongoing significant vision symptoms during follow-up which correlated to visible opacities on exam and or imaging. Three cases will be highlighted to present the practical applications of SLO and dynamic OCT imaging for YLV treatment.
RESULTS: Forty treated eyes were enrolled in this study, with twenty-six eyes (65%) requiring at least one repeat YLV treatment following the first treatment due to ongoing symptomatic floaters. Following the first YLV, there was a significant improvement in overall mean best corrected visual acuity compared to before treatment (0.11 ± 0.20 LogMAR units vs. 0.14 ± 0.20 LogMAR units, p = 0.02 (paired t test)). Case 1 demonstrates a dense, solitary vitreous opacity that has been localized with dynamic OCT imaging to track its movements and retinal shadowing with the patient\'s eye movements. Case 2 shows the utility of adjusting the fixation target to monitor the movement of vitreous opacities in real-time. Case 3 exhibits an association between decreased symptom burden and vitreous opacity density after YLV.
CONCLUSIONS: Image-guided YLV facilitates the localization and confirmation of vitreous opacities. SLO and dynamic OCT of the vitreous can provide a real-time evaluation of floater size, movement, and morphology, to help clinicians target treatment and monitoring of symptomatic floaters.
摘要：
目的：为了证明使用激光扫描检眼镜（SLO）和动态光学相干断层扫描（OCT）来识别和治疗有症状的玻璃体漂浮物，使用钇铝石榴石激光玻璃体溶解术（YLV）的方法和有效性。
方法：这是一个病例系列，来自多伦多玻璃体视网膜黄斑专家进行的横断面回顾性研究。在2018年11月至2020年12月期间，35例患者的40只眼接受YLV治疗，治疗有症状的漂浮物，并用SLO和动态OCT成像。如果患者在随访期间报告持续的明显视力症状，则用YLV重新治疗，这些症状与检查和/或成像上的可见混浊有关。将重点介绍三种情况，以介绍SLO和动态OCT成像在YLV治疗中的实际应用。
结果：这项研究纳入了40只接受治疗的眼睛，26只眼（65%），由于持续的症状性漂浮物，在第一次治疗后需要至少一次重复YLV治疗。在第一个YLV之后，与治疗前相比，总体平均最佳矫正视力显着改善（0.11±0.20LogMAR单位与0.14±0.20LogMAR单位，p=0.02(配对t检验))。案例1显示了一个密集的，用动态OCT成像定位的孤立性玻璃体混浊，以跟踪其运动和患者眼球运动的视网膜阴影。案例2示出了调节固定目标以实时监测玻璃体混浊的运动的效用。病例3表现出YLV后症状负担降低与玻璃体混浊密度之间的关联。
结论：图像引导的YLV有助于玻璃体混浊的定位和确认。玻璃体的SLO和动态OCT可以提供浮子大小的实时评估，运动,和形态学，帮助临床医生有针对性的治疗和监测有症状的漂浮物。
方法：这是一个病例系列，来自多伦多玻璃体视网膜黄斑专家进行的横断面回顾性研究。在2018年11月至2020年12月期间，35例患者的40只眼接受YLV治疗，治疗有症状的漂浮物，并用SLO和动态OCT成像。如果患者在随访期间报告持续的明显视力症状，则用YLV重新治疗，这些症状与检查和/或成像上的可见混浊有关。将重点介绍三种情况，以介绍SLO和动态OCT成像在YLV治疗中的实际应用。
结果：这项研究纳入了40只接受治疗的眼睛，26只眼（65%），由于持续的症状性漂浮物，在第一次治疗后需要至少一次重复YLV治疗。在第一个YLV之后，与治疗前相比，总体平均最佳矫正视力显着改善（0.11±0.20LogMAR单位与0.14±0.20LogMAR单位，p=0.02(配对t检验))。案例1显示了一个密集的，用动态OCT成像定位的孤立性玻璃体混浊，以跟踪其运动和患者眼球运动的视网膜阴影。案例2示出了调节固定目标以实时监测玻璃体混浊的运动的效用。病例3表现出YLV后症状负担降低与玻璃体混浊密度之间的关联。
结论：图像引导的YLV有助于玻璃体混浊的定位和确认。玻璃体的SLO和动态OCT可以提供浮子大小的实时评估，运动,和形态学，帮助临床医生有针对性的治疗和监测有症状的漂浮物。
