Closure Grading and Visual Outcome in Patients with Large Idiopathic Macular Holes: A Spectral-Domain Optical Coherence Tomography Observation.

IF 2 4区 医学 Q2 OPHTHALMOLOGY Ophthalmic Research Pub Date : 2024-01-01 Epub Date: 2024-01-22 DOI:10.1159/000536205
Yanping Yu, Zengyi Wang, Jing Wang, Biying Qi, Lingzi Liu, Zi-Bing Jin, Wu Liu
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Abstract

Introduction: So far, there has been no closure grade system synthesizing morphological and microstructural features for large idiopathic macular holes (IMHs) treated by vitrectomy and internal limiting membrane (ILM) peeling. This study aimed to propose a concise one and explore its relevance with visual acuity and the related preoperative factors.

Methods: Consecutive patients with large IMHs (minimum diameter >400 μm), undergoing vitrectomy and ILM peeling, obtaining primary closure and regularly followed-up were enrolled. Preoperative clinical charts and spectral-domain optical coherence tomography (SD-OCT) parameters were reviewed. SD-OCT images and best corrected visual acuity (BCVA) were assessed at 1, 4, and 10 months postoperatively. SD-OCT features at last visit were categorized by BCVA significance, and preoperative risk factors were analyzed.

Results: Sixty-eight eyes from 64 patients were enrolled. The 10-month postoperative SD-OCT images were categorized into closure grade 1, 2, and 3 with successively decreased BCVA (p < 0.001). During early follow-up, part of grades 2 and 3 could evolve into the upper grade, respectively, but grade 3 could never evolve into grade 1 and exhibited the least satisfactory long-term BCVA. Binary logistic regression showed that large minimum linear diameter (MLD) was a risk factor for grade 3 occurrence (p < 0.001), with a cutoff value of 625.5 μm from the receiver operating characteristic curve for MLD predicting grade 3 occurrence (p = 0.001).

Conclusion: Long-term closure status of large IMHs could be categorized into three grades with BCVA significance. Large horizontal MLD is a risk factor for occurrence of grade 3 closure with unsatisfactory visual recovery.

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特发性大黄斑孔患者的闭合分级和视觉效果:光谱域光学相干断层扫描观察。
导言:迄今为止,还没有一个综合形态学和微观结构特征的闭合等级系统,可用于通过玻璃体切除术和内缘膜(ILM)剥离术治疗的特发性黄斑大孔(IMH)。本研究旨在提出一种简明的方法,并探讨其与视力和相关术前因素的相关性:方法:选取接受玻璃体切除术和内层限界膜剥离术、获得原发闭合并定期随访的大型 IMH 患者(最小直径大于 400μm)作为研究对象。对术前临床病历和光谱域光学相干断层扫描(SD-OCT)参数进行了审查。术后1个月、4个月和10个月对SD-OCT图像和最佳矫正视力(BCVA)进行评估。根据 BCVA 的显著性对最后一次就诊时的 SD-OCT 特征进行分类,并对术前风险因素进行分析:结果:64 名患者的 68 只眼睛入选。术后 10 个月的 SD-OCT 图像被分为闭合 1 级、2 级和 3 级,BCVA 逐年下降(PConclusion:大IMH的长期闭合状态可分为三个等级,其BCVA意义重大。大的水平 MLD 是发生 3 级闭合且视力恢复不理想的风险因素。
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来源期刊
Ophthalmic Research
Ophthalmic Research 医学-眼科学
CiteScore
3.80
自引率
4.80%
发文量
75
审稿时长
6-12 weeks
期刊介绍: ''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.
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