Analysis of factors affecting the visual outcome after vitrectomy for idiopathic macular hole_Chinese Journal of Ocular Fundus Diseases

Authors：

XiaHonghe , ChenWeiqi ,  ChenHaoyu

Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou 515041, China;

Corresponding author：

ChenHaoyu, Email: chy@jsiec.org

Keywords：

Retinal perforations/surgery; Vitreoretinal surgery; Root cause analysis

DOI：

10.3760/cma.j.issn.1005-1015.2016.05.005

Video：

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Objective To investigate the factors correlated with the visual outcome of idiopathic macular holes (IMH) after vitreoretinal surgery. Methods A total of 57 eyes of 57 patients with IMH were included. There were 43 females (43 eyes) and 14 male (14 eyes), mean age was (60.46±4.79) years. All the eyes underwent best corrected visual acuity (BCVA), slit-lamp microscope, three-mirror contact-lens and optical coherence tomography (OCT) examinations. BCVA were examined with interactional visual chart and recorded with logarithm of the minimum angle of resolution (logMAR) acuity. The minimum diameter and base diameter of macular holes and central retinal thickness (CRT) were detected by OCT. The average logMAR BCVA of 57 eyes was 0.98±0.41. The minimum diameter and base diameter of macular holes were (479.53±164.16) μm and (909.14±278.65) μm. All the patients underwent pars plana vitrectomy combined with phacoemulsification cataract extraction and intraocular lens implantation. The mean follow-up period was (173.44±147.46) months. The relationships between final BCVA and these parameters were examined by single and multiple regression analysis. The valuable influence factors were filtrated and formulated using multiple linear regression models. Results At the final follow-up, the logMAR BCVA of 57 eyes was 0.44±0.31, the CRT was (158.79±86.96) μm. The final BCVA was positive related to minimum diameter of macular holes and preoperative BCVA (r=0.420, 0.448; P=0.001, 0.000), negative related to postoperative CRT (r=-0.371, P=0.004). There was no relationship between the final BCVA and base diameter of macular holes, age and follow-up (r=0.203, -0.015, 0.000; P=0.130, 0.913, 0.999). The incidence of preoperative BCVA for postoperative BCVA was bigger than preoperative minimum diameter of macular holes (P=0.008, 0.020). Conclusion The preoperative minimum diameter of macular holes and BCVA are related to postoperative BCVA in IMH eyes.

Citation： XiaHonghe, ChenWeiqi, ChenHaoyu. Analysis of factors affecting the visual outcome after vitrectomy for idiopathic macular hole. Chinese Journal of Ocular Fundus Diseases, 2016, 32(5): 478-480. doi: 10.3760/cma.j.issn.1005-1015.2016.05.005 Copy

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9.	Tirelli F,Sasso P,Scupola A.Idiopathic macular hole:post-operative morpho-functional assessment and prognostic factors for recovery of visual acuity[J].Ann Ist Super Sanita,2013,49(3):313-316.DOI:10.4415/ANN_13_03_14.
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11.	Purtskhvanidze K,Treumer F,Junge O,et al.The long-term course of functional and anatomical recovery after macular hole surgery[J].Invest Ophthalmol Vis Sci,2013,54(7):4882-4891.DOI:10.1167/iovs.13-11699.
12.	Pilli S,Zawadzki RJ,Werner JS,et al.Visual outcome correlates with inner macular volume in eyes with surgically closed macular hole[J].Retina,2012,32(10):2085-2095.DOI:10.1097/IAE.0b013e31825c1c0c.
13.	Hee MR,Puliafito CA,Duker JS,et al.Topography of diabetic macular edema with optical coherence tomography[J].Ophthalmology,1998,105(2):360-370.
14.	Lerche RC,Schaudig U,Scholz F,et al.Structural changes of the retina in retinal vein occlusion--imaging and quantification with optical coherence tomography[J].Ophthalmic Surg Lasers,2001,32(4):272-280.
15.	Azzolini C,Patelli F,Codenotti M,et al.Optical coherence tomography in idiopathic epiretinal macular membrane surgery[J].Eur J Ophthalmol,1999,9(3):206-211.
16.	Bentaleb-Machkour Z,Jouffroy E,Rabilloud M,et al.Comparison of central macular thickness measured by three OCT models and study of interoperator variability.Scientific World Journal,2012,2012:842795.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432357/.DOI:10.1100/2012/842795.

