Associated factors analysis for predicting anatomical outcomes of idiopathic macular hole after vitrectomy_Chinese Journal of Ocular Fundus Diseases

Authors：

LiuPeipei ,  ZhaoMingwei , DongChongya , 孙摇遥 , 黎晓新 , 姜燕荣 , 尹虹 , 梁建宏 , 曲进锋

Department of Ophthalmology, Peking University People's Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100044, China;

Corresponding author：

ZhaoMingwei, Email: zhaomingwei@medmail.com.cn

Keywords：

Retinal perforations/surgery; Tomography, optical coherence; Prognosis

DOI：

10.3760/cma.j.issn.1005-1015.2014.04.002

Video：

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Objective To evaluate the associated factors for predicting anatomical outcomes of idiopathic macular hole (IMH) after vitrectomy. Methods This is a retrospective study. A total of 165 eyes in 164 IMH patients underwent a successful vitrectomy and ILM peeling surgery were included in this study.The patients included 43 males and 121 females, with the mean age of (64.0±6.7) years. The corrected vision acuity of logarithm of the minimum angle of resolution (logMAR), indirect ophthalmoscope and spectral domain optical coherence tomography (SD-OCT) were measured for all patients. The mean logMAR corrected vision acuity was 1.0. The duration of disease was (8.7±14.9) months. The minimum diameter (MIN), base diameter (BASE) and height (H) were 521, 1010, 406 μm respectively. The macular hole index (MHI), tractional hole index (THI), diameter hole index (DHI) and macular hole closure index (MHCI) were 0.43, 0.82, 0.57, 0.92 respectively. Anatomical outcomes were divided into 3 levels. A: bridge-shaped healing; B: good healing; C: poor healing. The mean follow-up was (3.6±3.2) months. The multiple factors related with prognosis including age, sex, duration of disease, preoperative logMAR corrected vision acuity, MIN, BASE and H, MHI, THI, DHI, MHCI were analyzed. Results Duration of disease (r=0.141), preoperative logMAR corrected vision acuity (r=0.082), age (r=0.044), sex (r=0.109) was independent of anatomical prognosis (P > 0.05). MIN (r=0.397), BASE (r=0.276), H (r=-0.240), MHI (r=-0.363), THI (r=-0.432), DHI (r=0.272) was weak correlation to anatomical prognosis (P < 0.05). MHCI correlated significantly with anatomical outcomes (r=-0.543, P=0.000). The median MHCI of A, B and C were 1.07, 0.91, 0.56 respectively. There were significant difference of MHCI among the three levels (H=52.857, P < 0.05). Conclusions MHCI has the best correlation with anatomical outcomes. It can be considered a key factor for predicting anatomical outcomes of IMH after vitrectomy.

Citation： LiuPeipei, ZhaoMingwei, DongChongya. Associated factors analysis for predicting anatomical outcomes of idiopathic macular hole after vitrectomy. Chinese Journal of Ocular Fundus Diseases, 2014, 30(4): 339-342. doi: 10.3760/cma.j.issn.1005-1015.2014.04.002 Copy