1. Bainbridge J,Herbert E,Gregor Z.Macular holes:vitreoretinal relationships and surgical approaches[J].Eye (Lond),2008,22(10):1301-1309.DOI:10.1038/eye.2008.23.
2. Wu TT,Kung YH.Comparison of anatomical and visual outcomes of macular hole surgery in patients with high myopia vs.non-high myopia:a case-control study using optical coherence tomography[J].Graefe´s Arch Clin Exp Ophthalmol,2012,250(3):327-331.DOI:10.1007/s00417-011-1821-7.
3. Ryan EH Jr,Gilbert HD.Results of surgical treatment of recent-onset full-thickness idiopathic macular holes[J].Arch Ophthalmol,1994,112(12):1545-1553.
4. Roth DB,Smiddy WE,Feuer W.Vitreous surgery for chronic macular holes[J].Ophthalmology,1997,104(12):2047-2052.
5. Freeman WR,Azen SP,Kim JW,et al.Vitrectomy for the treatment of full-thickness stage 3 or 4 macular holes:results of a multicentered randomized clinical trial[J].Arch Ophthalmol,1997,115(1):11-21.
6. 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(4):390-393.
7. Leonard RE 2nd,Smiddy WE,Flynn HW Jr,et al.Long-term visual outcomes in patients with successful macular hole surgery[J].Ophthalmology,1997,104(10):1648-1652.
8. Takamura Y,Tomomatsu T,Matsumura T,et al.Correlation between central retinal thickness after successful macular hole surgery and visual outcome[J].Jpn J Ophthalmol,2015,59(6):394-400.DOI:10.1007/s10384-015-0406-0.
9. Tirelli F,Sasso P,Scupola A.Idiopathic macular hole:post-operative morpho-functional assessment and prognostic factors for recovery of visual acuity[J].Ann Ist Super Sanita,2013,49(3):313-316.DOI:10.4415/ANN_13_03_14.
10. Salter AB,Folgar FA,Weissbrot J,et al.Macular hole surgery prognostic success rates based on macular hole size[J].Ophthalmic Surg Lasers Imaging,2012,43(3):184-189.DOI:10.3928/15428877-20120102-05.
11. Purtskhvanidze K,Treumer F,Junge O,et al.The long-term course of functional and anatomical recovery after macular hole surgery[J].Invest Ophthalmol Vis Sci,2013,54(7):4882-4891.DOI:10.1167/iovs.13-11699.
12. Pilli S,Zawadzki RJ,Werner JS,et al.Visual outcome correlates with inner macular volume in eyes with surgically closed macular hole[J].Retina,2012,32(10):2085-2095.DOI:10.1097/IAE.0b013e31825c1c0c.
13. Hee MR,Puliafito CA,Duker JS,et al.Topography of diabetic macular edema with optical coherence tomography[J].Ophthalmology,1998,105(2):360-370.
14. Lerche RC,Schaudig U,Scholz F,et al.Structural changes of the retina in retinal vein occlusion--imaging and quantification with optical coherence tomography[J].Ophthalmic Surg Lasers,2001,32(4):272-280.
15. Azzolini C,Patelli F,Codenotti M,et al.Optical coherence tomography in idiopathic epiretinal macular membrane surgery[J].Eur J Ophthalmol,1999,9(3):206-211.
16. Bentaleb-Machkour Z,Jouffroy E,Rabilloud M,et al.Comparison of central macular thickness measured by three OCT models and study of interoperator variability.Scientific World Journal,2012,2012:842795.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432357/.DOI:10.1100/2012/842795.

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