1.	Kelly NE, Wendl RT.Vitreous surgery for idiopathic macular holes: results of a pilot study[J].Arch Ophthalmol, 1991, 109:654-659.
2.	Mester V.Internal limiting membrane removal in the management of full thickness macular holes[J].Am J Ophthalmol, 2000, 129:769-777.
3.	张钊填, 魏雁涛, 黄雄高, 等.影响特发性黄斑裂孔微创玻璃体切割手术后视力预后的相关因素研究[J].中华眼底病杂志, 2013, 29:126-130.
4.	邵倩, 邹悦, 徐吉, 等.特发性黄斑裂孔手术后黄斑结构变化及其与视功能的关系[J].中华眼底病杂志, 2012, 28:126-129.
5.	Barak Y, Ihnen MA, Schaal S. Spectral domain optical oherence tomography in the diagnosis and management of vitreoretinal interface pathologies[J/OL]. J Ophthalmol, 2012, 2012:876472[2012-06-04].http://www.hindawi.com/journals/joph/2012/876472/abs/.
6.	Jaffe GJ, Caprioli J. Optical coherence tomography to detect and manage retinal disease and glaucoma[J]. Am J Ophthalmol, 2004, 137:156-169.
7.	Kiernan DF, Mieler WF, Hariprasad SM. Spectral-domain optical coherence tomography: a comparison of modern high-resolution retinal imaging systems[J]. Am J Ophthalmol, 2010, 149:18-31.
8.	Kusuhara S, Teraoka Escaño MF, Fujii S, et al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes[J]. Am J Ophthalmol, 2004, 138:709-716.
9.	Ruiz-Moreno JM, Staicu C, Piñero DP, et al.Optical coherence tomography predictive factors for macular hole surgery outcome[J]. Br J Ophthalmol, 2008, 92:640-644.
10.	Ip MS, Baker BJ, Duker JS, et al. Anatomical outcomes of surgery for idiopathic macular hole as determined by optical coherence tomography[J]. Arch Ophthalmol, 2002, 120:29-35.
11.	Wakely L, Rahman R, Stephenson J. A comparison of several methods of macular hole measurement using optical coherence tomography, and their value in predicting anatomical and visual outcomes[J]. Br J Ophthalmol, 2012, 96:1003-1007.
12.	Ullrich S, Haritoglou C, Gass C, et al. Macular hole size as a prognostic factor in macular hole surgery[J]. Br J Ophthalmol, 2002, 86:390-393.
13.	Haritoglou C, Neubauer AS, Reiniger IW, et al. Long-term functional outcome of macular hole surgery correlated to optical coherence tomography measurements[J]. Clin Exp Ophthalmol, 2007, 35:208-213.
14.	Villate N, Lee JE, Venkatraman A, et al. Photoreceptor layer features in eyes with closed macular holes: optical coherence tomography findings and correlation with visual outcomes[J]. Am J Ophthalmol, 2005, 139:280-289.
15.	张一, 张含, 孙鹏, 等.黄斑裂孔指数与特发性黄斑裂孔手术视力预后的相关性分析[J].中华眼底病杂志, 2010, 26:509-512.
16.	Haritoglou C, Gass CA, Schaumberger M, et al. Macular changes after peeling of the internal limiting membrane in macular hole surgery[J]. Am J Ophthalmol, 2001, 132:363-368.
17.	Tsuiki E, Fujikawa A, Miyamura N, et al. Visual field defects after macular hole surgery with indocyanine green-assisted internal limiting membrane peeling[J]. Am J Ophthalmol, 2007, 143:704-705.
18.	Lai TY, Kwok AK, Au AW, et al. Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with indocyanine green-assisted internal limiting membrane peeling[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245:148-154.
19.	Terasaki H, Miyake Y, Nomura R, et al. Focal macular ERGs in eyes after removal of macular ILM during macular hole surgery[J]. Invest Ophthalmol Vis Sci, 2001, 42: 229-234.
20.	Ueno S, Kondo M, Piao CH, et al. Selective amplitude reduction of the PhNR after macular hole surgery: ganglion cell damage related to ICG-assisted ILM peeling and gas tamponade[J]. Invest Ophthalmol Vis Sci, 2006, 47:3545-3549.

1. Kelly NE, Wendl RT.Vitreous surgery for idiopathic macular holes: results of a pilot study[J].Arch Ophthalmol, 1991, 109:654-659.
2. Mester V.Internal limiting membrane removal in the management of full thickness macular holes[J].Am J Ophthalmol, 2000, 129:769-777.
3. 张钊填, 魏雁涛, 黄雄高, 等.影响特发性黄斑裂孔微创玻璃体切割手术后视力预后的相关因素研究[J].中华眼底病杂志, 2013, 29:126-130.
4. 邵倩, 邹悦, 徐吉, 等.特发性黄斑裂孔手术后黄斑结构变化及其与视功能的关系[J].中华眼底病杂志, 2012, 28:126-129.
5. Barak Y, Ihnen MA, Schaal S. Spectral domain optical oherence tomography in the diagnosis and management of vitreoretinal interface pathologies[J/OL]. J Ophthalmol, 2012, 2012:876472[2012-06-04].http://www.hindawi.com/journals/joph/2012/876472/abs/.
6. Jaffe GJ, Caprioli J. Optical coherence tomography to detect and manage retinal disease and glaucoma[J]. Am J Ophthalmol, 2004, 137:156-169.
7. Kiernan DF, Mieler WF, Hariprasad SM. Spectral-domain optical coherence tomography: a comparison of modern high-resolution retinal imaging systems[J]. Am J Ophthalmol, 2010, 149:18-31.
8. Kusuhara S, Teraoka Escaño MF, Fujii S, et al. Prediction of postoperative visual outcome based on hole configuration by optical coherence tomography in eyes with idiopathic macular holes[J]. Am J Ophthalmol, 2004, 138:709-716.
9. Ruiz-Moreno JM, Staicu C, Piñero DP, et al.Optical coherence tomography predictive factors for macular hole surgery outcome[J]. Br J Ophthalmol, 2008, 92:640-644.
10. Ip MS, Baker BJ, Duker JS, et al. Anatomical outcomes of surgery for idiopathic macular hole as determined by optical coherence tomography[J]. Arch Ophthalmol, 2002, 120:29-35.
11. Wakely L, Rahman R, Stephenson J. A comparison of several methods of macular hole measurement using optical coherence tomography, and their value in predicting anatomical and visual outcomes[J]. Br J Ophthalmol, 2012, 96:1003-1007.
12. Ullrich S, Haritoglou C, Gass C, et al. Macular hole size as a prognostic factor in macular hole surgery[J]. Br J Ophthalmol, 2002, 86:390-393.
13. Haritoglou C, Neubauer AS, Reiniger IW, et al. Long-term functional outcome of macular hole surgery correlated to optical coherence tomography measurements[J]. Clin Exp Ophthalmol, 2007, 35:208-213.
14. Villate N, Lee JE, Venkatraman A, et al. Photoreceptor layer features in eyes with closed macular holes: optical coherence tomography findings and correlation with visual outcomes[J]. Am J Ophthalmol, 2005, 139:280-289.
15. 张一, 张含, 孙鹏, 等.黄斑裂孔指数与特发性黄斑裂孔手术视力预后的相关性分析[J].中华眼底病杂志, 2010, 26:509-512.
16. Haritoglou C, Gass CA, Schaumberger M, et al. Macular changes after peeling of the internal limiting membrane in macular hole surgery[J]. Am J Ophthalmol, 2001, 132:363-368.
17. Tsuiki E, Fujikawa A, Miyamura N, et al. Visual field defects after macular hole surgery with indocyanine green-assisted internal limiting membrane peeling[J]. Am J Ophthalmol, 2007, 143:704-705.
18. Lai TY, Kwok AK, Au AW, et al. Assessment of macular function by multifocal electroretinography following epiretinal membrane surgery with indocyanine green-assisted internal limiting membrane peeling[J]. Graefe's Arch Clin Exp Ophthalmol, 2007, 245:148-154.
19. Terasaki H, Miyake Y, Nomura R, et al. Focal macular ERGs in eyes after removal of macular ILM during macular hole surgery[J]. Invest Ophthalmol Vis Sci, 2001, 42: 229-234.
20. Ueno S, Kondo M, Piao CH, et al. Selective amplitude reduction of the PhNR after macular hole surgery: ganglion cell damage related to ICG-assisted ILM peeling and gas tamponade[J]. Invest Ophthalmol Vis Sci, 2006, 47:3545-3549.

Chinese Journal of Ocular Fundus Diseases

Associated factors analysis for predicting anatomical outcomes of idiopathic macular hole after vitrectomy

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